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Hiff""""""'liEd;ff

Perk N
Samkim

'#[T,i:5;H

PAYROLL STATEMENT PLEASE RETAIN FOR YOUR RECORDS

Reese Plant

PAYROLL

AREA

EMP ID
00007708

PERIOD ENDING

PAY DATE
0L/37/20L4

DOC NUM
00770800548001
YEAR-TO-DATE
925 .7 6 652 .87 74 .42
3

or/26/20L4
401k Loan Deduction 401k EE pre tax Fit.ness Center Dentaf EE pre tax Medical EE pre-tax Vision EE pre Lax Dependent Child Life

HOURS
Regufar

CURRENT
2

YEAR-TO-DATE
4

CURRENT
297 .46

Straight Time Straight Time 2nd Additional Day @ 0.5 1sL Additional Day @ 0.25 Overtime Premium @ 0-5 overtlme Premium @ 0-5 2nd Shift Premi-um Holiday Paid

724 .00

80.00 4.00 40.00 16.00 16.00 4.00 40.00

L43 .20

,286 .40
422
. A4

I 071.60
s3s.

2t4 .32

2,304.53
217 .81

15.00

t07.L6

46 .98
B0

L, L52.26

58.84 3.74
.20

36 .34

72.73 850.80

TOTAL EARNINGS

249 36

9,

326 .57

TOTAL

297 .46

7,674.23
YEAR.TO-DATE

NET PAY
2 TAXABLE
EE

YTD NET PAY

,856 .40 BENEFITS CURRENT

5,413.00
YEAR.TO-DATE

TAX INFORMATION
Federal
TX withholding Tax TX EE Social Security Ta: TX wit.hholding Tax TX EE Unemployment Tax

TAX WITHHELD CURRENT YEAR-TO-DATE


549 .99 263 .46
6). . 62

CURRENT

TAXABLE EARNINGS
3,951.90 4,249.36 4,249.36 4,249.35
4

L,042.8t
245
5

GTLI Taxable
Employer

LTD

3.30 56.98

Tx EE Medicare Tax Pennsylvanla

57'7.).9
.'7 0

8,656.s 58 9,309.4 45
9

45 ,309 .4

130.46
2

0.00

60.28

Derry Township TX Local Servi -es Tax Swatara Township Tx withholding Tax

.94

5.53
.00

9,346.1 15
9

,249 .35 .35

5't ,326 .5

2.AA

4 , 249 4

15 9,306.1

L86.L2

,249 .36

9,306.1 15

1,095.5(
STAMS E&PTS

2,239.34
ELTcTBLE

NDTL o.oo o.00

w-l ronx I v
STATE I .. FoRu i t' MESSAGES

c1 o1

CURRENT
4,249.36

4o1K

YEAR-TO-DATE PRETAX POST CATCHUP


9.)26 .fl
^

wAGE ,fl!'rf,ffi,
.AA
O.

,oojitffi,,

POST

OO

O.0O

0.00

Direct Deposit Statement


THE HERSHEY COMPANY

DATE

0113112014

0077080054800

lllliHlTtffi

00 Crystal A Drive HERSHEY, PA 17033


1

BANK
CHECKING

ACCOUNT NBR
xxxx93
75

CURRENT YTD DEPOSIT DEPOSITS


2

031302955

,856 .40

5,413.00

0077080054800

00007708 1353 2
Perk N Samkim 8140 Evelyn Street Hummelstown PA 17036

ETfiIiTIMN / Perk N

uJlJltlJr'cJS pAy pRoFrLE


Samlram

THE HERSHEY

PAYROLL STATEMENT PLEASE RETAIN FOR YOUR RECORDS C9MPANY FoR pAyRoLL AREA EMp rD pERroD ENDTNG

Reese Plant

PAY DATE
01,/L7

DOC NUM
00770800545001
YEAR.TO.DATE

UT

00007708

ot /1-2 / 2ot4

/2014

NIN

HOURS
qo. oo

CURRENT YEAR-TO-DATE DEDUCTIONS


1,071.60
629 .57

CURRENT
462
. BB

St.raighc Time

Overtime Premium @ 0.5 2nd Shift Premium Hollday Paid

Regular I I 2nd AAdirional Day @ o.s L 1st Addirional Day @ 0.25 I

zl . qo -;:oo
LZ.OO

to't.L6

2 1

23 .50

63.50 16.00

314.78 1B .91 425 .44

80.37

L43.20 138.97 241.72 130.65


569 .48 36 .39

850.80

401k Loan DeducLion 401k EE pre tax Fitness Center Dentaf EE pre tax Medical EE pre-tax Vlsion EE pre Cax Dependent Child Llfe

185.35
'7

7.50
1.
B7

.4L

355.41 15.00
5B . B4

925 .7

29 .42

1.60

3.743 .2A

TOTAL EARNINGS

2,647 .79

o77 27

TOTAL

696.03

L,376.77
YEAR.TO-DATE

NET PAY
1-

YTD NET PAY


2

,350 .64

,556 .60
3.30

TAX INFORMATION
Federaf TX vlithholding Tax

TAX WITHHELD CURRENT YEAR-TO-DATE


26L .64
Ta)
1,63

CURRENT
2
2

TAXABLE EARNINGS
4,'.l04.6 68

BENEFITS CURRENT 1.5s EE GTLI Taxable


TAXABLE

YEAR-TO-DATE

Tx EE Social Security
TX EE Medicare Tax

492 .82

.64

313.73
2

,453 .88

LTD Employer

28 .49

55.98

Pennsylvanla

,639 -23
,63'7 .58

5,050.0 09 5,050.0 09
'79 5 , 055 .'7 2L

?x withholding

Tax

Derry Township RE Withholding Tax TX Local Services Tax 30.14


RE Wj,thholding Tax Swatara Township Tx withholding Tax

TX EE UnemploymenE Tax

80.97
3

.55
2

.00

4 00

,631 .58 ,637 .54

,456

.'7

92 ,') 5L - 3A 52 .'7 5 101 13


2

5,456.7

60L . ).2
STArcS
EXImTS A.DDTt

1, 143 84

w-E

ronn

o1 o1

o.oo o.oo

CURRENT

4O1K EL|G|BLE ,J3;1,n,, YEAR.TO.DATE PRETAX POST CATCHUP POST


2,647.19
5,01'7.21

WAGE ,f;P',.i^r,
7.oo o.oo

'"T*" I v
MESSAGES

o.oo lo.oo

Direct Deposit Statement

lltffiffi

THE HERSHEY COMPANY


1

DATE
TYPE
CHECKING

0111712014

00770800546001

OO

Crystal A Drive

HERSHEY,

PA 1 7033

BANK
031302955

ACCOUNT NBR
xxxx93
7

CURRENT YTD DEPOSIT DEPOSITS


5

1, 350 .64

,556 .60

00770800546001

00007708 1353 2
Perk N Samkim 8140 Evelyn Street Hummelstown PA 17036

1 Wages,

tips, other compensation

2 Federal lncome tax withheld

1 Wages, tips, other

compensation

z tseoerat tncome tax wrtnneto

79778.04
3 Social security wages

10289.02 5289.44
6 Medicare tax withheld
5 Medicare wages and

79774.O4
I
JOCtat SeCUflry EX Wtrnnero

10289.02 5289.44
6 Medicare tax withheld

85313.47
b

85313.47
tips

Medrre wages and trps

85313.47
a Emproyee s

1237.05
Employer use only

85313.47
a Employee's ssA number
Employer use only o uontrol numDer

1237.05

554

202-66-0420
0

20r-66-04?0
b

Emproyers rtru

Employer's FEU lU number

23-0691 590
Employer's name, address, and ZIP code

00007708

23-0691 590
: Employer's name, address, and ZIP code

00007708

The Hershey Company 19 E Chocolate Ave Hershey PA 17033-0810

The Hershey Company


19 E Chocolate Ave Hershey PA 17033-0810

7 Social security tjps

I rps
', , :' :::::t:::: ::::::::: ,:,::: :::rtr::tttf

Socral secuflty ilps

rps
uepenqenr

r::jtr:r:uri:ll

jr

uep
r Ll

ill i

rquailreo Prails

1Za Uee rn$rudEns rcr Dox 1z Sick

'-

"ED*"i-''
I r

4100.16
1

r prans

rxn
e

Employde

plan

pay

'
59.82

14 Otherp4

ggl initial

C tzc D
t2d

27.89 5535.43

txD
14 Otherp4

Statutorv plan Retirement


Employde

hird-Partv Sick pay '


I

6d*".i*'
12h

4100.16 27.89 5535.43

c
D

I
r

gg1 initial

59.82
2d

Employee's first name and

Last

name

Suff.

Employee's first name and

Last

name

Suff.

Perk N Samkim 8140 Evelyn Street Hummelstown PA 17036

Perk N Samkim 8140 Evelyn Street Hummelstown PA'17036


FmnlnveA'e addra(c a.d 7lP.^de 15 Employeis stale lD

15

PA 111489721 16 State wages, tlps, etc.


I / bEte lncome Ex

State I

Employeis state lD

16 LOGI WagS, lrps, elc

8528s.s8
tY LOG| rncome Ex

PA

State I

111489721 85285.58
zu Lortry

85285.58
1705.71

85285.58 2618.25 22

1705.71

tiii-Z
10289.02
secur[y

2618.25 22

5*r,,,,H:Aitfli,;tt,.2013#dplq#j?ffiirr.mt#,toqi*e
Wages, tips, other compensation
2 Federal lncome tax wrthheld

Coov 2 To Be Filed With Emolovee's STATE lncoma Tar Rellrn


1 Wages, tips, other compensatron

Bil;il#ji#;tt

* 2013 3:$""J*"'reasury'
79778.04 85313.47

rnterna Revenue

2 l-ederal lncome tax wrthheld

79778.04 85313.47
5 Medire wages and tips A5.14?' A7
a Employee's SSA

10289.02 5289.44
5 Medire tax withheld

3 Socral secur(y wages

5289.44
6 Medrcare tax wthneld c MeotGre wages anq nps

1237.05
=mployer use only o Lonrot numo

85313.47
a Employee's SSA number
Employer use only

1237.05

number

202-66-0420
o EilrlJroyer s rEU

202-46-04?0
Eil rPruyEr 5

rEU

23-0691 590
c Employeas name, address, and ZIP code

00007708

23-0691 590
c Employer's name, address, and ZIP code

00007708

The Hershey Company 19 E Chocolate Ave Hershey PA 17033-0810

The Hershey Company


19 E Chocolate Ave Hershey PA 17033-0810

soclal secuflty trps

Allocated

Ips

7 Social security tips

6 Allocated

!ps

uepenoenr
prans 12a See instructions for box 12 nrrd-Panv Sick pay '
I

uepen0ent care

'-

-5D*'i-c I
I D

4100.16 27.89 5535.43

prar

12a ." See rnstructrons lor box 12 Sick pay


I

"itD"""i"'"
c I
D

4100.16 27.89 5535.43

nxt
e

Statutory plan Retrement


Employde

1a otherPA

SUI

59.82
t2d

nxnSUI
PA

tJ SEtUtOry Kentemenl Employde p'an

ntro-ra

59.82
t2d

Employee's first name and

initial

Last

name

Suff.

Employee's fi6t name and

initial

Last

name

Suff.

Perk N Samkim 8140 Evelyn Street Hummelstown PA 17036


7tP Emolover's state lD

Perk N Samkim 8140 Evelyn Street Hummelstown PA 17036

d]
0-

l sf
N
wages, ulJs, cLu

f
85285.58
1705.71
ZU
LC

15 State

PA

11489721 '

Emolovee's address and ZIP code 15 Employefs state ID

16 State wages, trps, etc.

PA

State I

J =

111489721 85285.58
zu Locailry r

85285.58
uJ

85285.58 2618.25 22

1705.71

2618.25 22

tfiI-Z gl;il#J#,** 2013 3:$":'*"'reasury-rnternarRevenue


Copv B To Be Filed With Employee's FEDERAL Tax Return

W-z g;Ps#i#;i:, 2013


Copy 2 To Be Filed With Employee's

Dept ortherreasury-rnternarRevenue

Clry

or LOCAL lncome Tax Return

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ffi

PERK NY SAMKIM 8140 EVELYN ST HUMMELSTOWN PA 17036 INTEREST EARNED FOR STATEMENT PERIOD INTEREST PAID YEAR TO DATE 0.29
O.O1

ACCOUNT NUMBER: 9U2689375 STATEMENT PERIOD: NOV.16-DEC.17,2013

ACCOUNT SUMMARY
T,EUINNINU

UEI'Uti| I tt

lt
NO.
1

BALANCE

OTHERADDITIONS NO. AMOUNT

CHECKS PAID AMOUNT

() t HEt< SUBTRACTIONS NO. AMOUNT 13

CUI<FtENT

ENDING

INTEREST PD

BALANCE

301.1i

3,904.37

449.3i

2,982.3e

0.0r

773.8(

ACCOUNT ACTIVITY
DEPOSITS. INTEREST & OTHER ADDITIONS

12-17-13 12-17-13 12-17-13 12-13-13 12-12-13 12-12-13 12-10-13 12-10-13 12-09-13 12-@-13 12-06-13 12-05-13

WEB PMT UNITED WATER PENNSYLVANI WEB PMT SAM'S CLUB DISCOVER WEB PMT UGI UTILITIES INC WEB PMTVERIZON

$42.1
$11

SCOTTMDE MONEYDIRCT
WEB PMTSANTANDER WEB PMT PPL, ELECTRIC UTILITIES DEPOSIT THE HERSHEY COMP PAYROLL WEB PMT CARDMEMBER SERVICES GTay WEB PMT First National Bank Omah

$66. $265. $e. $27. $78.

$1,001.91
$1

$1,
$1 14.

$1,200.1

$142.

$419

https://onlinebankin g.mandtbank.com/eDelivery/eDeliveryMain.aspx

2/7/2014

Welcome to M&T Online Banking 12-03-13 12-02-13 12-02-13 11-25-13 11-22-13 11-22-13 1 1-19-13 1 1-18-13 11-16-13
WEB PMT BAC HOME LOAN SERVICING DEPOSIT CHECK NUMBER 1180

2/2 Page
$1,170. $449. $565. $561

SCOfiRADE MONEYDIRCT
THE HERSHEY COMP PAYROLL WEB PMT PNC Bank WEB PMT Citi Cards DEPOSIT BEGINNING BALANCE

$1,732.27 $1,721.62

$2,286
$309.1 $401.1 $301.1

CHECKS PAID SUMMARY


CHECK NO.

1180 12-02-13

DATE I

AMOUNT

CHECK NO.

DATE I

AMOUNT

CHECK NO.

DATE I

AMOUNT

449.35

Elral

H*'.rs,r':g

Le*d* Mer*er FDf rl

2014 Manufacturers and Traders Trust Company. Users of this web site agree to be bound by the provisions of the M&T Web Banking Terms and Conditions. Viewthe Terms and Canditisns, Frivacy Policy orSeQuritv lnformatien.

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