W-2

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					a Employer identification number           1 Wages, tips, other compensation                      2 Federal income tax withheld


b Employer's name, address, and ZIP code   3 Social Security wages                                4 Social security tax withheld


                                           5 Medicare wages and tips                              6 Medicare tax withheld


                                           7 Social Security tips                                 8 Allocated tips


c Employee's social security number        9 Advance EIC payment                                  10 Dependent care benefits


d Employee's name, address, and ZIP code   11 Non qualified plans                                 12 Employee pension contribution


                                           13 Statutory Employee                                  14 Other
                                               Pension Plan
                                              401(k)
                                              Other
15 State    Employer's state I.D. no.      16 State wages     17 State income tax 18 Local wages 19 Local income tax    20 Locality name




                                               Wage and Tax Statement
  W-2                        2009               Copy A for Employer                          Department of Treasury-Virtual Revenue Service




a Employer identification number           1 Wages, tips, other compensation                      2 Federal income tax withheld


b Employer's name, address, and ZIP code   3 Social Security wages                                4 Social security tax withheld


                                           5 Medicare wages and tips                              6 Medicare tax withheld


                                           7 Social Security tips                                 8 Allocated tips


c Employee's social security number        9 Advance EIC payment                                  10 Dependent care benefits


d Employee's name, address, and ZIP code   11 Non qualified plans                                 12 Employee pension contribution


                                           13 Statutory Employee                                  14 Other
                                               Pension Plan
                                              401(k)
                                              Other
15 State    Employer's state I.D. no.      16 State wages     17 State income tax 18 Local wages 19 Local income tax    20 Locality name




                                           Wage and Tax Statement Copy
  W-2                        2009                B for Employee                              Department of Treasury-Virtual Revenue Service

				
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