Current Pay Statement: This Is A Statement of Earnings and Deductions. This Pay Statement Is Non-Negotiable

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Current Pay Statement

This is a statement of earnings and deductions. This pay statement is non-negotiable.

Regal Medical Group, Inc Pay Statement


8510 Balboa Blvd, Suite 150 Period Start Date 09/04/2016
Northridge, CA 91325
Period End Date 09/17/2016
Pay Date 09/22/2016
Document 65707
Net Pay $1,098.40

Pay Details
Monica Lee Maniquiz Employee 602454 Pay Group Regal Medical Federal Income Tax S 4
P.O. Box 8281 Number Group RMG CA State Income Tax (Residence) H 4
Northridge, CA 91326 SSN xxxxxxxxx Location Northridge CA State Income Tax (Work) H 4
USA Job Customer Service Department 285 - Member
Rep Services
Pay Rate $15.12 Site 601 - San
Pay Frequency Biweekly Fernando Valley
NaturalClass 6000 -
Administration
Sub Site 00 - Default

Earnings Deductions

Pay Type Hours Pay Rate Current YTD Employee


Bonus Referral 0.0000 $0.0000 $0.00 $1,000.00 Deduction Pre-Tax Current YTD
Holiday 8.0000 $15.1200 $120.96 $483.84 401K Perc Yes $54.05 $1,030.65
Overtime 2.7500 $22.6800 $62.37 $0.00 Basic ADD - ER No $0.00 $0.00
Overtime 3.5000 $22.6800 $79.38 $2,783.74 Basic Life Ins No $0.00 $0.00
Paid Time Off 0.0000 $0.0000 $0.00 $838.41 Basic LTD - ER No $0.00 $0.00
Regular 32.0000 $15.1200 $483.84 $0.00 Pre Tx PPO Dent Yes $17.06 $307.08
Regular 40.0000 $15.1200 $604.80 $21,418.23 PT Medical Yes $0.00 $0.00
Sick Time 0.0000 $0.0000 $0.00 $241.92 PT Pharmacy Yes $0.00 $0.00

Taxes

Total Hours 86.2500 Taxes Current YTD


CA Disability Employee $12.01 $238.15
CA State Income Tax $0.00 $102.30
Employee Medicare $19.35 $383.66
Federal Income Tax $67.76 $1,552.97
Social Security Employee Tax $82.72 $1,640.46

Paid Time Off Net Pay Distribution

Account Number Account Type Amount


xxxxxxxxxx3008 Checking $65.90
xxxxxx0753 Checking $1,032.50
Total $1,098.40

Pay Summary
Gross FIT Taxable Wages Taxes Deductions Net Pay
Current $1,351.35 $1,280.24 $181.84 $71.11 $1,098.40
YTD $26,766.14 $25,428.41 $3,917.54 $1,337.73 $21,510.87

Originally printed in English

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