Company Name
FOR THE MONTH OF Month-Year
A. PERSONNEL DETAILS
NAME : _________ Employee NO : _________
POSITION : _________ SITE/HO : _________
B. PAYMENT DETAILS
BASIC SALARY / WAGE : _________
NO. OF WORKING DAY : _________
PAYMENT : _________
B.1. PAYMENTS DUE
TOTAL PAYMENT FOR BASIC SALARY : _________
TOTAL PAYMENT FOR ACCOMODATION : _________
TOTAL PAYMENT FOR FOOD : _________
NOTICE PAYMENT : _________
LEAVE PAYMENT : _________
END OF SERVICE GRATUITY PAYMENT : _________
TOTAL PAYMENT DUE
B.2. DEDUCTIONS
ADVANCE PAYMENT :_________
TELEPHONIC CHARGES :_________
OTHER DEDUCTIONS :_________
PAID BY :_________
TOTAL DEDUCTIONS DUE :_________
NET PAYMENT DUE TO FOR THE MONTH OF _________
I, hereby acknowledge that the amount indicated above _________ is the full and complete reimbursement for the normal days, extra hours, holidays that I have worked in the month of _________ including the reimbursement for the leaves, seniority premiums, notice payment due under the Employment Contract.
BY EMPLOYEE BY EMPLOYER
_________ _________
Signed : Signed :
BANK :
BRANCH :
BANK ACCOUNT NUMBER :
TRANSFER AMOUNT :
I have received the above transfer/cash with no obligation
Signed :_________
Date : _________
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