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t- tofHuman.Re,
jun. ,201-9,
Re: Unpaid Self :Pay Insurance Prerniums K;athryn Nola �iE 5742*
n
k. d as- a Community Livmg Support -
Kathryn Nollanis a fbem'er Gra' t Cou- h-ty e mi ploy
n: ,ee who wor fe
Aide with DCL -from June 12, 2018 through March 6, 2019*Wun n
hen she vol1v resigned for
Personal reasons,
Whille employed with Grant;County Kathryn Nolan moved'.[nto leave without pay
status during pay
pedod 11/9/18 fbr a tota'.*[ of $82.00.
�yg.
r.n,was:s.-ent.s;eif-petypre.mj'um.noticies-onll./9-118 1.1121/18 1-2/10/18t, 12121118-1/10/19
tdate
1/25/191) 2125/1913/811 9-1... �/22119- 4/10/19., 4125/19s 5/1011:9, Fina'i Notice on:5/-24/19, -an-d o-
ent on thisamount du nt Countv
has not made a.,,pa . e to G ra
ym
Lau Of ssa. Perez
Behefits &.Paymll S'pecialist.
r fo
BoardAction. on E lo, .'R , e, q ... equest.. nv ar. . U..,.I*.:QT S ffil C. I.On rgive
MIUM.-
am.q.U.-i:.It due ($82) for -unpai'd. p4y - -e "od. 11/9/1&
_pn..,. Pre...
M'fora
....,_ive- debt. Cl send forward. to. Auditor .for collect'
Thomas Tayl6r., haix
71ol
V t
c idn
C(i! ady Datebf A. t'
&h - a -rd. Ste vens',Commi'ssigner
Grant .County Human* Resources �?O Box. 37 35 C. Street NVV Ephrata, WA 98-82.3.- (50 9) 754-2 11