Workplace Provincial Directorate No:
Workplace SSI Registry No.:
Workplace Tax Office No:
Period:
Employee’s Name Surname:
Employee’s SSI Registry Name:
ACCRUALS:
1-
2-
DEDUCTIONS:
1-
2-
NET PAYMENT:
Employer/Signature/Seal/Stamp
Workplace Provincial Directorate No:
Workplace SSI Registry No.:
Workplace Tax Office No:
Period:
Employee’s Name Surname:
Employee’s SSI Registry Name:
ACCRUALS:
1-
2-
DEDUCTIONS:
1-
2-
NET PAYMENT:
Employer/Signature/Seal/Stamp