Housing NZ

1. Copy details onto a Housing NZ Income Statement form

INCOME STATEMENT for Wages, Salaries and Accident Compensation

1.	EMPLOYEE CONTACT DETAILS (employee to complete)
	Employee last name	Matthews
	Employee first names	John William
	Home address	Queenstown NEW ZEALAND

EMPLOYER TO COMPLETE

1.	EMPLOYMENT DETAILS (employer to complete)
	Employer's organisation name	Angling Adventures (Demo)
	Employer's postal address	P O Box 12345 Queenstown NEW ZEALAND

2.	INCOME DETAILS
	In the last 52 weeks, the employee was employed
	full time part time casually (PLEASE TICK ONE)
	for the period 11-Feb-2011 to 10-Feb-2012
	Pay Periods: weekly fortnightly 4 weekly monthly

3.	During this period they earned
	Gross ordinary pay	$14,080.00
	Overtime	$0.00
	Other payments and allowances	$0.00
	Sub-total	$14,080.00
	less PAYE	$-2,336.40
	Net pay	$11,743.60

4.	Last pay
	The last pay made to this employee was for the period
	- - to 10-Feb-2012
		PLEASE TURN OVER

5.	Details of this last pay are:
	Gross ordinary pay	$640.00
	Overtime	$0.00
	Other payments and allowances	$0.00
	Sub-total	$640.00
	less PAYE	$-106.20
	Net pay	$533.80
	If the last net pay is not the normally expected net pay for each pay period (as shown in section 2) please summarise why:



	Normally expected net pay:	$533.80

6.	Does the employee receive any fringe benefit?
	No Yes (please complete the details below)
	TYPE OF FRINGE BENEFIT	GROSS VALUE TO EMPLOYEE PER PAY PERIOD
		$
		$

INCOME STATEMENT