Employee Compensation Record
Name Address Phone
Hours Worked Pay Period Date Ending Paid Earnings Total Regular Overtime Regular S M T W T F S Hours Overtime Rate Rate Total
Full Time Part Time
Soc. Sec. No. Date of Birth No. of Exemptions
Deductions Federal Social Income Security Medicare Tax State Income Tax Net Pay
S M T W T F S
. . QUARTERLY TOTALS .
. . . $
. . $
. . $
. . $
. . $
. . $
. . .