Company Code Loc/Dept Number Page j AXIPUSSe0N797 OU seeeib Tat Earnings Statement BD? DARREN K INDYKE PLLC = 575 LEXINGTON AVENUE Period Starting: 11/28/2016 SUITE 92 4TH FLOOR Period Ending: 12/11/2016 NEW YORK, NY 10022 Pay Date: 12/08/2016 Taxable Marital Status: Marned Exemptions/Allowances: Tax Override: Federal; 0 Federal: LESLEY K GROFF State: 0 Stale: Local ] Locat Social Security Number XXX-XX-XAKX Earnings rate hours/units this period year to date Regular 0.00 1538.46 48076.90 Gross Pay $1,538.46 $48,076.90 Deposits Statutory Deductions this period year to date account number : transivVABA amount Federal income -145.77 5542.15 XXXXXX31 1207.11 Socal Security -95.39 2980.77 nes TONIMAAR Medicare ~22.31 697.12 New York State income -66.68 2322.43 = Voluntary Deductions this period year to date New York voluntary disability -1.20 30.00 3 Net Pay $1,207.11 4 o « 2 & c 2 o = | 2 S < _ w ra —_— Your tederal taxable wages this period are $1,538.46 = _ a v 7 eHOM SARC AT SOP To llrirse Ar SUTTON F ?§ Yeni y DOSU Mai AUTHaN Telit y= COLney AHeA MUST SHAN DARREN K INDYKE PLLC 575 LEXINGTON AVENUE SUITE 92 4TH FLOOR Pay Date: 12/08/2016 NEW YORK, NY 10022 transiVABA amount f : XXXXKAXKK 1207.11 I Depositedto the account _ Checking DirectDeposit LESLEY K GROFF EFTA00316294