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: 0 SOMERVILLE, MA 02145
Local: 0
SSN: XXX-XX-8341

rate hours this period year to date Other Benefits and

Regular SALARY 40.00 388.42 9,710.50 this period total to date
Max Elig/Comp 388.42 9,710.50
Gross Pay $388.42 9,710.50
BASIS OF PAY: SALARY
Statutory
Federal Income Tax - 12.21 305.25
Social Security Tax - 24.08 602.00
Medicare Tax - 5.63 140.75
Taxable Marital Status:
MA: Single
Exemptions/Allowances:
MA: 0

Net Pay $346.50

Checking 1 - 346.50
Net Check $0.00

Your federal taxable wages this period are

$388.42

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 $346.50

NON-NEGOTIABLE