Scribd Logo
Upload

Welcome to Scribd!

  • 2K views

    Final Paycheck Acknowledgment-KH

    Uploaded by

    Jennifer Cooperrider
    The total amount of the paycheck is: $ __________. To the best of my knowledge, there is no additional money owed to me by the employer at the present time. Paycheck amount represents: Wages Accrued Vacation Pay Other Deductions Federal Income Tax Social Security Medicare Tax State Income Tax UI / SDI Health Insurance.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd

    Final Paycheck Acknowledgment-KH

    Uploaded by

    Jennifer Cooperrider
    2K views2 pages
    The total amount of the paycheck is: $ __________. To the best of my knowledge, there is no additional money owed to me by the employer at the present time. Paycheck amount represents: Wages Accrued Vacation Pay Other Deductions Federal Income Tax Social Security Medicare Tax State Income Tax UI / SDI Health Insurance.

    Copyright

    © Attribution Non-Commercial (BY-NC)

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    The total amount of the paycheck is: $ __________. To the best of my knowledge, there is no additional money owed to me by the employer at the present time. Paycheck amount represents: Wages Accrued Vacation Pay Other Deductions Federal Income Tax Social Security Medicare Tax State Income Tax UI / SDI Health Insurance.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    2K views2 pages

    Final Paycheck Acknowledgment-KH

    Uploaded by

    Jennifer Cooperrider
    The total amount of the paycheck is: $ __________. To the best of my knowledge, there is no additional money owed to me by the employer at the present time. Paycheck amount represents: Wages Accrued Vacation Pay Other Deductions Federal Income Tax Social Security Medicare Tax State Income Tax UI / SDI Health Insurance.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Clear All Fields

    v030707

    Final Paycheck Acknowledgment


    I, the undersigned recipient, have received my final paycheck from:

    ______________________________
    Hospitality Partners
    Company

    The total amount of the paycheck is: $ __________


    5,372.57

    Paycheck amount represents:


    Wages $ __________
    1,885.52
    Accrued Vacation Pay $ __________
    7,086.52
    Other _________________________ $ __________
    _________________________ $ __________
    _________________________ $ __________
    _________________________ $ __________
    _________________________ $ __________

    Deductions
    _________________________
    Insurance $ __________
    -133.00
    _________________________
    Garnishment $ __________
    -153.67
    _________________________
    FICA-SS $ __________
    -548.02
    _________________________
    FICA-HI $ __________
    -128.17
    _________________________
    F.I.T $ __________
    -1,827.00
    _________________________
    S.I.T $ __________
    -712.38
    _________________________
    S.D.I $ __________
    -97.23

    To the best of my knowledge, there is no additional money owed to me by the employer at the present time.

    ______________________________
    Name of Recipient

    ________________________________________________________ __________
    Signature of Recipient Date

    ________________________________________________________ __________
    Signature of Person Issuing Final Paycheck Date

    © CalChamber Page 1 of 1
    v030707

    Final Paycheck Acknowledgment - Sample


    I, the undersigned recipient, have received my final paycheck from:

    California Computer Company


    Company

    The total amount of the paycheck is: $ 442.19

    Paycheck amount represents:


    Wages $ 372.00
    Accrued Vacation Pay $ 64.00
    Other Sales Commission $ 160.00
    _________________________ $ __________
    _________________________ $ __________
    _________________________ $ __________
    _________________________ $ __________

    Deductions
    Federal Income Tax $ 47.24
    Social Security $ 36.10
    Medicare Tax $ 8.45
    State Income Tax $ 4.78
    UI/SDI $ 5.24
    Health Insurance $ 52.00
    _________________________ $ __________

    To the best of my knowledge, there is no additional money owed to me by the employer at the present time.

    Julie K. Douglas
    Name of Recipient

    Julie K. Douglas
    ________________________________________________________ 11/28/XX
    __________
    Signature of Recipient Date

    Chris Martinez
    ________________________________________________________ 11/28/XX
    __________
    Signature of Person Issuing Final Paycheck Date

    © CalChamber Page 1 of 1

    You might also like