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1.
Employee Information
Today's Date
*
Employer/Company Name
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Employee Name
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Hours
Wage Rate
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2.
Employee Pay Stub
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Social Security Rate
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Medicare Rate
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PA Income Tax Rate
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PA Unemployment Tax Rate
Gross Pay
Federal Income Tax Rate
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Federal W/H
*
Social Security
*
Medicare
*
PA Income Tax
*
PA Unemployment
*
Local Tax
*
Local W/H
*
Local Service Tax
*
Local Service W/H
*
Total Withholding
*
Net Wages
*
3.
Employer's Tax
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Federal Unemployment Rate
*
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PA Unemployment Rate
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FICA
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Medicare
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Federal Unemployment
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(estimated)
PA Unemployment
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(estimated)
Total Employer Tax
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