Free Motion for Miscellaneous Relief - District Court of Arizona - Arizona

Social Security Administration
Retirement, Survivors and Disability Insurance
Earnings Record Information

From: Office of Central Operations
300 North Greene Street, Baltimore, Maryland 21201

O
AKIN GUMP Date; MAR fl G
. STEPHANIE OSTEEN
SUITE 4100 Refer to: S2RBlB/ 61323
1700 PACIFIC AVENUE ·
DALLAS TX 75201 V Your Reference:
We are sending you the statement of earnings you requested for the number holder shown below.

Number Holder’s Name: Social Security Number:
PATRICE JEROME
lf we recently received earnings information, it may not yet be shown on this statement.
Please read the back of this letter for more information about Social Security records.
If you have any questions, you should call, write or visit any social Security office. lf you visit,
please bring this letter. It will help us answer questions.
Enclosures:
Original Letter —·
Earnings Statement
Control Number: # 0607216060l
Remittance CTL Number: # 200603130158

Department of Health and Human Services Form SSA-L460 (4-91) Destroy Prior Editions
Social Security Administration
EXHIBIT
§ T
Case 2:03-cv-01913-IVIHIVI Document 64-3 Filed O3/28/2006 Iga

a _ SOCIAL SECURITY ADMINISTRATION
Baltimore, Maryland 21235
CERTIFICATION OF EXTRACT FROM RECORDS
Pursuant to the provisions of Title 42, United States Code, Section 904, and the
authority vested in me by 42 United States Code 902. I hereby certify that I have ·
legal custody of certain records, documents, and other information established
and maintained by the Social Security Administration, pursuant to Title 42, United
States Code, Section 405, and that the annexed is a true extract from such records ‘
in my custody as aforesaid.
l I further certify that all signatures of Social_Security Administration annexed
document(s) are genuine and made to the signers’ official capacity.
IN WITNESS WHEREOF, I have hereunto set my hand and caused the seal of the
Social Security Administration to be affixed this M W2 day of 2006
, »Wa»< aziié
Steve Donnell I
_\, l. _ U Division Director
A J A ,1; V ‘ Division of Earnings Record Operations
· Office of Central Operations
* ‘rtt ,` I
I I {Egg ` Ar A .
_ r A la , ‘
rl rli|||IlIli i
*4;, If P ‘ r
Form SSA-473 (3-96)
Destroy Prior Edition
l
Case 2:03-cv-01913-IVIHIVI Document 64-3 Filed O3/28/2006 Page 2 of 4 V

SSA-1826 _, -- ITEMIZED STATEMENT OF EARNINGS JOB:
VERSION 1984.002 * * * FOR SSN * * *
M I I
h FROM: SOCIAL SECURITY ADMINISTRATION · 'L
OFFICE OF CENTRAL OPERATIONS
300 N. GREENE STREET .
BALTIMORE, MARYLAND 21290-0300
ANN GUMP V NUMBER HOLDER NAME:
STEPHANE OSTEEV PATRICE JEROME
1700 PACIFIC AVE STE 4100 ‘
DALLAS TX 75201
PERIOD REQUESTED JANUARY 2001 THRU DECEMBER 2004
I YEAR JAN - MARCH APRIL —JUNE_ JULY - SEPT OCT - DEC TOTAL
EMPLOYER NUMBER: ~86-0661598
INFINITI OF SCOTTSDALE INC I
% LARRY VAN TUYL PRES
6420 E MCDOWELL RD
SCOTTSDALE AZ 85257-3134
I 2001 --—— $
` EMPLOYER NUMBER: 86-0985682 H
BILL HEARD CHEVROLET INC-SCOTTSDALE
7224 E MCDOWELL RD _
SCOTTSDALE AZ 85257-3404
2001 - - — - $ .
2002 - - — - $ I _____2
EMPLOYER NUMBER: 94-1737782
CHARLES SCHWAB & CO INC _ I
215 FREMONT STREET FLOOR 7A_
SAN FRANCISCO CA 94105-2318 _ I
2001 - ~ - - _ - $ ‘
PAGE 001 I I
I ` I 1 nt 64-3 Filed O3/28/2006 PGQG 3 OI 4
Case 2:03-cv-01913-IVIHIVI DOCUITIG

SSA-1826 ITEMIZED STATEMENT OF-EARNINGS JOB:
VERSION 1984,002 * * * FOR SSN * * *
YEAR JAN — MARCH APRIL -JUNE JULY — SEPT OCT - DEC TOTAL
EMPLOYER NUMBER: 86-0850437 l
MIDWAY HOLDINGS INC .
% LARRY VAN TUGL -
2201 W BELL RD V
PHOENIX AZ 85023-3213 Q
2002 - - - » - $
EMPLOYER NUMBER: 86-0721295 I
PAY-TECH INCORPORATED
` % RUTHANNE HUMPHREY
640 E PURDUE SUITE 102
PHOENIX AZ 85020-2053
2004 A- - 0 .1- — $
EMPLOYER NUMBER: 86-0971538 _ ` »
DHR PAYROLL CORPORATION
COMMON PAYMASTER
2735 E CAMELBACK RD
PHOENIX AZ 85016-4302 _
2004 ---— 0 $ W,_ 4
EMPLOYER NUMBER: 90-0006816
ALPINE LENDING LLC
2425 E CAMELBACK RD STE 800
PHOENIX AZ 85016-4208 _
2004 -—-— $
THERE ARE NO OTHER EARNINGS RECORDED UNDER THIS SOCIAL SECURITY
NUMBER FOR THE PERIOD(S) REQUESTED.
EARNINGS FOR THE YEARS AFTER 2004 MAY NOT BE SHOWN, OR ONLY _
PARTIALLY SHOWN, BECAUSE THEY MAY NOT YET BE ON OUR RECORDS.
_ PAGE 002 END ·
A D ment 64-3 Filed O3/28/2006 Pagé 4 of 4
Case 2:03-cv-01913-IVIHIVI ocu ,

Case 2:03-cv-01913-MHM

Document 64-3

Filed 03/28/2006

Page 1 of 4

Case 2:03-cv-01913-MHM

Document 64-3

Filed 03/28/2006

Page 2 of 4

Case 2:03-cv-01913-MHM

Document 64-3

Filed 03/28/2006

Page 3 of 4

Case 2:03-cv-01913-MHM

Document 64-3

Filed 03/28/2006

Page 4 of 4