ACC 401 ASSIST Motivated Minds/acc401assist.com ACC 401 ASSIST Motivated Minds/acc401assist.com | Page 28

Medicare: $730.34
State: $682.38
sdi (mandatory disability insurance): $393.24
Employer: PointMark, INC
Address: 1111 One Park Place
City: One City
State: California
Zip code: 11111
Employer’s FED ID number: 33-01XXX11
Sarah Petersan
SSN: 001-02-XXXX
DOB: 08/11/1979
Gross Pay: $50,000
401(k) contributions: $4,000
Healthcare costs (payroll deductions): $1347
Reported wages: $44,653
Social Security Wages: $48,653
Medicare Wages: $48,653
State Wages: $44,653
Taxes withheld:
Federal: $2795.28