7/21/2021 Pay Stub
WELLSTAR HEALTH SYSTEM
Number 4129078
793 Sawyer Rd
Check Date 07/01/2021
Marietta, GA 30062 United States of America
VOID VOID VOID VOID VOID VOID VOID VOID
Pay to the order of
Antionette Perrian Net Pay 428.37
201 Butler Industrial Drive Apt.812
Dallas, GA 30132 NON-NEGOTIABLE
US
Name Social Number Employee Number Process Level Department Period End
Antionette Perrian 0145 76488 230 20035 06/26/2021
Summary
Description Hours Current Year to Date
Total Gross 82.00 676.86 9041.77
Total Deductions 248.49 3235.96
Total Net 428.37 5805.81
Earnings
Description Hours Rate Current Year to Date
Education 173.60
Holiday Differential 109.55
MyCare Rewards Grant 500.00
PTO Unpaid
Paid Time Off 9.00 14.00 126.00 916.58
Regular 36.00 14.00 504.00 6685.00
Shift 2 Differential 11.85 0.00 13.05 172.94
Shift 3 Differential 24.15 0.00 33.81 465.29
Unscheduled Absence 1.00
Weekend Differential 18.81
Total 82.00 676.86 9041.77
Taxes
Description Current Year to Date
Federal Tax 40.63
Georgia State Tax
Medicare Tax-Employee 8.77 117.53
OASDI Tax-Employee 37.50 502.55
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7/21/2021 Pay Stub
Total 46.27 660.71
Pretax Deductions
Description Current Year to Date
403B-PCT : M: EE 54.15 717.74
Dental Choice - EE 19.46 252.98
Medical Premier PPO 49.13 638.69
Vision - Essential - EE 3.42 44.46
Total 126.16 1653.87
Aftertax Deductions
Description Current Year to Date
Meals 12.99 94.51
ROTH - PCT : M : EE 27.07 358.87
Vol Permanent Life - EE 36.00 468.00
Total 76.06 921.38
Company Deductions
Description Current Year to Date
403B - PCT : M: CO 9.04 119.78
HSA Employee Only - Company 1000.00
ROTH - PCT : M : CO 4.50 59.66
Total 13.54 1179.44
Auto Deposit Distributions
Routing Account Description Amount
xxxxx0013 xxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxxx1549 JP Morgan Chase / IL 428.37
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