CO. FILE DEPT. CLOCK VCHR. NO.

CU8 806364 110091 0000220589 1

Earnings Statement
Period Beginning: 06/16/2024
870 COMMONS DRIVE Period Ending: 06/22/2024
AURORA, IL 60504 Pay Date: 06/28/2024
CO PH NUMBER 630-375-6631

JESSIE JOHN TAMAYO

Filing Status: Single/Married filing separately 2345 TRIDENT WAY
Exemptions/Allowances: RENO NV 89512
Federal: Standard Withholding Table

rate hours this period year to date

Regular 31.2100 55.75 1,739.96 12,861.45
P T O 46.8150 0 1,520.89
2nd Shift $2 1,396 50
Other Benefits and
Overtime 267.83
this period total to date
Birthday 169.68
J - Non-Cntrb M 44 39 524 47
EBONUS 750.00
K - Contrib Mat 88 78 1 048 90
EIP Bonus 606.06
HOLIDAY 672.00 Totl Hrs Worked 55 75
Gross Pay $1,739.96 17,714.47 401K 1 713 85

Statutory CO PH NUMBER 630-499-2688

Federal Income Tax -65 35 1 008 46
Social Security Tax -80 34 963 22 BASIS OF PAY: HOURLY
Medicare Tax -18 79 225 27

Dental -4 39* 48 29 Exemptions/Allowances:

Health Care Fsa -60 00* 660 00 NV: No State Income Tax

Medical Ppo -116 72* 1 207 77

Vision Essentia -2 71* 29 81
401(K)$ -147 96* 1 713 85
401K Loan -20 66 103 30

Net Pay $1,195.52

CHECKING -1,195.52

Net Check

Excluded from federal taxable wages

2000 ADP, Inc.

Advice number: 00000220589

870 COMMONS DRIVE Pay date: 06/28/2024
AURORA IL 60504
CO PH NUMBER 630-375-6631

Deposited to the account of account number transit ABA amount

TAMAYO, JESSIE JOHN xxxxxxxx9597 xxxx xxxx $1,195.52

NON-NEGOTIABLE