Form W-* Wage and Tax Statement

Copy C — For EMPLOYEE’S RECORDS

OMB No. 1545-0008

Department of Treasury -

Internal Revenue Service

Control

number

Employer’s name, address, and ZIP code

Employee’s name, address, and ZIP code

1 Wages, tips, other comp. 2 Federal income tax withheld 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

910 Dependent care benefits

11 Nonqualified plans 12a

12b

Statutory

employee

Retirement

plan

Third-party

13 sick pay 12c

12d

Employee’s social security no. 14

Employer ID number (EIN)

15 St. Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name Copy B — To Be Filed With Copy 2 — To Be Filed With Employee’s State, City, or Local

Income Tax Return.

Copy 2 — To Be Filed With

Employee’s State, City, or Local

Income Tax Return.

Employee’s FEDERAL Tax Return.

This information is being furnished to the IRS.

Control

number

Control

number

Control

number

Employer’s name, address, and ZIP code Employer’s name, address, and ZIP code Employer’s name, address, and ZIP code Employee’s name, address, and ZIP code Employee’s name, address, and ZIP code Employee’s name, address, and ZIP code 1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 910 Dependent care benefits 910 Dependent care benefits 910 Dependent care benefits 11 Nonqualified plans 12a 11 Nonqualified plans 12a 11 Nonqualified plans 12a 12b 12b 12b

Statutory

employee

Retirement

plan

Third-party

sick pay

Statutory

employee

Retirement

plan

Third-party

sick pay

Statutory

employee

Retirement

plan

Third-party

13 12c 13 12c 13 sick pay 12c

12d 12d 12d

Employee’s social security no. 14 Employee’s social security no. 14 Employee’s social security no. 14 Employer ID number (EIN) Employer ID number (EIN) Employer ID number (EIN) 15 St. Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 15 St. Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 15 St. Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name This information is being furnished to the IRS. If you are required to file a tax return, a negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. NTF 2585828 3 PYW2

Form W-2 Wage and Tax Statement

OMB No. 1545-0008

Department of Treasury -

Internal Revenue Service

Form W-2 Wage and Tax Statement

OMB No. 1545-0008

Department of Treasury -

Internal Revenue Service

Form W-2 Wage and Tax Statement

OMB No. 1545-0008

Department of Treasury -

Internal Revenue Service

0U793 4602 00000

2023 W-2 and Earnings Summary Whirlpool

0U793 4602 00397

0U793 4602 00397 0U793 4602 00397 0U793 4602 00397 Wages, Tips, Other Comp.

Box 1 of W-2

Social Security Wages

Box 3 of W-2

Medicare Wages and Tips

Box 5 of W-2

Gross Pay $6,855.30 $6,855.30 $6,855.30

Less: Non-Taxable Earnings $0.00 $0.00 $0.00

Less: Retirement Deductions $0.00 N/A N/A

Less: Other Pre-tax Deductions $0.00 $0.00 $0.00

Less: Third Party Sick Pay $0.00 $0.00 $0.00

Less: Excess Wages N/A $0.00 N/A

Total Reported Wages $6,855.30 $6,855.30 $6,855.30 ISAIAH J FARNSWORTH

ISAIAH J FARNSWORTH ISAIAH J FARNSWORTH ISAIAH J FARNSWORTH 308 BAVEN DR

308 BAVEN DR 308 BAVEN DR 308 BAVEN DR

Fed Income

Box 2 of W-2

Social Security

Box 4 of W-2

Medicare

Box 6 of W-2

MCDONALD TN 37353

MCDONALD TN 37353 MCDONALD TN 37353 MCDONALD TN 37353 Tax Withheld $43.80 $425.03 $99.40

6855.30

6855.30 6855.30 6855.30

43.80

43.80 43.80 43.80

6855.30

6855.30 6855.30 6855.30

425.03

425.03 425.03 425.03

6855.30

6855.30 6855.30 6855.30

99.40

99.40 99.40 99.40

***-**-****

***-**-**** ***-**-**** ***-**-****

ISAIAH J FARNSWORTH

308 BAVEN DR

46-1061394

46-1061394 46-1061394 46-1061394

MCDONALD, TN 37353

The Form W-2 Box 1 wages are the Gross Wages as of your last pay statement for the year minus any non-taxable earnings or deductions, plus any additional compensation received after the last pay statement. Gross pay may not match Box 1 wages due to deductions for retirement deferrals, health insurance, or other Sec. 125 cafeteria plan deductions, etc. ZENITH TALENT CORPORATION

ZENITH TALENT CORPORATION ZENITH TALENT CORPORATION ZENITH TALENT CORPORATION PROSPERIX

PROSPERIX PROSPERIX PROSPERIX

3540 W SAHARA AVE SUITE 440

3540 W SAHARA AVE SUITE 440 3540 W SAHARA AVE SUITE 440 3540 W SAHARA AVE SUITE 440 LAS VEGAS NV 89102

LAS VEGAS NV 89102 LAS VEGAS NV 89102 LAS VEGAS NV 89102 Notice to Employee

Instructions for Employee (Continued from

back of Copy B.)

Instructions for Employee (Continued from

back of Copy 2.)

(Instructions for Employee continued on back of Copy 2.)

(Instructions for Employee continued on back of Copy C.)

(See also Notice to Employee on back of Copy B.)

Do you have to file? Refer to the Form 1040

instructions to determine if you are required to file a tax return. Even if you don’t have to file a tax return, you may be eligible for a refund if box 2 shows an amount or if you are eligible for any credit.

Earned income credit (EIC). You may be able to

take the EIC for 2023 if your adjusted gross income

(AGI) is less than a certain amount. The amount

of the credit is based on income and family size.

Workers without children could qualify for a smaller credit. You and any qualifying children must have

valid social security numbers (SSNs). You can’t take the EIC if your investment income is more than the specified amount for 2023 or if income is earned

for services provided while you were an inmate at a penal institution. For 2023 income limits and more information, visit www.irs.gov/EITC. See also Pub. 596. Any EIC that is more than your tax liability is refunded to you, but only if you file a tax return. Employee’s social security number (SSN). For

your protection, this form may show only the last

four digits of your SSN. However, your employer

has reported your complete SSN to the IRS and the

Social Security Administration (SSA).

Clergy and religious workers. If you aren’t subject to social security and Medicare taxes, see Pub. 517. Corrections. If your name, SSN, or address is

incorrect, correct Copies B, C, and 2 and ask your employer to correct your employment record.

Be sure to ask the employer to file Form W-2c,

Corrected Wage and Tax Statement, with the SSA

to correct any name, SSN, or money amount error

reported to the SSA on Form W-2. Be sure to get

your copies of Form W-2c from your employer for all corrections made so you may file them with your tax return. If your name and SSN are correct but aren’t the same as shown on your social security card, you should ask for a new card that displays your correct name at any SSA office or by calling 800-***-****. You may also visit the SSA website at www.SSA.gov. Cost of employer-sponsored health coverage

(if such cost is provided by the employer). The

reporting in box 12, using code DD, of the cost of employer-sponsored health coverage is for your

information only. The amount reported with code

DD is not taxable.

Credit for excess taxes. If you had more than one

employer in 2023 and more than $9,932.40 in social security and/or Tier 1 railroad retirement (RRTA)

taxes were withheld, you may be able to claim a

credit for the excess against your federal income

tax. See the Form 1040 instructions. If you had more than one railroad employer and more than $5,821.20 in Tier 2 RRTA tax was withheld, you may be able to claim a refund on Form 843. See the Instructions for Form 843.

Instructions for Employee

Box 1. Enter this amount on the wages line of your tax return.

Box 2. Enter this amount on the federal income tax withheld line of your tax return.

Box 5. You may be required to report this amount

on Form 8959. See the Form 1040 instructions to

determine if you are required to complete Form

8959.

Box 6. This amount includes the 1.45% Medicare

tax withheld on all Medicare wages and tips shown

in box 5, as well as the 0.9% Additional Medicare

Tax on any of those Medicare wages and tips above

$200,000.

Box 8. This amount is not included in box 1, 3, 5, or 7. For information on how to report tips on your tax return, see the Form 1040 instructions.

You must file Form 4137 with your income tax

return to report at least the allocated tip amount unless you can prove with adequate records that

you received a smaller amount. If you have records that show the actual amount of tips you received,

report that amount even if it is more or less than the allocated tips. Use Form 4137 to figure the social security and Medicare tax owed on tips you didn’t

report to your employer. Enter this amount on the

wages line of your tax return. By filing Form 4137, your social security tips will be credited to your social security record (used to figure your benefits). Box 10. This amount includes the total dependent

care benefits that your employer paid to you or

incurred on your behalf (including amounts from a

section 125 (cafeteria) plan). Any amount over your employer’s plan limit is also included in box 1. See Form 2441.

Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from a nonqualified

deferred compensation or nongovernmental section

457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior year deferral under a nonqualified or section 457(b) plan that became taxable for social security and Medicare taxes this year because there is no longer a substantial risk of forfeiture of your right to the deferred amount. This box shouldn’t

be used if you had a deferral and a distribution in the same calendar year. If you made a deferral and received a distribution in the same calendar year, and you are or will be age 62 by the end of the

calendar year, your employer should file Form SSA- 131, Employer Report of Special Wage Payments,

with the Social Security Administration and give you a copy.

Box 12. The following list explains the codes

shown in box 12. You may need this information to

complete your tax return. Elective deferrals (codes D, E, F, and S) and designated Roth contributions

(codes AA, BB, and EE) under all plans are generally limited to a total of $22,500 ($15,500 if you only have SIMPLE plans; $25,500 for section 403(b) plans if you qualify for the 15-year rule explained in Pub. 571). Deferrals under code G are limited to $22,500. Deferrals under code H are limited to $7,000.

However, if you were at least age 50 in 2023, your employer may have allowed an additional deferral

of up to $7,500 ($3,500 for section 401(k)(11) and 408(p) SIMPLE plans). This additional deferral

amount is not subject to the overall limit on elective deferrals. For code G, the limit on elective deferrals may be higher for the last 3 years before you reach retirement age. Contact your plan administrator for more information. Amounts in excess of the overall elective deferral limit must be included in income. See the Form 1040 instructions.

Note: If a year follows code D through H, S, Y,

AA, BB, or EE, you made a make-up pension

contribution for a prior year(s) when you were in

military service. To figure whether you made excess deferrals, consider these amounts for the year

shown, not the current year. If no year is shown, the contributions are for the current year.

A—Uncollected social security or RRTA tax on tips. Include this tax on Form 1040 or 1040-SR. See the

Form 1040 instructions.

B—Uncollected Medicare tax on tips. Include this

tax on Form 1040 or 1040-SR. See the Form 1040

instructions.

C—Taxable cost of group-term life insurance over

$50,000 (included in boxes 1, 3 (up to the social

security wage base), and 5)

D—Elective deferrals to a section 401(k) cash or

deferred arrangement. Also includes deferrals under a SIMPLE retirement account that is part of a section 401(k) arrangement.

E—Elective deferrals under a section 403(b) salary reduction agreement

F—Elective deferrals under a section 408(k)(6) salary reduction SEP

G—Elective deferrals and employer contributions

(including nonelective deferrals) to a section 457(b) deferred compensation plan

H—Elective deferrals to a section 501(c)(18)(D)

tax-exempt organization plan. See the Form 1040

instructions for how to deduct.

J—Nontaxable sick pay (information only, not

included in box 1, 3, or 5)

K—20% excise tax on excess golden parachute

payments. See the Form 1040 instructions.

Box 12. (continued)

L—Substantiated employee business expense

reimbursements (nontaxable)

M—Uncollected social security or RRTA tax on

taxable cost of group-term life insurance over

$50,000 (former employees only). See the Form

1040 instructions.

N—Uncollected Medicare tax on taxable cost of

group-term life insurance over $50,000 (former

employees only). See the Form 1040 instructions.

P—Excludable moving expense reimbursements

paid directly to a member of the U.S. Armed Forces

(not included in box 1, 3, or 5)

Q—Nontaxable combat pay. See the Form 1040

instructions for details on reporting this amount. R—Employer contributions to your Archer MSA.

Report on Form 8853.

S—Employee salary reduction contributions under a

section 408(p) SIMPLE plan (not included in box 1) T—Adoption benefits (not included in box 1).

Complete Form 8839 to figure any taxable and

nontaxable amounts.

V—Income from exercise of nonstatutory stock

option(s) (included in boxes 1, 3 (up to the social security wage base), and 5). See Pub. 525 for

reporting requirements.

W—Employer contributions (including amounts the

employee elected to contribute using a section 125

(cafeteria) plan) to your health savings account.

Report on Form 8889.

Y—Deferrals under a section 409A nonqualified

deferred compensation plan

Z—Income under a nonqualified deferred

compensation plan that fails to satisfy section 409A. This amount is also included in box 1. It is subject to an additional 20% tax plus interest. See the Form 1040 instructions.

AA—Designated Roth contributions under a section

401(k) plan

BB—Designated Roth contributions under a section

403(b) plan

DD—Cost of employer-sponsored health coverage.

The amount reported with code DD is not

taxable.

EE—Designated Roth contributions under a

governmental section 457(b) plan. This amount

does not apply to contributions under a tax-exempt organization section 457(b) plan.

FF—Permitted benefits under a qualified small

employer health reimbursement arrangement

GG—Income from qualified equity grants under

section 83(i)

HH—Aggregate deferrals under section 83(i)

elections as of the close of the calendar year

Box 13. If the “Retirement plan” box is checked,

special limits may apply to the amount of traditional IRA contributions you may deduct. See Pub. 590-A.

Box 14. Employers may use this box to report

information such as state disability insurance

taxes withheld, union dues, uniform payments,

health insurance premiums deducted, nontaxable

income, educational assistance payments, or

a member of the clergy’s parsonage allowance

and utilities. Railroad employers use this box to

report railroad retirement (RRTA) compensation,

Tier 1 tax, Tier 2 tax, Medicare tax, and Additional Medicare Tax. Include tips reported by the employee to the employer in railroad retirement (RRTA)

compensation.

Note: Keep Copy C of Form W-2 for at least 3 years after the due date for filing your income tax return. However, to help protect your social security

benefits, keep Copy C until you begin receiving

social security benefits, just in case there is a

question about your work record and/or earnings in a particular year.

NTF 2585802 3 BW23UPI

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