Eusserlene Johnson - GCWooo005116430000r065AF579E5F521

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CO. FILE DEPT. CLOCK VCHR. NO.

WCG 006283 0000346115


NASHTN201
1
Earnings Statement
8229-0002
COMPREHENSIVE HEALTH MANAGEMENT INC Period Beginning: 08/02/2020
7700 FORSYTH BLVD. Period Ending: 08/15/2020
ST. LOUIS, MO 63105 Pay Date: 08/21/2020

EUSSERLENE S JOHNSON
Filing Status: Married filing jointly 163 BROOKE CASTLE DRIVE
Exemptions/Allowances:
Federal: Tax blocked
HERMITAGE TN 37076

rate hours this period year to date


Overtime 28 1800 50 14 09 34 38
Net Check $0 00
Regular Ne 18 7903 64 29 1 208 03 5 200 78
Sick 18 7903 8 00 150 32 413 38
Vacation 18 7903 8 00 150 32 319 43 Excluded from federal taxable wages
Holiday 150 32
Gross Pay $1 522 76 6 118 29 Your federal taxable wages this period are
$1 277 48
Statutory Other Benefits and
Social Security Tax -81 09 326 06 this period total to date
Medicare Tax -18 96 76 25 Wellness Credit 23 08 92 32

Totl Hrs Worked 64 79


A D & D -1 95 7 80 Sick Balance 10 00
Additional Life -9 48 37 92 Vac Balance 5 71
Dental -5 52* 22 08 Ytd Sick Taken 22 00
Hsa -98 08* 392 32 Ytd Vac Taken 17 00
Limited Prp Fsa -96 15* 384 60 Ytd 401K Match 168 12
Loan 4 -8 88 35 52 401K Match 15 23
Medical -11 72* 46 88
EMPLOYEE ID 330254
Supple Spouse -5 84 23 36
Vision -3 35* 13 40
401(K) -30 46* 122 38 YOUR COMPANY PHONE NUMBER IS: 1-833-GOASKHR

Net Pay $1 151 28


Checking 1 -477 28 1 933 72 Taxable Marital Status:
Checking 2 -200 00 800 00 TN: Married
Exemptions/Allowances:
Checking 3 -219 00 876 00 TN: No State Income Tax
Savings 1 -255 00 1 020 00

2000 A DP, LLC

COMPREHENSIVE HEALTH MANAGEMENT INC Advice number: 00000346115


7700 FORSYTH BLVD Pay date: 08/21/2020
ST LOUIS MO 63105

Deposited to the account of account number transit ABA amount


EUSSERLENE S JOHNSON $477 28
$200 00
$219 00
$255 00

NON-NEGOTIABLE

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