Simplified Fictional WH-347 Report Illustration

Simplified fictional illustration only. This page is not generated output or an exact replica of the official WH-347. Every company, project, worker, identifier, and dollar amount in this example is invented. It is not for filing and is not legal advice.

Sample report header

U.S. Department of Labor Payroll (For Contractors Optional Use). OMB Control No. 1235-0008. Expires September 30, 2026. The sample contractor is Example Builders LLC at 100 Demo Avenue, Sample City, USA. The fictional project is the Fictional Community Center under demonstration contract DEMO-2026-001, payroll number 07, for the week ending September 4, 2026.

Fictional worker entries

Jordan Sample is shown with a masked worker identifier, carpenter classification, daily straight-time and overtime hours, straight-time and overtime rates, gross pay across projects, itemized FICA, withholding and other deductions, and net wages. Casey Example is shown with the same representative categories. All hours, rates, deductions, and totals are fictional.

Statement of Compliance demonstration

The second section illustrates where an authorized contractor representative would review the payroll period, completeness, classifications, rates, and applicable fringe-benefit obligations. It includes illustrative options for benefits paid to plans or in cash and for listed exceptions. Signature and date lines are intentionally blank. A contractor must verify its own data and agency instructions before filing.

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