FORM AD-***

USDA

(REV. */**)

SOCIAL SECURITY NO. PAY PERIOD DATE

MO DA YR MO DA YR

P/P T&A CONTACT POINT ACCT.

STAT.

ORGANIZATIONAL

STRUCTURE

PERSNL

OFFICE

PAY

PLAN

GR. STEP

SALARY RATE TYPE

EMPL.

SCD FOR

LEAVE

RET. DEDUCTIONS

THIS APPOINTMENT

STATEMENT OF EARNINGS AND LEAVE

EARNINGS AND DEDUCTIONS

ITEM HOURS AMOUNT

CODE DESCRIPTION P/P YR. TO DATE P/P YR TO DATE

YEAR TO DATE LEAVE STATUS YEAR TO DATE LEAVE STATUS PT. HRS

UNAPP

MAX. C/O

TYPE ACCRUED USED BALANCE TYPE ACCRUED USED BALANCE PROJECTED

USE OR LOSE

CREDIT HOURS-BY PAY PERIOD ANN

RELIGIOUS COMP-BY PAY PERIOD SICK LEAVE CATEG

TRAVEL COMP-BY PAY PERIOD COMP

MILITARY REMARKS

TIME OFF AWARD

BPAPRA COMPENSATORY

BPAPRA OBLIGATED DEBT

DISABLED VETERAN LEAVE

TYPE 1ST YEAR 2ND YEAR 3RD YEAR BALANCE

REST. ANN. LEAVE HRS.

NAME AND ADDRESS

AGENCY HR ADDRESS

BRITTANI L JORDAN Official Pay Date 10/19/2023

2250 NW 191 TERR

MIAMI GARDENS, FL

33056-0000

57.72

20.19

291.57

23.56

20.00

3.53

9.95

100.73

46.06

67.55

1,648.34

134.75

28.47

26.96

1,356.77

18.00

48.00

39.00

10.00

49.00

40.00

1.50

41.50

6.00

331.75

6.00

12.00

80.00

0.25

7.00

14.75

4.00

DD/EFT ROUTING NO.

NET PAY

TOTAL DEDUCTIONS

MEDICARE TAX WITHHELD

UNION/ASSOCIATION DUES 84 0558

VISION PLAN

DENTAL PLAN

FEDERAL TAX EXEMPTS HH

SOCIAL SECURITY (OASDI)

ROTH TSP-FERS

TSP-FERS

RETIREMENT

PAY PERIOD HOURS & GROSS PAY

ABSENCE W/OUT OFFIC LV

OTHER LEAVE

SICK LEAVE

ANNUAL LEAVE

CASH AWARD

FLSA

HOLIDAY WORKED

SUNDAY DIFFERENTIAL

OT OVER 8 W/NIGHT DIFF

OT OVER 40 W/NIGHT DIFF

OVERTIME - PREMIUM RATE

NIGHT DIFFERENTIAL

SUN DIFF W/NIGHT DIFF

**

**

**

11

10

31

15

02

**

04

**

72

66

62

61

44

34

31

26

25

21

11

05

**

**

97

87

83

83

77

76

75

75

75

**

01 REGULAR TIME 72.75 1,254.75 1,400.44 23,819.33

$40,168.00 PA F/T 02/12/2023 $1,130.53

09/24/2023 10/07/2023 20 TA-12-078*-**-**-**** TA-59-13-938*-**** SV D 01 4.00

$ .00 GRO ADJ-PP 2319-2319

$ .00 NET ADJ-PP 2319-2319

17.25 4

68 39.00 29.00

68.00 10.00 58.00 240.00

86.58

23,657.88

5,063.80

410.98

300.00

56.48

323.04

284.68

1,757.22

725.67

75.20

1,130.53

28,721.68

909.60

747.15

188.68

144.00

15.81

759.20

42.30

1,170.30

169.20

629.09

40.44

33056 - 0000-0

EPP Print

TSA-ADMINISTRATOR

TSA SHARED SERVICE

CENTER

6363 WALKER LANE, STE

400

ALEXANDRIA VA 22310

Phone 877-***-****

Contact this candidate