Company Code Loc/Dept Number Page RX / PUJ 21609797 01/ 3537684 1 of 1 DARREN K INDYKE PLLC 575 LEXINGTON AVENUE SUITE 92 4TH FLOOR NEW YORK, NY 10022 Taxable Marital Status: Married Exemptions/Allowances: Tax Overnde: Federal: 0 Federat State: ° State: Local. ° Local: Social Security Number: XXX-XX-XXKK Earnings Statement A>? Period Starting: 11/14/2016 Period Ending: 11/27/2016 Pay Dale 11/23/2016 LESLEY K GROFF Earnings rate hours/units this period year to date Regular 0.00 1538.46 46538.44 Gross Pay $1,538.46 $46,538.44 Deposits Statutory Deductions _ ____ this period year to date account number transivABA Federal Income -145,77 5396.38 XXXXXX3159 XXXXXKAXK Social Security -95.38 2885 . 38 Medicare -22.31 674.81 New York Stale income 66.68 2255.75 Voluntary Deductions this period year to date New York voluntary disability -1.20 28.80 Net Pay $1,207.12 _ Your federal taxable wages this period are $1,538.46 % sre AUTHE rer 7 - Cole MUST CaANGE be) TONE GHADUALLY AO SYSN¢ FOU Os\rtit iF DARREN K INDYKE PLLC 576 LEXINGTON AVENUE Pay Date: 11/23/2016 SUITE 92 4TH FLOOR NEW YORK. NY 10022 Deposited to the account Checking DireciDeposit LESLEY K GROFF __.ccouint number". transit/ABA XXXKRXS1 89 XXXXXAKXX amount 1207.12 served. © 1998, 2006. ADP, LLC All Rights Res amount 1207.12 EFTA00316292