JP Morgan Chase

Impact Staff Leasing LLC Service Provided For: Miami, FL

1315 W. Indiantown Road, Floor 2 FAZA CONTRACTORS INC. 63-8413/2670
Jupiter, FL 33458 798 PRAIRIE ROAD W
WEST PALM BEACH, FL 33408
561-603-0363
Check No: 827213
Date: 03/06/2017

Pay To: ZACARIAS P. DE JESUS

This Amount: NON-NEGOTIABLE DO NOT CASH VOID
Void After 90 Days

ZACARIAS P. DE JESUS
798 PRAIRIE ROAD
WEST PALM BEACH, FL 33406

IMPACT STAFF LEASING, LLC 27-2986311

1315 W. INDIANTOWN RD, FLR 2 JUPITER, FL 33458
I understand that I am not covered by Impact Staff Leasing's Workers' Compensation unless I am receiving a paycheck from Impact Staff Leasing.

ZACARIAS P. DE JESUS Impact Staff Leasing 1751 2 ***-**-9177 03/06/2017 827213

800.00 0.00 92.35 0.00 707.65 707.65 0.00 800.00

3200.00 0.00 369.40 0.00 2830.60 0.00 0.00 3200.00
Fed:M-1 St:FL-A-0 Pay Period: 02/18/17 thru 03/03/17

Salary 800.00 3200.00 Fed Income Tax 31.15 124.60

Social Security 49.60 198.40
Medicare 11.60 46.40
Total Taxes: 92.35 369.40

CHECKING Acct: ****3863 707.65

Total Direct Deposits: 707.65

* Exempt from Federal W/H, FICA and Medicare

** Exempt from Federal W/H
 JP Morgan Chase
Impact Staff Leasing LLC Service Provided For: Miami, FL
1315 W. Indiantown Road, Floor 2 FAZA CONTRACTORS INC. 63-8413/2670
Jupiter, FL 33458 798 PRAIRIE ROAD W
WEST PALM BEACH, FL 33408
561-603-0363
Check No: 827214
Date: 03/06/2017

Pay To: ANA R. LOPEZ

This Amount: NON-NEGOTIABLE DO NOT CASH VOID
Void After 90 Days

ANA R. LOPEZ
798 PRAIRIE ROAD
WEST PALM BEACH, FL 33406

IMPACT STAFF LEASING, LLC 27-2986311

1315 W. INDIANTOWN RD, FLR 2 JUPITER, FL 33458
I understand that I am not covered by Impact Staff Leasing's Workers' Compensation unless I am receiving a paycheck from Impact Staff Leasing.

ANA R. LOPEZ Impact Staff Leasing 1751 1 ***-**-0949 03/06/2017 827214

1250.00 0.00 174.00 0.00 1076.00 1076.00 0.00 1250.00

5000.00 0.00 696.00 0.00 4304.00 0.00 0.00 5000.00
Fed:M-1 St:FL-A-0 Pay Period: 02/18/17 thru 03/03/17

Salary 1250.00 5000.00 Fed Income Tax 78.37 313.48

Social Security 77.50 310.00
Medicare 18.13 72.52
Total Taxes: 174.00 696.00

CHECKING Acct: ****3863 1076.00

Total Direct Deposits: 1076.00

* Exempt from Federal W/H, FICA and Medicare

** Exempt from Federal W/H
Client: 1751 FAZA CONTRACTORS INC. Co: 01 Page 1
3/3/2017
Pay Date: 03/06/2017 Payroll Id:17510004 PAYROLL DIRECT DEPOSIT RECAP 12:23 PM
Period: 02/18/2017 thru 03/03/2017 PR_DD
Total Deposit Check Bank Check
Empl Name Check No Net Pay Amount Amount Bank Account Routing No Chk/Sav Ref# Pre Note
2 DE JESUS, ZACARIAS P 827213 707.65 707.65 0.00 1090012273863 063107513 C 69054
1 LOPEZ, ANA R 827214 1,076.00 1,076.00 0.00 1090012273863 063107513 C 69055
1,783.65

*-Deductions sent via Direct Deposit 0.00

Number of Deposits Listed: 2 Deposit Totals: 1,783.65 1,783.65 0.00
IMPACT STAFF LEASING INVOICE Page 1 of 1
1315 W. INDIANTOWN ROAD, 2ND FLOOR
JUPITER, FL 33458 Invoice No. 81360
PHONE: 561-743-0065 FAX: 561-748-3235 Invoice Date 03/06/2017
Check Date 03/06/2017
Period Ending 03/03/2017
Payroll Number 17510004 3
Customer Number 01-1751
ANA LOPEZ Delivery Fed Ex Priority
FAZA CONTRACTORS INC. Method ACH
798 PRAIRIE ROAD W ACH Draft Date 03/06/2017
WEST PALM BEACH, FL 33408
Phone:561-603-0363 Fax:561-603-9982

DESCRIPTION AMOUNT

GROSS WAGES 2,050.00

PAYROLL TAXES & EXPENSES 554.94
GROSS PAYROLL AMOUNT 2,604.94

DELIVERY FEE .00

TOTAL FOR THIS INVOICE 2,604.94

TOTAL AMOUNT DUE 2,604.94

Items Processed: 2 Starting Check: 827213

Checks Printed: 2 Ending Check: 827214

ALL ACH/DD
Client: 1751 FAZA CONTRACTORS INC. Co: 01 Page 1
3/3/2017
Pay Date: 03/06/2017 Payroll Id:17510004
PAYROLL REGISTER 12:23 PM
Period: 02/18/2017 thru 03/03/2017 PR_REG
DE JESUS, ZACARIAS P Emp:2 Dept: Net: 707.65 DDep: 707.65 Check: 0.00 Check No: 827213
Pay Type Hours Rate Pay YTD Hrs YTD Pay Taxes Curr Tax YTD Tax
Salary 800.00 120.0000 3,200.00 Fed Income Tax 31.15 124.60
Total Pay .0000 800.00 120.0000 3,200.00 Social Security 49.60 198.40
Medicare 11.60 46.40
Total Taxes 92.35 369.40
LOPEZ, ANA R Emp:1 Dept: Net: 1076.00 DDep: 1076.00 Check: 0.00 Check No: 827214
Pay Type Hours Rate Pay YTD Hrs YTD Pay Taxes Curr Tax YTD Tax
Salary 1,250.00 120.0000 5,000.00 Fed Income Tax 78.37 313.48
Total Pay .0000 1,250.00 120.0000 5,000.00 Social Security 77.50 310.00
Medicare 18.13 72.52
Total Taxes 174.00 696.00
Report Grand Totals: Net: 1783.65 DDep: 1783.65 Chk: 0.00

Pay Type Curr Hours Curr Pay Taxes Curr Tax

Salary .0000 2,050.00 Fed Income Tax 109.52
Total Pay .0000 2,050.00 Social Security 127.10
Medicare 29.73
Total Taxes 266.35

Checks Printed 2