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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, 2018

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN): 00-0801787
SAMPLE PAYER 1
8228 MAIN AVE
BOSTON, MA 02123

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:$105,208.00
Federal Income Tax Withheld:$8,505.00
Social Security Wages:$105,208.00
Social Security Tax Withheld:$6,522.00
Medicare Wages and Tips:$105,208.00
Medicare Tax Withheld:$1,525.00
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): 00-2316856
SAMPLE PAYER 2
4165 MAPLE AVE
PHOENIX, AZ 85005

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:$15.00
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

Form 1099-G

Payer:

Payer's Federal Identification Number (FIN): 00-8475512
SAMPLE PAYER 3
1688 ELM ST
LOS ANGELES, CA 90013

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
ATAA Payments:$0.00
Tax Withheld:$0.00
Taxable Grants:$0.00
Unemployment Compensation:$0.00
Agricultural Subsidies:$0.00
Prior Year Refund:$22.00
Market gain on Commodity Credit Corporation loans repaid:$0.00
Year of Refund:2017
1099G Offset:Not Refund, Credit, or Offset for Trade or Business

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN): 00-6815480
SAMPLE PAYER 4
1921 MAPLE 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):999999999
Interest:$0.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

Form 1099-MISC

Payer:

Payer's Federal Identification Number (FIN): 00-2867058
SAMPLE PAYER 5
4798 FIRST ST
DALLAS, TX 75243

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:$28,289.00
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