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					OIVBNo.1545-0008

0 W-2Waqeand TaxstatementED I
8

Socjal securily tips Allocatedtips

t 3 5

Wages, tips, other compensatim

27207.14
Socialsecuritywages

Federal income td )ial security ta

2788.4a
1839.72

MRS GOOCH NATURALFOODMKT INC 550 BOWIE STREET AUSTIN 78703 TX DANIEL KAUWE K 933 BEGONIA AVE cosTA MESACA 92626
Emp@yers 16 Statewages,tips,etc.

29672.A3
9 Advance paymenl EIC
to b a uependent care benefits Employefidentificationnumbe(ElN) Employee'ssocial secuilty r sratutory emp I 17 Befuement Thirdoatu sjckp?ryo,*X J l\4edicarewagesandtips 6

29672.83
Nonqualifiedplans

l\iledicare tn withheld

430.26
D | 2465.69
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14

Other

95-3096433

575-13-2719
t3

cAsDf 2373A HCRA 2422.9A wPF 21.OO

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18

Local wages, tips, etc

19

Local income til

20

Localityname

27207 14
Copy 2 To Be FiledWiih Emptoyee's State,City,or LocalIncomeTaxReturn.

374.2A
Dept.of the Treasury- IRS

OMB No. 1545-0008

U 0I W-2 Waqe and Tax statementE
MRS GOOCHNATURALFOODMKT INC 550 BOWIESTREET AUSTINTX 78703

7 8 9 10 b

Social securitytips Allocated tips Advance EIC payment Dependent care benefits Employeridentification number(EtN)

1 Wages, tips,othercompensation

2 4

Federal income td withheld

27207.14
3 5 11 14 Social securitywages

27A8.4A
Social security td withheld

29672.83
Medjcare wages and tips

1839.72
Medicare til withheld

29672.83
Nonqualifiedplans

430.26
D | 2465"69

DANIEL KAUWE K 933 BEGONIA AVE cosTA MESACA 92626
16 Statewages, tips, etc.

95-?Oq64""
a Employee'ssocial securitynumber

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'13 Statutory emp Retfement Thftd-patu sickPay o,un y I I

cAsDf 2373A HCRA 2422.58 wPF 21.OO

Other

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3 3

17

Shte incometd

18

Local wages,tips, etc.

19

Local incometd

27) 07

14

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Dept. of the Treasury - tRS

Copy 2 To Be Filed With Emptoyee,s State, City, or Local Income Tax Return.

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u Wageand Tax StatementE 0 ,o,.W-2 ,o,.W-2 Wage and TaxStatementP 0I MRSGOOCH NATURAL FOOD MKT INC 550 BOWIE STREET AUSTIN 78703 TX DANIEL KAUWE K 933 BEGONIA AVE cosTA MESACA 92626
16 Slatewages, tips, etc

7 8 I 10 b
c

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EHrPruyees soetarsl

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ta

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Dept. ot the Treasury - IRS

Copy C For EMPLOYEE'S RECORDS (See Noilce fo Employee on the back of Copy B.)

W-2 Wage qnd Tax
.'ty.'yvi ly'ie T9re]l mf zlf cooe : , , '

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OMB No. 1545-0008 7 8 9 lO, b Social s@urity tips Allocated tips Advance EIC payment Uependenlcarebenelits 1 Wag6s, tips, other compenaation 2 Fedsal income h withhek{

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::1dr f999nry,wqs9sr' tac-rt Qra
and tipi ta

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11 14

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aa

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DANIEL KAUWE K 933 BEGONIA AVE cosTA MESACA 92626
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e income tax 2'r A aa

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l,YithEmployr Copy B To 8e FilEd

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Thisinformation beingfumished the lnternal is to Bevenue Seruice

Dept.of the Treasury IRS -


				
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