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Sample Employee Data Sheet

 

0000*SAMPLE                                Sample Company, Inc.                                  Page:    1
                                            Employee Data Sheet
                                               June 11, 2003

Employee number....2           
Social Security....541-32-8861                                        Family Member         [N]
Name...........Adler, Jimmy A.                                        Citizen               [Y]
Address 1......321 Someother Street                                   Statutory Emp.        [N]
Address 2......Apartment 204                                          Deceased              [N]
City,St. Zip...Garland, TX  75040                                     Pension Plan          [N]
Phone..........(972)555-8794                                          Legal Representative  [N]
Birth Date.....10/06/70                                               Section 942           [N]
Marital Status.Married                                                Deferred Compensation [N]
Hire Date......09/06/89                                               Pay Period............Semi-Monthly
Raise Date.....10/01/98                                               Employee Status.......Active
Department.....     

Pay Chart:
Skill Code & Description                            Type         Hours/Sal       Rate/Amt      Remainder
-----------------------------------------------------------------------------------------------------------
102     Wages                                       Wage             80.00          18.50               
400     FICA Withheld                               Deduction    Calculate        Formula      Unlimited
401     Medicare Withholding                        Deduction    Calculate        Formula      Unlimited
500     FIT Withholding                             Deduction    Calculate        Formula      Unlimited
802     Group Medical                               Deduction    Flat Rate         115.00      Unlimited
-----------------------------------------------------------------------------------------------------------
Exemptions Table:
Description          Exemptions    Addl. W/H Type    Addl. W/H Rate    Dependent Credit
------------------------------------------------------------------------------------------
Federal                  1                                                       
State                                                                            
Local