Pay Group:

Pay Begin Date:

Pay End Date:

OhioHealth Corporation
180 East Broad Street
Columbus, OH 43215

Associate ID:
Department:
Location:
Job Title:
Pay Rate:

Kari S. Kennedy
138 Rome Dr
Pataskala, OH 43062

Description
Regular
Shift 2 Evening
Tuition Reimbursed-Before
TAP Authorized
Shift 3 Night
TAP Unscheduled
Holiday Pay
WorkShop

80.00

BEFORE-TAX DEDUCTIONS
Description
Current
Medical - PCA
114.00
Dental
18.37
Vision Service Plan
10.35
403(b) Savings Plan
149.96
FSA - Health Care Account
96.15

YTD
1,140.00
183.70
103.50
1,499.13
961.52

TOTAL:

3,887.85

LEAVE BALANCES
Available Balance

60120
13040-Neonatal Special Care
Riverside Methodist Hospital
Clinical Nurse Mgr
$32.740000 Hourly

HOURS AND EARNINGS

Current
--------Hours
Earnings
80.00
2,619.20
80.00
380.00
0.00
0.00
0.00
0.00
0.00
0.00

------Rate
32.740000
4.750000

TOTAL:

Current
YTD

388.83
TOTAL GROSS
2,999.20
34,817.50
TAP
163.14

R01-Grant/Riverside Methodist Hosp

05/01/2011
05/14/2011

SSP
0.0

2,999.20

TAX DATA:
Marital Status:
Allowances:
Addl. Pct:
Addl. Amt:

Federal
Single
0

OH State
Not applicable
0

60.00

10.00
48.00
30.00
8.00
2.00

--------Earnings
24,555.00
3,562.50
4,835.00
327.40
228.00
982.20
261.92
65.48

Description
Fed Withholdng
Fed MED/EE
Fed OASDI/EE
OH Withholdng
OH COLUMBUS Withholdng
OH SW LCKNGSD
Withholdng

1,598.00

34,817.50

TOTAL:

YTD

YTD
41.40
48.60
13.80
11.10
275.00
231.72
50.70
162.58
22.17
15.00

TOTAL:

91.09

872.07

FED TAXABLE GROSS

2,610.37
26,094.65

TOTAL TAXES
889.95
8,895.98

PERS LEAVE
Payment Type
Advice #000000003402870

TAP Hours Earned this Pay

MESSAGE:

RVHSP
000000003402870
05/20/2011

10.00

TAXES
-----Hours
750.00
750.00

AFTER-TAX DEDUCTIONS
Description
Current
Group Term Life
4.14
AD&D (Personal Acc. Ins.)
4.86
Dependent Life Insurance
1.38
Supplemental Spousal Life
1.15
Long Term Disability
27.50
Nutrition Deduction
24.93
Riverside Gift Shop
6.30
Tim Horton's
20.83
RMB Pharmacy
0.00
United Way
0.00

0.0

Business Unit:
Check #:
Check Date:

Description

YTD
5,431.34
400.11
1,158.94
1,020.00
689.86
195.73

889.95

8,895.98

EMPLOYER PAID BENEFITS

Current

YTD

*TAXABLE
TOTAL DEDUCTIONS
479.92
4,759.92

NET PAY DISTRIBUTION

Account Type
Account Number
Savings
xx5139
Checking
xxxxxxxxx2140

6.15

Current
543.36
40.02
115.94
102.04
69.01
19.58

TOTAL:

NET PAY
1,629.33
21,161.60
Amount
$200.00
$1,429.33

$1,629.33