1833418 - OMB No. 1545-0008 REISSUED STATEMENT 1 Wages,...

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OMB No. 1545-0008 OMB No. 1545-0008 d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code 7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment Code 12b 12c 12d 10 Dependent care benefits 11 Nonqualified plans 12a Co de Cod e 10 Dependent care benefits 11 Nonqualified plans 12a 12b 12c 12d 13 Statutory Retirement Third-party 14 Other employee plan sick pay 13 Statutory Retirement Third-party 14 Other employee plan sick pay e Employee’s name, address and ZIP code Wage and Tax Statement Copy C For EMPLOYEE’S RECORDS (See Notice to Employee on back of Copy B.) e Employee’s name, address and ZIP code This information is being furnished to the Internal Revenue Service. If you are requi to file a tax return, a negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. red Department of the Treasury – Internal Revenue Service tate Employer’s state I.D. no. 16 State wages, tips, etc. 15 S 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name Form W-2 Wage and Tax Statement Copy B To Be Filed With Employee’s FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Department of the Treasury – Internal Revenue Service 15 State Employer’s state I.D. no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name W-2 Form OMB No. 1545-0008 OMB No. 1545-0008 c Employer’s name, address and ZIP code d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld c Employer’s name, address and ZIP code a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld 7 Social security tips 8 Allocated tips 9 Advance EIC payment 10 Dependent care benefits 11 Nonqualified plans 12a 10 Dependent care benefits 11 Nonqualified plans 12a C ode 12b 12c 12d 7 Social security tips 8 Allocated tips 9 Advance EIC payment 12b 12c 12d 13 Statutory Retirement Third-party 14 Other employee plan sick pay 13 Statutory Retirement Third-party 14 Other employee plan sick pay e
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1833418 - OMB No. 1545-0008 REISSUED STATEMENT 1 Wages,...

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