The document is a payroll register for October 8, 2015 that includes earnings, deductions, and tax amounts for multiple employees in different departments. It shows details such as salary, bonuses, allowances, 401k contributions, insurance premiums, taxes withheld and net pay for individuals in departments including the Office of the CEO, COO, Facilities, CHRO, CFO, Risk Management, and CIO.

1. Payroll Register - Department Oct 8, 2015 2:31 PM
1 / 12
10000 Office of CEO
10000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Holiday Pay 0.00
Housing Allowance
[USA]
5,000.00
Imputed Income -
GTL [USA]
10.75
Salary Base Pay 23,062.68
Taxable Gym
Membership [USA]
20.00
Vacation Paid 1,172.72
29,916.15
401(k) Catch-up [USA] 458.33
401(k) Employer Match
[USA]
969.42
401(k) Roth [USA] 484.71
401(k) [USA] 969.42
Basic Life - Liberty Mutual -
ER [USA]
33.00
Dental - Blue Cross of CA -
EE (Pre Tax) [USA]
30.00
Dental - Blue Cross of CA -
ER [USA]
35.00
Gym Membership - ER
[USA]
20.00
Healthcare FSA [USA] 100.00
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - Blue Cross of CA -
EE (Pre Tax) [USA]
262.00
Medical - Blue Cross of CA -
ER [USA]
432.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
United Way 200.00
United Way Annual Pledge 2,200.00
Voluntary AD&D - Liberty
Mutual - EE [USA]
8.00
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
180.00
Wellness Credits [USA] -45.00
6,352.78
CA: Employment Training Tax (ETT) - Employer Paid [USA] 7.00
CA: State Disability Insurance (SDI) - Mandatory [USA] 298.85
FUI (ER) Credit Reduction [USA] 84.00
FUI (ER) [USA] 42.00
Federal Withholding [USA] 6,716.91
Local City Withholding (Work) - Employer [USA] 403.72
Medicare (ER) [USA] 428.75
Medicare [USA] 428.75
OASDI (ER) [USA] 1,833.29
OASDI [USA] 1,833.29
SUI (ER) [USA] 196.00
State Withholding (Work) [USA] 2,335.14
14,607.70
Net
13,425.00

2. Payroll Register - Department Oct 8, 2015 2:31 PM
2 / 12
30000 Office of COO
30000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Holiday Pay 0.00
Housing Allowance
[USA]
5,000.00
Imputed Income -
GTL [USA]
3.75
Salary Base Pay 15,084.16
Vacation Paid 1,616.16
22,354.07
401(k) Employer Match
[USA]
501.01
401(k) [USA] 668.02
Basic Life - Liberty Mutual -
ER [USA]
33.00
Deferred Compensation
[USA]
8,350.16
Dental - AETNA - EE (Pre
Tax) [USA]
35.00
Dental - AETNA - ER [USA] 34.50
Healthcare FSA [USA] 100.00
Legal Assistance [USA] 18.00
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - AETNA - EE (Pre
Tax) [USA]
312.00
Medical - AETNA - ER [USA] 579.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
85.00
Wellness Credits [USA] -45.00
10,686.59
FUI (ER) [USA] 42.00
Federal Withholding [USA] 2,118.99
Medicare (ER) [USA] 318.31
Medicare [USA] 318.31
OASDI (ER) [USA] 1,361.03
OASDI [USA] 1,361.03
SUI (ER) [USA] 220.32
State Withholding (Work) [USA] 611.09
6,351.08
Net
8,417.72

3. Payroll Register - Department Oct 8, 2015 2:31 PM
3 / 12
34000 Facilities
34000
Earning Hours Amount Deduction Amount Tax Amount
CA Paid Sick Leave
Hours [USA]
0.00
Holiday Pay 0.00
Imputed Income -
GTL [USA]
2.65
Salary Base Pay 3,318.30
Sick Paid [USA] 109.18
Vacation Paid 1,487.76
4,917.89
Basic Life - Liberty Mutual -
ER [USA]
106.61
Dental - AETNA - EE (Pre
Tax) [USA]
26.07
Dental - AETNA - ER [USA] 73.38
Dental - Blue Cross of CA -
EE (Pre Tax) [USA]
0.00
Dental - Blue Cross of CA -
ER [USA]
13.38
Gym Membership - ER
[USA]
9.23
Health Savings Account
(HSA) [CAN USA]
0.00
Healthcare FSA [USA] 46.15
Legal Assistance [USA] 8.31
Long Term Disability -
Liberty Mutual - EE [USA]
6.84
Long Term Disability -
Liberty Mutual - ER [USA]
3.42
Medical - AETNA - EE (Pre
Tax) [USA]
426.82
Medical - AETNA - ER [USA] 1,249.39
Parking Spending Account
[USA]
0.00
Short Term Disability -
Liberty Mutual - EE [USA]
7.84
Short Term Disability -
Liberty Mutual - ER [USA]
3.92
Transit Spending Account
[USA]
0.00
United Way 0.00
United Way Annual Pledge 245.00
Vision - VSP - EE (Pre Tax)
[USA]
15.69
Vision - VSP - ER [USA] 106.16
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
2.03
Wellness Credits [USA] -116.09
Withholding Order
(Bankruptcy) [USA]
0.00
Withholding Order (Creditor)
[USA]
0.00
CA: Employment Training Tax (ETT) - Employer Paid [USA] 0.00
CA: State Disability Insurance (SDI) - Mandatory [USA] 0.00
FUI (ER) Credit Reduction [USA] 1.31
FUI (ER) [USA] 24.42
Federal Withholding [USA] 451.51
GA: Georgia Administrative Assessment - Employer Paid [USA] 0.15
MA: Massachusetts Health Insurance - Employer Paid [USA] 0.00
MA: Massachusetts Workforce Training Fund - Employer Paid [USA] 0.00
Medicare (ER) [USA] 53.18
Medicare [USA] 53.18
NY: New York Metropolitan Commuter Transportation Mobility Tax -
Employer Paid [USA]
0.05
NY: New York Re-Employment Service Fund - Employer Paid [USA] 0.08
NY: State Disability Insurance (SDI) [USA] 0.55
OASDI (ER) [USA] 227.41
OASDI [USA] 227.41
SUI (ER) [USA] 77.97
State Withholding (Resident) [USA] 10.00
State Withholding (Work) [USA] 192.55
1,319.77

4. Payroll Register - Department Oct 8, 2015 2:31 PM
4 / 12
34000 Facilities
34000
Earning Hours Amount Deduction Amount Tax Amount
Withholding Order (Support)
[USA]
0.00
Workers Compensation -
ER [USA]
0.43
2,234.58
Net
3,310.95

5. Payroll Register - Department Oct 8, 2015 2:31 PM
5 / 12
40000 Office of CHRO
40000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Holiday Pay 0.00
Imputed Income -
GTL [USA]
2.50
Salary Base Pay 13,419.21
Taxable Gym
Membership [USA]
20.00
Vacation Paid 2,278.80
16,370.51
401(k) Employer Match
[USA]
941.89
401(k) [USA] 1,255.85
Basic Life - Liberty Mutual -
ER [USA]
33.00
Dental - Blue Cross of CA -
EE (Pre Tax) [USA]
30.00
Dental - Blue Cross of CA -
ER [USA]
35.00
Dependent Care FSA [USA] 100.00
Gym Membership - EE
[USA]
20.00
Gym Membership - ER
[USA]
20.00
Healthcare FSA [USA] 66.68
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - Blue Cross of CA -
EE (Pre Tax) [USA]
262.00
Medical - Blue Cross of CA -
ER [USA]
432.00
Parking Spending Account
[USA]
75.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
United Way 50.00
United Way Annual Pledge 1,000.00
Vision - VSP - EE (Pre Tax)
[USA]
39.00
Vision - VSP - ER [USA] 53.00
Voluntary AD&D - Liberty
Mutual - EE [USA]
8.00
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
42.50
Wellness Credits [USA] -81.50
4,398.32
CA: Employment Training Tax (ETT) - Employer Paid [USA] 7.00
CA: State Disability Insurance (SDI) - Mandatory [USA] 163.48
FUI (ER) Credit Reduction [USA] 84.00
FUI (ER) [USA] 42.00
Federal Withholding [USA] 2,465.29
Local City Withholding (Work) - Employer [USA] 220.97
Medicare (ER) [USA] 230.25
Medicare [USA] 230.25
OASDI (ER) [USA] 984.52
OASDI [USA] 984.52
SUI (ER) [USA] 196.00
State Withholding (Work) [USA] 951.06
6,559.34
Net
8,685.88

6. Payroll Register - Department Oct 8, 2015 2:31 PM
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50000 Office of CFO
50000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Holiday Pay 0.00
Housing Allowance
[USA]
5,000.00
Imputed Income -
GTL [USA]
10.75
Salary Base Pay 12,631.48
Vacation Paid 7,978.24
26,270.47
401(k) Catch-up [USA] 206.10
401(k) Employer Match
[USA]
1,236.59
401(k) [USA] 1,236.59
Basic Life - Liberty Mutual -
ER [USA]
33.00
Dental - AETNA - EE (Pre
Tax) [USA]
22.50
Dental - AETNA - ER [USA] 27.00
Healthcare FSA [USA] 150.00
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - AETNA - EE (Pre
Tax) [USA]
196.00
Medical - AETNA - ER [USA] 413.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
Vision - VSP - EE (Pre Tax)
[USA]
13.00
Vision - VSP - ER [USA] 25.00
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
133.00
Wellness Credits [USA] -58.00
3,649.68
FUI (ER) Credit Reduction [USA] 84.00
FUI (ER) [USA] 42.00
Federal Withholding [USA] 5,408.03
Local City Withholding (Resident) [USA] 1,003.81
Medicare (ER) [USA] 376.23
Medicare [USA] 376.23
NY: New York Metropolitan Commuter Transportation Mobility Tax -
Employer Paid [USA]
59.68
NY: New York Re-Employment Service Fund - Employer Paid [USA] 7.73
NY: State Disability Insurance (SDI) [USA] 2.60
OASDI (ER) [USA] 1,608.71
OASDI [USA] 1,608.71
SUI (ER) [USA] 412.00
State Withholding (Work) [USA] 1,670.66
12,660.39
Net
14,290.49

7. Payroll Register - Department Oct 8, 2015 2:31 PM
7 / 12
52000 Risk Management
52000
Earning Hours Amount Deduction Amount Tax Amount
Holiday Pay 0.00
Imputed Income -
GTL [USA]
5.30
Salary Base Pay 4,024.79
Vacation Paid 2,288.32
6,318.41
401(k) Employer Match
[USA]
378.79
401(k) Roth [USA] 69.50
401(k) [USA] 561.83
Basic Life - Liberty Mutual -
ER [USA]
30.46
Dental - AETNA - EE (Pre
Tax) [USA]
21.92
Dental - AETNA - ER [USA] 26.54
Healthcare FSA [USA] 23.08
Long Term Disability -
Liberty Mutual - ER [USA]
6.84
Medical - AETNA - EE (Pre
Tax) [USA]
239.08
Medical - AETNA - ER [USA] 381.24
Parking Spending Account
[USA]
11.54
Short Term Disability -
Liberty Mutual - ER [USA]
7.84
Vision - VSP - EE (Pre Tax)
[USA]
9.69
Vision - VSP - ER [USA] 17.08
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
62.07
Wellness Credits [USA] -30.00
1,817.50
FUI (ER) Credit Reduction [USA] 75.76
FUI (ER) [USA] 37.88
Federal Withholding [USA] 756.48
Medicare (ER) [USA] 87.63
Medicare [USA] 87.63
NY: New York Metropolitan Commuter Transportation Mobility Tax -
Employer Paid [USA]
7.60
NY: New York Re-Employment Service Fund - Employer Paid [USA] 4.74
NY: State Disability Insurance (SDI) [USA] 2.40
OASDI (ER) [USA] 374.67
OASDI [USA] 374.67
SUI (ER) [USA] 252.52
State Withholding (Resident) [USA] 147.70
State Withholding (Work) [USA] 127.56
2,337.24
Net
3,847.96

8. Payroll Register - Department Oct 8, 2015 2:31 PM
8 / 12
60000 Office of CIO
60000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Floating Holiday Paid 2,574.40
Holiday Pay 0.00
Housing Allowance
[USA]
5,000.00
Imputed Income -
GTL [USA]
5.75
Salary Base Pay 24,026.64
32,256.79
401(k) Employer Match
[USA]
1,117.25
401(k) [USA] 1,489.66
Basic Life - Liberty Mutual -
ER [USA]
33.00
Deferred Compensation
[USA]
7,980.32
Dental - Blue Cross of CA -
EE (Pre Tax) [USA]
24.00
Dental - Blue Cross of CA -
ER [USA]
29.00
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - Blue Cross of CA -
EE (Pre Tax) [USA]
186.00
Medical - Blue Cross of CA -
ER [USA]
306.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
Vision - VSP - EE (Pre Tax)
[USA]
21.00
Vision - VSP - ER [USA] 37.00
Voluntary AD&D - Liberty
Mutual - EE [USA]
8.00
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
180.00
Wellness Credits [USA] -40.00
11,387.13
CA: Employment Training Tax (ETT) - Employer Paid [USA] 7.00
CA: State Disability Insurance (SDI) - Mandatory [USA] 322.51
FUI (ER) Credit Reduction [USA] 84.00
FUI (ER) [USA] 42.00
Federal Withholding [USA] 4,562.64
Local City Withholding (Work) - Employer [USA] 435.39
Medicare (ER) [USA] 464.95
Medicare [USA] 464.95
OASDI (ER) [USA] 1,988.08
OASDI [USA] 1,988.08
SUI (ER) [USA] 196.00
State Withholding (Work) [USA] 1,739.19
12,294.79
Net
13,324.69

9. Payroll Register - Department Oct 8, 2015 2:31 PM
9 / 12
70000 Sales Executive Mgmt
70000
Earning Hours Amount Deduction Amount Tax Amount
Car Allowance [USA] 500.00
Cell / Mobile
Allowance
150.00
Floating Holiday Paid 2,745.12
Holiday Pay 0.00
Housing Allowance
[USA]
5,000.00
Imputed Income -
GTL [USA]
5.75
Salary Base Pay 16,012.06
Vacation Paid 9,607.92
34,020.85
401(k) Employer Match
[USA]
850.96
401(k) [USA] 850.96
Basic Life - Liberty Mutual -
ER [USA]
33.00
Deferred Compensation
[USA]
11,346.04
Dental - AETNA - EE (Pre
Tax) [USA]
25.00
Dental - AETNA - ER [USA] 30.50
Healthcare FSA [USA] 50.00
Legal Assistance [USA] 18.00
Long Term Disability -
Liberty Mutual - ER [USA]
7.40
Medical - AETNA - EE (Pre
Tax) [USA]
222.00
Medical - AETNA - ER [USA] 413.00
Short Term Disability -
Liberty Mutual - ER [USA]
8.50
United Way 100.00
United Way Annual Pledge 1,200.00
Vision - VSP - EE (Pre Tax)
[USA]
21.00
Vision - VSP - ER [USA] 37.00
Voluntary AD&D - Liberty
Mutual - EE [USA]
8.00
Voluntary Supplemental Life
- Liberty Mutual - EE [USA]
144.00
Wellness Credits [USA] -45.00
15,320.36
FUI (ER) [USA] 47.08
Federal Withholding [USA] 4,652.87
MA: Massachusetts Health Insurance - Employer Paid [USA] 53.45
MA: Massachusetts Workforce Training Fund - Employer Paid [USA] 8.91
Medicare (ER) [USA] 501.61
Medicare [USA] 501.61
OASDI (ER) [USA] 2,144.82
OASDI [USA] 2,144.82
SUI (ER) [USA] 357.22
State Withholding (Work) [USA] 1,012.62
11,425.01
Net
11,763.18

10. Payroll Register - Department Oct 8, 2015 2:31 PM
10 / 12
Totals

11. Payroll Register - Department Oct 8, 2015 2:31 PM
11 / 12
Net
77,065.87
Earning Hours Amount
CA Paid Sick Leave
Hours [USA]
0.00
Car Allowance
[USA]
3,000.00
Cell / Mobile
Allowance
900.00
Floating Holiday
Paid
5,319.52
Holiday Pay 0.00
Housing Allowance
[USA]
25,000.00
Imputed Income -
GTL [USA]
47.20
Salary Base Pay 111,579.32
Sick Paid [USA] 109.18
Taxable Gym
Membership [USA]
40.00
Vacation Paid 26,429.92
172,425.14
Deduction Amount
401(k) Catch-up [USA] 664.43
401(k) Employer Match
[USA]
5,995.91
401(k) Roth [USA] 554.21
401(k) [USA] 7,032.33
Basic Life - Liberty Mutual
- ER [USA]
335.07
Deferred Compensation
[USA]
27,676.52
Dental - AETNA - EE (Pre
Tax) [USA]
130.49
Dental - AETNA - ER [USA] 191.92
Dental - Blue Cross of CA
- EE (Pre Tax) [USA]
84.00
Dental - Blue Cross of CA
- ER [USA]
112.38
Dependent Care FSA
[USA]
100.00
Gym Membership - EE
[USA]
20.00
Gym Membership - ER
[USA]
49.23
Health Savings Account
(HSA) [CAN USA]
0.00
Healthcare FSA [USA] 535.91
Legal Assistance [USA] 44.31
Long Term Disability -
Liberty Mutual - EE [USA]
6.84
Long Term Disability -
Liberty Mutual - ER [USA]
54.66
Medical - AETNA - EE (Pre
Tax) [USA]
1,395.90
Medical - AETNA - ER
[USA]
3,035.63
Medical - Blue Cross of
CA - EE (Pre Tax) [USA]
710.00
Medical - Blue Cross of
CA - ER [USA]
1,170.00
Parking Spending
Account [USA]
86.54
Short Term Disability -
Liberty Mutual - EE [USA]
7.84
Tax Amount
CA: Employment Training Tax (ETT) - Employer Paid [USA] 21.00
CA: State Disability Insurance (SDI) - Mandatory [USA] 784.84
FUI (ER) Credit Reduction [USA] 413.07
FUI (ER) [USA] 319.38
Federal Withholding [USA] 27,132.72
GA: Georgia Administrative Assessment - Employer Paid [USA] 0.15
Local City Withholding (Resident) [USA] 1,003.81
Local City Withholding (Work) - Employer [USA] 1,060.08
MA: Massachusetts Health Insurance - Employer Paid [USA] 53.45
MA: Massachusetts Workforce Training Fund - Employer Paid [USA] 8.91
Medicare (ER) [USA] 2,460.91
Medicare [USA] 2,460.91
NY: New York Metropolitan Commuter Transportation Mobility Tax -
Employer Paid [USA]
67.33
NY: New York Re-Employment Service Fund - Employer Paid [USA] 12.55
NY: State Disability Insurance (SDI) [USA] 5.55
OASDI (ER) [USA] 10,522.53
OASDI [USA] 10,522.53
SUI (ER) [USA] 1,908.03
State Withholding (Resident) [USA] 157.70
State Withholding (Work) [USA] 8,639.87
67,555.32

12. Payroll Register - Department Oct 8, 2015 2:31 PM
12 / 12
Deduction Amount
Short Term Disability -
Liberty Mutual - ER [USA]
62.76
Transit Spending Account
[USA]
0.00
United Way 350.00
United Way Annual Pledge 4,645.00
Vision - VSP - EE (Pre Tax)
[USA]
119.38
Vision - VSP - ER [USA] 275.24
Voluntary AD&D - Liberty
Mutual - EE [USA]
32.00
Voluntary Supplemental
Life - Liberty Mutual - EE
[USA]
828.60
Wellness Credits [USA] -460.59
Withholding Order
(Bankruptcy) [USA]
0.00
Withholding Order
(Creditor) [USA]
0.00
Withholding Order
(Support) [USA]
0.00
Workers Compensation -
ER [USA]
0.43
55,846.94
TOTAL 77,065.87 172,425.14 55,846.94 67,555.32
Pay Periods: Dec 23, 2013 to Jan 31, 2014