Company Code Loc/Dept Number Pa j RX / PUJ 21609797 _01/ 3495554 1 of 1 Earnings Statement iD) DARREN K INDYKE PLLC - 575 LEXINGTON AVENUE Period Starting 10/31/2016 SUITE 92 4TH FLOOR Period Ending: 11/13/2016 NEW YORK. NY 10022 Pay Date 11/10/2016 Taxable Marital Status: Married Exemptions/Allowances Tax Override: LESLEY K GROFF Federal: 0 Federal State: ° State: Local: ° Local: Social Security Number: XXX-KK-XKXK Earnings rate hours/units this period year to date Regular 0.00 1538.46 44999.98 Gross Pay $1,538.46 $44,999.98 Deposits Statutory Deductions this period year to date account number transiVABA amount Federal Income -145.77 5250.61 XXXXXXI 159 XXXXXXKXK 1207.11 Social Security -95.39 2790.00 Medicare -22.31 652.50 New York State Income ~66.68 2189.07 Voluntary Deductions this period year to date New York voluntary disability 1.20 27.60 Net Pay $1,207.11 Zz oO. a s i) s 8 w Your tederal taxable wages this period are $1,538.46 zx Vv . VETERE DOCUMENT AUTHENTICIT f - COLOHED Anza MUST CAGE WI TONE GHADUALLY AIO EYEE FROM OArt AT TOR TO LIGHTEH AT BOTTOM DARREN K INDYKE PLLC $75 LEXINGTON AVENUE , SUITE 92 4TH FLOOR Pay Date: 11/10/2016 NEW YORK, NY 10022 Deposited to the account ou Rtcoum number oe transiV/ABA amount Checking DrectDeposit ; < XXXXRXS1 69 XXXXXKARXX 1207.11 LESLEY K GROFF GD Fite eiceerenni ad errvenieuwe we ve eervere : sis od aT) ¢ ' ¢ ere wt ’ ‘ft ¢ ' re EFTA00316291