Employee Income Statement

Employee income statement is a document stating the total income of the employee received by the organization. Hence, such a document should be constructed with utmost precision so that it could serve as evidence incase of any future discrepancies.

Sample Employee Income Statement

Houston Food Company

Employee Income Statement

Name of the employee: Mr. Tiran Uzubeki

Job position: Food Quality Analyst

Grade: A

Employee id: 6787777

No. of months payable: All the pay as stated in this income statement is being framed in accordance to the annual income of the concern employee.

Years of services: 10 years 4 months


Basic salary per annum: $78900

Family allowance per annum: $2310

Transportation pay per annum: $2500

Accommodation pay per annum: $2700

The profit sharing amount from the employer per annum: $2500

Bonus received from the employer per annum: $3500

Commission received from the employer per annum: $40000

Total amount of other annual benefit received by the employee per annum: $2500

Benefit on children education [Annual educational benefit provided to each child has been specified]

-The employee declared that he has two children and for which the employer is paying

  • $2500 per annum for the 1st child
  • $1400per annum for the 2nd child


Declaration: I certify that all the above stated income of the employee has been framed in accordance to the income details of the company. Moreover, it has been verified according to the pay-scale of the particular grade on which the employee belongs to.

Signature of the employer __________________________

Company seal ___________________

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