Pub15-A11:59PMon 12/31$200,0006monthsWhenmakingchangesJanuary15thEnter SS& Medamt asnegativeBox 12Code CS CorpHealthInsBox 12CodeW6$8,975.32$684 perweek or$35,568annually100%net payWrite inEXEMPT$132,900ER HSAcontributionsA dollaramountSub$50,00022%Box1310%Head ofHouseholdPub15-A11:59PMon 12/31$200,0006monthsWhenmakingchangesJanuary15thEnter SS& Medamt asnegativeBox 12Code CS CorpHealthInsBox 12CodeW6$8,975.32$684 perweek or$35,568annually100%net payWrite inEXEMPT$132,900ER HSAcontributionsA dollaramountSub$50,00022%Box1310%Head ofHousehold

Payroll YE Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.


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  1. Pub 15-A
  2. 11:59PM on 12/31
  3. $200,000
  4. 6 months
  5. When making changes
  6. January 15th
  7. Enter SS & Med amt as negative
  8. Box 12 Code C
  9. S Corp Health Ins
  10. Box 12 Code W
  11. 6
  12. $8,975.32
  13. $684 per week or $35,568 annually
  14. 100% net pay
  15. Write in EXEMPT
  16. $132,900
  17. ER HSA contributions
  18. A dollar amount
  19. Sub
  20. $50,000
  21. 22%
  22. Box 13
  23. 10%
  24. Head of Household