Company Code

Company Code Loo/Dapt Number Papa MI/ Pal 21609797 011 2392014 1 of DARREN K INDYICE PLLC Taxable Martial Status: Marred ExativionvAlionanaps: Tax Cremes Federal: 0 Federal: Sleet: 0 Slag: Local: 0 Social Secunly Number XXX4000000 Earnings Statement Period Slarlrg: 01(25/2016 Period Ending: 02/07/2016 Pay Dime: 024)412016 Dueness Phone: 212.971.1307 Earnings rate hours/unite Ibis period year to as Regular 0.00 3461.54 14230.78 Grose Pay 43,461.54 $14,230.78 Statutory Deductions Federal beans Social Socuilly IM case New 'fat Sane Maine Voluntary Deductions New Yeek volunterydnabiley LESLEY K GROFF Oils period we to dMs Deposits aocounl number tyineluABA amount -457.89 2335.21 50000(0169 )1003000M 2546.76 -214.62 882.31 -50.20 206.3S -190.87 855.47 this period nano date -1.20 3.60 Nat Pay $2,340.74 A .tigflIFF" LI5Y4IMUL45(7140r: FF 1,471EiTlific7E510Allf" '2" 3 ` DARREN K iNDYKE PILC: HI Are, 11C. Your leana1 taxable wages OS penal are $31 51.54 LESLEY K GROFF 02108/2016. ;. • y. iT tremiYABA mat ICOCCOODX 2546.76 • 'JAE tail:Ili/AL LeltahfIgIff HAS Ail AKL.F11.1xL S ntiLu Ar TO llEY/ Wind tilEg1Ilitg I:111 :Uiri entlr hi r•ar EFTA00311465