My Payroll Information

Dallas County Community College District

Employee Pay Statement for 00/00/0000

Today's Date:

00/00/2017

Direct Deposit

Number:

000000

Name/Address:

Heather Wireman

0123 Sleepy Lane

Dallas, TX 00555

Earnings

Current Month

YTD

Regular Pay

Total Gross Pay

$0.00

$0.00

$0.00

$0.00

Pre-tax Deducations/Additions

Medical Ins

Dental Ins

Emp Term Life/AD&D

Vision Ins

TRS Retirement

Tax Life Ins Prem

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Taxes Withheld

F.I.C.A. Medicare

FITW

$0.00

$0.00

$0.00

$0.00

Post-Tax Deductions

Dep Term Life AD&D

Disability

Charity Donations

$0.00

$0.00

$0.00

$0.00

$0.00

$0.00

Your net pay was sent to:

Poor Man's Bank

Account Number:

01234567890

Post-Tax Deductions

Federal Withholding Status

Exemptions

Additional Amt.

Married

12

0

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