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 9.84 40.00 393.60 9,840.00 this period total to date
Max Elig/Comp 393.60 10,233.60
Gross Pay $4,600.00 9,840.00
BASIS OF PAY: HOURLY
Statutory
Federal Income Tax - 12.73 318.25
Social Security Tax - 24.40 610.00
Medicare Tax - 5.71 142.75
NJ State Income Tax - 18.17 454.25 Taxable Marital Status:
Family Leave Insurance - 0.43 MA: Single
10.75
Exemptions/Allowances:
Medical Leave Insurance - 0.82 20.50
MA: 0

Net Pay $331.34

Checking 1 - 331.34
Net Check $0.00

Your federal taxable wages this period are

$393.60

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 $331.34

NON-NEGOTIABLE