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Get and Sign Ls 55s 2017-2022 Form
Employee’s rate(s) of pay for each type of work or
shift/Tarifa de pago del empleado por cada tipo de trabajo
o turno:
$_________ per hour for/por hora por _____________
$_________ per hour for/por hora por _____________
$_________ per hour for/por hora por _____________
4. Allowances taken/Asignaciones tomadas:
None/Ninguna
Tips/Propinas __________ per hour/por hora
Meals/Comidas _________ per meal/por comida
Lodging/Alojamiento ________________________
Other/Otro...
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