Employer id no 12 3456676 1 wages etc 22500 2 fed tax

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Unformatted text preview: loyee's SSN: 123-45-6789 Void b. Employer ID No. 12-3456676 1. Wages, etc. 22,500 2. Fed Tax WH 1,500 c. Employer/payer name, address, and zip code: Name1: News Shopping Network 3. Soc Sec Wages 22,500 4. SocSec Tax WH 1,395 5. Med. Wages 22,500 6. Med. Tax WH 326 7. Soc Sec Tips 8. Alloc. tips d. Control Number 9. Advance EIC 10. Depndnt Care e. Employee's name (1st,MI,last,Jr) Gloria Ramsay 11. Nonqual plans 12. See instrns. Code Amt. Name2: Street: 345 Sahara Rd. Lancaster City: 23456 State: MS ZIP: Check if foreign address. Note: See help panel for special data entry instructions. Do NOT carry name from Bkgd Wkst f. Employee's address and ZIP code Add1: 123 Main St. Add2: Apt No. Cicero Town/City MS 99999 State & ZIP Do NOT carry addr from Bkgd Wkst Note: To e-file your address and your employer's address must be entered exactly as it appears on the W-2. 15. State MS Employer State Tax ID # 3422555 13. Statutory employee . . . Retirement plan . . . . . . . Third party sick pay . . . . Note: If you have a Code P amount complete the section for ad...
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