Gedmin v. North American Safety Products, Inc.

Filing 93

MOTION by Plaintiff Janelle Gedmin for judgment damages (Attachments: # 1 Exhibit A through G, # 2 Exhibit H and I, # 3 Exhibit J to M)(Doran, Karen)

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EMPLOYEE HISTORY ,';\f ' tl~C.(i(ctt){VH/A(i'\/' ) '.J 'Ii j . .J ;J I; ,.\ ; ., i~ T? ' (.' .. ' j · ·' {""\:,1" l) bl ;' i ,,( " Ex A EMPLOYEE HISTORY f.:' ,.j ;.;). {, 1<. Janelle Wozniak - E0007 - 2005 Sales and Commission Earned Report Date Paid Amount Paid I For the Period From Dec 1, 2004 to Dec 31, 2004 EOO07 Marketing Incentive 200,144.63 0.50% 1,000.72 2/15/2005 1,OOO~QQ. For the Period From Jan 1,2005 to Jan 30,2005 ED007 Marketing Incentive 164,804.65 0.50% 824.02 For the Period From Feb 1,2005 to Feb 29, 2005 EOO07 Marketing Incentive 167,586.65 0.50% 837.93 3/18/2005 1,000.00 For the Period From Mar 1, 2005 to Mar 31, 2005 Eoo07 Marketing Incentive 108,363.49 0.50% 541.82 4/29/2005 2,662.68 For the Period From Apr 1,2005 to Apr 30, 2005 Eo007 Forthe MarketinQ Incentive 140,384.97 0.50% 701.92 5/13/2005 5/27/2005 6/10/2005 6/24/2005 7/22/2005 8/5/2005 8/19/2005 541.82 500.00 500.00 500.00 500.00 500.00 500.00 Period From May 1, 2005 to May 31, 2005 EOO07 Marketing Incentive 165,922.34 0.50% 829.61 For the Period From J un 1, 2005 to J un 30, 2005 EOO07 Marketing Incentive 224,801.06 0.50% 1,124.01 For the Period From Ju11, 2005 to Ju131, 2005 EOO07 Marketing Incentive 171,031.73 0.50% 855.16 For the Period From AUQ 1, 2005 to AUQ 31, 2005 EOO07 Marketing Incentive 157,357.93 0.50% 786.79 9/16/2005 500.00 For the Period From Sep 1, 2005 to Sep 30, 2005 EOO07 Marketing Incentive 158,367.17 0.50% 791.84 10/14/2005 500.00 For the Period From Oct 1, 2005 to Oct 31, 2005 EOo07 Marketing Incentive 121,352.48 0.50% 606.76 11/22/2005 500.00 For the Period From Nov 1, 2005 to Nov 30, 2005 EOO07 Marketing Incentive For the Period From December 297,271.02 0.50% 1,486.36 12/9/2005 700.00 1, 2005 to Dcember 31, 2005 EDDD? Marketing Incentive 166,876.13 0.50% 834.38 1/20/2006 816.82 For the Period From Jan 1,2006 to Jan 30, 2006 EOO07 Marketing Incentive 160,391.16 0.50% 801.96 2/17/2006 700.00 ----- For the Period From Feb 1, 2006 to Feb 28, 2006 EOO07 Marketing Incentive TOTALS 132,923.18 2,537,578.59 0.50% 664.62 12,687.89 3/17/2006 766.57 12,687.89 Department State Of Illinois Of Emplovment Security Work Search Record SOc:i_1 Security No. . . Client !iignm.,e ~!ftb Instructions. Please print this form and use the following tables to keep a record of all the employers and labor unions you contact while filing for Unemployment Insurance benefits. You are responsible for maintaining your work search information on the form proVided by IDES on a weekly basis, for up to 26 weeks. YOu will be required to produce your work search upon request. Failure to do so may result in denial of benefits. Be sure to bring your work search record with you if you come into the local office. If you need additional pages, contact your local office or duplicate thiS fonn. Important Notice: Keep Your Work search Records A determination that you were actively seeking work during a week being claimed is subject to reconsideration (the determination may be reconsidered despite the fact that you have been paId benefits or returned to work). In order to preserve evidence that you were actively seeking work, do not discard your wrftten work search record for any week being daimed until 53 weeks have passed from the end of that week. Further, if there Is an appeal pending regarding your active work search for a week, keep your written work search record until there has been a final resolution of the matter. Week Ending 2:2- "-I - oto Type Of W~rk', A(R.~, II ht :,',:, , . :Results ,"u ft'3 ~p Week Ending ~ - II ·. a.e .' ., ' .~~~.: .._ ~Il~~e'~1j4Add'!!5s'0f Contacz ,: .. c~~~ .,'.. Ex A2 Contact I-----~ate :.: """"And . _.. .. AddFess OfCoRtae:t . Co'":'':''oi :··Me1IIodGf COIlt!~_ Type.Of Work ~.':"Saught .R·····t5 l -:'>.';.,:1G. ", n fC'i'c. A~ ~ Admin 4;;-;,,1. C>Cc 4rlOlJn. ~ec·IAd~ E:xec.-4s~+. (.f:3~- n1ons+er & {Y/ons+er Ei. ~. ot+iLe. CrerJ.. AUG-12-201012:15 Week Ending ~_- ...· CLe 17083014295 _ Method Of-" C~Jlbe:t_ , Method,Of , : t';onta~ Week Ending (\ c.,t:W. . ,Results': " lhe. ·.it'd' ·l.t..~ <' I.l' .. . i.(.t" ,. re,,\c "1 e- mn ~-:;\ ,n l~'. , '" SO., Typ. ,Of'work'" , , lit' ' Results, Adyn;'" ' Th (\il {~ c..(~'t,Q..J. , niL.(jh~J'h I .,~ e.- '1'l6.j'" ,-'f mei:. ,I I f.k!,fMf (") fi ; Ad))), i'l STATE OF ILLINOIS DEPARTMENT OF EMPLOYMENT SECtJR.JTY wOJU( SEARCD RltCOIU) ~llB<DfrYNO. , CUPl<l'SSlGNATIJIdlren.etae ~ Use the bible below to bep a record Df all the employers and labor unioos you c:oatac:t while 81in Unemployment InsulanCfl benefits. You Ullift malDtala yoar .··ork seareb i.formatloJII OD the form provided by IDES 0 ·· a weekly basis. Yon will be requ.incl tG plI'Oduce . your work seareh UpODrequest. Failure to do so may result EDdellial ofbenents. Be sure to bring your work seardl Tecord with you if you are c:alled to report into the local office. If you need adcijtional pages to iecont your work search. contact your local office or duplicate this fonJ IMPORTANT NOnCE: KEEPING YOUR WORK SEAaCR RECORDS A determination that you were actively seeking work during a week beiDs claim is subject to RlCOnSidenrtion. (The detennination may be reconsidered despite the filet thlt you have been paid benefits or returned to work since thai.) In order to preserve evidence 1h1l1 you were actively seeking work, do not WSCIII'd your written work search record fur any week beitlg-claimed until S3 weeks bave passed ft'om the l'lIld oithat week. Further, if there is an appeal pcn.din.8 regarding your active work seafCh for a week, keep-your written work searcb record until there bas t>een a final resolution of the matter. WEEKENDINC~ CONTACT PERSON CONTACTED DATE NAME AND I\DDRESS OF CONTACT METHOOOF CONTACt- F'A)( ~1'S)t#iD3~1'113 FA~ r"}08Jlc81-5~"<a r:cod 5en,l. :WEEKENDING CONTACT DATE CONTACTED PERSON \-2v H~ i --)tp [ ( - (ilo WEEK ENDING OATE Ht2.. N'llKe.. \ H~ -~ a ..1- 0'\ . CONTACTED CONTACT PERSON SOCIAL SECURITY NO. __ WEEK ENDING COt/T"er a· I .., Q'I - "__ "__ WENT'S SIGNATIJU&» q M e ~.yru. 171383014295 P. El6 n ""K«.'(. RESULTS OATE ktfe.··..~ AUG-12-2010 12:18 " _ 17083014295 SOCIAL SECURITY NO. __ CUENT'S SIGNATURE ~CIJ e Lft P.01 \c}j.lljluvu/'f\ CONTACr METHOD OF TYPE OF WORK SOUGHT RESULTS fV10tl5fer "PersOl"k:\ I WEEK ENDING_~~_ DATE CONTACT ~~ ~Ct1e. WEEKENDlNG~ CONTACT DATE PERSON CONTACTED METHODOF CONTAeT- bf{'(le Dt'{ice e-rvta' ) SOCIAL SECURITY NO. WEEK ENDING COf'lT.'CT OATE L..l ~ II - a1- _ CLIENT'S SIGNATURE '::rj2/'Il £. tV e y, ·JLCfLl11 (.Y\ . 1 ... 17083014295 P.02 PERSON CONTACTED CONT'ACT" WTHOO OF ~ E-Mli~ I . · M'~' . ~ WEEKE1\l>ING ~ CONTACT C'Te lYPEOFWORK SOUGHT 4\ili e..t , t (Q DV\·e.vt.l. off i <.. e... f E~ LviIu , . etar WEEK ElmlNG ~: CONTACT DATe aez ".cB... WEEKEDJNG DATE CONTACT AUG-12-2010 12:18 - __ 17083014295 SOCIAL SECURITY NO. __ CLIENT'S SIGNATURB Ba:'Yl e 0 WEEK ENDING CONTACT 5- q - 09_ c.c'mp.;ft'r ..ctl';,. METHOD OF CONTAeT- e, ..~.(., . P.03 'Y, . DATE WEEK Er.'DlNG ~ CONTACT DATE WEEK ENDING 5" d e,..cfL . WEEK ENDING 5 -:"D :-r:a.. a fhQl1t,. APPly O~liVJ·e l!t'~'M.~4\f ~. k 'BiC. c: I-klM;n, .'. Mif6t-er i-{ f( . SOCIAL SECURITY NO. __ WEEI( ENDING CONTACT OATE Jo- (" - 09- -_- __ PERSON CONTACTS) Oll'" M(:.~'l . I, AWl:' PERSON OONl'ACTED ME1MOP F O OON'I"ACr Oa.t"\ · (.1 , e.tter' e/~ WEEK ENDING..1" CONTACT ~TE ao -oCL WEiK ENnING DATE (X)NTACT Jp ..a ~ - 0 q 17083014295 SOCIAL SECURITY NO. .......-- CLlEN1"S SIGNATURE ~ C (' Of) ,l:J-e cel'WL.(;/'(, P.05 WEEKENDlNG~ CONTACT DATE PERSON CONTACTED METHOD F O coNTACT" :rt'ltAt.<:ltl. C! WEEK E~1)(NG CON'I'ACT DATE P!:RSON CONTACTED MeTHOOOF CONTACT* . SOUGHT lYPEOFWORK · C '·c"O AilI- i ~c:cpm "J:f) ?eiSOO Admio . mOt'\5fer l\(. CATE <XlNTACT NAUEANDADORESS OF CONTACT CONTACTED PERSON OONTACr ME1HOOOF SOUGHT TVPeOFWORK RESULTS WEEK ENDING.-J OATE CONTACT d t') - 0 9CONTACTED PERSON NAME AND AODRI5SS OF CONTACT MElHODOF CON'IACr SOUGtn' TYPE OF WORK RESULTS r UIU AUG-12-2010 2:19 1 ,IUU:>: .)t;:a.l'vll 1111l1lUU:S VI JVLJ::I UUW 17083014295 I IVIVU::IL~Lt,,;V1U Don't lose trllck Of the jobs you've ~ppliea ror. You can reView the status of your submitted resume, tr"ck your progress, Mil compare with other CIlIl/lj(fate~ I/ho applied tor the same lob, I see how you AlISJlied with Rc5l1mC itle: r~~dicill S;St~lIl: fJ4~l"tr.o T M Cliver Letter: N/A o.te Applied: 6/J9/2010 Applv stBtIIs: Received Davs Pll.!ltedl a/9/2010 QUl!!ItiD,",aire: N/ A Applied with R.eSUIIM! Tiue: Me(llr.a: Mr.,stall! (J12UO Cover Letter: N/A Date Applied: 6/19/2010 Apply Status: Received Notes r~'\te-u--vetuecQ i Days Pasted: 7/18/2010 Questionnaire: N/A (\00 ~~er Appliod with Rc5"me Titfe; Mt::dlC31 A~~i~tan:: !'i42:l.10 Cover ~~r: Vir,,, ,~wt\,ie~t,ll' Notes Date Applied: 4/21/2010 Apply Status: Received Days Posted: 5/27/2010 Questlonnillre: N/A 'I(\1-er U\e~ d-' ALCf.p+eoR \)Ob 500 cha ·.·· ter~ remaining C Applied with Resume "title: Cover Lefter: Oilte Applied: Apply Stl'M: DayS po.sled, Questionnaire: R~ceiv~d 4/26/2010 N/A ."4~·1:c,,1 SSI~~~n~04;'.~,\l) A liieo: ,ov~r I(~t~<" 4/2114010 RUG-12-2810 12: 19 CBJobs Job Title ~ \fC:a~ Location 17883814295 17883814295 P.89 .A. "1:>"'" ·. VA ·. Posted Expires Saved Floater. Phlebotomy Service @ Quest Diagnostics Expired 6/1912010 Application History Job Title Certified Medical Assistant Medical Assistant Rap. Phlebotorny Services Location Posted Expires Expired Expired Appli9d 6/19/2010 6/23/2010 6119/2010 US-IL-Plainfield 3 Weeks Ago In 3 Days 666 Dundee Rd., #501 Northbrook, IL 60062-2733 (847)562-0267 ~@06 $ 3 Other income Miscellaneous Income Copy B For Recipient Form 1099-MISC 4 Feder.ll incvme laX wi1hheld $ 5 Fishing boat proceeds $ 6 Medicaland hallh care paymerts $ 9 $ Payer made direct sales of 10 $5,000 or more 01 consumer Crop insurance proceeds This is Important tax information and is befng furnished to the Internal Revenue Service. If you are required to file a 7618 W. Saint City, slate, and ZIP code Francis Road products to 8 buyer (ltlClpient) for resale ~ 0 $ 12 Frankfort, IL $ 16 State t2lC withheld "n. _. Account number (see instroetions) penalty or other sanction may be imposed on you If this income is taxable and tt1e IRS determines that it has not been reltJrn, a negligence reported. 17 $ Form $ 1099-MISC MV1099M·B JL __ .___. ,.___. ., . . . _.!! StatefPayer's state no. _n ····· _.P.. 18 State Income ;$ ·. __ _.. _"""" Ex B &.176900000 SLM Financial Corporatlon Educatlonal Loan ProgrlUl1 Re a ment Schedule aOl;l Truth-Jn-Lendln Disclosure V.Ui».,:';,;'~!p,miili',iBc1i'g~er~W!NWIli'il.::",,~IJljl!"U!U' i;; if ! iiii:'''! dli " li,,~iI!~ iii;Jllo~f ",'!:r.'''!~1l!1i !l!iii,,;''''!~ I I Date 08/29/2006 iI1li~!,,;: JANELLE GEDMlN In this disclosure thc words 'you' and 'your' refer to Borrower and any Cosigner. Lender refers to SALLIE MAE BANK , located in the state of UT School refers to COMPUTERTRAINING.COM - IL The Lender has approved a Loan for $ 25.265.00 . The estimated funding date for this Joan is 08f3lf06 The interest rate you will pay on the loan is the Prime Rate as pUblished in The WalJ Streer Journal plus 3.000 % (the Margin), Your current variable interest rate is 1 1.250 % . In no way will the interest rate, exceed the maximum rote allowed by law The Prime Rate used to calculate your variable interest rate was 8.250 % The supplemenlal fee for tbis loan is 3.1224 % ruth-Inending Isclosure TIle amount of credit provided 10 you or on your behalf. The amount you Will have paid when you have made all scheduled payments. )~:;I~\\j\.l\!iNNu]\l!!i\2~~NjjI~)(:~I~.,m~.¢El'lrIf~'&wtl~;'.:I.I , ;! ~ l ~I : The cost of your credit as a yearly rate. ; Mr:!~i;~.~~ilA~lifiWrmlcifl:\ll! illlU.r,\,'::iralllil\~&~~r.~~m:~I\UiilT.t11\lln~I~J1 s 11.743 % Late Charge: Prepayment: Variable Rate: The dollar amount the credit' will cost you. Security: Addltlunal Terms: 57,682.85 S 33,182.85 $ 24500.00 Ifany part ofa principal or interest payment is more than~ days lale, you will have to pay a late charge of.J.Q..QQ!!..'/o, of !he monthly paymenl or .$ 2000 , whichever is greater. rfyou pay off the loan early, you will not have to pay a penalty, if you prepay your loan, you arc not entitled 10 11 refund of any finance charge. The interest rate will change monthly on the lirst day of each month. The rate is equal to the sum of !he highest Prime Ralc as published in The Wall Street JOllrnul 2 business days before the end of the prior month, plus the Margin disclosed above per annum, rounded to Ihe nearest one· fourth of one percent (0.25%). For example, the interest rate for January will bc de1ermincd by the Prime Rate published the preceding December 29th (iflhere is no intervening weekend). Your interest rate will increase if the Prime Rate increases. An increase on lbe anniversary dale of this loan will take the fonn of big her payments. For example assume tbat your Joan is for Slo,OOO at 10.00% interest for 120 months. If the interest rate increases 1010.25%, your monthly p.1yment amount will increase on the next anniversary of your first disbursement from $132.15 to S 133.54 An increase in the Prime Rate may result in payments insufficient to cOver the interest due. Any difference not made up durinllthe year will be added to your loun amount on the next anniversary date. You have given a security interest in any refund that may be due 10 the student from tbe School. Please see your Promissory Note for information about nonpayment, default, the right 10 accelerate the maturity of the obligation, and prepayment rebates and penalties. e means an eslimate average. :V:;;~P~~~\Jj~~i'~'ffi'l~yt~:"i'l;Wr,~ii~~;PJ!'h~;~(;~'~l"o!'Jta~~~iif?~~~tJii!''diliJ!~';lil:li!l~l.lill:l~iIlllH:l·lIl!nl!m.M'i'l'l'~W·!ma\ililiI:1~.~lr!i1I!1l!l1lf1Uc~1W;rti!i.i!nl'1"Ii~:1iIl\iI~edr;I,:r'~Jrdlili,"mrilllmi;'"IT!lllIni . !l ll "'; " i l; ' i\,' : ll ~ il le 'i i l l Q", if ~; \ i nm Number of PaymenL, 12 179 ! S S Amount of Pavments· 10.00 319.68 340.13 'These payment amounts are an eshmated S $ $ When Payments Are Due (MonthlY Beginning) 1l9J28/l}{j 1l9J21l1lJ7 08128122 $ $ $ 24,500,00 765.00 Amount Financed Supplemental Loan Amount Fee (Prepaid Finance Charge) 25.265.00 S S S SLM Financial Corporation (as servleer fur Lender) S S $ $ S S $ $ S $ $ S Addltlonll1 Fees: Payment Return Fee: If you make a payment by check or otherwise and !hat payment is returned or refused by your bank for Bny reason, you agree to pay a cbarge up to 520,00 for each payment so returned. Such Payment Return Fee may be added to your prmcipal balance hercunder and accrue interest at the rate provided in this Disclosure, without notice. You may request and thc Lender. at the Lender's sole discretion, may grant you a Forbearance under which Forbearance Fee: you may defer regularly scheduled payments for up to six months. If you request such a Forbearance and the Lender grants it. you agree to pay up to a $50.00 Forbearance Fee. Such fee may be added to Your Principal Balance By signing you acknowledge receipt of a compleled copy oftnis two page disclosure of x Borrower's sraturc x Cosigner's JANELL GEDMIN Date Date x Cosigner's x Cosigner's Sign Sign Date Date Signature Sign and return to: SLM Financial Corporation· SLM Financial Corporation· PO Box 470. Marlton, NJ 08053-0470 or 6000 Commerce Parkway. Suite A · MI. Laurel, NJ 08054 SLMF0506 1111111 1111111111111111111 IIIIj ' '11 Iml Jllif ifill 11111I J11II1IJ1I1J11IfIIIIII r IlJllI/IJIIII'" IIIIIIIJIII fill 11II1 11111 11111 111111 11I11 1111 1111I 1111111111111111111111111111 I JIIIIII 1111 1111111111 1II1111111111111111J 11I111111111111111 Ex C x. ~ _ x Cosigner's Signature _ _ Borrower's Signature Date JANELLE x GEDMIN x. Cosigner's Signature _ Cosih'ller's Signature Date Sign and return to: SLM Flnanehd Corporation' PO Box 470 · Marlton, NJ 08053·0470 or SLM Financial Cor oration' 6000 Commerce Parkwa , Suite A · Mt. Laurel, NJ 08054 [---~----l Cn:_~._~J L .__ _ +~.~: __ .J 2 4 6 ederallncome tal< w1l11lleld --~-~ .._ 988.11 Sodlll 5eQllily lax V/ilhheld Jr::J:. De iIf1meni of the Treasu - - InlemuT Revenua Service Control roo 1 Wages. lips. ather CC/TP. 8439.46 3 Socialsecuritywages 5 Me1Ilcare wages and tips 849 = 58 ~$ C ~_ ··· __ t l trol no. This Infomallon 843946 EmpIO)'flI'll name. adcIn::o$, and ZIP code ~e~e/nlu"e::S:1r.vfic'ee.d Rv e name. addnlss, lIlId ZIP code Wi. ChIcago Bath.s.yslems LLC 7748 W. 99Th Street Hickory Hills. IL 60457 Chicago Bath Systems LLC 7748 W. 99Th Street Hickory Hills. IL 60457 9 0.00 Advance EIC payment 7 Sodil security tips 0.00 8 Allocated tips 10Dependl!fll ClUe benefits 11 NonquaUfiedp1D1lS 12aSee Ins!. 0.00 fill" boJ< 12 7 Sadal securilyUp$ 10Depenclenl QI1e benefits 0.00 8 Allocaledtlps p/DIls 11 NonquaIified Employee's name. addless, and ZIP code Janelle L Gedmin 7618 W St Francis Road Frankfort. It 60423 Employee's narre. address, and ZIP code Janelle L Gedmln 7618 W St Francis Road Frankfort. It 60423 38-2099803 2007 1~~:~D~::_ ~6_~~=-~0!0~ 1~~:..~~_ 27 .38-2OS9B03 17StaI ·· lncome~_ ~6~~~~~J~~~6 18Localwages.llps. ._".. .-wF~2- W~@JI!l.d_ Tax ._ Statement Copy.2 - To Be Filed ------------ 253:18- 18Loca1wages.lips,elc. ----------- -"---'- ···W--2-Starement-· --'---'_.'-_.'-""-253;18-".-'--"'---' Copy Form Wage and Tax 17slaleinc:omelax 2- To Be Flied ------------ ----------- .. .-- ele. With Employee's State, City, or Local IncomaTaxRelum. 19Local Income lax ------------ 20 Locality name ----------- With Employee's State, City, or Local Income Tax Relum. 19LClall income lax ------------ 20 LOCSrily ame n ----------- Ex 0 FllER'S name. slreet address,clly,lltale. ZIP code, and telephone number o C RRECTED $ $ 1 PaymenLs rec:elved far qualified tultion and relatedllllpl!llSes Joliet Junior College J.215 Soubolt Rd Joliet, __L &0431-8938 I Tel~phone: FILER'S Fedelal identllicallon no. -' 897.00 related expenses qualIfied lullion and 2 AmountsbBIedfor ~@07 Tuition Statement CopyB For Student 3 If this ball is clled<ed.your educationalinsUlulfon lias changedits nlPDfllngmalhod lor 2007 4 Acf)USlrnenlsmade lor a prior year Janelle Gedm.i.n IL 60423-6931 $ $ AdjuSlmenls to 7618 W SAINT FRANCIS RD Frankfort, 6 7 Checked il lhe IIIIlOIlllt This is important sdlolllnlhlps or gl1InIs In box 1 or 2 includes amout1l!1 for en aCllllemlc pedod begiming JanumyMardi 2008 1ax information and is being for a prior year Service Provider/Acel No. (see instr.) 8 $ Checked 1/atlellel hafr.ume sluden! 0 furnished to the Internal Revenue Setvice. 0222063 - ·-'---Form-1098--T IE 9 Checked If a gmduale Illudant ···· 0 10 Ins. ""nlred relmbJrelimcl $ -------------Ot:piltllT'olnl'Dft/WTIlIllsorr--mmrllal"ReYli'llue~ietl-·_- (l'leep-foryourrecords)--" -- --- An eligible educational institution, such as a college or university, in wtrich you are enrolled and an insurer who makes reimbursements 01 refunds of qIJiIMtled tlllllon and related expensas to yOll, must fumlsh thls statement to you. YOll. or Ihe person who may claim you as a dependenl, may be able 10 take either the tuition and fees deduction or claim an education credit on Form 1040 or 1Q40A for the qualified tll/llon and related expenses that were aclualty paid In 2007.lnstnullons may report alther paymenls ruceived In box 1 or amounts billed In box 2. The amount shown In box 1 or 2 may represent an amolint other than the amount actually paid In 2007. Your Institution must Include iI$ name, address, and Information contact telephone number on this statement. it may also InclUde contact Information for a selllice provider. AI/hough lhe service provIder may be sble to 'snswer certain QUeslions alloutthe stalement, do nol c:on/a(;Ithem or the filer for$lplanalions of the requirements for (and how to figure) any allowable tuition and fees deduction or edUcallon credit that you may claim. For more Information about the deduction or credit. see Pub. 970, Tax Beneflls for EducalJon, Form 8863. Educallon Cte<lits. and the Fonn 1040 or 1040A Instructions. Account number. May show an account orolJler unique number the fiIe,asslgned to distingulsh your 8Q:OUnt 80x 1. Shows the Iotal payments recelYed rrom any sowce for quallfied lullIon and related expenses Ie" any relaled refmbul8emenls or refunds. Box 2. Shows the lolal amounts billed for qualified tufUon and related expenses less any related reduellons In cherges. Sox 3. Shows whether your Instltullon changed /Is method of reporting for 2007. II has changed lis melhod of reporting If the method (payments received or amounts bUled) used for 2007 Is dltrerentlhan the raporUng'method used for 2006. You should be aware 01 this change In fl!Juring your allowable tullioR and fees deduction or educatIon credits. The deduction and the credits are allowable only for amounls actually paid during the year and not amounts _ eported as billed, but not paid. during Ihe year. r Ball 4. Shows any adjustment made for a prior year for qualltled tuition and related expensesthet wern reported 011 a prior year Fann 1098-T. This amallnl may reduce any allowable educalion Cll!ldit you may claim for the prior year. See Form 8863 01 Pub. 970 for mare InformaUon. BOil 5. ShoWs the total of ell scholarships or grants administered and processed by the eligible educationallnstilutian. The amount of scholarships or grants for the calendar year (including those not reported by the lnstituflOfl) may reduce the emount of any allowable tulllon and fees deducllon or the educellon credit you may claim for the yeer. · Box 6. Shows adjustments to schofalShlps or grants for a prior year. This amount may affect the amount of any allowable tultlon and fees deduction or educallon credlt you may claim for the prior year. See Pub. 970 for how to report·these amounts. Box 7. Shows whelher the amount In box 1 or 2 Includes amounts for an academic period beginning January-Mardl 2008. See Pub. 970 lor how 10 report lhesa amounts. ~ Box 8. Shows whether you are considered 10 be canylng et least one-half the normal tun·time WOIk load for your I';OUlSl! of study at the reparting Inslilution. If you are at least a half·llme student for at least one academic period II1at begins during the year. you meet one of the Rlquirements for the Hope credit You do not have to meet the wor1<Ioadrequirement to qualify for the Iuitlon and fees deduclIon or the Rfellme learning credit. Box 9. Shows whether YOlIare considered to be enrolled in a program leading 10 a graduate degree, graduate·level certificate. or other recognfud graduate.Jevel educational credential. If you are enrolled In a graduate program. you are not eligible for the Hope credll, but you may qualify for the tulUon and fees deducllon or the Ilfallmaleamlng credIt Box 10. Shows the tala I amount of reimbursements or refundS of qualified tulUon ll1Id related expenses made by an Insurer. The amount of reimbursements or refunds for the calendar year may reduca the amount of any allowable tuition and fees deduction or education credit you may claim lor the year. f\o.·wr"\ vy, lau Student Class Schedule ~t )i..Pki/}V).R/)..... . JZ~lC.~C~"(\ (~to --{)Ler r"lt) (0 l 'O./~.Y..1Q.t ()c»vu.Q.Qc __C_l_c__t_ print Schedul_.'_, 0e ik o . _. __ .-.-------_ ~ 1-- .. ..--------- --~\r------- . ~-r CI:".J ~. ----'----------~------_.---------------------~------ ..----i-----' ,-., FORM Copy 8· To Be fIIod With Empl"V""'s FEDEJIALT ····1IatJ.m. ThIlt Inlormallon Is bIIslg f\lmiShIId 10 1he In""naI Rev ······ Semce. W2 - Wage and Tax Statement 2007 L_~_.·_. . ._~ "·..."331eJr--. ~ j i I ·.···. ··.. ·~McI tu r xw held 2 4 6 --_! o.1.imifti" Dfifiilfiln.v-k.,nit mpensatian Federal income c plolet · Mme, address. and ZIP code Medicar. tax withheld f tv tPo whhhekl 773.05 386,95 BIG SHOULDERS DIGITAL VIDEO PR 303 E WACKER DRIVE CHICAGO, IL 60601 .- ·· Lastname JANELLE L. GEDMIN 7618 W SAINT FRANCIS RD FRANKFORT, IL 60423 I Emplo-ye.'. ocIdmss and ZIP code _f~_ FORM Statement Cop, 2 · To Be filed wlth Employee's W2 Tilt Wage and Tax 2007 Slole, CIty, or Loc81 · Ol1-20205 DMIlNo.11_ 7 cIII_trlills 3 SoclalAaJll1Y_ 5 Mod1caIe W"ll"8 _ 6241.13 4 8 SaclolllDCUri1'("" Withheld MedlcIre 11111 II_ w 773.05. 386.95 m-ne Return. c Employe", name, address, end ZIP code 624l.13 lip. BIG SHOULDERS DIGITAL VIDEO PR 303 E WACKER DRIVE CHICAGO, IL 60601 ·· Employee's 1St nameandinltla Last name JANELLE L. GEDMIN 7618 W SAINT FRANCIS RD ___ -l[~KFO..E%, It. 60423 I Employee's address and ZIP code .X!>. _ ,_.~ 1 ~._ . .. ! ---<.!!;".;.." . Ex F I I I Em 0 r idenlif ·····ion number (EII\ EmplQyl>l"S name. alIcfress. and Z1PCCllle '20 SQIIInsIIIldIDllS for Box 12 , Wages, tips. lllher oompensallon 2 RKI81ll1 1I1C0l1llIIax WlIMl!1C ; Ub 27657.41 .SocIaIseculily VIlIgeS 4 Social seculily 3506.36 lel< llrilhheld ALLSTATE INSURANCE COMPANY HUMAN RESOURCE SUPPORT TEAM Sl WEST HIGGINS ROAD Sl'E VGA SOUTH BARRINGTON, IL 60010 1~ 12. i2c ! 27657.41 MelIlCa/.8·waues and lips' . B MedIcate 1714.76 Ialllllil!ll1el!l . ~~~~57.41 401. 03 ! ".:'8 JANELLE 7618 W SAINT FRANCIS RD FRANKFORT, XL 60423-6931 L. GEDMIN = o o letu)' ~~'"':Jo.:J,-;1 5 Slale ~~-.. Em I . idllirlific:atlail : '6 ~,1I;!Igll$;;:.~:;< ',7S1l1e _____ §~1~_tl ~1 . laxL:::: ..... _.. ." . _ ~~2~§1 __ ;lgll$;.!IJI$o;Jllnef,cemperl1ia tax WI ni.iiJiei' - '.' .. . INSlJIUINCE COMPAID! f2tJ , Employer's name.:address.llIld ZIP coile ALLSTATE SOUTH BARRINGTON, !lOMAN RESOURCE SUPPORT TEAM 51 WEST BIGGINS ROAD STS VGA IL 60010 12c -- ..·.. .::.>:·l~ i 12· I ! ~"'.s!!cUI!lY'wageS,.. :M~:waoes_~UPlF . ,.~Ilp!!'>':"'.: - -··-2·'1-6-57.413506;36 .. 4Soc1.als":'"!lylaxwltNleld ; 27657.41 :. i. ' &~~.tai<".ltlhekf· l! AIIoi:itIedtipS' 1714.76 401.03 27657.41 .. :: 1'L.~.L1o rSHH"lIro·'3-OXc;n 7618 W SAINT FRANCIS RD FRANKFORT, IL 60423-6931 JANELLE L. GEOMIN 604 001615 :.'8= o 1-'111111111I111111111111111111_11 1111111.11111.-111._111.111 III) Em Ir idet1tmi:iation nUmber Bnployer's name, address, and ZIP code ALLSnTE HUMAN an·' : ; ~.SodBI ~dly.lax 121: lax·\IIiI!e. :l lJ 3506 .. 36 WltNleld TEAM 51 WEST BIGGI:NS ROAD STE VGA RESOURCE INSURANCE COMPANY StlPPORT 1714.76 IJ-Medio:lirel\ll!' wi1llheld . SOUTH BARRINGTON, IL 60010 "..:.. :.~t;-:·:::'::-;::. ::. r- 1 ! 2d 401.03 JANEU.E 7618 W SAINT FRANCIS RD FRANKFORT, IL 60423-6931 L. GEDMIN .(Z~~!~i:~·:~ ;.-.. :"'.!.':~:"':"' ·. ' _ ". ':l · '. _. · .' ThIs In!cnnation Is being fUrnished 10 Ille Intemal ReYEnUeserviCe '13 o "-"=.,r. " '-. . 5 St8 e Employer's state I number.-, ~J;;__ ; 22bl2 EmplOridenlitlCallOn hUmbel' El emploY8~.'s·name. ~ acldr<l!o&,.lIM ZIP cocIe INSURANCE COMPANY RESOURCE SUPPORT TEAM . ... 3506.36 . ;~at ...... S!l!'UIi1y lnCame1llll I ALLSTATE iex wi1l!h~ 51 WEST BIGGINS ROAD STE VGA SOUTH BARRINGTON, IL 60010 li;~_I!I'.Il.1axWilltlllld 1714.76 401.03 'b Em 0 I!f c enployer'sname, ilenlillcaUon number IEtN addfess, and ZiP cccle Y2e elf BnlllOYws naml!, BddrBSs,llIld.ZIP.i:ode ', .. ' ".".' '.~ " .. ::'.'. ! :'. 7618 W SAINT FRANCIS RD FRANKFORT, IL 60423-6931 8 ·,."8S1ll.Ie .·····.·. - JANELLE ~DMIll .. With Employeo's ' C~py 2";''(0 Be·Flled· . State. City, or Loc;al> . 14 Olher Income Tax Return'.; :,i soi:Iolse<Uilyl1!'Jll!lir 1I ···· ~'$ __~!~~ __ ~····..·'.8te. ".:'~ ,1 · . e.I.nco.· 8.. 111ll : ' -'-" . .m / 1' '· IC·'· .. 1]~a!_:~._~ a1~:::~~e:~· ~~~_l._~ncan&lalC~_:~~~~ '. ~s .,. IlCall ~ 2O'~IY'Nf1\e _ Taa Rd omelaK ····1I!IG ' ------------------------~------------------------"-.----~ b Em iilenUIication number Et c ·Employer's namu, adc:tess, and 2IP'lIllde .Form W-2 W·· and T.~ Stalement llOOl -Oepal1menI or· the Treasury-lnlemal. Revenue 5arviee ..---.-------_.--_._.----------------------------"-----------------------------_.----_ OMIU·' 545-0008 - Te ····.··.·· . Wl!9SS;·/lpS;. . EmpIDrloe'. _e, CU" .r.Le·· ,_ "II" r campensalian. .. .. ' 2. . ALLSXATE INSURANCE COMPANY HUMAN RESOURCE SUPPORT TEAM 51 WEST BIGGINS ROAD STE TGA SOUTH BARRINGTON, IL 60010 >:~";; :.;.. 121> 2441.26 . SoC:laI. "":Wlly.Wll9eS·; MelIICiie:~ ~Ilps lC 4 Social security tax "~llVleld . 6'Medicara tax y,ilhheld 308.04 151.36 35.40 12d 1 : : 1 20 2441.26 1I~ l1}1ps.· . 2441.26 210 %LALL 7S*·"''''Auro**]-1lrG:rT JANELLE L. GEDMIN 7618 K SAINT FRANCIS RD FRANKFORT, IL 60423-6931 6alli '1 .....,., o .....,.. I'll JIll II Mil '11I11I11t11'"111'1 "Ull"1I11"III'llu'II'1I11 /If,m . rJientlrlCaliOn number· EJN .~' C Bnploy~r'gname. actlraS'i, :8I1dZ1P..code .; .. 8QI!l!, ps,: .. erCllllllJlen&a e . 18K Wit ALLSTATE HUMAN RESOURCE INSURANCE 51 WEST HIGGINS ROAD STE TGA SOUTH BARRINGTON, IL 60010 SUPPORT COMPANY :$Ql:l!l! $IlCUli!YlIlliIgBS '.'. c., ":'.' ,. ,. "~lII.!;BCUriIv 2441.26 18K\\ilhllelcl 308.04 151.36 35.40 TEAM 'M~'Wages 2441.26 2441.26 .' 1II1d!IllS:::': '; ·. U~edlciu'e.tall y,ilhheltl· .. ' " II Anoca19Cf Ups , s!JCl!l1~' .J:lS,: '~':"" JANELLE L. GEDMIN 761B W SAINT FRANCIS RD FRANKFORT, IL 60423-6931 .~~JJir. . oepanmenl TIlls rnirmnaUon Is being furnlsl1ed 10 \he 'memlll Revenue Service """" o" ~"l' .b c 'Employer'$ name ·.·adclr~ ·.and ZJf>·C«Ie HUMAN RESOURCE em ... ri~ iiumber eN' ---------------_._----:---_. __ .._----------_ of.lhe Trea:5U.'Y·.I.nlellllllRsvel1.u ··.~...vIc:" OMB' 1545-0008 Co., B-T. . ..S~._With..;".,·-··-·~·. .:....-_----R.. ~ "" · ·· _~ Fu.el FEDERAL T·· ALLSTATE INSURANCE SOUTH BARRINGTON, 51 WEST HIGGINS SUPPORT COMPANY ROAD STE TGA IL 60010 TEAM JAN&LLE L. GEDMIN FRANKFORT, 7618 o . ··,,=',".. W SAINT FRANCIS RD IL 60423-6931

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