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Pay stub for an employee paid an hourly wage Last 4 digits of the employee s social security number or an The name and address of the legal entity that is the employer Name of the employee All applicable hourly rates The inclusive dates of the period for which the employee is paid SMITH AND COMPANY INC. 123 West Street Smalltown CA 98765 EMPLOYEE Johnson Bob Total hours worked employee ID number PAY PERIOD SOCIAL SECURITY NO. PAY RATE XXX-XX-6789 18. 00 regular 2/11/02 to 2/17/02 27. 00 overtime All deductions EARNINGS HOURS AMOUNT Regular 40. 00 720. 00 Overtime 54. 00 Gross wages earned GROSS EARNINGS TOTAL DEDUCTED NET EARNINGS DEDUCTIONS Federal W/H FICA Medicare CA State W/H CA State DI AMOUNT 60. 45 49. 67 12. 36 10. 04 77. 40 774. 00 217. 04 556. 96 Net wages This pay stub is not applicable to an employee whose compensation is solely based on a salary and who is exempt from payment of overtime under Labor Code section 515 a or any applicable IWC order. 123 West Street Smalltown CA 98765 EMPLOYEE Johnson Bob Total hours worked employee ID number PAY PERIOD SOCIAL SECURITY NO. PAY RATE XXX-XX-6789 18. 00 regular 2/11/02 to 2/17/02 27. 00 overtime All deductions EARNINGS HOURS AMOUNT Regular 40. PAY RATE XXX-XX-6789 18. 00 regular 2/11/02 to 2/17/02 27. 00 overtime All deductions EARNINGS HOURS AMOUNT Regular 40. 00 720. 00 Overtime 54. 00 Gross wages earned GROSS EARNINGS TOTAL DEDUCTED NET EARNINGS DEDUCTIONS Federal W/H FICA Medicare CA State W/H CA State DI AMOUNT 60. 00 720. 00 Overtime 54. 00 Gross wages earned GROSS EARNINGS TOTAL DEDUCTED NET EARNINGS DEDUCTIONS Federal W/H FICA Medicare CA State W/H CA State DI AMOUNT 60. 45 49. 67 12. 36 10. 04 77. 40 774. 00 217. 04 556. 96 Net wages This pay stub is not applicable to an employee whose compensation is solely based on a salary and who is exempt from payment of overtime under Labor Code section 515 a or any applicable IWC order. 123 West Street Smalltown CA 98765 EMPLOYEE Johnson Bob Total hours worked employee ID number PAY PERIOD SOCIAL SECURITY NO. PAY RATE XXX-XX-6789 18. 00 regular 2/11/02 to 2/17/02 27. 00 overtime All deductions EARNINGS HOURS AMOUNT Regular 40. 00 720. 00 Overtime 54. 00 Gross wages earned GROSS EARNINGS TOTAL DEDUCTED NET EARNINGS DEDUCTIONS Federal W/H FICA Medicare CA State W/H CA State DI AMOUNT 60. PAY RATE XXX-XX-6789 18. 00 regular 2/11/02 to 2/17/02 27. 00 overtime All deductions EARNINGS HOURS AMOUNT Regular 40. 00 720. 00 Overtime 54. 00 Gross wages earned GROSS EARNINGS TOTAL DEDUCTED NET EARNINGS DEDUCTIONS Federal W/H FICA Medicare CA State W/H CA State DI AMOUNT 60. 45 49. 67 12. 36 10. 04 77. 40 774. 00 217. 04 556. 96 Net wages This pay stub is not applicable to an employee whose compensation is solely based on a salary and who is exempt from payment of overtime under Labor Code section 515 a or any applicable IWC order. .

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