Finance Payroll Allocation Form
Employee Name | [Your Name] |
Employee ID | [EMP12345] |
Department | [Production] |
Position | [Senior Engineer] |
Payroll Period | [January 2051] |
Earnings Allocation
Earnings Component | Amount ($) |
Regular Salary | [$5,000] |
Overtime Pay | |
Bonuses | |
Commissions | |
Other Earnings | |
Total Earnings | |
Deductions Allocation
Deduction Component | Amount ($) |
Federal Tax | [$1,200] |
State Tax | |
Social Security | |
Medicare | |
Health Insurance | |
Retirement Plan | |
Other Deductions | |
Total Deductions | |
Net Pay: [$4,650]
Bank Account Information
Acknowledgment
I hereby acknowledge that the above information is accurate to the best of my knowledge and that I have reviewed this Payroll Allocation Form.
Employee's Signature:
___________________________
Date: [Month Day, Year]
Supervisor's Approval
I certify that the earnings and deductions listed above are accurate and have been reviewed and approved.
Supervisor's Signature:
____________________________
[Your Name]
Date: [Month Day, Year]
HR Department Use Only
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