CO. FILE DEPT. CLOCK VCHR. NO.

TZM 106714 129900 2523 0000426149 1

Earnings Statement
AMAZON.COM SERVICES LLC Period Beginning: 09/19/2021
ATTN: AMAZON PAYROLL Period Ending: 09/25/2021
202 WESTLAKE AVE N Pay Date: 10/01/2021
SEATTLE, WA 98109

RICHARD LOUIS
Filing Status: Single/Married filing separately 7265 ROYCE PLACE
Exemptions/Allowances:
Federal: Standard Withholding Table
APT 2ND FLOOR
BROOKLYN NY 11234

rate hours this period year to date Other Benefits and

Personal Time 18 2500 22 00 401 50 401 50 this period total to date
Shift Pay 1 5000 22 00 33 00 495 53 Groupterm Life 0 60 7 20
Regular 7 512 25 Personal Balnce 22 05
Overtime 165 34 Pp Pto Earned 1 85
Double Time 151 49 Pp Vac Earned 0 78
Holiday O/T 285 25 Vacation Balnce 10 18
Holiday Pay 292 00
Shft Hol @O/T 23 45
BASIS OF PAY: HOURLY
Shft Pay @D/T 7 55
Shft Pay @O/T 12 28
LEGAL ADDR 410 TERRY AVE NORTH SEATTLE WA 98109
Gross Pay $434 50 9 346 64
@ THE SHIFT PAY RATE MAY NOT DISPLAY CONSISTENTLY
Statutory DUE TO CALCULATION METHOD AND ROUNDING.
Federal Income Tax -19 35 735 31
Social Security Tax -26 97 579 94
Taxable Marital Status:
Medicare Tax -6 30 135 63 NY: Single
NY State Income Tax -13 01 401 80 New York Cit: Single
New York Cit Income Tax -9 43 281 58 Exemptions/Allowances:
NY: 0
NY SDI Tax -0 60 7 20
New York Cit: 0
Net Pay $358 84
Checking Dep -358 84

Net Check $0 00

Your federal taxable wages this period are $434 50

2000 A DP, LLC

AMAZON COM SERVICES LLC Advice number: 00000426149

ATTN: AMAZON PAYROLL Pay date: 10/01/2021
202 WESTLAKE AVE N
SEATTLE WA 98109

Deposited to the account of account number transit ABA amount

RICHARD LOUIS xxxxxxx1258 xxxx xxxx $358 84

NON-NEGOTIABLE