CO FILE DEPT. CLOCK VCHR. NO.

120
B7H 183911 AL 0000211226 1 Earnings Statement

Period Beginning: 07/08/2022

SIZEMORE INC Period Ending: 07/14/2022
905 N FLORIDA AVE Pay Date: 07/15/2022
TAMPA, FL 33602

Social Security Number: XXX-XX-9036 VENITA BEACHAM

Taxable Marital Status: Single 15501 BRUCE B DOWNS BLVD
Exemptions/Allowances: 0 TAMPA, FL 33647

Earnings Rate Hours This period Year to date Other Benefits and
Regular 19.00 72.40 1,375.60 27,966.70
29,777.70 Information This period Total to date
Overtime 8.00 22.00 184.00 2,992.50
4,212.00 Group Term Life 0.00 0.00
Bereavement 0.00
Holiday 0.00
Additional Tax Withholding Information
Otvic 0.00
Exemptions/Allowances:
Shift Diff 0.00
TX: No State Income Tax
Shift Diff Ot 0.00
Vacation 0.00
Vic Bonus 0.00
Gross Pay $1,559.60 36,6096.99
34,625.24

Deductions Statutory
Social Security Tax -50.60 1,243.00
1,311.80
Medicare Tax -11.60 266.80
347.75
Federal Income Tax - 49.30 1,884.00
1,306.00

Other
Ad&D -0.00 0.00
Dental -0.00 0.00
Optional Life -0.00 0.00
Vision -0.00 0.00
Vol Hospital -0.00
Net Pay - 1,450.00
Check -0.00 0.00
Net Check -1,450.00

SIZEMORE INC Advice number: 00000211226

905 N FLORIDA AVE Pay date: 07/22/2022
TAMPA, FL 33602 Social Security Number: XXX-XX-9036

Pay to the
order of VENITA BEACHAM

This amount: ONE THOUSAND FOUR HUNDRED AND FIFTY DOLLARS $1,450.00

NON-NEGOTIABLE