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Wage and Income Transcript

Request Date: 05-21-2020
Response Date: 05-21-2020
Tracking Number: 999999999999

SSN Provided: 401-00-1000
Tax Period Requested: December, 2019

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN): 101000000
NORTH POLE TOY COMPANY
10011 ELM ST
ORLANDO, FL 32804

Employee:

Employee's Social Security Number: 401-00-1000
SANTA CLAUS
2813 SHAMROCK N
TALLAHASSEE, FL 32309

Submission Type:Original document
Wages, Tips and Other Compensation:$99,999.00
Federal Income Tax Withheld:$17,262.00
Social Security Wages:$99,999.00
Social Security Tax Withheld:$6,200.00
Medicare Wages and Tips:$99,999.00
Medicare Tax Withheld:$1,450.00
Social Security Tips:$0.00
Allocated Tips:$0.00
Dependent Care Benefits:$0.00
Deferred Compensation:$0.00
Code "Q" Nontaxable Combat Pay:$0.00
Code "W" Employer Contributions to a Health Savings Account:$0.00
Code "Y" Deferrals under a section 409A nonqualified Deferred Compensation plan:$0.00
Code "Z" Income under section 409A on a nonqualified Deferred Compensation plan:$0.00
Code "R" Employer's Contribution to MSA:$0.00
Code "S" Employer's Contribution to Simple Account:$0.00
Code "T" Expenses Incurred for Qualified Adoptions:$0.00
Code "V" Income from exercise of non-statutory stock options:$0.00
Code "AA" Designated Roth Contributions under a Section 401(k) Plan:$0.00
Code "BB" Designated Roth Contributions under a Section 403(b) Plan:$0.00
Code "DD" Cost of Employer-Sponsored Health Coverage:$0.00
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b) Plan:$0.00
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:Unanswered
Statutory Employee:Not Statutory Employee
W2 Submission Type:Original
W2 WHC SSN Validation Code:Correct SSN

Form 5498 Individual Retirement Arrangement Contribution Information

Trustee:

Trustee/Issuer's Federal Identification Number (FIN): 101000001
SAMPLE PAYER 2
10012 ELM ST
ORLANDO, FL 32804

Participant:

Participant's Identification Number: 401-00-1000
SANTA CLAUS #1
2813 SHAMROCK N
TALLAHASSEE, FL 32309

Submission Type:Original document
Account Number (Optional):999999999
IRA Contributions:$0.00
Rollover Contributions: $0.00
Roth Conversion Amount:$0.00
Recharacterized Contributions:$0.00
Fair Market Value of Account:$33,702.00
Life Insurance Cost Included in Box 1:$0.00
SEP Code:Not Checked
IRA Code:Not Checked
Simple Code:Not Checked
Roth IRA Code:Checked
RMD For Subsequent Year:RMD box not checked
RMD Date:00-00-0000
Year:
Postponed Contribution Code:
Repayments Code:
Fair Market Value of certain specified assets:N/A
SEP Contributions:$0.00
SIMPLE Contributions:$0.00
Roth IRA Contributions:$0.00
Required Minimum Distribution Amount:$0.00
Postponed Contributions:$0.00
Repayment of a qualified reservist distribution or federally designated disaster withdrawal repayment:$0.00
Fair Market Value of Certain Specified Assets:$0.00

Form 1098 Mortgage Interest Statement

Recipient/Lender:

Recipient's Federal Identification Number (FIN): 101000001
SAMPLE PAYER 4
10014 ELM ST
ORLANDO, FL 32804

Payer/Borrower:

Payer's Social Security Number: 401-00-1000
SANTA CLAUS
2813 SHAMROCK N
TALLAHASSEE, FL 32309

Submission Type:Original document
Account Number (Optional):999999999
Mortgage Interest Received from Payer(s)/Borrower(s):$9,242.00
Points Paid on Purchase of Principal Residence:$0.00
Refund of Overpaid Interest:$0.00
Mortgage Insurance Premiums:$0.00
Outstanding Mortgage Principle: $401,351.00
Mortgage Origination Date:05-23-2016
Property Address Verification:
Address of property securing Mortgage:

2813 SHAMROCK N

Description of Property:
Other information from recipient:TALLAHASSEE, FL 32309
The number of mortgaged properties:00000000
Mortgage Acquisition Date:00-00-0000

This Product Contains Sensitive Taxpayer Data