This Product Contains Sensitive Taxpayer Data |
Wage and Income Transcript |
Request Date: | 04-28-2022 |
Response Date: | 04-28-2022 |
Tracking Number: | 999999999999 |
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Payer: | ||
Payer's Federal Identification Number (FIN): 00-2504890 | ||
SOCIAL SECURITY ADMINISTRATION | ||
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Payee: | ||
Payee's Identification Number: 976-00-1879 | ||
BRIAN MARTIN | ||
7967 MAPLE ST | ||
KNOXVILLE, TN 37918 | ||
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Submission Type: | Original document | |
Account Number (Optional): | N/A | |
Pensions and Annuities (Total Benefits Paid): | $22,855.00 | |
Tax Withheld: | 0.00 | |
Repayments: | 0.00 | |
Workman's Compensation Offset: | 0.00 | |
TY 2019 Payments: | 0.00 | |
TY 2018 Payments: | 0.00 | |
TY 2017 Payments: | 0.00 | |
TY 2016 Payments: | 0.00 | |
Trust Fund Indicator: | Retirement | |
SSA/RRB Payments: | Either RRB or SSA payments |
Payer: | ||
Payer's Federal Identification Number (FIN): 00-8885740 | ||
CAPITAL ONE BANK | ||
4851 COX RD | ||
GLEN ALLEN, VA 23058 | ||
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Recipient: | ||
Recipient's Identification Number: 976-00-1879 | ||
BRIAN MARTIN | ||
7967 MAPLE ST | ||
KNOXVILLE, TN 37918 | ||
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Submission Type: | Original document | |
Account Number (Optional): | 99925987456 | |
Interest: | $200.00 | |
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 |
Payer: | ||
Payer's Federal Identification Number (FIN): 00-1617082 | ||
SAMPLE PAYER 3 | ||
9215 SIXTH ST | ||
DETROIT, MI 48216 | ||
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Recipient: | ||
Recipient's Identification Number: 976-00-1879 | ||
BRIAN MARTIN | ||
7967 MAPLE ST | ||
KNOXVILLE, TN 37918 | ||
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Submission Type: | Original document | |
Account Number (Optional): | 999999999 | |
Distribution Code Value: | Normal distribution | |
Distribution Code: | 7 | |
Distribution Code Value: | Not significant | |
Distribution Code: | Blank | |
Tax Amount Undetermined Code: | Not checked | |
Total Distribution Code: | Not checked | |
First Year Roth Contribution: | 0000 | |
SEP Indicator: | IRA/SEP/SIMP box not checked | |
FATCA Indicator: | not FATCA | |
Date of Payment for Reportable Death Benefits under Section 6050Y: | 00-00-0000 | |
Tax Withheld: | $300.00 | |
Total Employee Contributions: | $0.00 | |
Unrealized Appreciation: | $0.00 | |
Other Income: | $0.00 | |
Gross Distribution: | $14,958.00 | |
Taxable Amount: | $14,958.00 | |
Eligible Capital Gains: | $0.00 | |
Amount to IRR: | $0.00 |
This Product Contains Sensitive Taxpayer Data |