Joanne Herz Joann Caramonica Barbara Rooney Karin Agovino

44 Boxwood D903 Constance Lane 20 Ronkonkoma Blvd 48 Thomas Street

Kings Park, Port Jeff Station, NY 1177 Centereach, NY 11720 Coram, NY 11727

ST CATHERINE OF SIENA NURSING HOME -- STATEMENT OF CHARGES AND PAYMENTS

Dates Billed Billed Bill Amount Running

From/To Rate Days Due Rec'd Balance
1/9-2/14/18 $0.00 $0.00 $0.00
2/15-2/28/18 $520.00 $0.00 $0.00
3/2018 $1,767.05 $0.00 $0.00
4/2018 $1,767.05 $0.00 $0.00
5/2018 $1,767.05 $0.00 $0.00
6/2018 $1,767.05 $0.00 $0.00
7/2018 $1,767.05 $0.00 $0.00
8/2018 $2,579.05 $0.00 $2,000.00 $2,000.00 Joanne Caramonica-ck#613-8/28/18
9/2018 $2,579.05 $0.00 $2,000.00 $4,000.00 Barbara Rooney—ck#852-9/24/18
$2,764.30 $6,764.30 Virginia Herzog/Joanne-ck#3267-9/24/18
10/2018 $2,579.05 $0.00 $4,895.00 $11,659.30 Karin Agovino—ck#831330011—10/12/18
$2,764.30 $14,423.60 Virginia Herzog/Joanne-ck#3346-10/18/18
$2,764.30 $17,187.90 Virginia Herzog/Joanne-ck#681-10/30/18
11/2018 $2,579.05 $0.00 $1,372.30 $18,560.20 Direct Deposit Pension Income
$1,207.75 $19,767.95 Virginia Herzog/Joanne-ck#682-11/29/18
12/2018 $2,579.05 $0.00 $1,372.30 $21,140.25 Direct Deposit Pension Income
$2,207.75 $23,348.00 ** Two check combined
1/2019 $2,621.55 $0.00 $1,372.30 $24,720.30 Direct Deposit Pension Income
$1,230.25 $25,950.55 Virginia Herzog/Joanne-ck#685-1/19/19
2/2019 $2,621.55 $0.00 $1,372.30 $27,322.85 Direct Deposit Pension Income
3/2019 $2,621.55 $0.00 $1,372.30 $28,695.15 Direct Deposit Pension Income
$1,230.25 $29,925.40 Virginia Herzog/Joanne-no check image
$1,230.25 $31,155.65 Virginia Herzog/Joanne-ck#688-3/22/19
4/2019 $2,621.55 $0.00 $1,372.30 $32,527.95 Direct Deposit Pension Income
$1,287.75 $33,815.70 Virginia Herzog/Joanne-ck#841-4/22/19
5/2019 $2,621.55 $0.00 $1,372.30 $35,188.00 Direct Deposit Pension Income
$1,237.75 $36,425.75 Virginia Herzog/Joanne-ck#843-5/10/19
6/2019 $2,621.55 $0.00 $1,372.30 $37,798.05 Direct Deposit Pension Income
$1,237.75 $39,035.80 Virginia Herzog/Joanne-ck#845-6/12/19
7/2019 $2,573.05 $0.00 $1,372.30 $40,408.10 Direct Deposit Pension Income
$1,237.75 $41,645.85 Virginia Herzog/Joanne-ck#846-7/9/19
8/2019 $2,609.05 $0.00 $1,372.30 $43,018.15 Direct Deposit Pension Income
$1,237.75 $44,255.90 Virginia Herzog/Joanne-ck#847-8/9/19
9/2019 $2,609.05 $0.00 $1,372.30 $45,628.20 Direct Deposit Pension Income
$1,237.75 $46,865.95 Virginia Herzog/Joanne-ck#369-9/10/19
10/2019 $2,609.05 $0.00 $1,372.30 $48,238.25 Direct Deposit Pension Income
$1,237.75 $49,476.00 Virginia Herzog/Joanne-ck#848-10/8/19
11/2019 $2,609.05 $0.00 $1,237.75 $50,713.75 Virginia Herzog/Joanne-ck#849-11/5/19
$1,372.30 $52,086.05 Direct Deposit Pension Income
12/2019 $2,609.05 $0.00 $1,372.30 $53,458.35 Direct Deposit Pension Income
$1,237.75 $54,696.10 Virginia Herzog/Joanne-ck#850-12/6/19
1/2020 $2,609.05 $0.00 $500.00 $55,196.10 Joann & Thomas Herzog-ck#1050-1/6/19
$1,372.30 $56,568.40 Direct Deposit Pension Income
$1,253.75 $57,822.15 Virginia Herzog/Joanne-ck#853-1/6/20
2/2020 $2,609.05 $0.00 $1,372.30 $59,194.45 Direct Deposit Pension Income
$1,253.75 $60,448.20 Virginia Herzog/Joanne-ck#855-2/5/20
$250.00 $60,698.20 Joann & Thomas Herzog-ck#1052-2/23/20
3/2020 $2,609.05 $0.00 $1,372.30 $62,070.50 Direct Deposit Pension Income
$1,253.75 $63,324.25 Virginia Herzog/Joanne-ck#857-3/5/20
4/2020 $2,609.05 $0.00 $1,253.75 $64,578.00 Virginia Herzog/Joanne-ck#858-4/5/20
$1,372.30 $65,950.30 Direct Deposit Pension Income
5/2020 $2,609.05 $0.00 $1,253.75 $67,204.05 Virginia Herzog/Joanne-ck#859-5/5/20
$1,372.30 $68,576.35 Direct Deposit Pension Income
6/2020 $2,609.05 $0.00 $1,372.30 $69,948.65 Direct Deposit Pension Income
$1,253.75 $71,202.40 Virginia Herzog/Joanne-ck#860-6/5/20
7/2020 $2,609.05 $0.00 $1,372.30 $72,574.70 Direct Deposit Pension Income
 $1,253.75 $73,828.45 Virginia Herzog/Joanne-ck#861-7/5/20
$500.00 $74,328.45 Joann & Thomas Herzog-ck#1060-7/24/20
8/2020 $2,609.05 $0.00 $1,372.30 $75,700.75 Direct Deposit Pension Income
$750.00 $76,450.75 Joann & Thomas Herzog -ck#
$1,253.75 $3,526.00 Virginia Herzog/Joanne-
9/2020 2,609.05 2,609.05 $1,372.30 $4,762.75 Direct Deposit Pension Income
$1,253.75 $3,509.00 Virginia Herzog/Joanne-
10/1/2020 2,609.05 2,609.05 $1,372.30 $4,745.75 Direct Deposit Pension Income
$1,253.75 $3,492.00 Virginia Herzog/Joanne-
$1,372.30 $2,119.70 Direct Deposit Pension Income
11/1/20 2,609.05 2,609.05 $1,253.75 $3,475.00 Virginia Herzog/Joanne-
$500.00 $2,975.00 Joann & Thomas Herzog -ck#
12/1/2020 2,609.05 2,609.05 $5,584.05 MONTHLY RM CHG
$1,253.75 $4,330.30 Virginia Herzog/Joanne-
$1,372.30 $2,958.00 Direct Deposit Pension Income
1/1/2021 2,609.05 2,609.05 $5,567.05 MONTHLY RM CHG
$1,253.75 $4,313.30 Virginia Herzog/Joanne-
$1,372.30 $2,941.00 Direct Deposit Pension Income
2/1/21 2,609.05 2,609.05 $5,550.05 MONTHLY RM CHG
$1,253.75 $4,296.30 Virginia Herzog/Joanne-
$1,372.30 $2,924.00 Direct Deposit Pension Income
3/1/21 2,609.05 2,609.05 $5,533.05 MONTHLY RM CHG
$1,372.30 $4,160.75 Direct Deposit Pension Income
$1,270.75 $2,890.00 Virginia Herzog/Joanne-
$34.00 $2,856.00 Adj. per March statement from St. Catherine
4/1 2,609.05 $5,465.05 MONTHLY RM CHG
$1,372.30 $4,092.75 Direct Deposit Pension Income
$1,270.75 $2,822.00 Virginia Herzog/Joanne
$1,372.30 $1,499.70 Direct Deposit Pension Income
$1,270.75 $178.95 Virginia Herzog/Joanne
5/9 2,609.05 $2,788.00 MONTHLY RM CHG
$1,372.30 $1,415.70 Direct Deposit Pension Income
$1,270.75 $144.95 Virginia Herzog/Joanne
6/9 2,609.05 $1,372.30 $1,381.70 Direct Deposit Pension Income
$1,270.75 $110.75 Virginia Herzog/Joanne
7/9 2,609.05 $1,372.30 $1,347.50 Direct Deposit Pension Income
$1,270.75 $76.75 Virginia Herzog/Joanne
8/9 2,609.05 $1,372.30 $1,313.50 Direct Deposit Pension Income
$1,270.70 $42.80 Virginia Herzog/Joanne
9/9 2,609.05 $2,694.65 MONTHLY RM CHG
$1,270.75 $1,423.90 Virginia Herzog/Joanne
$1,372.30 $51.60 Direct Deposit Pension Income
10/9 2,609.05 $2,651.60 MONTHLY RM CHG
$1,270.75 $1,379.30 Virginia Herzog/Joanne
$1,372.30 $7.00 Direct Deposit Pension Income
11/9 2,609.05 $2,616.05 MONTHLY RM CHG
$1,270.75 $1,345.30 Virginia Herzog/Joanne
$1,372.30 <27.00> Direct Deposit Pension Income
$1,626.75 adj. per Dec, statement from St. Catherine
12/9 2,609.05 $4,235.80 MONTHLY RM CHG
12/2 $1,469.00 $2,766.80 Virginia Herzog/Joanne
12/3 $1,372.30 $1,394.50 Direct Deposit Pension Income
1/1/22 2,609.05 $4,003.55 MONTHLY RM CHG
1/3/22 $1,372.30 $2,631.25 Direct Deposit Pension Income
1/3/22 $1,546.00 $1,085.25 Virginia Herzog/Joanne
2/1/22 2,609.05 $3,694.30 MONTHLY RM CHG
2/3/22 $1,372.30 $2,322.00 Direct Deposit Pension Income
2/7/22 $1,546.00 $776.00 Virginia Herzog/Joanne
3/1/22 2,609.05 $3,385.05 MONTHLY RM CHG
3/2/22 $1,546.00 $1,839.05 Virginia Herzog/Joanne
3/3/22 $1,372.30 $466.75 Direct Deposit Pension Income
4/1/22 2,609.05 $3,075.80 MONTHLY RM CHG
4/1/22 $1,372.30 $1,703.50 Direct Deposit Pension Income
4/11/2022 1546.00 $157.50 Virginia Herzog/Joanne
PLEASE MAKE CHECKS PAYABLE TO ST. CATHERINE OF SIENA NURSING HOME.

*Denotes Pension Direct Deposit

** 12/20/18 – Virginia Herzog/Joanne Caramonica – ck#684-- $1207.75 ---12/19/18
** 12/20/18 – Joanne Caramonica – ck#622 – $1000.00 – 12/18/18
 PRIVATE PAY WE OWE $16115.25

JOANNE BARBARA
KARIN-owes owes TOM-owes DATE owes
4529.00 DATE PAID 4529.00 DATE PAID $3529.00 PAID 3529.00 DATE PAID
4895.00 10/12/2018 2000 8/28/2018 500.00 1/16/2020 2000 9/24/2018
1000 12/18/2018 250.00 2/26/2020
500.00 7/24/2020
750.00 8/16/2020
500.00 11/1/2020
$2,500.00
** KARIN OVERPAID $366.00

4895
Very truly yours, 3000
Anna Schaefer 2500
(631) 828-7429 Phone 2000
(631) 828-7670 Fax 12395 Total Paid