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Federal and Pennsylvania Payroll Withholding

 
.....General Information.....
For Payroll in Tax Year:
Federal Withholding Status?:
Federal Allowances?:
Federal Additional Withholding Amount?:
State Additional Withholding Amount?:
School District
(and municipality):
Municipality
(and County) Taxing Body:
Resident of Municipality? Resident Non-resident
Pay Periods per Year:
.....Paycheck Income.....
Employee Type: Salaried  Hourly
Gross Salary Per Pay Period:
Income to be taxed as supplemental income?:
.....Paycheck Deductions.....
Before Tax Retirement Benefits?:
Before Tax Cafeteria Plan Benefits?:
After Tax Deduction?:
Does Employee pay Unemployment Insurance Tax?
Yes
No
Check Box for FICA Withholding?:
Check Box for Medicare Withholding?:
Gross Salary YTD?
(Do not include this paycheck)

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