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CITIZENS BANK
5-7017/2110

Friendlys Ice Cream LLC
1855 Boston Road
Wilbraham, MA 01095

Check Date
April 1, 2016

Check Number
589843
PAYROLL CHECK

Pay this
amount:

Two hundred sixty-two dollars and five cents **************************

******** 262.05
VOID AFTER 180 DAYS

To the B4399 100-1213-51100
order of MICHAEL BROWN

169886 589843 477331

89

Non
Negotiable - This is not a check - Non Negotiable
10 CHURCH PLACE
WETHERSFIELD, CT 06109

Authorized Signature

C00589843C A000000000A 000000000C
Friendlys Ice Cream LLC
MICHAEL BROWN
Employee ID
Location

Earnings Statement

169886
100-1213-51100

Fed Taxable Income
Fed Filing Status
State Filing Status

Week of 03/14/2016 to 03/20/2016
Earnings
Rate
RATE 3
9.60
REGULAR PA
6.07
Week of 03/21/2016 to 03/27/2016
Earnings
Rate
RATE 3
9.60
REGULAR PA
6.07
TIP CREDIT
Gross Earnings (2 weeks)
Year-to-Date Earnings
Earnings
RATE 3
REGULAR PA
TIP CREDIT
Total Year-to-Date

Rate
9.60
6.07

EMPLOYEE DISCOUNT 15%

540.11
S-0
F-0

Check Date
April 1, 2016
Period Beginning March 14, 2016
Period Ending
March 27, 2016

Amount
18.91
134.63

Deductions
FESIP PRETAX CONTRIB
TIP CREDIT
Deductions

Hours
2.83
30.43
0.00

Amount
27.17
184.71
185.71

Taxes
CT
FITW
MED
SS
Taxes

57.41

551.13

YTD Hours
9.23
345.58
0.00
354.81

YTD
88.61
2,097.68
1,219.89
3,406.18

Hours
1.97
22.18

MICHAEL BROWN

Filing Status
F-0
S-0

Direct Deposits Type

Check Number
Net Pay
Check Amount

589843
262.05
262.05

Amount
11.02
185.71
196.73

YTD
68.12
1,219.89
1,288.01
Amount
0.00
50.20
7.99
34.16
92.35

Account

YTD
0.27
299.36
49.38
211.18
560.19
Amount

No Direct Deposits

Check Date: April 1, 2016

Show this portion of your paycheck stub along with a photo ID and receive your EMPLOYEE DISCOUNT, good for 15% off the total
check! This stub will expire 14 days from this check date. This offer is valid in ALL FRIENDLY'S company operated restaurants.
Friendlys Ice Cream LLC | 1855 Boston Road Wilbraham, MA 01095 | (413) 731-4255


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