 |
| Statement of Earnings and Deductions | |
Company
| | Margaret R. Pardee Memorial Hospital | |
Employee Name
|
Employee No.
|
Department
|
Deposit Date
|
Deposit #
|
Pay Period End
|
Rate
|
| FIRST LAST |
XXXXX |
XXX.XXX | 11/25/09 |
XXXXXX | 11/21/09 | 16.322 |
|
| Earnings | |
Description
|
Hours
|
Amount
| | REGULAR | 80.000 | 1,305.76 | |
Total Earnings
| 80.000 | 1,305.76 |
| |
| Taxes and Deductions | |
Description
|
Current
|
YTD
| | PRE-TAX HEALTH | 144.47 | 3,178.34 | | PRE-TAX DENTAL | 20.52 | 451.44 | | PRE-TAX VISION | 13.20 | 290.40 | | PRE-TAX CANCER | 11.16 | 223.20 | | SOCIAL SECURITY | 69.22 | 1,727.32 | | MEDICARE | 16.19 | 404.00 | | FEDERAL TAX | 59.86 | 787.40 | | STATE TAX | 65.99 | 1,075.63 | | LIFE INSURANCE | 4.72 | 102.44 | | DEPENDANT LIFE | 4.65 | 102.30 | | WHOLE LIFE INS. | 8.66 | 173.24 | | ACCTS RECEIVABL | 25.00 | 600.00 | | CAFETERIA | | 16.33 | | GARDEN CAFE | | 15.07 | | GIFT SHOP | | 27.72 | | UW / FOUNDATION | | 4.00 | |
Total Taxes and Deductions
| 443.64 | 9,178.83 |
|
| Available Benefit Hours | |
Description
|
Hours
| | PTO | 91.874 |
| |
| Direct Deposit | |
Account
|
Type
|
Amount
| |
*
*
*
*
*
*0065 | C | 350.00 | |
*
*
*
*
*
*
*9806 | C | 512.12 |
|
| Summary | |
Earnings
|
Taxes
|
Deductions
|
Net Pay
| |
Current
| 1,305.76 | 211.26 | 232.38 | 862.12 | |
YTD
| 32,003.02 | 3,994.35 | 5,184.48 | 22,824.19 |
|
|