Sole Proprietorship: Account #2530.01 Last Name % Time Devoted % _________________ Salary First Name _________________ Emp. Benefits Payroll Taxes Workers’ Comp. Title ______________________ Gr. Life/Hlth Ins. Draw $ Other: Total $ Partnership: Account #2540.01 # # # # Last Name % Time Devoted % % % % % _________________ Salary $ $ $ $ First Emp Benefits $ $ $ $ Name__________________ Payroll Taxes $ $ $ $ Workers’ Comp. $ $ $ $ Title Gr. Life/Hlth Ins. $ $ $ $ (Circle one) Draw $ $ $ $ $ Officer / Partner Other: $ $ $ $ Total $ $ $ $ $ Account #2540.01 # # # # Last Name % Time Devoted % % % % % _________________ Salary $ $ $ $ First Name Empl Benefits $ $ $ $ _________________ Payroll Taxes $ $ $ $ Workers’ Comp. $ $ $ $ Title Gr. Life/Hlth Ins. $ $ $ $ (Circle one) Draw $ $ $ $ $ Officer / Partner Other: $ $ $ $ Total $ $ $ $ $ 1Annual Draw or Earnings Distribution Corporation: Account # # # # # Last % Time Devoted % % % % % Name__________________ Salary $ $ $ $ $ First Name Emp Benefits $ $ $ $ $ _________________ Payroll Taxes $ $ $ $ $
Sole Proprietorship: Account #2530.01 Last Name _________________ % Time Devoted % Salary First Name _________________ Emp. Benefits Payroll Taxes Workers’ Comp. Title ______________________ Gr. Life/Hlth Ins. Draw $ Other: Total $ Partnership: Account #2540.01 # # # # Last Name _________________ % Time Devoted % % % % % Salary $ $ $ $ First Name__________________ Emp Benefits $ $ $ $ Payroll Taxes $ $ $ $ Workers’ Comp. $ $ $ $ Title Gr. Life/Hlth Ins. $ $ $ $ (Circle one) Draw $ $ $ $ $ Officer / Partner Other: $ $ $ $ Total $ $ $ $ $ Account #2540.01 # # # # Last Name _________________ % Time Devoted % % % % % Salary $ $ $ $ First Name _________________ Empl Benefits $ $ $ $ Payroll Taxes $ $ $ $ Workers’ Comp. $ $ $ $ Title Gr. Life/Hlth Ins. $ $ $ $ (Circle one) Draw $ $ $ $ $ Officer / Partner Other: $ $ $ $ Total $ $ $ $ $ 1Annual Draw or Earnings Distribution Corporation: Account # # # # # Last Name__________________ % Time Devoted % % % % % Salary $ $ $ $ $ First Name _________________ Emp Benefits $ $ $ $ $ Payroll Taxes $ $ $ $ $
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