1

Company number

10

Employee/spouse - Smoker/Non-smoker Plan status

17

Total amount for this period

2

Division and service

3

Period covered by the report

11

Standard hours

18

Employee YTD

4

Date report was produced

12

Regime Status

19

Employee totals

5

Employee number

13

Employee's coverage

20

Service totals

6

Last name, First name

14

Ratio (salary multiplier)

7

Social insurance number

15

Amount paid by employee (current period)

8

Allocation

9

Salary

16

Amount paid by employer (current period)