CO. FILE DEPT. CLOCK VCHR. NO.

BK5 547747 008034 0000101946 1

Earnings Statement
081-0045
PACKERS SANITATION SERVICES, INC., LTD Period Beginning: 03/01/2021
3681 PRISM LANE Period Ending: 03/07/2021
KIELER, WI 53812 Pay Date: 03/12/2021
888-871-6335

EISY PORTELA PADRON

Filing Status: Married filing jointly 915 PINECREST DR
Exemptions/Allowances:
Federal: Tax blocked
STORM LAKE IA 50588

rate hours this period year to date Other Benefits and

Regular 15 7000 17 73 278 36 4 423 33 this period total to date
Sunshine Pay 15 7000 6 27 98 44 1 354 29 Hours Worked 17 73
Overtime 598 88
Sick Balance 0 00
Gross Pay $376 80 6 376 50

BASIS OF PAY: HOURLY

Statutory
Social Security Tax -21 75 379 27
Medicare Tax -5 09 88 70 Taxable Marital Status:
Federal Income Tax 42 72 IA: Married
Exemptions/Allowances:
IA State Income Tax 73 45 IA: 0,Tax Blocked

Dental Pre Tax -3 40* 34 00

Medical Pre Tax -22 00* 220 00
Vision -0 52* 5 20

Net Pay $324 04

Checking -324 04

Net Check $0 00

Excluded from federal taxable wages

Your federal taxable wages this period are $350 88

2000 A DP, LLC

PACKERS SANITATION SERVICES INC LTD Advice number: 00000101946

3681 PRISM LANE Pay date: 03/12/2021
KIELER WI 53812
888-871-6335

Deposited to the account of account number transit ABA amount

EISY PORTELA PADRON xxx3851 xxxx xxxx $324 04

NON-NEGOTIABLE