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Employer Information

Company Name*

Company Address*

City*

State*

ZIP Code

EIN

Optional — Employer Identification Number

Employee Information

Full Name*

Address

City

State

ZIP Code

Filing Status*

Employee ID

Optional

Pay Period

Pay Frequency*

Period Start*

Period End*

Pay Date*

Earnings

Pay Type*

Regular Hours*

Hourly Rate*

Overtime Hours

Optional

Overtime Rate

Defaults to 1.5x

Additional Earnings

Additional Deductions

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Updates as you type

Company Name

123 Main St, City, ST 00000

EIN: XX-XXXXXXX

Earnings Statement

Employee

Employee Name

Address, City, ST 00000

SSN: XXX-XX-XXXXID: N/A

Pay Information

Pay Period:Start - End

Pay Date:YYYY-MM-DD

Frequency:Bi-Weekly

Earnings	Rate	Hrs	Current	YTD
Regular (80)	$25.00	80	$2,000.00	$16,000.00
Gross Pay				$2,000.00

Deductions	Current	YTD
Federal Tax	$249.73	$1,997.85
Social Security	$124.00	$992.00
Medicare	$29.00	$232.00
Total Ded.	$402.73	$3,221.85

YTD Gross

$16,000.00

YTD Taxes/Ded

$3,221.85

YTD Net Pay

$12,778.15

Gross

$2,000.00

Taxes/Ded

$402.73

Net Pay

$1,597.27

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