Employee Wage and Benefits Statement – 2004

 

 

 

 

Employee:_________________________ 

 

SSN:_____________________________

 

Base Wage or Salary $ _______________  
Vacation Pay $ _______________  
Bonus or Incentive Pay  $ _______________  
Other $ _______________  
          Total Direct Cash Compensation     $ ____________
Commodities or Produce   $ _______________  
Personal Use of Farm Equip. (including vehicles) $ _______________  
House $ _______________  
Utilities $ _______________  
Meals $ _______________  
Life Insurance $ _______________  
Health Insurance $ _______________  
Retirement Plan $ _______________  
Employer’s Share of Social Security Taxes $ _______________  
Other: _________________________   $ _______________  

Other: _________________________    

$ _______________  
          Total Fringe & Non-cash Benefits

 

  $ ____________

 

          Total Compensation – 2004   $ ____________