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STATE OF KANSAS

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Date: MM DD YY STATEMENT OF EARNINGS No.80000000 or 40000000
Soc. Sec. No. Empl. I.D. Fed. State Deductions

Current Period

Year To Date

123456789W0000012345M 0  M 0 OASDI $$.$$
MEDICARE $$.$$
Earnings Current Period

Year To Date

 FEDERAL TAX $$.$$
REGULAR $$.$$ EIC -$.$$
OVERTIME $$.$$ STATE TAX $$.$$
STANDBY $$.$$ KPER $$.$$
SHIFT DIF 1 $$.$$ GHI MED $$.$$
SHIFT DIF 3 $$.$$ GHI DEN $$.$$
SHIFT DIF 4 $$.$$
SUGGEST AWD $$.$$ TSA $$.$$
HOLIDAY PAY $$.$$ VOL TSA $$.$$
BENEFIT INC $$.$$ SAVING BOND $$.$$
TX GRP LIFE $$.$$ UNITED WAY $$.$$
LONGEVITY $$.$$ DEFER COMP $$.$$
SL PAYOUT $$.$$ ORG DUES $$.$$
VL PAYOUT $$.$$ FEGLI $$.$$
BONUS$$.$$ KPER BUYBAK $$.$$
TAX EE BUS $$.$$ GARNISHMENT $$.$$
CALL BACK $$.$$ LEVY $$.$$
COMP PAYOUT $$.$$ WAGE EARNER $$.$$
MOVING EXP $$.$$ WAGE ASSIGN $$.$$
NON CSH AWD $$.$$ SETOFF-WA $$.$$
NRA EARNS $$.$$ SETOFF-DA $$.$$
SUBSISTENCE $$.$$ SETOFF-REG $$.$$
NONTX FRING $$.$$ PAY DED AGR $$.$$
GROSS PAY $$$.$$ MED WTH ORD $$.$$
FED CSRS $$.$$
INCOME W/H $$.$$
N/TAX GHI M $$.$$
N/TAX GHI D $$.$$
N/TAX VISION $$.$$
FED FERS $$.$$
DEPEND CARE $$.$$
HEALTH CARE $$.$$
AGY PAY DED $$.$$
ARR COLLECT $$.$$
OPT GRP LIF $$.$$
FED TSP $$.$$
VISION $$.$$
LEARN QUEST $$.$$
LTC $$.$$
N/TAX PARK $$.$$
FED GARN $$.$$
WILLIE THE WILDCAT Leave as of 00/00/00 NET PAY $$$.$$

Division of Human Resources email  hr@ksu.edu  103 Edwards Hall  Manhattan, KS 66506-4801  (785) 532-6277
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 Kansas State University
March 18, 2008