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CO. FILE DEPT. CLOCK VCHR. NO.
8H5 014812 457232 0000341056 1
Earnings Statement 2523−0026 TOP CHOICE TRANSPORT LLC Period Beginning: 12/05/2021 30 N GOULD ST Period Ending: 12/18/2021 SHERIDAN, WY 82801 Pay Date: 12/23/2021
Taxable Marital Status: Single DASHA MARIE FONS
Exemptions/Allowances: 29050 E 151ST ST Federal: 2 COWETA OK 74429 OK: 2
rate hours this period year to date
Regular 32 0000 80 00 2,560.00 64,512.00 Your federal taxable wages this period are Holiday 2,048.00 $2 560 00 Overtime 0.00 Vacation 0.00 Other Benefits and Personal 0.00 this period total to date Sick Pay 0.00 Employee Id 2005588 Gross Pay $2,560.00 66,560.00
Statutory YOUR COMPANY PHONE NUMBER IS 702−580−2788
Federal Income Tax −60 31 2,171.16 Social Security Tax −64 85 2,334.60 Medicare Tax −23 17 834.12 OK State Income Tax −19 71 709.56
Hlth Insur -124.62* 4,486.32
401K Pre−Tx -128.00* 4,608.00 Net Pay $2,139.34 Checking Dep 2 −2,139.34 Net Check $0 00
Excluded from federal taxable wages
2018 TCT LLC
TOP CHOICE TRANSPORT LLC Advice number: 00000342025
30 N GOULD ST Pay date: 12/23/2021 SHERIDAN, WY 82801
Deposited to the account of account number transit ABA amount