SM 2-29
EMPLOYEE INFORMATION FORM NAME Avery Towle ADDRESS 4011 Route 100 CITY/STATE/ZIP Plymouth/VT/05102 TELEPHONE 802-967-
Hire Date 2/4/2014 Date of Birth 7/14/1991 Position Production Worker
5873 No. of exemptions 1 SOCIAL SECURITY NUMBER 089-74-0974 Pay Rate $12.00/hour
Period Hrs. OT Ended Worked Reg Pay Pay
Gross Social Fed Inc. State Total Pay Sec. Tax Medicare Tax Inc. Tax 401(k) Deduc Net pay YTD 0 0 0