We Window 1 View Window 2 Company Name 128 Main Street ot Earnings Statement Page 001 of 001 ¥, eo Taxable Mprital Status: Excigtions/AT onances oS ers eres, RON? SEE trove 3 State Lived: Period Ending 4/29/2005 Check Date: 04/29:2005 Check Number: ‘0000000100 Batch Number ‘200000000001 Employee Name a2 Any ‘Street Anytown, US 98765 Other Benefits and Earnings Rate Hours This Period Year-to-Date Information This Period Year-to-Date Earnings Pay 24.00 637.82 21698.33 Training Pay 128.96 Vacation Pay. 1164.87 Sick Pay 408.15 Hotiday Pay 330.32 Personal Hot iday 111.08 Bonus. 1680.00 Retroactive 67.20 Vacation Summary U: Additional Earnings ‘Adéi tional Earnings Tax Deductions wey ST Trcene Tex Presa Free Chis 029 Federal Incone Tax CR z0s.98zans.03 local Tax G wer s077 Aad tional Tax Dedubsjon¢ dub one TEE I Deductions ite 9.33 721.93 ‘nD80 21.15 1888.29 Dependent Life 0.26 5.96 Health Insurance 54.10 1035.30 401K 25.00 400.00 ‘Total Raaitionay edetions 81965873 Vacation Message: Open enrotiment begins on Novenber 1, 2005. Deadline for changes is Decenber 15, 2005. CaT1 1-800-999-0999 for the benefits desk. I BS TI DT ‘Company Name Ses Main Strost