HomeMy WebLinkAbout20221026152648851 U.S. Department of Labor PAYROLL
Wage and Hour Division (For Contractor's Optional Use; See Instructions at www.dol.gov/whd/forms/wh347instr.htm)
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NAME OF CONTRACTOR OR SUBCONTRACTOR_ ADDRESS
769 Pinto Circle OMB NO.:
White Rock Construction Inc. Gardnerville NV 89410 Expires:
PAYROLL NO. FOR WEEK ENDING PROJECTAND LOCATION PROJECT OR CONTRACT NO.
Keller Heavenly 3
11 10/22/2022 12:00:00 AM 1275 Meadow Crest Drive
South Lake Tahoe CA
(1); (2) (3) (4)DAY AND DALE (5) (6) (7) (8)DEDUCTIONS (9)
Sun Mon Tue Wed Thu FriF22
Sat GROSS
NAME AND INDIVIDUAL IDENTIFYING NO,OF AMOUNT FEDERAL' STATE NET
NUMBER(e.g.,LAST FOUR DIGITS OF W/H OT 16 17 18 19 20 21 EARNED WITH- WITH- WAGES
SOCIAL SECURITY NUMBER)OF EXEMP WORK OR TOTAL RATE PROJECT HOLDING HOLDING' TOTAL PAID
WORKER TONS I CLASSIFICATION ST HOURS WORKED EACH DAY HOURS OF PAY /PERIOD FICA TAX TAX MEDICARE OTHER DEDUCTIONS FOR WEEK
Eduardo A Acevedo 1 1000 0 _ _37_5_._24_
PO Box 425 GLP S 6.00 6.00 62.54 375.24 23.26 12.62 5.44 4.13 45.45 329.79
Rincon PR 00677
Dwight E Bolton 1 1000 0 3.50 3.50 88.19 _ 864.04
759 Hornet Drive TS S 8.00 8.00 69.42 4,381.30 271.64 694.88 309.20 63.53 48.19 1,387.44 2,993.86
Gardnerville NV 89460
German Franco 1 1000 0 1.00 1.00 80.17 _ 580.49
1080 Centerville Road GLP S 8.00 8.00 62.54 2,814.19 174.48 609.70 143.43 40.81 30.96 999.38 1,814.81
Gardnerville NV 89460
Richard A Jacobson 1 1000 0 312.70
P.O.Box 8720 GLP S 5.00 5.00 62.54 312.70 19.39 6.37 4.53 3.44 33.73 278.97
South Lake Tahoe CA 96158
Alejandro C Martinez 1 1000 0 .---375.24
P.O.Box 13063 GLP S 6.00 6.00 62.54 2,358.52 146.23 291.58 165.69 34.20 25.94 663.64 1,694.88
South Lake Tahoe CA 96151
Leslie McCroskv 0 1000 0 1.00 1.00 11SA0 _ 816.22
897 Sprinq Valley Road EX3 S 8.00 8.00 87.64 3,703.97 229.65 591.86 242.64 53.71 40.74 1,158.60 2,545.37
Gardnerville NV 89410
Steven Nieves Badillo 0 1000 0 375.24
BO:Rio Grande HC 57 GLP S 6.00 6.00 62.54 375.24 23.26 31.04 5.44 4.13 63.87 311.37
Box 9042
Aquada PR 00602
Richard R Nieves Sanchez 1 1000 0 375.24
HC57 Box 9042 GLP S 6.00 6.00 62.54 375.24 23.26 12.62 5.44 4.13 45.45 329.79
Aquada PR 00602
Gerald S Rousseau III 1 1000 0 343.97
727 Bluerock Road GLP S 5.50 5.50 62.54 343.97 21.33 4.99 3.78 30.10 313.87
Gardnerville NV 89460
Totals for Project Keller Heavenly 3 64.00 64.001 1 4,418.38