| Company name, address, EIN, phone and logo | Employer and employee in a tinted box |
| Employee name, address and ID | Employer and employee in a tinted box |
| Last four digits of the SSN | Title, stub number and pay facts |
| Pay period, pay date and pay frequency | Title, stub number and pay facts |
| Filing status and how the pay was made | Title, stub number and pay facts |
| Hours and rate, or the salary for the period | Earnings table with zebra rows and a totals row |
| Overtime, bonus, commission and tips lines | Earnings table with zebra rows and a totals row |
| Federal, state, Social Security and Medicare (estimated) | Taxes withheld beside deductions |
| Your own deductions (health plan, retirement, garnishment) | Taxes withheld beside deductions |
| Year-to-date totals | Earnings table with zebra rows and a totals row |
| Memo or notes | Time off and a memo note, when you add them |