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For Period Ending December 27, 20-- No. of Earnings Marital W/H (a) (b) (c) FICA Employee Name Status Allowances Regular Supp'l Total OASDI HI

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For Period Ending December 27, 20-- No. of Earnings Marital W/H (a) (b) (c) FICA Employee Name Status Allowances Regular Supp'l Total OASDI HI Wayne, Bret MFJ N/A $3,000.00* Young, Gina MFJ N/A 2,500.00* Course, Rudy 5 N/A 810.00 Dickson, Emile MFJ N/A 715.00 Woodrow, Walt MF) N/A 695.00 Noblet, Jim S N/A $25.00 Ono, Joan MFJ N/A 800.00 Jones, Carries N/A 645.00 Totals "Monthly Compute the employer's FICA taxes for the pay period ending December 27, 20-- OASDI Taxes OASDI taxable earnings HI Taxes HI taxable earnings OASDI taxes HI taxes

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