Payroll Certification Form
A payroll certification form is a document which is used by an employer to certify that all the employees in the payroll of the company has been paid accurately. The form is also a kind of acknowledgement stating that the wage information, deductions and others details in the payroll are true and accurate.
Sample Payroll Certification Form
Payroll Certification Form
Details of the organization
Name: Oil Manufacturers Limited
Principal office address: 41 Glenn Low Road,
New York, New Jersey
Contact number: 78945
Website: oil.com
I, Ben John of Oil Manufacturers Limited working in the position of Finance department head certify and state that:
All individuals employed in my organization have been paid their wages in full for the month of November as per the Labour Laws of State of New Jersey. I would also like to state the following:
a) The records submitted by me are completely true and accurate.
b) The rate of wages paid is as per the Labour Laws of State of New Jersey and he total wages is not lesser than the one mentioned in their contract.
c) The employer does not receive any sort of commission, fee, credit, gift or compensation of any kind.
d) The employer assures that he had abide by all the compliances stated in the Labour Laws of State of New Jersey.
e) The employee is aware that if a false certified payroll is filed, the employer has to pay a fine and can face imprisonment charges.
Signature: ____________ Submitted on: 1st December 2011
Designation: Finance department head
Category: Payroll Forms
