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HomeMy WebLinkAboutDocumentation_Pension Public Safety_Tab 17_11/08/2005 1 f 07f 2~5 0~: 20 2813046848 PAGE 01(01 • V~'LLAGE !~ '~'~Qi.r'ESTA I,L)itilP SUS $T11iEF~'~' FAYME~+~' A'U'I'HU~ZATZUN ~,., ~ Gcaet'al ° naplayees Pensaaz~ '~ntst Fnnd ^ ~toIIawer ~~ .• ,'III Fubiic S fety O!"licers ,lfeasiun 'Trost ~'uttd ~DistrTtbutiian ~A,3fi~'I~ATA '>Cax ~'ot'mAdttre5s Q (same as tttsiliag addrase) Mail ghcrlc tn: 3 F'inatlCial lnstttutierullirect D sit ~ GT1,eek if a ;S a benefici Payed iVama ~ F~ Midrie) Addr~S .. City ~.., $easmt far separation of service: ~ Nartool termitl8tivn Sarial5estmi ~ I~i,~ kart3 of Ccasas KM lion (, Narmal xecirement Date ai'birtb : >aaoc oflura: ! ~ _! ~ D 1 - Early retirstrsent 1]eath U~ncfit from the account af; TJatc of.entry_ Date of separation bf service: I 'S`O f~~/ ~'O~ Directrallover Fart{~Jpontlt~scIecrodadire~xrpllovcr 17i9t<bi',ityret;rert~ettt G7 Direct rollgver to IItA TnfbrrnaCion yes, answer ehe F,allawing: 1] YCS ] No lJ Ditaet r+oltaver to quali5ed plan - C Other • • ,A unt o1' R*lbver AUT)IfOR1ZAT[UN $1GiYATYJIt~: Employer: Tsts+~loyee: Total: E'BO (Nalrse of PartiCi ) ~inanae Director Dare Account. number. 5ccretary Bard of 7ru~tccs Iyatc Address of financial insti 'on: Board ofTrustees Date Distribu:ian Intamtadcf prep y; ~ 9 ...~~- Distribufzan fnf~7~matir»! `l Sent`t'i#s lam to er Ern lv •ee T'ottal Taxable ~~` ~ ,r-~r~ Nan-taxable Taial Foss ~ ~ , ~ ~ ~~~ rJ ~.. ~o~/n mandatory withholdin ~-} ~ / ~.~ ~ y~ / ~~ • ~~ Total ebeck amo ~ ~ ~ ~~. ~~ ~~Q- ~~ .' ~:~" }~ date ~FZ9SLSX9S :ulOtl.d L'L :0ti ~~~-LO-t10N NOU-A7-2005 10:19AM FAX:2S13046848 ID: PAGE:i001 R=97% l;~T'd gbB9b0~T68:01 Earnings Histo~eport (Detail) . Emp. Code Desc.: All Employers Village of Tequesta From: 10/01 /2004 To: 11 /06/2005 t.D. #: 3581 Name: Jason Fleming Dept Code: 175 Address: 283 Newhaven Boulevard S.S.#: 592-16-7768 Gender: M Local Tax Status: State Marital Table: Birthday: 07/19/1974 Hire Date: 10/15/2001 EIC Status: # State Exempts: 0 - City: Jupiter Prom Date: Fed Marital Table: S Extra State W/H: $ 0.0000 State: FL ZIP: 33458 Term Date: # Fed Exempts: 1 # Local Exempts: 0 Phone: (561)799-3600 x Employment Status: A Marital St: S Extra Fed W/H: $ 0.0000 Extra Local W/H: $ 0.0000 Pay Date Check No. Hourly Rate Regular Pay Regular Hours Overtime Pay Overtime Hours Leave pay Leave Hours Other Pay Gross Pay Federal Tax State Tax Local Tax Medicare Social Security Retirement W/H Other Deduct. Net Pay 05/20/2005 14342 $ 19.3124 $ 627.23 32.0000 $ 174.85 6.0000 $ 927.00 48.0000 $ 0.00 $ 1,729.08 $ 181.64 $ 0.00 $ 0.00 $ 25.07 $ 107.20 $ 86.45 $ 1,328.72 $ 0.00 06/03/2005 14439 $ 19.3124 $ 1,554.22 80.0000 $ 451.70 15.5000 $ 0.00 0.0000 $ 0.00 $ 2,005.92 $ 264.67 $ 0.00. $ 0.00 $ 29.09 $ 124.37 $ 100.30 $ 1,487.49 $ 0.00 06/17/2005 14533 $ 19.3124 $ 1,554.22 80.0000 $ 106.85 9.0000 $ 0.00 0.0000 $ 155.42 $ 1,816.49 $ 219.69 $ 0.00 $ 0.00 $ 26.34 $ 112.62 $ 90.82 $ 1,367.02 $ 0.00 07/01/2005 14635 $ 19.3124 $ 1,399.72 72.0000 $ 29.14 1.0000 $ 154.50 8.0000 $ 0.00 $ 1,583.36 $ 164.32 $ 0.00 $ 0.00 $ 22.96 $ 98.17 $ 79.17 $ 1,218.74 $ 0.00 07/15!2005 14738 $ 19.3124 $ 1,554.22 80.0000 $ 194.28 12.0000 $ 0.00 0.0000 $ 194.04 $ 1,942.54 $ 249.62 $ 0.00 $ 0.00 $ 28.17 $ 120.44 $ 97.13 $ 1,447.18 $ 0.00 07/29/2005 14844 $ 19.3124 $ 1,399.72 72.0000 $ 0.00 0.0000 $ 154.50 8.0000 $ 0.00 $ 1,554.22 $ 157.40 $ 0.00 $ 0.00 $ 22.54 $ 96.36 $ 77.71 $ 1,200.21 $ 0.00 08/12/2005 14950 $ 19.3124 $ 1,554.22 80.0000 $ 145.71 5.0000 $ 0.00 0.0000 $ 7.72 $ 1,707.65 $ 193.84 $ 0.00 $ 0.00 $ 24.76 $ 105.87 $ 85.38 $ 1,297.80 $ 0.00 08/26/2005 15056 $ 19.3124 $ 936.23 48.0000 $ 0.00 0.0000 $ 618.00 32.0000 $ 46.35 $ 1,600.58 $ 168.41 $ 0.00 $ 0.00 $ 23.21 $ 99.24 $ 80.03 $ 1,229.69 $ 0.00 09/09/2005 15152 $ 19.3124 $ 1,399.72 72.0000 $ 0.00 0.0000 $ 154.50 8.0000 $ 7.72 $ 1,561.94 $ 159.23 $ 0.00 $ 0.00 $ 22.65 $ 96.84 $ 78.10 $ 1,205.12 $ 0.00 09/23/2005 15243 $ 19.3124 $ 1,206.60 62.0000 $ 194.28 12.0000 $ 347.62 18.0000 $ 155.42 $ 1,903.92 $ 240.45 $ 0.00 $ 0.00 $ 27.61 $ 118.04 $ 95.20 $ 1,422.62 $ 0.00 09/30/2005 15338 $ 19.3124 $ 723.79 37.0000 $ 0.00 0.0000 $ 830.44 43.0000 $ 0.00 $ 1,554.23 $ 157.40 $ 0.00 $ 0.00 $ 22.54 $ 96.36 $ 77.71 $ 1,200.22 $ 0.00 10/21/2005 15475 $ 20.4711 $ 828.07 40.0000 $ 169.84 5.5000 $ 818.84 40.0000 $ 0.00 $ 1,816.75 $ 250.52 $ 0.00 $ 0.00 $ 26.34 $ 112.64 $ 90.84 $ 1,336.41 $ 0.00 11 /01 /2005 15573 $ 20.4711 $ 0.00 0.0000 $ 0.00 0.0000 $ 0.00 0.0000 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 $ 0.00 Employee Totals: $ 35,858.87 1,841.0000 $ 3,594.00 146.5000 $ 6,207.02 319.0000 $ 2,908.16 $ 48,568.05 $ 5,560.54 $ 0.00 $ 0.00 $ 704.26 $ 3,011.23 $ 2,402.16 $ 36,785.00 $ 104.86 Grand Totals: $ 35,858.87 1,841.0000 $ 3,594.00 146.5000 $ 6,207.02 319.0000 $ 2,908.16 $ 48,568.05 $ 5,560.54 $ 0.00 $ 0.00 $ 704.26 $ 3,011.23 $ 2,402.16 $ 36,785.00 $ 104.86 Date: 11 /6/2005 Time: 14:19:55 Page: 2 Earnings Histo~Report (Detail) • Emp. Code Desc.: All Employers Village of Tequesta ' From: 10/01/2004 Date: 11/6/2005 To: 11/06/2005 Time: 14:19:55 I.D. #: 3581 Name: Jason Fleming Dept Code: 175 Address: 283 Newhaven Boulevard S.S.#: 592-16-7768 Gender: M Local Tax Status: State Marital Table: Birthday: 07/19/1974 Hire Date: 10/15/2001 EIC Status: # State Exempts: 0 City: Jupiter Prom Date: Fed Marital Table: S Extra State W/H: $ 0.0000 State: FL ZIP: 33458 Term Date: # Fed Exempts: 1 # Local Exempts: 0 Phone: (561)799-3600 x Employment Status: A Marital St: S Extra Fed W/H: $ 0.0000 Extra Local W/H: $ 0.0000 Pay Date Check No. Hourly Rate Regular Pay Federal Tax Regular Hours State Tax Overtime Pay Local Tax Overtime Hours Medicare Leave pay Social Security Leave Hours Retirement W!H Other Pay Other Deduct. Gross Pay Net Pay 10/08/2004 12832 $ 19.3124 $ 9.23 0.0000 $ 116.57 4.0000 $ 0.00 0.0000 $ 0.00 $ 125.80 $ 0.00 $ 0.00 $ 0.00 $ 1.82 $ 7.80 $ 6.29 $ 5.03 $ 104.86 10/22/2004 12912 $ 19.3124 $ 1,090.72 56.0000 $ -102.02 4.0000 $ 463.50 24.0000 $ 312.50 $ 1,764.70 $ 198.45 $ 0.00 $ 0.00 $ 25.59 $ 109.41 $ 72.61 $ 1,358.64 $ 0.00 11/05/2004 13003 $ 19.3124 $ 1,554.22 80.0000 $ 116.57 4.0000 $ 0.00 0.0000 $ 0.00 $ 1,670.79 $ 173.18 $ 0.00 $ 0.00 $ 24.23 $ 103.59 $ 83.54 $ 1,286.25 $ 0.00 11/19/2004 13096 $ 19.3124 $ 1,554.22 80.0000 $ 203.99 7.0000 $ 0.00 0.0000 $ 270.37 $ 2,028.58 $ 254.58 $ 0.00 $ 0.00 $ 29.41 $ 125.77 $ 101.43 $ 1,517.39 $ 0.00 12/03/2004 13190 $ 19.3124 $ 1,554.22 80.0000 $ 116.57 4.0000 $ 0.00 0.0000 $ 424.87 $ 2,095.66 $ 269.84 $ 0.00 $ 0.00 $ 30.39 $ 129.93 $ 104.78 $ 1,560.72 $ 0.00 12/17/2004 13281 $ 19.3124 $ 1,322.47 68.0000 $ 116.57 4.0000 $ 231.75 12.0000 $ 0.00 $ 1,670.79 $ 173.18 $ 0.00 $ 0.00 $ 24.23 $ 103.59 $ 83.54 $ 1,286.25 $ 0.00 12/29/2004 13381 $ 19.3124 $ 1,245.22 64.0000 $ 203.99 7.0000 $ 309.00 16.0000 $ 309.00 $ 2,067.21 $ 263.37 $ 0.00 $ 0.00 $ 29.97 $ 128.17 $ 103.36 $ 1,542.34 $ 0.00 01/14/2005 13474 $ 19.3124 $ 1,457.66 75.0000 $ 116.57 4.0000 $ 96.56 5.0000 $ 376.59 $ 2,047.38 $ 254.05 $ 0.00 $ 0.00 $ 29.69 $ 126.94 $ 102.37 $ 1,534.33 $ 0.00 01/28/2005 .13570 $ 19.3124 $ 1,370.75 70.5000 $ 116.57 4.0000 $ 183.47 9.5000 $ 154.50 $ 1,825.29 $ 203.52 $ 0.00 $ 0.00 $ 26.47 $ 113.17 $ 91.26 $ 1,390.87 $ 0.00 02/11/2005 13666 $ 19.3124 $ 1,554.22 80.0000 $ 116.57 4.0000 $ 0.00 0.0000 $ 0.00 $ 1,670.79 $ 168.37 $ 0.00 $ 0.00 $ 24.23 $ 103.59 $ 83.54 $ 1,291.06 $ 0.00 02/25/2005 13758 $ 19.3124 $ 1,554.22 80.0000 $ 116.57 4.0000 $ 0.00 0.0000 $ 0.00 $ 1,670.79 $ 168.37 $ 0.00 $ 0.00 $ 24.23 $ 103.59 $ 83.54 $ 1,291.06 $ 0.00 03/11/2005 13854 $ 19.3124 $ 1,206.60 62.0000 $ 203.99 7.0000 $ 347.62 18.0000 $ 270.37 $ 2,028.58 $ 249.77 $ 0.00 $ 0.00 $ 29.41 $ 125.77 $ 101.43 $ 1,522.20 $ 0.00 03/25/2005 13958 $ 19.3124 $ 1,196.94 61.5000 $ 116.57 4.0000 $ 357.28 18.5000 $ 0.00 $ 1,670.79 $ 168.37 $ 0.00 $ 0.00 $ 24.23 $ 103.59 $ 83.54 $ 1,291.06 $ 0.00 04/08/2005 14054 $ 0.0000 $ 1,496.28 77.0000 $ 116.57 4.0000 $ 57.94 3.0 00 0 $ 10.79 $ 1,681.58 $ 170.83 $ 0.00 $ 0.00 $ 24.38 $ 104.26 $ 84.08 $ 1,298.03 $ 0.00 04/22/2005 14150 $ 19.3124 $ 1,476.97 76.0000 $ 145.71 5.0000 $ 77.25 4.0000 $ 0.00 $ 1,699.93 $ 175.00 $ 0.00 $ 0.00 $ 24.65 $ 105.40 $ 85.00 $ 1,309.88 $ 0.00 05/06/2005 14245 $ 19.3124 $ 1,476.97 76.0000 $ 305.99 10.5000 $ 77.25 4.0000 $ 212.50 $ 2,072.71 $ 262.47 $ 0.00 $ 0.00 $ 30.05 $ 128.51 $ 93.01 $ 1,558.67 $ 0.00 Page: 1 F- F 7 m O~~n g F- ~: Q Z O U 0~ 'n ~ ~ N Q U U~~ ~mo~ ~ ~ N ~ Q ~ LL ~ U ~m~N ~ ~ N ~ Qp} a U LL m N ~ ~ N a~LL O W F- F 2 ~ ~m~ Q'N Q Z V J Q F- F R' a C 0 L F d S F V Q' H a 0 t+~ O Z N m p ~ 2 N O 0 QJ°f r F- Q D w F 0 a WF'w u 1-hQQ Q Otn W d' W W J d U gaLL ig ~ ~ H Q H J ~ T LL O C ~ O A ~ h W W Z F oW5 r 0 0 w 0 0 x w m 0 0 w Q z F- z LL W ~ Q Z F ~ g~ N r