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Check Number Check Date Fund Name <br />0 05/15/2014 Police Grants <br />0 OS/27/2014 Police Grants <br />0 05/15/2014 Police Grants <br />0 05/27/2014 Police Grants <br />73781 05/15/2014 Police Grants <br />73914 OS/28/2014 Police Grants <br />73781 05/15/2014 Police Grants <br />73920 05/28/2014 Police Grants <br />73920 05/28/2014 Police Grants <br />73920 OS/28/2014 Police Grants <br />73779 05/15/2014 Police Grants <br />0 OS/15/2014 Police Grants <br />0 OS/27/2014 Police Grants <br />AP-Checks far Approval (6/3/2014 - 1032 AM) <br />Account Name <br />FICA Employee Ded. <br />FICA Employee Ded. <br />FICA Employers Share <br />FICA Employers Share <br />HSA Employee <br />HSA Employee <br />HSA Employer <br />Life Ins. Employee <br />Life Ins. Employer <br />Long Term Disability <br />Medical Ins Employer <br />MN State Retirement <br />MN State Rerirement <br />Vendor Name Invoice Desc. Amount <br />Federal Income Tax Total: 534.12 <br />IRS EFTPS- Non Bank PR Batch 00001.05.2014 Medicare E� 2.97 <br />IRS EFTPS- Non Bank PR Batch 00002.05.2014 Medicare E� 54.67 <br />FICA Employee Ded. Total: 57.64 <br />IRS EFTPS- Non Bank PR Batch 00001.05.2014 Medicare E� 2.97 <br />IRS EFTPS- Non Bank PR Batch 00002.05.2014 Medicare E� 54.67 <br />FICA Employers Share Total: 57.64 <br />Premier Bank PR Batch 00001.05.2014 HSA Emplc 1.71 <br />Premier Bank PR Batch 00002.05.2014 HSA Emplc 56.45 <br />HSA Employee Total: 58.16 <br />Premier Bank PR Batch 00001.05.2014 HSA Emplo 9.87 <br />HSA Employer Total: 9.87 <br />Standard Insurance Company Life Insurance Premium far May 201� 9.74 <br />Life Ins. Employee Total: 9.74 <br />Standard Insurance Company Life Insurance Premium for May 201� 0.40 <br />Life Ins. Employer Total: 0.40 <br />Standard Insurance Company Life Insurance Premium far May 201� 0.67 <br />Long Term Disability Total: 0.67 <br />NJPA Health Insurance Premium-May 2014 18.02 <br />Medical Ins Employer Total: 18.02 <br />MSRS-Non Bank PR Batch 00001.05.2014 Post Emplo� 2.09 <br />MSRS-Non Bank PR Batch 00002.05.2014 Post Emplo� 39.23 <br />Page 37 <br />