Income Tax A D
Resume:
Employee Reference COPY
W-* Wage and Tax
WN Ascenso Sarre 155.0008
eee trrumber Da] Game Empey Use ny
gocsovcanmy —_jrer7as BUUO A 381011
ee aplayer's namaadaress, and Zip code
SAFEWAY. ING
PO BOX 52131
PHOENIX, AZ 85072-2131
ee
Employee's name address, and ZIP code
DAVID_N SHARMA
644 ARCADE BLVD
SACRAMENTO, CA 95815
ts—Employers FED 10 number employees SSA number
Te TS ee SUO 6548
—wages lips, othercomp, Z Federal income tax withheld
63334.21 7928.53
Social security wages 7 Social security tax withheld
67431.94 4180.78
Medicare wages and ips —] 6 Wedieare tax withheld
67431.94 977.76
7—sectar security Ure SaISeaiE
3 0 Dependent care benehits
a Eee ratvctors Tor
By 4087.73
aa 125 AN B35.51
zd
13 sarong Re ge aye
[6 State wages, tins, etc.
6333421
75 State Employer's state ID no]
GA oo7sers__ 5
77 State income tax [16 Local wages, tips, elc.
2474.27
7a Local income tax [20 Locality name
2023 W-2 and EARNING
DAVID N SHARMA’
644 ARCADE BLVD
SACRAMENTO, CA 95815
0 2029 ADP, We.
Ss SUMMARY
Social Security Number
PAGE 01 OF 014
car tipe, other ear 7 ca Ta cther comp, 2) Federal incomatax warnsts <—wages,tips,ethercomp, [2 F
Taam rooney [en 1528.55 ase essal atincome 7928.53 63334. é
it i it it cial securi 4. Social security tax withheld 3 Social security wages
T Social eoO MAPRS a Social secur ex wana 7 Socal soruriy wPES og eal security x wine ng i ri eS
6 Medicare withheld 5 Medicare wages 2) ips
‘5 Medicare wants a 4 6 Medicare taxwinneld 96 i ey lodic tex te 76 lac esa34.04 :
ibe Empiyeriuse ory dcontralnumber Cat [ apn] Emnoyer use only di Control nurnver Dept.
agcenvalnereil [aa suuol PAL i veoh [Gooezsseaner liet729 [pUUO A sont \‘oooossses wm fst7aa B
¢ Employer's name, address, and ZIP code ‘¢ Employer's name, ‘address; and ZIP code ¢ Employer's name, ‘address, and 7
SAFEWAY INC SAFEWAY. INC SAFEWAY INC
PO BOX 52131 PO BOX 52131 PO BOX 52131
PHOENIX, AZ 85072-2131 PHOENIX, AZ 85072-2131 PHOENIX, AZ 85072-2
Ib Emple rs a D pb Employers FED 10 number [2 Employee's SSA number pb Employer's FED 1D number
By Emeloyersieranagmee’ ee PPT KK 0949 POY 43019135. eXK-6949 eye
7 Social security tips 7 Allocated tips Social security tips @ Allocated tips 7 Social security tips
a) 40 Dependent care ‘benefits: Bie: # 40 Dependent care benefits 2
77 Nonquallfied pi Za Seo Instructions forboxt2 (11 Nonqualified plans za 41 Nonqualified plans
eee DI 409: DI 4097.73,
Adj Other gent 221 CA SOL AA 36.51 \14 Other 601.22 CASO)
01,22, CASD)
18 AA 635.51
2c
Bird party sick pay
xX
44 Other
13 Siat emp]Ret. plan
lize
Ret. raat party sick pa)
x x
a
[13 siat emo!
aif Employee's name, address and zip code
eif Employee's name, addres
af Employee's name, address and ZIP code
DAVID N SHARMA
644 ARCADE BLVD
SACRAMENTO, CA 95815
DAVID N SHARMA
644 ARCADE BLVD
SACRAMENTO, CA 95815
DAVID N SHARMA
644 ARCADE BLVE
SACRAMENTO, C/
Employer's state
State] Employers state 1D no.i6 State wages tips, etc.
34.21
75 State] Employer’ PR a33
eee teersiabele wages e342
1p State
CA 0076785
CA
7, State Income tax 8 Local wages, tips, ete.
7 State income tax Fe Local wages, tips, ete.
2474.27
47 State income tax
2:
2474.27
@ Local Income tax 120 Locality name 79 Localincome tax 0 Locality name 19) Local income tax
ges Filing Copy CA Slate Filing Copy is City or Le
age and Tax Was
5 Wage and Tax
Ww 2 Statement W- ae ee 2 \W-2 Ss
e ‘OMB No. 1545-0008 Copy2to be fled with emplo
OMG No. 1545-0008
Copy. 1a be fled with employee's Federal income Tex Return.
Copy 2 to berfiled with employee's State Income TexRetum-
Contact this candidate