| Company name, address, EIN, phone and logo | Employer and employee under color chips |
| Employee name, address and ID | Employer and employee under color chips |
| Last four digits of the SSN | Employer and employee under color chips |
| Pay period, pay date and pay frequency | Title and pay facts |
| Filing status and how the pay was made | Title and pay facts |
| Federal, state, Social Security and Medicare (estimated) | Taxes and deductions table with the total band |
| Your own deductions (health plan, retirement, garnishment) | Taxes and deductions table with the total band |
| Year-to-date totals | Net pay band with YTD, and a memo note |
| Memo or notes | Net pay band with YTD, and a memo note |