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    Insurance Statement

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    christophernkwenti

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    © All Rights Reserved
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    Insurance Statement

    Uploaded by

    christophernkwenti
    4 views1 page

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    © © All Rights Reserved

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    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    4 views1 page

    Insurance Statement

    Uploaded by

    christophernkwenti

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
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    CO. FILE DEPT. CLOCK VCHR. NO.

    052
    QY0 702075 0000160180 1 Earnings Statement
    PCHANGE LLC Period Beginning: 0/29/2024
    8181 PROFESSIONAL PLACE #150 Period Ending: /13/2024
    HYATTSVILLE MD 20785 Pay Date: /15/2024

    ROLAND CHO TABE


    Filing Status: Single/Married filing separately 12015 OLD COLUMBIA PIKE
    Exemptions/Allowances:
    Federal: Standard Withholding Table
    SILVER SPRING MD 20904

    rate hours this period year to date Other Benefits and


    Regular 20 0000 80 00 1 600 00 1 934 80 this period total to date
    Overtime 30 0000 7 28 218 40 03 10 Totl Hrs Worked 87 28
    Holiday Work 84 00
    Gross Pay $1 818 40 2 21 90
    BASIS OF PAY: HOURLY

    Statutory
    Taxable Marital Status:
    Federal Income Tax -141 91  0 23 MD: Single
    Social Security Tax -112 74  Exemptions/Allowances:
    Medicare Tax -26 37 94 62 DC: 0
    MD: 1
    MD State Income Tax -126 53 924 56

    License Renewal 84 00
    Uniform Deduc 67 52
    Net Pay $1 410 85
    Checking 1 -1 410 85

    Net Check $0 00

    Your federal taxable wages this period are


    $1 818 40

    2000 ADP, Inc.

    PCHANGE LLC Advice number: 00000160180


    8181 PROFESSIONAL PLACE #150 Pay date: /15/2024
    HYATTSVILLE MD 20785

    Deposited to the account of account number transit ABA amount


    ROLAND CHO TABE xxxxxxxx6867 xxxx xxxx $1 410 85

    NON-NEGOTIABLE

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