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Moden Paystub

Other benefits and information

Earnings

Deductions Statutory

CO.
FILE
DEPT.
CLOCK
NUMBER

MCB
02470383 0
Taxable Marital Status:
Exemptions/Allowances:
Earnings Statement
Period start:
Period ending:
Pay date:
Emp #:
Earnings rate hours this period year to date
Regular
Overtime
Holiday
Vacation *
Bonus *
Float *
Gross Pay
$
Deductions Statutory
Federal Income Tax
Social Security Tax
Medicare
State Income Tax
%   SUI/SDI Tax
Net Pay

* Excluded from federal taxable wages

Other Benefits and
Information this period total to date
Group Term Life 0.00 0.00
Loan Amt Paid 0.00
Vac Hrs Left 0.00
Sick Hrs Left 0.00
Title
 
Important
Notes

WE WILL BE STARTING OUR UNITED WAY FUND
DRIVE SOON AND LOOK FORWARD TO YOUR
PARTICIPATION.

60-162/433
Payroll check number:
Pay date
Social Security No.

SAMPLE
NON-NEGOTIABLE
VOID VOID VOID

VOID AFTER 180 DAYS

AUTHORIZED SIGNATURE