ER HSAcontributionsWrite inEXEMPTA dollaramount6$8,975.32Pub15-ABox13WhenmakingchangesS CorpHealthIns$684 perweek or$35,568annually10%Head ofHousehold22%$132,90011:59PMon 12/31Enter SS& Medamt asnegativeBox 12Code CJanuary15th100%net pay$200,000Box 12CodeW6months$50,000SubER HSAcontributionsWrite inEXEMPTA dollaramount6$8,975.32Pub15-ABox13WhenmakingchangesS CorpHealthIns$684 perweek or$35,568annually10%Head ofHousehold22%$132,90011:59PMon 12/31Enter SS& Medamt asnegativeBox 12Code CJanuary15th100%net pay$200,000Box 12CodeW6months$50,000Sub

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