Form WH-347, Payroll for Contractors Instructions
This form contains 308 fields organized into 14 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Compliance Statement | ||
| Date (in mm/dd/yyyy format) | Text |
Enter the date in mm/dd/yyyy format.
|
| Name of signatory party | Text |
Enter the name of the person signing the compliance statement.
|
| Title | Text |
Enter the title of the person signing the compliance statement.
|
| Contractor Information | ||
| contractorOrSub_contractor | CheckBox |
Check this box if you are the contractor.
|
| contractorOrSub_subcontractor | CheckBox |
Check this box if you are the subcontractor.
|
| Name of contractor or subcontractor | Text |
Enter the name of the contractor or subcontractor.
|
| Address | Text |
Enter the address of the contractor or subcontractor.
|
| contractorCopy1 | Text |
Enter the contractor's or subcontractor's name.
|
| Contractor or subcontractor | Text |
Enter the contractor's or subcontractor's name.
|
| Deductions | ||
| Deduction Label 1 | Text |
Enter the label for the first deduction.
|
| Deduction Label 2 | Text |
Enter the label for the second deduction.
|
| fica1 | Text |
Enter the amount of FICA (Social Security and Medicare) deductions for the employee.
|
| withholding1 | Text |
Enter the amount of federal withholding tax deductions for the employee.
|
| deductionA1 | Text |
Enter the amount for Deduction A for the first worker.
|
| deductionB1 | Text |
Enter the amount for Deduction B for the first worker.
|
| deductionOther1 | Text |
Enter the amount for any other deductions for the first worker.
|
| Total deduction 1 | Text |
Enter the total amount of all deductions for the first worker.
|
| FICA 2 | Text |
Enter the FICA (Federal Insurance Contributions Act) deductions for the employee in the second period.
|
| Withholding 2 | Text |
Enter the withholding tax deductions for the employee in the second period.
|
| Deduction A2 | Text |
Enter any other deduction A for the employee in the second period.
|
| Deduction B2 | Text |
Enter any other deduction B for the employee in the second period.
|
| Deduction other 2 | Text |
Enter any other deductions for the employee in the second period.
|
| Total deduction 2 | Text |
Enter the total amount of deductions for the employee in the second period.
|
| FICA 3 | Text |
Enter the FICA deductions for the third worker.
|
| Withholding 3 | Text |
Enter the withholding tax deductions for the third worker.
|
| Deduction A3 | Text |
Enter any other deductions (A) for the third worker.
|
| Deduction B3 | Text |
Enter any other deductions (B) for the third worker.
|
| Deduction other 3 | Text |
Enter any other deductions for the third worker.
|
| Total deduction 3 | Text |
Enter the total deductions for the third worker.
|
| FICA 4 | Text |
Enter the FICA (Federal Insurance Contributions Act) deductions for the employee.
|
| Withholding 4 | Text |
Enter the withholding tax deductions for the employee.
|
| Deduction A4 | Text |
Enter any other deductions (A) for the employee.
|
| Deduction B4 | Text |
Enter any other deductions (B) for the employee.
|
| Deduction other 4 | Text |
Enter any other deductions for the employee.
|
| FICA 5 | Text |
Enter the FICA (Federal Insurance Contributions Act) deductions for the fifth employee.
|
| withholding5 | Text |
Enter the withholding amount for the fifth employee.
|
| Deduction A5 | Text |
Enter the first deduction for the fifth employee.
|
| Deduction B5 | Text |
Enter the second deduction for the fifth employee.
|
| Deduction other 5 | Text |
Enter any other deductions for the fifth employee.
|
| Total deduction 5 | Text |
Enter the total deductions for the fifth employee.
|
| FICA 6 | Text |
Enter the FICA (Federal Insurance Contributions Act) deductions for the employee for this pay period.
|
| Withholding 6 | Text |
Enter the federal withholding tax deductions for the employee for this pay period.
|
| Deduction A6 | Text |
Enter any other deductions (A) for the employee for this pay period.
|
| Deduction B6 | Text |
Enter any other deductions (B) for the employee for this pay period.
|
| Deduction other 6 | Text |
Enter any other deductions not specified for the employee for this pay period.
|
| Total deduction 6 | Text |
Enter the total deductions for the employee for this pay period.
|
| FICA 7 | Text |
Enter the FICA (Federal Insurance Contributions Act) deductions for the employee.
|
| Withholding 7 | Text |
Enter the withholding tax deductions for the employee.
|
| Deduction A7 | Text |
Enter any other specific deduction (A) for the employee.
|
| Deduction B7 | Text |
Enter any other specific deduction (B) for the employee.
|
| Deduction other 7 | Text |
Enter any other deductions for the employee.
|
| Total deduction 7 | Text |
Enter the total deductions for the employee for the specified period.
|
| FICA 8 | Text |
Enter the amount of FICA (Social Security and Medicare) tax withheld from the employee's wages.
|
| Withholding 8 | Text |
Enter the amount of federal income tax withheld from the employee's wages.
|
| Permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A | Text |
Enter permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A.
|
| Permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A | Text |
Enter permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A.
|
| Permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A | Text |
Enter permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A.
|
| Permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A | Text |
Enter permissible deductions as defined in Regulation, Part 3 29 CFR Subtitle A.
|
| Check if applies | CheckBox |
Check this box if the fringe benefits apply.
|
| Employee Information | ||
| nameAddrSSN1 | Text |
Enter the name, address, and SSN of the first employee.
|
| noWithholdingExemptions1 | Text |
Enter the number of withholding exemptions claimed by the employee.
|
| workClassification1 | Text |
Specify the classification of work performed by the employee (e.g., carpenter, electrician).
|
| Name, address, and SSN 3 | Text |
Enter the name, address, and Social Security Number (SSN) of the employee in the third period.
|
| Number of withhold exemptions 3 | Text |
Enter the number of withholding exemptions claimed by the employee in the third period. Maximum length is 2 digits.
|
| Work classification 3 | Text |
Enter the work classification of the employee in the third period.
|
| Name, address, and SSN 5 | Text |
Enter the name, address, and Social Security Number of the fifth employee.
|
| Number of withhold exemptions 5 | Text |
Enter the number of withholding exemptions claimed by the fifth employee. Maximum length is 2 digits.
|
| Work classification 5 | Text |
Enter the work classification for the fifth employee.
|
| Name, address, and SSN 6 | Text |
Enter the name, address, and Social Security Number of the sixth employee.
|
| Number of withhold exemptions 6 | Text |
Enter the number of withholding exemptions for the sixth employee. Maximum length is 2 digits.
|
| Work classification 6 | Text |
Enter the work classification for the sixth employee.
|
| Name, address, and SSN 7 | Text |
Enter the name, address, and Social Security Number (SSN) of the employee.
|
| Number of withhold exemptions 7 | Text |
Enter the number of withholding exemptions claimed by the employee.
|
| Work classification 7 | Text |
Enter the work classification of the employee (e.g., laborer, carpenter).
|
| Name, address, and SSN 8 | Text |
Enter the name, address, and Social Security Number (SSN) of the employee.
|
| Number of withhold exemptions 8 | Text |
Enter the number of withholding exemptions claimed by the employee for this payroll period.
|
| Work classification 8 | Text |
Specify the work classification of the employee for this payroll period.
|
| Exceptions | ||
| exception1 | Text |
Enter the first exception to the payroll details, if any.
|
| explanation1 | Text |
Provide an explanation for the first exception listed.
|
| exception2 | Text |
Enter the second exception to the payroll details, if any.
|
| Explanation 2 | Text |
Provide an explanation for the second exception listed.
|
| Exception 3 | Text |
Enter the third exception to the payroll details, if any.
|
| Explanation 3 | Text |
Provide an explanation for the third exception listed.
|
| exception4 | Text |
Enter the fourth exception to the payroll details, if any.
|
| explanation4 | Text |
Provide an explanation for the fourth exception listed.
|
| exception5 | Text |
Enter the fifth exception to the payroll details, if any.
|
| explanation5 | Text |
Provide an explanation for the fifth exception listed.
|
| Exception 6 | Text |
Enter the sixth exception to the payroll details, if any.
|
| Explanation 6 | Text |
Provide an explanation for the sixth exception listed.
|
| Exception 7 | Text |
Enter the seventh exception to the payroll details, if any.
|
| Explanation 7 | Text |
Provide an explanation for the seventh exception listed.
|
| Exception 8 | Text |
Enter the eighth exception to the payroll details, if any.
|
| Explanation 8 | Text |
Provide an explanation for the eighth exception listed.
|
| Fringe Benefits | ||
| Check if applies | CheckBox |
Check this box if the fringe benefits are paid in cash.
|
| Overtime Hours | ||
| OT21 | Text |
Enter the overtime hours worked by the second worker on day 1.
|
| OT22 | Text |
Enter the overtime hours worked by the second worker on day 2.
|
| OT23 | Text |
Enter the overtime hours worked by the second worker on day 3.
|
| OT24 | Text |
Enter the overtime hours worked by the second worker on day 4.
|
| OT25 | Text |
Enter the overtime hours worked by the second worker on day 5.
|
| OT26 | Text |
Enter the overtime hours worked by the second worker on day 6.
|
| OT27 | Text |
Enter the overtime hours worked by the second worker on day 7.
|
| Total hours OT2 | Text |
Enter the total overtime hours worked by the second worker.
|
| Rate of pay 2 | Text |
Enter the rate of pay for the second worker's overtime hours.
|
| OT51 | Text |
Enter the overtime hours worked by the fifth employee on the first day.
|
| OT52 | Text |
Enter the overtime hours worked by the fifth employee on the second day.
|
| OT53 | Text |
Enter the overtime hours worked by the fifth employee on the third day.
|
| OT54 | Text |
Enter the overtime hours worked by the fifth employee on the fourth day.
|
| OT55 | Text |
Enter the overtime hours worked by the fifth employee on the fifth day.
|
| OT56 | Text |
Enter the overtime hours worked by the fifth employee on the sixth day.
|
| OT57 | Text |
Enter the overtime hours worked by the fifth employee on the seventh day.
|
| Total hours OT5 | Text |
Enter the total overtime hours worked by the fifth employee.
|
| Rate of pay 5 | Text |
Enter the rate of pay for overtime hours for the fifth employee.
|
| OT61 | Text |
Enter the overtime hours for the sixth employee on day 1.
|
| OT62 | Text |
Enter the overtime hours for the sixth employee on day 2.
|
| OT63 | Text |
Enter the overtime hours for the sixth employee on day 3.
|
| OT64 | Text |
Enter the overtime hours for the sixth employee on day 4.
|
| OT65 | Text |
Enter the overtime hours for the sixth employee on day 5.
|
| OT66 | Text |
Enter the overtime hours for the sixth employee on day 6.
|
| OT67 | Text |
Enter the overtime hours for the sixth employee on day 7.
|
| Total hours OT6 | Text |
Enter the total overtime hours for the sixth employee.
|
| Rate of pay 6 | Text |
Enter the rate of pay for the sixth employee's overtime hours.
|
| Payroll Details | ||
| Payroll number | Text |
Enter the payroll number for this report.
|
| For week ending (in mm/dd/yyyy format) | Text |
Enter the ending date of the payroll week in mm/dd/yyyy format.
|
| day1 | Text |
Enter the hours worked on Day 1.
|
| Day 2 | Text |
Enter the hours worked on Day 2.
|
| Day 3 | Text |
Enter the hours worked on Day 3.
|
| Day 4 | Text |
Enter the hours worked on Day 4.
|
| Day 5 | Text |
Enter the hours worked on Day 5.
|
| Day 6 | Text |
Enter the hours worked on Day 6.
|
| Day 7 | Text |
Enter the hours worked on Day 7.
|
| date1 | Text |
Enter the date for Day 1 in mm/dd/yyyy format.
|
| Date 2 | Text |
Enter the date for Day 2 in mm/dd/yyyy format.
|
| Date 3 | Text |
Enter the date for Day 3 in mm/dd/yyyy format.
|
| Date 4 | Text |
Enter the date for Day 4 in mm/dd/yyyy format.
|
| Date 5 | Text |
Enter the date for Day 5 in mm/dd/yyyy format.
|
| Date 6 | Text |
Enter the date for Day 6 in mm/dd/yyyy format.
|
| Date 7 | Text |
Enter the date for Day 7 in mm/dd/yyyy format.
|
| OT11 | Text |
Enter the number of overtime hours worked by the employee on day 1.
|
| OT12 | Text |
Enter the number of overtime hours worked by the employee on day 2.
|
| OT13 | Text |
Enter the number of overtime hours worked by the employee on day 3.
|
| OT14 | Text |
Enter the number of overtime hours worked by the employee on day 4.
|
| OT15 | Text |
Enter the number of overtime hours worked by the employee on day 5.
|
| OT16 | Text |
Enter the number of overtime hours worked by the employee on day 6.
|
| OT17 | Text |
Enter the number of overtime hours worked by the employee on day 7.
|
| Total hours OT1 | Text |
Enter the total number of overtime hours worked by the employee for the week.
|
| rateOfPayOT1 | Text |
Enter the rate of pay for overtime hours worked by the employee.
|
| ST11 | Text |
Enter the number of straight time hours worked by the employee on day 1.
|
| ST12 | Text |
Enter the number of straight time hours worked by the employee on day 2.
|
| ST13 | Text |
Enter the number of straight time hours worked by the employee on day 3.
|
| ST14 | Text |
Enter the number of straight time hours worked by the employee on day 4.
|
| ST15 | Text |
Enter the number of straight time hours worked by the employee on day 5.
|
| ST16 | Text |
Enter the number of straight time hours worked by the employee on day 6.
|
| ST17 | Text |
Enter the number of straight time hours worked by the employee on day 7.
|
| Total hours ST1 | Text |
Enter the total number of straight time hours worked by the employee for the week.
|
| rateOfPayST1 | Text |
Enter the rate of pay for straight time hours worked by the employee.
|
| rateOfPaySTfringe1 | Text |
Enter the fringe benefit rate of pay for straight time hours worked by the employee.
|
| gross1 | Text |
Enter the gross wages earned by the employee for the week.
|
| Gross T1 | Text |
Enter the total gross wages earned by the employee including any additional amounts.
|
| netWages1 | Text |
Enter the net wages paid to the first worker after all deductions.
|
| Total hours ST2 | Text |
Enter the total number of standard time (ST) hours worked by the employee in the second period.
|
| Rate of pay ST 2 | Text |
Enter the rate of pay for standard time (ST) hours for the employee in the second period.
|
| Rate of pay ST fringe 2 | Text |
Enter the fringe benefit rate of pay for standard time (ST) hours for the employee in the second period.
|
| gross2 | Text |
Enter the gross earnings for the employee in the second period.
|
| Gross T2 | Text |
Enter the total gross earnings for the employee in the second period.
|
| Net wages 2 | Text |
Enter the net wages for the employee in the second period after all deductions.
|
| OT31 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT32 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT33 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT34 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT35 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT36 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| OT37 | Text |
Enter the overtime (OT) hours worked by the employee in the third period.
|
| Total hours OT3 | Text |
Enter the total number of overtime (OT) hours worked by the employee in the third period.
|
| Rate of pay 3 | Text |
Enter the overtime rate of pay for the third worker.
|
| ST31 | Text |
Enter the standard time hours worked by the third worker on the first day.
|
| ST32 | Text |
Enter the standard time hours worked by the third worker on the second day.
|
| ST33 | Text |
Enter the standard time hours worked by the third worker on the third day.
|
| ST34 | Text |
Enter the standard time hours worked by the third worker on the fourth day.
|
| ST35 | Text |
Enter the standard time hours worked by the third worker on the fifth day.
|
| ST36 | Text |
Enter the standard time hours worked by the third worker on the sixth day.
|
| ST37 | Text |
Enter the standard time hours worked by the third worker on the seventh day.
|
| Total hours ST3 | Text |
Enter the total standard time hours worked by the third worker.
|
| Rate of pay ST 3 | Text |
Enter the standard rate of pay for the third worker.
|
| Rate of pay ST fringe 3 | Text |
Enter the fringe benefits rate of pay for the third worker.
|
| gross3 | Text |
Enter the gross wages for the third worker.
|
| Gross T3 | Text |
Enter the total gross wages for the third worker.
|
| Net wages 3 | Text |
Enter the net wages for the third worker.
|
| OT41 | Text |
Enter the overtime hours worked by the fourth worker on the first day.
|
| OT42 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT43 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT44 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT45 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT46 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT47 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| Total hours OT4 | Text |
Enter the total overtime hours worked by the employee for the specified period.
|
| Rate of pay 4 | Text |
Enter the rate of pay for the overtime hours worked by the employee.
|
| ST41 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST42 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST43 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST44 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST45 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST46 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| ST47 | Text |
Enter the standard hours worked by the employee for the specified period.
|
| Total hours ST4 | Text |
Enter the total standard hours worked by the employee for the specified period.
|
| Rate of pay ST 4 | Text |
Enter the rate of pay for the standard hours worked by the employee.
|
| Rate of pay ST fringe 4 | Text |
Enter the fringe benefit rate of pay for the standard hours worked by the employee.
|
| gross4 | Text |
Enter the gross earnings for the employee for the specified period.
|
| Gross T4 | Text |
Enter the total gross earnings for the employee for the specified period.
|
| Total deduction 4 | Text |
Enter the total amount of deductions for the fourth employee.
|
| Net wages 4 | Text |
Enter the net wages paid to the fourth employee after deductions.
|
| gross5 | Text |
Enter the gross wages for the fifth employee.
|
| Gross T5 | Text |
Enter the total gross wages for the fifth employee.
|
| Net wages 5 | Text |
Enter the net wages for the fifth employee after all deductions.
|
| Total hours ST6 | Text |
Enter the total hours worked by the employee for this pay period.
|
| Rate of pay ST 6 | Text |
Enter the rate of pay for the employee for this pay period.
|
| Rate of pay ST fringe 6 | Text |
Enter the fringe benefit rate of pay for the employee for this pay period.
|
| gross6 | Text |
Enter the gross wages earned by the employee for this pay period.
|
| Gross T6 | Text |
Enter the total gross wages earned by the employee for this pay period.
|
| Net wages 6 | Text |
Enter the net wages paid to the employee for this pay period after all deductions.
|
| OT71 | Text |
Enter the overtime hours worked by the employee for this pay period.
|
| OT72 | Text |
Enter the overtime hours worked by the employee for this pay period.
|
| OT73 | Text |
Enter the overtime hours worked by the employee for this pay period.
|
| OT74 | Text |
Enter the overtime hours worked by the employee for this pay period.
|
| OT75 | Text |
Enter the overtime hours worked by the employee for this pay period.
|
| OT76 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| OT77 | Text |
Enter the overtime hours worked by the employee for the specified period.
|
| Total hours OT7 | Text |
Enter the total overtime hours worked by the employee for the specified period.
|
| Rate of pay 7 | Text |
Enter the rate of pay for the overtime hours worked by the employee.
|
| ST71 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST72 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST73 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST74 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST75 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST76 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| ST77 | Text |
Enter the standard time hours worked by the employee for the specified period.
|
| Total hours ST7 | Text |
Enter the total standard time hours worked by the employee for the specified period.
|
| Rate of pay ST 7 | Text |
Enter the rate of pay for the standard time hours worked by the employee.
|
| Rate of pay ST fringe 7 | Text |
Enter the rate of pay for the standard time fringe benefits for the employee.
|
| gross7 | Text |
Enter the gross wages earned by the employee for the specified period.
|
| Gross T7 | Text |
Enter the total gross wages earned by the employee for the specified period.
|
| Net wages 7 | Text |
Enter the net wages earned by the employee after all deductions for the specified period.
|
| OT81 | Text |
Enter the overtime hours worked by the employee on the first day of the payroll period.
|
| OT82 | Text |
Enter the overtime hours worked by the employee on the second day of the payroll period.
|
| OT83 | Text |
Enter the overtime hours worked by the employee on the third day of the payroll period.
|
| OT84 | Text |
Enter the overtime hours worked by the employee on the fourth day of the payroll period.
|
| OT85 | Text |
Enter the overtime hours worked by the employee on the fifth day of the payroll period.
|
| OT86 | Text |
Enter the overtime hours worked by the employee on the sixth day of the payroll period.
|
| OT87 | Text |
Enter the overtime hours worked by the employee on the seventh day of the payroll period.
|
| Total hours OT8 | Text |
Enter the total overtime hours worked by the employee during the payroll period.
|
| Rate of pay 8 | Text |
Enter the rate of pay for overtime hours worked by the employee.
|
| ST81 | Text |
Enter the straight time hours worked by the employee on the first day of the payroll period.
|
| ST82 | Text |
Enter the straight time hours worked by the employee on the second day of the payroll period.
|
| ST83 | Text |
Enter the straight time hours worked by the employee on the third day of the payroll period.
|
| ST84 | Text |
Enter the straight time hours worked by the employee on the fourth day of the payroll period.
|
| ST85 | Text |
Enter the straight time hours worked by the employee on the fifth day of the payroll period.
|
| ST86 | Text |
Enter the straight time hours worked by the employee on the sixth day of the payroll period.
|
| ST87 | Text |
Enter the straight time hours worked by the employee on the seventh day of the payroll period.
|
| Total hours ST8 | Text |
Enter the total straight time hours worked by the employee during the payroll period.
|
| Rate of pay ST 8 | Text |
Enter the rate of pay for straight time hours worked by the employee.
|
| Rate of pay ST fringe 8 | Text |
Enter the fringe benefit rate of pay for straight time hours worked by the employee.
|
| gross8 | Text |
Enter the gross wages earned by the employee for this payroll period.
|
| Gross T8 | Text |
Enter the total gross wages earned by the employee for this payroll period.
|
| Deduction A8 | Text |
Enter the amount for Deduction A for the 8th worker.
|
| Deduction B8 | Text |
Enter the amount for Deduction B for the 8th worker.
|
| Deduction other 8 | Text |
Enter the amount for any other deductions for the 8th worker.
|
| Total deduction 8 | Text |
Enter the total amount of deductions for the 8th worker.
|
| Net wages 8 | Text |
Enter the net wages for the 8th worker after all deductions.
|
| Project Information | ||
| Project and location | Text |
Enter the project name and location.
|
| Project or contract number | Text |
Enter the project or contract number.
|
| ST64 | Text |
Enter the state abbreviation for the project location.
|
| ST65 | Text |
Enter the state abbreviation for the project location.
|
| ST66 | Text |
Enter the state abbreviation for the project location.
|
| ST67 | Text |
Enter the state abbreviation for the project location.
|
| Building or work | Text |
Enter the name of the building or work being performed.
|
| Commence day (dd) | Text |
Enter the day the work commenced (dd).
|
| Commence month (mm) | Text |
Enter the month the work commenced (mm).
|
| Commence year (yyyy) | Text |
Enter the year the work commenced (yyyy).
|
| End day (dd) | Text |
Enter the day the work ended (dd).
|
| End month (mm) | Text |
Enter the month the work ended (mm).
|
| endYear | Text |
Enter the year the work ended (yyyy).
|
| Remarks | ||
| Remarks | Text |
Enter any additional remarks or comments regarding the payroll details.
|
| Signature | ||
| Name and title | Text |
Enter the name and title of the person completing the form.
|
| Standard Hours | ||
| ST21 | Text |
Enter the standard hours worked by the second worker on day 1.
|
| ST22 | Text |
Enter the standard hours worked by the second worker on day 2.
|
| ST23 | Text |
Enter the standard hours worked by the second worker on day 3.
|
| ST24 | Text |
Enter the standard hours worked by the second worker on day 4.
|
| ST25 | Text |
Enter the standard hours worked by the second worker on day 5.
|
| ST26 | Text |
Enter the standard hours worked by the second worker on day 6.
|
| ST27 | Text |
Enter the standard hours worked by the second worker on day 7.
|
| ST61 | Text |
Enter the standard time hours for the sixth employee on day 1.
|
| ST62 | Text |
Enter the standard time hours for the sixth employee on day 2.
|
| ST63 | Text |
Enter the standard time hours for the sixth employee on day 3.
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| Straight Time Hours | ||
| ST51 | Text |
Enter the straight time hours worked by the fifth employee on the first day.
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| ST52 | Text |
Enter the straight time hours worked by the fifth employee on the second day.
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| ST53 | Text |
Enter the straight time hours worked by the fifth employee on the third day.
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| ST54 | Text |
Enter the straight time hours worked by the fifth employee on the fourth day.
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| ST55 | Text |
Enter the straight time hours worked by the fifth employee on the fifth day.
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| ST56 | Text |
Enter the straight time hours worked by the fifth employee on the sixth day.
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| ST57 | Text |
Enter the straight time hours worked by the fifth employee on the seventh day.
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| Total hours ST5 | Text |
Enter the total straight time hours worked by the fifth employee.
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| rateOfPayST5 | Text |
Enter the rate of pay for straight time hours for the fifth employee.
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| Rate of pay ST fringe 5 | Text |
Enter the rate of pay for straight time fringe benefits for the fifth employee.
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| Worker Information | ||
| Name, address, and SSN 2 | Text |
Enter the name, address, and Social Security Number of the second worker.
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| Number of withhold exemptions 2 | Text |
Enter the number of withholding exemptions claimed by the second worker. Maximum length is 2 digits.
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| Work classification 2 | Text |
Enter the work classification for the second worker.
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| Name, address, and SSN 4 | Text |
Enter the name, address, and Social Security Number of the fourth worker.
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| Number of withhold exemptions 4 | Text |
Enter the number of withholding exemptions for the fourth worker. Maximum length is 2 characters.
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| Work classification 4 | Text |
Enter the work classification for the fourth worker.
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