February 2020

Reimbursment for Medicare

To: UDY Corporation 201 Rome Court

Please pay:
Laird Griffing $144.60
Home address: 914 Lepus dr. Loveland Co. 80537
phone: 970-388-5466

This invoice is for the reimbursement of monthly medicare payment as per the employment agreement for health coverage. These funds have been withheld from my social security dividens payment for January 2020.
Note: Deduction increase starting February 2020. Was $135.40 in 2019

Note: This amount is now being added to my monthly paycheck. (starting in January 2020.)

Thank you

Laird Griffing