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Home My WebLink About20230531165040526 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) Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. 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 PROJECTOR CONTRACT NO. Keller Heavenly 3 42 51271202312:00:00 AM 1275 Meadow Crest Drive South Lake Tahoe CA (1)r (2) (3) (4)DAY AND DATE (5) (6) (7) (8)DEDUCTIONS (9) Sun Mon Tue! Wed Thu Fri Sat GROSS NAME AND INDIVIDUAL IDENTIFYING NO,OF AMOUNT FEDERAL STATE NET NUMBER(e.g„LAST FOUR DIGITS OF W/H [OR 21 22 23 24 25 26 27 EARNED WITH- WITH- WAGES SOCIAL SECURITY NUMBER)OF EXEMP WORK TOTAL RATE PROJECT HOLDING' HOLDING' TOTAL PAID WORKER TIONS CLASSIFICATION HOURS WORKED EACH DAY HOURS OF PAY /PERIOD FICA TAX TAX MEDICARE OTHER DEDUCTIONS FOR WEEK Eduardo A Acevedo 1 1000 1.00 0.50 0.50 2.00 80.17 _2,661.93 PO Box 425 GLP S 8.00 8.00 8.00 8.00 8.00 40.00 62.54 21661.93 165.04 448.02 184.52 38.60 23.96 860.14 1,801.79 Rincon PR 00677 Dwight E Bolton 1 1000 0 1.50 1.50 113.03 _ 579.28 759 Hornet Drive L0928 S 4.75 4.75 86.26 4,075.33 252.67 598.90 199.22 59.09 30.77 1,140.65 2,934.68 Gardnerville NV 89460 Dwight E Bolton 1 1000 0 3.00 5.00 1.50 1 9.501 88.20 1,740.32 T3 S 5.00 8.00 13.00 69.42 Dwight E Bolton 1 1000 0 1 1.25 1.25 88A91 1,099.48 TE S 3.25 8.00 3.00 14.25 69.42 German Franco 1 1000 0 0.50 0.50 1.00 115.10 _2,218.46 1080 Centerville Road EX3 S 8.00 8.00 8.00 24.00 87.64 3,299.27 204.55 713.61 181.04 47.84 29.69 1,176.73 2,122.54 Gardnerville NV 89460 German Franco 1 1000 0 1.00 1.00 80.17 1,080.81 GLP S 8.00 8.00 16.00 62.54 Richard A Jacobson 1 1000 0 1.50 1.50 80.17 2,215.34 P.O.Box 8720 GLP S 8.00 3.00 7.50 7.50 7.50 33.50 62.54 2,646.64 164.09 444.35 188.88 38.38 23.82 859.52 1,787.12 South Lake Tahoe CA 96158 Richard A Jacobson 1 1000 0 431.30 L0928 S 1 5.001 5.00 86.26 Alejandro C Martinez 1 1000 0 1.00 0.50 1.50 80.17 _2_,55_9_.31 P.O.Box 13063 GLP S 8.00 8.00 7.50 8.00 7.50 39.00 62.54 2,559.31 158.68 327.24 179.95 37.11 23.03 726.01 1,833.30 South Lake Tahoe CA 961SI Leslie McCrosky 0 1000 0 0.50 2.00 2.501 80.16 _2,107.88 897 Sorinq Valley Road GLP 5 8.00 8.00 6.50 8.00 30.50 62.54 2,237.27 138.71 249.10 87.19 32.44 20.14 527.58 1,709.69 Gardnerville NV 89410 Leslie McCrosky 0 1000 0 129.39 L0928 5 1.50 1.50 86.26 Steven Nieves Badillo 0 1000 0 1.00 0.50 0.50 2.00 80.17 _2,661.93 BO:Rio Grande HC 57 GLP S 8.00 8.00 8.00 8.00 8.00 40.00 62.54 2,661.93 165.04 487.71 193.40 38.60 23.96 908.71 1,753.22 Box 9042 Aquada PR 00602 Richard R Nieves Sanchez 1 1000 0 1.00 0.50 1.50 80.17 _2,62_1_._85 HC57 Box 9042 GLP S 8.00 8.00 8.00 8.00 8.00 40.00 62.54 2,621.85 162.55 438.40 186.34 38.02 23.60 848.91 1,772.94 Aquada PR 00602 Gerald S Rousseau III 1 1000 0 1.00 0.50 0.50 2.00 80.17 1!911.4.5