Attachment C Payroll Calculation Sheet Employee Name: Pay Period: Program: Approved Pay Rate (per Agreement) Hourly: Monthly Salary: $ $ Overtime: $ Pay Period Salary: $ Personal Services Hours Worked Rate of Pay X = Not Applicable Not Applicable Salaried Employee $ X = Hourly Employee $ $ X = Overtime $ $ = Gross Salary $ Fringe Benefits Amount Paid (employer’s contribution) % $ Pension Health Insurance (less dependents) $ $ / month Total Fringe Benefits $ Social Security Amount Paid (employer’s contribution) F.I.C.A. % $ = Total Social Security Benefits $ Attachment D
Attachment C Payroll Calculation Sheet Employee Name: Pay Period: Program: Approved Pay Rate (per Agreement) Hourly: $ Monthly Salary: $ Overtime: $ Pay Period Salary: $ Personal Services Hours Worked Rate of Pay Salaried Employee Not Applicable X Not Applicable = $ Hourly Employee X $ = $ Overtime X $ = $ Gross Salary = $ Fringe Benefits (employer’s contribution) Amount Paid Pension % $ Health Insurance (less dependents) $ / month $ Total Fringe Benefits $ Social Security (employer’s contribution) Amount Paid F.I.C.A. = % $ Total Social Security Benefits $ Attachment D
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