Freedom Care LLC

1979 Marcus Ave, Suite C115 Voucher Date Voucher Number

Lake Success, NY 11042 08/16/2019 367898

***** This is not a check *****

Direct Deposit Amount $ *******138.22

3988 15365 367898 2103

Pay to Dewitt Gibson

the order of: 2 Fuller Street
Apt 13
Schenectady, NY 12305

Freedom Care LLC Dewitt Gibson Voucher Number: 367898

1979 Marcus Ave, Suite C115 Employee Id 15365 Check Date 08/16/2019
Lake Success, NY 11042 Hire Date 07/04/2019 Period Begin 08/04/2019
(718) 989-3886 Employee Status A Period End 08/10/2019

Pay Details Statement Summary

Earnings Hours Rate Amount YTD Gross Pay 210.90
Hourly 19.00 11.10 210.90 1,307.03 Federal Taxes -29.91
Spread of Hours 0.00 0.00 11.10
19.00 210.90 1,318.13
State and Local Taxes -3.67
Other Deductions -39.10
Taxes Taxable Amount YTD
Net Pay 138.22
Federal Income S-0 210.90 13.78 87.96
OASDI 210.90 13.07 81.72 Direct Deposits 138.22
Medicare 210.90 3.06 19.11 Net Check 0.00
New York SITW S-0 210.90 2.74 18.57
New York Paid F 210.90 0.33 2.02 Punches Date In Out Hours
NY Disability - 210.90 0.60 3.60
Mon 08/05 02:59PM 06:59PM 4.00
33.58 212.98 Tue 08/06 08:00AM 01:00PM 5.00
Wed 08/07 08:00AM 01:00PM 5.00
Deductions Amount YTD Thu 08/08 07:56AM 12:56PM 5.00

Child Support 10.03 20.06

Child Support 2 9.69 19.38
Child Support 3 19.38 38.76
39.10 78.20

Other Info
Direct Deposits Amount
WEX Bank ****7813 138.22
138.22
"The Employee Self Service (ESS) website has moved to a new and
improved site hub.empeon.com. Your username and password remain
the same."
"El sitio web de Employee Self Service (ESS) ha sido mejorado y
trasladado a nueva página web hub.empeon.com. Su nombre de usuario
y contraseña siguen siendo los mismos."