
Personal	Employee Name:	ID:
Period Ending:
Check No.:	Check Date:Invalid Date!Date Required!
State:	--Select State-- Alabama Alaska American Samoa Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Marshall Islands Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Northern Mariana Islands Ohio Oklahoma Oregon Palau Pennsylvania Puerto Rico Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virgin Islands Virginia Washington West Virginia Wisconsin Wyoming

Earnings	Gross Pay:	per Pay Period Annually




Gross Pay YTD:
Pay Frequency:	Daily Weekly Bi-Weekly Bi-Weekly (9 months/yr) Semi-Monthly Monthly Quarterly Semi-Annually Yearly

US Taxes

	Federal Tax Filing Status: Married Single Head of Household Addl W/H:
	Exempt./Allow.:
	Social Security
	Medicare

NJ Taxes

	NJ State Tax Filing Status: Married - B Single - A Rate C Rate D Rate E Addl W/H:
	Exempt./Allow.:
	NJ SUI
	NJ SDI
	NJ Family Leave Insurance

Other Deductions	Deduction #1 Name:
Deduction #1 Amount:	Fixed Amount % of Gross % of Net % of Gross-Taxes
Deduction #1 Type:	Not Tax-Exempt 401(k) 403(b) 457(b) 501(c) SAR-SEP SIMPLE Section 125 FSA-Dependent Care FSA-Medical

Deduction #2 Name:
Deduction #2 Amount:	Fixed Amount % of Gross % of Net % of Gross-Taxes
Deduction #2 Type:	Not Tax-Exempt 401(k) 403(b) 457(b) 501(c) SAR-SEP SIMPLE Section 125 FSA-Dependent Care FSA-Medical

Disclaimer

E-NEWSLETTER » SUBSCRIBE NOW
Sign up for our newsletter and receive the latest tax updates and due date reminders.

Lawrence R. Pappas, CPA, P.C. • 300 Broadacres Drive 4th Floor • Bloomfield, New Jersey 07003
Phone: (973) 893-8077 • Fax: (973) 893-8099

The news, advice, and resources within this website are meant for informational purposes only. They are not to be used in lieu of services offered by a professional accountant and the information posted cannot be used to avoid penalties imposed by the Internal Revenue Service.