BUSINESS NAME

Address Line 1
Address Line 2
City, State, Zip LOGO
Phone
Web / Email

Employee Name PAY AND HOURS HOURS PYMNT

Employee Number Regular Hours

Federal Filing Status Overtime Hours

Pay Begin Date Holiday Hours

Pay End Date Vacation Hours

Tax Allowance Sick Time Hours

GROSS CURRENT YTD NET CURRENT YTD

Gross Pay $ - Net Pay

Federal Taxable
Gross Pay

PRE-TAX WITHHOLDINGS FEDERAL / STATE / PAYROLL TAX

401(K) Contribution Federal Tax

Other State Tax

POST-TAX DEDUCTIONS Local Tax

Insurance Premiums Social Security

Other Medicare

LEAVE TYPE HOURS SPENT HOURS REMAINING DAYS REMAINING

Holidays

Vacation

Sick Time

Messages
REGISTER
PRE-TAX WITHHOLDINGS FEDERAL, STATE AND PAYROLL TAXES POST-TAX DEDUCTIONS

REGULAR OVERTIME FEDERAL

EMPLOYEE EMPLOYEE GENDER HIRE ANNUAL PAY YEARLY YEARLY YEARLY OVERTIME TAX 401(K) STATE LOCAL SOCIAL SSN
JOB TITLE HOURLY HOURLY FILING OTHER MEDICARE INSURANCE OTHER ADDRESS CITY STATE ZIP
NUMBER NAME M/F DATE SALARY FREQUENCY HOLIDAYS VACATION SICK DAYS EXEMPTION ALLOWANCE CONTRIBUTION TAX TAX SECURITY LAST 4
RATE RATE STATUS

12345 Jane Doe F 07/18/15 Project Manager $ 75,388.00 $ 36.24 $ 54.37 Biweekly 10.00 15.00 5.00 Yes Married 4 8.00% $ - 5.25% 0.00% 6.20% 1.45% $ 125.00 $ - 555 Street NW City ST 00000-0000 1234

67890 James Doe M 01/03/10 Mailing Coordinator $ 68,950.00 $ 33.15 $ 49.72 Biweekly 10.00 20.00 5.00 No Single 1 6.50% $ 10.00 5.25% 0.00% 6.20% 1.45% $ 45.00 $ 22.00 555 Street NW City ST 00000-0000 6789

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -

$ - $ -
Any articles, templates, or information provided by Smartsheet on the website are for reference
only. While we strive to keep the information up to date and correct, we make no representations
or warranties of any kind, express or implied, about the completeness, accuracy, reliability,
suitability, or availability with respect to the website or the information, articles, templates, or
related graphics contained on the website. Any reliance you place on such information is
therefore strictly at your own risk.