Warehouse Labor

STATEMENT OF EARNINGS FOR FERNANDO DOMINGUEZ JR

Payment Date Check No Payment Amount

*/**/202*-****** $878.47

Pay Period Employee No SSNO

*/*/**** - */*/2022 5047 XXX-XX-8729

Company Info, Bulletins, and Upcoming Events

N/A

Earnings Hours Rate Amount YTD

Bonus Earnings 0.00 $0.0000 $0.00 $250.00

Holiday Time Pay 8.00 18.6000 $148.80 $579.20

OT Earnings 14.12 27.9001 $393.95 $5,193.07

OTBNS Earnings 0.00 $0.0000 $0.00 $7.90

Personal 0.00 $0.0000 $0.00 $80.70

Regular Pay 40.00 18.6000 $744.00 $19,841.38

VAC Earnings 0.00 $0.0000 $0.00 $604.50

Totals: 62.12 $1,286.75 $26,556.75

Expenses Amount YTD

Totals: $0.00 $0.00

Pre-Tax Deductions Amount YTD

Employee 401k $102.94 $2,124.51

Pre-Tax Dental Insurance $3.22 $90.16

Pre-Tax Medical Insurance $35.75 $984.75

Pre-Tax Vision Insurance $0.64 $17.92

Totals: $142.55 $3,217.34

Taxes Filing Amount YTD

Clyde-Green Springs SD S $17.16 $350.08

Fed. Income Tax + $5.00 S-6 $68.78 $932.53

Fed. Medicare Employee $18.08 $369.22

Fed. Soc. Sec. Employee $77.32 $1,578.75

FREMONT CITY $18.71 $381.97

OH State Income Tax + $5.00 S-3 $34.15 $659.19

Totals: $234.20 $4,271.74

Deductions Amount YTD

401k Loan 2 $24.09 $674.52

Childlife $0.83 $23.24

Employee Life $1.56 $43.68

* Employer 401k $32.17 $663.97

Long Term Disability $5.05 $141.13

Shoes $0.00 $129.57

Totals: $31.53 $1,012.14

Style Crest Enterprises

2450 Enterprise St

Drawer A

Fremont OH 43420

419-***-****

MB FINANCIAL BANK,

N.A.

6TH FLOOR

ROSEMONT, IL 60018

Payment Date

7/14/2022

Check Number

134946

Payment Amount

$878.47

Pay: VOID - NON NEGOTIABLE - VOID $878.47 PAY TO THE ORDER OF:

Fernando Dominguez Jr

740 CR 212

# 147

Fremont, OH 43420

BeneXt Accrued YTD Avail.

N/A

Totals: 0 0 0

Net Pays Amount YTD

ACH Checking Account - XX7240 $250.00 $7,149.61

ACH Checking Account - XX3262 $628.47 $10,905.92

Totals: $878.47 $18,055.53

Begin Date End Date Pay Code Hours Rate Shift Total Paid Labor 1 Labor 2 Labor 3 Labor 4 7/3/2022 7/9/2022 HOLIDAY 8.00 18.6000 $148.80 07 8004 WAREHOUSE NA 7/3/2022 7/9/2022 OT 6.00 27.9000 $167.40 07 8004 WAREHOUSE NA 7/3/2022 7/9/2022 OT 8.12 27.9000 $226.55 07 8004 WAREHOUSE NA 7/3/2022 7/9/2022 REGULAR 40.00 18.6000 $744.00 07 8004 WAREHOUSE NA Totals: 62.12 $1,286.75

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