Pay Period Start Pay Period End Pay Date

03/01/2023 03/15/2023 03/15/2023

Justworks Employment Group LLC 46-2283648

PEO for XO Health, LLC

901 18th Street

Plano, TX 75074

(866) 509-3122

Carl Dorvil

1114 Newcastle Drive

Rockwall, TX 75032

Payment Summary

Gross earnings $8,333.33

Total taxes and deductions -$1,830.15

Net pay $6,503.18

Direct deposit to NBKC BANK XXXX4740 $6,503.18

Gross Earnings

Description Rate Hours Current YTD

Salary ($200,000.00/year) $8,333.33 $47,916.67

Gross Earnings Totals $8,333.33 $47,916.67

Taxes Withheld

Description Current YTD

Federal Income Tax $1,187.04 $7,388.70

Social Security $516.29 $2,968.96

Medicare $120.75 $694.35

Taxes Withheld Totals $1,824.08 $11,052.01

Pre-Tax Deductions

Description Current YTD

Dental $4.00 $20.02

Vision $2.07 $10.35

Pre-Tax Deductions Totals $6.07 $30.37

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: 029F2DED-A36E-4622-84B4-377A7D20A722

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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After-Tax Deductions

Description Current YTD

After-Tax Deductions Totals $0.00 $0.00

Paid Time Off (PTO) Policies

Description Used Accrued Balance

PTO Policy 3.96 days

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: 029F2DED-A36E-4622-84B4-377A7D20A722

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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Pay Period Start Pay Period End Pay Date

03/16/2023 03/31/2023 03/31/2023

Justworks Employment Group LLC 46-2283648

PEO for XO Health, LLC

901 18th Street

Plano, TX 75074

(866) 509-3122

Carl Dorvil

1114 Newcastle Drive

Rockwall, TX 75032

Payment Summary

Gross earnings $8,333.33

Total taxes and deductions -$1,830.16

Net pay $6,503.17

Direct deposit to NBKC BANK XXXX4740 $6,503.17

Gross Earnings

Description Rate Hours Current YTD

Salary ($200,000.00/year) $8,333.33 $56,250.00

Gross Earnings Totals $8,333.33 $56,250.00

Taxes Withheld

Description Current YTD

Federal Income Tax $1,187.04 $8,575.74

Social Security $516.29 $3,485.25

Medicare $120.75 $815.10

Taxes Withheld Totals $1,824.08 $12,876.09

Pre-Tax Deductions

Description Current YTD

Dental $4.01 $24.03

Vision $2.07 $12.42

Pre-Tax Deductions Totals $6.08 $36.45

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: D2D7E4CC-75C5-4082-8E71-949FA4D2FE14

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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After-Tax Deductions

Description Current YTD

After-Tax Deductions Totals $0.00 $0.00

Paid Time Off (PTO) Policies

Description Used Accrued Balance

PTO Policy 4.43 days

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: D2D7E4CC-75C5-4082-8E71-949FA4D2FE14

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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Pay Period Start Pay Period End Pay Date

04/01/2023 04/15/2023 04/14/2023

Justworks Employment Group LLC 46-2283648

PEO for XO Health, LLC

901 18th Street

Plano, TX 75074

(866) 509-3122

Carl Dorvil

1114 Newcastle Drive

Rockwall, TX 75032

Payment Summary

Gross earnings $8,333.33

Total taxes and deductions -$1,830.15

Net pay $6,503.18

Direct deposit to NBKC BANK XXXX4740 $6,503.18

Gross Earnings

Description Rate Hours Current YTD

Salary ($200,000.00/year) $8,333.33 $64,583.33

Gross Earnings Totals $8,333.33 $64,583.33

Taxes Withheld

Description Current YTD

Federal Income Tax $1,187.04 $9,762.78

Social Security $516.29 $4,001.54

Medicare $120.75 $935.85

Taxes Withheld Totals $1,824.08 $14,700.17

Pre-Tax Deductions

Description Current YTD

Dental $4.00 $28.03

Vision $2.07 $14.49

Pre-Tax Deductions Totals $6.07 $42.52

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: CD2C97E8-A58B-4ADF-9F1D-58EFAEBCCA72

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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After-Tax Deductions

Description Current YTD

After-Tax Deductions Totals $0.00 $0.00

Paid Time Off (PTO) Policies

Description Used Accrued Balance

PTO Policy 4.82 days

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: CD2C97E8-A58B-4ADF-9F1D-58EFAEBCCA72

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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Pay Period Start Pay Period End Pay Date

04/16/2023 04/30/2023 04/28/2023

Justworks Employment Group LLC 46-2283648

PEO for XO Health, LLC

901 18th Street

Plano, TX 75074

(866) 509-3122

Carl Dorvil

1114 Newcastle Drive

Rockwall, TX 75032

Payment Summary

Gross earnings $8,333.33

Total taxes and deductions -$1,830.16

Net pay $6,503.17

Direct deposit to NBKC BANK XXXX4740 $6,503.17

Gross Earnings

Description Rate Hours Current YTD

Salary ($200,000.00/year) $8,333.33 $72,916.66

Gross Earnings Totals $8,333.33 $72,916.66

Taxes Withheld

Description Current YTD

Federal Income Tax $1,187.04 $10,949.82

Social Security $516.29 $4,517.83

Medicare $120.75 $1,056.60

Taxes Withheld Totals $1,824.08 $16,524.25

Pre-Tax Deductions

Description Current YTD

Dental $4.01 $32.04

Vision $2.07 $16.56

Pre-Tax Deductions Totals $6.08 $48.60

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: 521F6BC5-67B6-48DB-A70B-A4969F446F2B

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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After-Tax Deductions

Description Current YTD

After-Tax Deductions Totals $0.00 $0.00

Paid Time Off (PTO) Policies

Description Used Accrued Balance

PTO Policy 5.22 days

Justworks Employment Group LLC

55 Water St, 29th Floor, New York, NY 10041-0008

Voucher ID: 521F6BC5-67B6-48DB-A70B-A4969F446F2B

Employee ID: 3B2E2C90-7637-43FC-B000-4D0B4E667DC5

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