CO. FILE DEPT. CLOCK VCHR. NO.

071
74F 7778 1665697 01 69283348 1 Earnings Statement
BE HEALTH INC Period Beginning: 06/11/2023
218 W CUMMINGS PARK Period Ending: 06/17/2023
WOBURN, MA 01801 Pay Date: 06/23/2023

Taxable Marital Status: Single DIEGO GOMES

Exemptions / Allowances: 136 PERKINS ST #3
Federal: 1
State: 1 SOMERVILLE, MA 02145
Local: 0
SSN: XXX-XX-8341

rate hours this period year to date Other Benefits and

Regular SALARY 40.00 393.31 9,832.75 this period total to date
Max Elig/Comp 393.31 9,832.75
Gross Pay $393.31 9,832.75
BASIS OF PAY: SALARY
Statutory
Federal Income Tax - 12.70 317.50
Social Security Tax - 24.39 609.75
Medicare Tax - 5.70 142.50
State Income Tax - 18.16 454.00 Taxable Marital Status:
MA: Single
Exemptions/Allowances:
MA: 0

Net Pay $332.36

Checking 1 - 332.36
Net Check $0.00

Your federal taxable wages this period are

$393.31

2000 ADP, Inc.

BE HEALTH INC Advice number: 69283348

218 W CUMMINGS PARK Pay date: 06/23/2023
WOBURN, MA 01801

Deposited to the account of account number transit ABA amount

DIEGO GOMES xxxxxxxxx xxxxxxxx $332.36

NON-NEGOTIABLE