Form W-2 Wage and Tax Statement 1995
| a Control No. | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| b
Employer's identification number 238949568 |
1 Wages,
tips, other compensation 25000.00 |
2 Federal
income tax withheld 5000.00 |
|||||||||||
| c
Employer's name, address, and ZIP code SCT University 4 Country View Road Malvern, PA 19335 |
3 Social
security wages 2000.00 |
4 Social
security tax withheld 2000.00 |
|||||||||||
| 5 Medicare wages and
tips 2000.00 |
6 Medicare tax withheld 2000.00 |
||||||||||||
| 7 Social security tips 2000.00 |
8 Allocated tips 2000.00 |
||||||||||||
| d
Employee's social security number 123-45-6789 |
9 Advance
EIC Payment 0.00 |
10 Dependent care
benefits 0.00 |
|||||||||||
| e,f
Employee's name and address Bob Smith 412 Farnsworth Avenue Bordentown, NJ 09238 |
11
Nonqualified plans 2000.00 |
12
Benefits included in box 1 2000.00 |
|||||||||||
| 13 See Instrs. for box
13 2000.00 |
14 Other 2000.00 |
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|
|||||||||||||
| 16 State PA |
Employer's state I.D.
No. 1293847 |
17 State wages, tips,
etc. 22000.00 |
18 State income tax 847.00 |
19 Locality name Upper Merion |
20 Local wages, tips,
etc. 22000.00 |
21 Local income tax 247.00 |
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