Employee Information Sheet



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Only applicable if state income tax and filing status/allowances are different from federal Specify any payroll taxes that this employee is exempt from, such as state unemployment, social security, or Medicare: Specify any local taxes that need to be withheld from this employee’s paycheck: Notes: Pay Information Which types of pay does this employee receive Salary per Overtime Pay Hourly Rates (up to 8 different) Clergy Housing (Cash) Double Overtime Clergy Housing (In-Kind) Sick Pay Bereavement Pay / hour Holiday Pay Group Term Life Insurance / hour Vacation Pay S-Corp Owners Health Ins..

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