1. CO. FILE DEPT. CLOCK VCHR. NO. 060
GGF 092009 030103 0000520039 1 Earnings Statement
PUTMAN MEDIA, INC. Period Beginning: 12/16/2011
555 W. PIERCE RD. Period Ending: 12/31/2011
SUITE 301 Pay Date: 12/30/2011
ITASCA,IL 60143
Taxable Marital Status: Single DIANE TOOPS
Exemptions/Allowances: 33 W. DELAWARE, #13K
Federal: 1
IL: 1
CHICAGO, IL 60610
Social Security Number: XXX-XX-9349
rate hours this period year to date Other Benefits and
Regular 1922 86 78 54 1 922 86 45 476 52 this period total to date
Medical Reimbr 88 50 2 124 00 401K Wages 2 011 36
Gifts 229 00
Pers Hrs Rem 203 00
Gross Pay 2 011 36 47 829 52
Vac Hrs Rem 0 00
Statutory
YOUR COMPANY’S PHONE NUMBER IS 630-467-1301
Federal Income Tax 259 68 6 126 62
Social Security Tax 83 43 1 983 80
Medicare Tax 28 80 684 88
IL State Income Tax 92 14 2 154 41
Checking 1 462 13
Flexible Spendg 20 84* 500 16
Medical 4 00* 96 00
401K 60 34* 1 428 00
Misc 229 00
Net Pay 0 00
* Excluded from federal taxable wages
Your federal taxable wages this period are
$1 926 18
2000 A DP, Inc
PUTMAN MEDIA INC Advice number: 00000520039
555 W PIERCE RD Pay date: 12/30/2011
SUITE 301
ITASCA IL 60143
Deposited to the account of account number transit ABA amount
DIANE TOOPS xxxxxx3267 xxxx xxxx $1 462 13
NON-NEGOTIABLE