Earnings Statement
Pay Date:
Period Start:
Period End:
01/13/2022
12/26/2021
01/08/2022
BRENDALEE GONZALEZ
Company: 0YH83 - BRISTOL HOSPITAL INCORPORATED
Emp #: A36H
PO BOX 977
Dept: 6129 - Diagnostic Support Staff
BRISTOL CT 06011
Pay Basis: Hourly
Rate Hours/Units Current Period Year To Date
Earnings
Regular
Weekend Premium 10.75
15.73
17.13
Gross
W/H Taxes
Federal W/H(H)
Medicare
Social Security
Connecticut State W/H(E/0)
Conn. Paid Family Medical Leave
15.98
13.63
251.37
233.48
251.37
233.48
29.61
484.85
484.85
0.00
7.03
30.06
0.00
2.42
0.00
7.03
30.06
0.00
2.42
Deductions
Net Pay
Net Pay Distribution
Direct Deposit Net Check
445.34
445.34 Voucher No. 358354466DD
445.34
445.34 A/C:9692
Voucher No. 358354466DD
BRISTOL HOSPITAL INCORPORATED
PO BOX 977
BRISTOL, CT 06010
DATE: 01/13/2022
Dept: 6129
Net Pay:
445.34
Four Hundred Forty Five And 34/100 Dollars
BRENDALEE GONZALEZ
1320 MERIDEN RD, APT 13
WATERBURY, CT 06705
For Record Purposes Only
**NON-NEGOTIABLE**