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CO.
2rv
FILE
811139
DEPT
583670
CLOCK
45734
VCHR. NO
82034
062
COMPANY NAME
COMPANY ADDRESS
CITY, STATE ZIP
Social Security Number:
Taxable Marital Status:
Exemptions/Allowances:
Employee ID:
XXX-XX-
Single
1
Earnings
Rate
Hours
Amount
Year to Date
Regular
$20.00
80.00
$1,600.00
$600.00
Gross Pay
$1,600.00
Deduction
Statutory
FICA - Medicare
- $23.20
$278.40
FICA - Social Security
- $99.20
$1,190.40
Federal Tax
- $119.62
$1,076.58
State Tax
- $0.00
$0.00
Net Pay
$1,357.98
Check
-$1,357.98
Earnings Statement
Period Beginning:
Period Ending:
Pay Date:
08/07/2025
08/20/2025
08/25/2025
EMPLOYEE NAME
EMPLOYEE ADDRESS
CITY, STATE ZIP
Other benefits and
Information
This Period
Year To Date
Important Notes
COMPANY NAME
COMPANY ADDRESS
CITY, STATE ZIP
Advice Number:
Pay date:
Social Security Number:
1260895
08/25/2025
XXX-XX-
Pay to the order of:
EMPLOYEE NAME
This amount:
one thousand three hundred fifty seven and 98/100 dollars
$1,357.98
NON-NEGOTIABLE
VOIDED CHECK

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