Transcription of Payroll Certification Form - State
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Payroll Certification Form - State
Payroll Certification FOR PUBLIC WORKS PROJECTS (for Contractor and Sub-Contractor s Use for Weekly and Final Certification ) ( 12 and ) NJ Department of Labor & Workforce Development division of Wage and Hour Compliance Public Contracts section Box 389 Trenton, New Jersey 08625-0389 Submit to Public Body or Lessor NAME OF CONTRACTOR OR SUBCONTRACTOR ADDRESS DATE WAGES DUE AND PAID Payroll NO. WEEK ENDING OR FINAL Certification PROJECT NAME AND LOCATION PROJECT OR OR NO. 3. DAY AND DATE 6. GROSS AMOUNT EARNED 7. DEDUCTIONS 1. NAME, ADDRESS AND SOCIAL SECURITY NUMBER OF EMPLOYEE 2. WORK CLASSIFICATION OT. OR ST. HOURS WORKED EACH DAY 4. TOTAL HOURS 5. RATE OF PAY THIS PROJECT THIS WEEK FICA WITH- HOLDING TAX TOTAL DEDUC- TIONS 8. NET WAGES PAID FOR WEEK 9.
PAYROLL CERTIFICATION FOR PUBLIC WORKS PROJECTS (for Contractor and Sub-Contractor’s Use for Weekly and Final Certification) (N.J.A.C. 12:60-2.1 and 6.1) NJ Department of Labor & Workforce Development Division of Wage and Hour Compliance Public Contracts Section P.O. Box 389 Trenton, New Jersey 08625-0389 Submit to Public Body or Lessor
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