Earnings Company Code Loc/Dept Number Page RX/ 21609797 01/ 3818226 fof i DARREN K INDYKE PLLC 575 LEXINGTON AVENUE SUITE 92 4TH FLOOR NEW YORK, NY 10022 fh /2rnlFf OCU Earnings Statement Period Starting: 01/23/2017 Period Ending: 02/05/2017 Pay Date: 0202/2017 —a | Taxable Marital Status: I Exemptions/Allowances: ‘ax Override: rhage heh LESLEY K GROFF State: 0 State: Local: 0 Local: Social Security Number: XXX-XX- KKK rate hours/units this period year to date 0.00 1538.46 4615.38 Gross Pay ~* $4,538.46 $4,615.38 Deposits Statutory Deductions this period year to date account number ___transivABA amount Federal Income -145.00 435.00 XXXXXX3159 XXXXKKXXK 1208.08 Social Security ~95.38 286.15 Medicare ~22.30 66.92 New York State income -66.50 199.50 Voluntary Deductions this period year to date New York voluntary disability -1.20 3.60 B Net Pay $1,208.08 e « 2 8 c 2 oO | a oS < 8 & w c Your federal taxable wages this period are $1,598.46 ¢ g F v SUMENT AUTHASNSICISY - COLORED AREA MUST CHANGE Ii) TONE GHAUUALLY ANY SVEN 7 FROM Uri AS TOY To Liesl Ter sr BOTT Os oh ST tae RESTORE AN oan 575 LEXI IN AVENU A 7 SUITE 92 4TH FLOOR Pay Date: 02/02/204 NEW YORK, NY 10022 Deposited to the account 24 _-accotint number...‘ transiVABA amount Checking DirectDeposit ©. XXXKERKG 159 | XXXXXKXAK 1208.08 LESLEY K GROFF oe EFTA00316321