Free Illinois Certified Transcript Of Payroll PDF Download
Available for Download in PDF Format
Illinois Certified Transcript Of Payroll PDF Preview
State of Illinois
Illinois Department of Labor
IDOL Case File Number:
Certified Transcript of Payroll
Print Form
Please Note: The submission of falsified payroll records is a criminal offense.
Payroll Date:
Contractor and/or Subcontractor
Public Body Information
(Contract Number) (Project Number)
(Project Location)
(State)
(Company Name) (Contact Name) (Street Address) (City)
(Zipcode) (Telephone Number)
(State)
(Public Body Name) (Contact Name)
(Street Address) (City)
(Zipcode) (Telephone Number)
Report Hours for Each Day, Including Overtime Hours, List Hourly Prevailing Wage Rate and Hourly Fringe Benefits Allotments.
Worker Name, Address
* Hours worked each day
Total Hrs Each
Total OT
Hourly Wage
OT Wage
Per Pay Period
SSN & Telephone Number
SUN MON TUE WED THR FRI SAT
PW N
PW and Reg.
Hours
Rate
Rate
Gross
Net
Labor Classification
Hourly Fringe Benefit: Pension: Health/Welfare: Vacation: Training:
PW N
Labor Classification
Hourly Fringe Benefit: Pension: Health/Welfare: Vacation: Training:
PW N
Labor Classification
Hourly Fringe Benefit: Pension: Health/Welfare: Vacation: Training:
PW N
Labor Classification
Hourly Fringe Benefit: Pension: Health/Welfare: Vacation: Training:
New Page
IL452CM02
*PW - Prevailing Hours Worked *N - Non Prevailing Hours Worked
Remove Last Page
State of Illinois
Illinois Department of Labor
Certified Transcript of Payroll
Instructions:
Fringe benefits (health insurance, pension, vacation, and training) must be paid, if it is required for the work classification, regardless of your union or nonunion status.
We give you credit for health insurance paid (if any) and ERISA approved pension plan (if any) and training if your employees are in a BAT approved program.
If the fringe benefit rate is paid into a fund, please note by placing the letter āFā behind the fringe benefit rate; if the fringe benefit rate is included on an employee's payroll check, please note by placing the letter āEā behind the fringe benefit rate.
On the back of this form please list all subcontractors, independent contractors and owner operator's your company used on this project. If you wish information regarding coverage of the Act, please visit our web site at www.state.il.us/agency/idol/ or call 217-782-1710.
IL452CM02
Illinois Certified Transcript Of Payroll PDF Thumbnail Preview
Click to Expand
Text Preview:
Related Posts
Related PDF Downloads

Download
809 downloads
Free Free Diamond Color Scale And Clarity Chart PDF Download

Download
771 downloads
Free February 2019 Calendar 1 PDF Download

Download
438 downloads
Free February 2018 Calendar 3 PDF Download

Download
820 downloads
Free February 2015 Calendar 3 PDF Download

Download
910 downloads
Free Example Business Continuity Gap Analysis PDF Download

Download
722 downloads
Free Electric Guitar Chords Chart For Beginner PDF Download

Download
904 downloads
Free Electric Guitar Bar Chords Chart PDF Download

Download
389 downloads
Free Diamond Grading Color Chart PDF Download

Download
509 downloads
Free Diamond Cut And Clarity Chart Template PDF Download

Download
204 downloads
Free December 2018 Calendar 3 PDF Download

Download
180 downloads
Free December 2018 Calendar 1 PDF Download

Download
119 downloads
Free December 2017 Calendar 1 PDF Download