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INDIVIDUAL PAYROLL RECORD Name Employee Address: Social Security -- Position Birth Date Phone Regular Rate Overtime Rate Withholding Status First Day Worked Last Day Worked PERIOD ENDING 1 JAN. 2 3 4 5 TOTAL JAN. 1 FEB. 2 3 4 5 TOTAL FEB. 1 MAR. 2 3 4 5 TOTAL MAR. TOTAL 1ST QTR..
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