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CLIENT PAYROLL

Payroll Timesheet Form

Please fill out the following form completely. If this form is not received by the due date/time, your payroll will not be processed.

Any changes should be stated on the Benefit Change Form, and faxed to (702) 442-1928, but will not take effect until the next billing cycle on the benefit.

Business Name:
Address:
Period Ending:
Delivery Date:

Employee Name	Hours
Last, First	Salary	Reg	OT	Vac	Sick	Holiday	Bonus	Total










Last, First	Salary	Reg	OT	Vac	Sick	Holiday	Bonus	Total










Last, First	Salary	Reg	OT	Vac	Sick	Holiday	Bonus	Total





Column Total:


By submitting this form, I hereby declare that the hours/commission/bonus above are true and correct.

Security Code: Please duplicate the following 6 character security code.

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Glossary

Salary

Annual salaried employee
(enter "x" if salaried)

Reg

Regular hours earned by an employee

OT

Work hours earned over and above regular hours

Vac

Vacation time taken by an employee

Sick

Time an employee is off sick and receives pay

Holiday

Time an employee is off but receives pay

Bonus

Any commission or bonus an employee receives
(enter an amount)

Total

Total hours earned by an employee

Column Total

Total number of hours reported for all employees
(total should be in 1/4 hr increments in decimal format- eg. .25, .50 or .75)