Test 20240122_190055

SheetJS Table Export

Company Name: Test
Address: 216 South 8th Street
State: AL
Zip Code: 36801
Point of Contact: Kim Email Census to: sales@safeharborsavings.com
Safe Harbor Rep: BBFA
Payroll Frequency: Weekly * Please note any changes to Employee census info will result in changes to estimated savings
First Name Last Name
Email Address
Date of Birth Home State Tax Filing:
Single=I
Married Filling Jointly=M
Married Filling Separately=MS
Head of Household= HH
Approx. Annual Income
(Emp. Only)
Date of Hire Child Dependents Claimed Other Dependents Claimed Health Insurance Premiums PRE-TAX 401(K) Additional Pre-Tax Witholdings (Only Pre-Tax)
Stephanie Hurt 1/6/90 AL I 27040 11/21/23 0 0 $0.00 $0.00 $0.00
Ashley Jerkins 12/18/85 AL M 56120 3/13/09 0 0 $0.00 $42.37 $0.00
Katrina Johnson 4/21/92 AL I 31200 10/28/20 1 0 $0.00 $0.00 $0.00
Spring Kimbro 11/14/68 AL I 42640 6/22/15 1 0 $83.27 $0.00 $7.07
Angela Kogutz 2/22/00 AL I 27040 3/3/23 0 0 $83.27 $0.00 $7.07
Gloria Lopez Giron 5/7/86 AL I 27040 10/20/23 0 0 $0.00 $0.00 $0.00
Dixie Poling 5/7/91 AL I 27040 9/4/23 0 0 $0.00 $0.00 $0.00
Helen Russell 5/13/85 AL M 28080 11/12/22 0 0 $0.00 $0.00 $7.07

Don’t miss a thing

Stay connected with Safe Harbor Health to keep up with all the happenings etc etc.