File name : R30394101372022013.

04261419
Employer name: P2M2-AC TRANSPORT Date: Apr 26, 2013
Employer No : 03-9410137-2 App. Period: 02-2013

PAYMENT INFORMATION
TR/SBR NUMBER : 976082FR
DATE OF PAYMENT : Mar 11, 2013
AMOUNT PAID : 2,068.00

ENCODED INFORMATION
SS AMOUNT : 2,028.00
EC AMOUNT : 40.00
TOTAL AMOUNT : 2,068.00

Total number of Employees: 4

CERTIFIED CORRECT AND PAID

RECEIVED BY : _____________________________
DATE RECEIVED : _____________________________
TRANSACTION NO: _____________________________