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This Product Contains Sensitive Taxpayer Data

Wage and Income Transcript

Request Date: 12-21-2021
Response Date: 12-21-2021
Tracking Number: 999999999999

SSN Provided: 707-00-8679
Tax Period Requested: December, 2016

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN): 00-2635065
SAMPLE PAYER 1
9398 MAIN ST
LOS ANGELES, CA 90013

Employee:

Employee's Social Security Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Wages, Tips and Other Compensation:$4,230.00
Federal Income Tax Withheld:$324.00
Social Security Wages:$4,230.00
Social Security Tax Withheld:$262.00
Medicare Wages and Tips:$4,230.00
Medicare Tax Withheld:$61.00
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
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): 00-5259610
SAMPLE PAYER 2
1416 THIRD ST
DETROIT, MI 48216

Participant:

Participant's Identification Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

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:$39.00
Life Insurance Cost Included in Box 1:$0.00
SEP Code:Not Checked
IRA Code:Checked
Simple Code:Not Checked
Roth IRA Code:Not 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

Schedule K-1 1065

Partnership:

Partnership's Employer Identification Number: 00-4607629
SAMPLE PAYER 3
7895 NINTH ST
CHICAGO, IL 60603

Partner:

Partner's Identifying Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Partner Share of Capital Beginning:10.83%
Partner Share of Capital Ending:10.83%
IRA SEP KEOGH Indicator:Box is not checked
Dividends:$0.00
Interest:$1,602.00
Royalties:$0.00
Ordinary Income K-1:-$1,313.00
Real Estate:$0.00
Other Rental:$0.00
Guaranteed Payments:$0.00
Section 179 Expenses:$0.00
Short Term Capital Gain:$0.00
Long Term Capital Gain:$0.00

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-8506923
SAMPLE PAYER 4
4203 OAK ST
DETROIT, MI 48216

Recipient:

Recipient's Identification Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Account Number (Optional):
Tax Withheld:$0.00
Non-Employee Compensation:$21,631.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-1922602
SAMPLE PAYER 5
9442 FIRST ST
BIRMINGHAM, AL 35064

Recipient:

Recipient's Identification Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Account Number (Optional):
Tax Withheld:$0.00
Non-Employee Compensation:$65,336.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-2727045
SAMPLE PAYER 6
8491 NINTH AVE
NEW ORLEANS, LA 70032

Recipient:

Recipient's Identification Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Account Number (Optional):
Tax Withheld:$0.00
Non-Employee Compensation:$4,800.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-1728413
SAMPLE PAYER 7
4696 FOURTH ST
DETROIT, MI 48216

Recipient:

Recipient's Identification Number: 707-00-8679
BRIAN TAYLOR
8721 Flint Falls Dr
DALLAS, TX 75243

Submission Type:Original document
Account Number (Optional):999999999
Tax Withheld:$0.00
Non-Employee Compensation:$24,257.00
Medical Payments:$0.00
Fishing Income:$0.00
Rents:$0.00
Royalties:$0.00
Other Income:$0.00
Substitute Payments for Dividends:$0.00
Excess Golden Parachute:$0.00
Crop Insurance:$0.00
Attorney Fees:$0.00
Foreign Tax Paid:$0.00
Section 409A Deferrals:$0.00
Section 409A Income:$0.00
Direct Sales Indicator:Not Direct Sales
FATCA Filing Requirement:Box not checked no Filing Requirement
Second Notice Indicator:No Second Notice

This Product Contains Sensitive Taxpayer Data