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Home My WebLink About20230607132820384 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 01148 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 CONTRACTNO. Keller Heavenly 3 43 6/3/2023 12:00:00 AM 1275 Meadow Crest Drive South Lake Tahoe CA (1) (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 28 29 30 31 1 2 3 AMOUNT FEDERAL STATE NET NUMBER(e.g.,LAST FOUR DIGITS OF W/H OT EARNED WITH- WITH- WAGES SOCIAL SECURITY NUMBER)OF EXEMP WORK OR TOTAL RATE PROJECT HOLDING HOLDING TOTAL PAID WORKER TIONS CLASSIFICATION ST HOURS WORKED EACH DAY HOURS OF PAY /PERIOD FICA TAX TAX MEDICARE OTHER DEDUCTIONS FOR WEEK Eduardo A Acevedo 1 1000 0 2.50 1.00 3.50 80.17 2,281.86 PO Box 425 GLP S 8.00 8.00 8.00 8.00 32.00 62.54 2,281.86 141.48 356.80 145.64 33.09 20.54 697.55 1,584.31 Rincon PR 00677 Dwight E Bolton 1 1000 0 1.50 3.75 2.00 4.50 11.75 88.19 _3,257.73 759 Hornet Drive TE S 8.00 8.00 8.00 8.00 32.00 69.42 3,426.48 212.44 456.15 182.72 49.68 29.32 930.31 2,496.17 Gardnerville NV 89460 German Franco 1 1000 0 2.50 2.50 115.10 _2,215.82 1080 Centerville Road EX3 S 8.00 4.00 4.00 6.00 22.00 87.64 2,921.39 181.13 622.90 142.39 42.36 26.29 1,015.07 1,906.32 Gardnerville NV 89460 German Franco 1 1000 0 1.00 1.00 80.17 705.57 GLP S 4.00 4.00 2.00 10.00 62.54 Richard A Jacobson 1 1000 0 2.00 1.00 3.00 80.17 _1,991.62 P.O.Box 8720 GLP S 6.00 6.00 8.00 8.00 28.00 62.54 2,164.14 134.18 328.55 139.52 31.38 19.48 653.11 1,511.03 South Lake Tahoe CA 96158 Richard A Jacobson 1 1000 0 172.52 L0928 S 2.00 2.00 86.26 Alejandro C Martinez 1 1000 0 2.00 1.00 3.00 80.17 _2_,241.78 P.O.Box 13063 GLP S 8.00 8.00 8.00 8.00 32.00 62.54 2,241.78 138.99 251.03 147.46 32.51 20.18 590.17 1,651.61 South Lake Tahoe CA 96151 Leslie McCrosky 0 1000 0 0.50 0.50 115.10 _ 890.13 897 Sprinq Valley Road EX3 S 4.50 5.00 9.50 87.64 2,603.14 161.39 329.59 119.38 37.75 23.43 671.54 1,931.60 Gardnerville NV 89410 Leslie McCrosky 0 1000 0 2.00 1.00 3.00 80.17 1,053.52 GLP S 4.00 8.00 1.00 13.00 62.54 Leslie McCroskv 0 1000 0 659.49 T3 S 4.00 3.50 2.00 9.50 69.42 Steven Nieves Badillo 0 1000 0 2.00 0.50 1.00 3.50 80.17 _2,281.86 BO:Rio Grande HC 57 GLP S 8.00 8.00 8.00 8.00 32,00 62.54 2,281.86 141.48 396.49 154.52 33.09 20.54 746.12 1,535.74 Box 9042 Aquada PR 00602 Richard R Nieves Sanchez 1 1000 0 2.00 0.50 1.00 3.50 80.17 _2,281.86 HC57 Box 9042 GLP S 8.00 8.00 8.00 8.00 32.00 62.54 2,281.86 141.48 356.80 151.56 33.09 20.54 703.47 1,578.39 Aquada PR 00602 Gerald S Rousseau III 1 1000 0 1,001 1 1.50 2.50 80.17 _ 1,857.73 727 Bluerock Road GLP S 8.00 8.00 2.50 8.00 26.50 62.54 1,857.73 115.18 311.97 108.17 26.94 266.87 829.13 1,028.60