Employee Information Sheet Page 2
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2Which types of pay does this employee receive?
Salary
______ per ____
Bonus
Clergy Housing (Cash)
Hourly
______ per hour
Commission
Clergy Housing (In-Kind)
nd
2
hourly rate ______ per hour
Double overtime
Bereavement Pay
Overtime Pay
Allowance
Group Term Life Insurance
Sick Pay
Reimbursement
S-Corp Owners Health Ins.
Vacation Pay
Cash Tips
Personal Use of Company Car
Holiday Pay
Paycheck Tips
Other:
Select the voluntary deductions that apply and enter the $ or % amount to be deducted from each
paycheck
Deduction
$ Amount or
Deduction
$ Amount or
% of Gross
% of Gross
Pre-tax medical
403b
Pre-tax vision
Simple IRA
Pre-tax dental
SAR SEP
Taxable medical
Medical expense FSA
Taxable vision
Dependent care FSA
Taxable dental
Loan Repayment
401K
Cash Advance Repayment
Simple 401K
Other __________
Is this employee subject to wage garnishments, such as a federal tax or child support garnishment?
Yes
No
If yes, attach copies of all garnishment orders
Sick and Vacation
If this employee earns paid time off, complete the section below; otherwise, leave blank.
Sick Pay
Vacation Pay
No. of Hours Earned Per Year
________
No. of Hours Earned Per Year
________
Max. hours accrued per year (if any) ________
Max. hours accrued per year (if any) ________
Current Balance
________
Current Balance
________
Hours are accrued:
Hours are accrued:
As a lump sum at the beginning of year
As a lump sum at the beginning of year
Each pay period
Each pay period
Each hour worked
Each hour worked
Notes:
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Parent category: Business