Welding
Resume:
d Control number Dept. Corp. Employer use only
c Employer’s name, address, and ZIP code
e/f Employee’s name, address, and ZIP code
b Employer’s FED ID number a Employee’s SSA number 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
9 10 Dependent care benefits
11 Nonqualified plans 12a See instructions for box 12 12b
14 Other 12c
12d
13 Stat emp. Ret. plan 3rd party sick pay
15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
19 Local income tax 20 Locality name 2021 ADP, Inc. 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 d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 9 10 Dependent care benefits 9 10 Dependent care benefits 9 10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a 11 Nonqualified plans 12a 14 Other 12b 14 Other 12b 14 Other 12b
12c 12c 12c
12d 12d 12d
13 Stat emp.Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name PAGE 01 OF 02
889.98 17.90
889.98 17.90
889.98 17.90
889.98 55.18
889.98 55.18
889.98 55.18
889.98 12.90
889.98 12.90
889.98 12.90
4291474 W9Z P659 N
4291474 W9Z P659 N 197462
4291474 W9Z P659 N 197***-******
FEDEX GROUND PKG SYSTEM INC
FEDEX GROUND PKG SYSTEM INC FEDEX GROUND PKG SYSTEM INC 30 FEDEX PARKWAY
BATCH# N 1990
30 FEDEX PARKWAY
BATCH# N 1990
30 FEDEX PARKWAY
BATCH# N 1990
2ND FLOOR HORIZONTAL
XXX-XX-1535
2ND FLOOR HORIZONTAL
XXX-XX-1535
2ND FLOOR HORIZONTAL
COLLIERVILLE, TN 38017
2021
COLLIERVILLE, TN 38017
858.38
COLLIERVILLE, TN 38017
34-1441019
KANSAS CTY
34-1441019
2021
34-1441019 XXX-XX-1535
KION L MITCHELL
OMB No. 1545-0008
KION L MITCHELL
OMB No. 1545-0008
KION L MITCHELL
858.38
3727 E28ST
Wage and Tax
17.90
3727 E28ST
Wage and Tax
3727 E28ST
Wage and Tax
KANSAS MISSOURI, MO 64128
197462
KANSAS MISSOURI, MO 64128 KANSAS MISSOURI, MO 64128 All States
Statement
55.18
KS 036-341441019F-01 KS 036-341441019F-01
2021
Employee Reference Copy
21.00 21.00
OMB No. 1545-0008
W-2
12.90
KS. State Reference Copy KS. State Filing Copy
Copy C for employee’s records.
N
OMB No. 1545-0008 Statement Statement
889.98
W-2 W-2
XXX-XX-1535
889.98
BATCH# N 1990
Copy 2 to be filed with employee’s State Income Tax Return. Social Security Number:
889.98
XXX-XX-1535
Copy 2 to be filed with employee’s State Income Tax Return. 4291474 W9Z P659
KANSAS CTY
2021 W-2 and EARNINGS SUMMARY
FEDEX GROUND PKG SYSTEM INC
KION L MITCHELL
30 FEDEX PARKWAY
2021
3727 E28ST
2ND FLOOR HORIZONTAL
KANSAS MISSOURI, MO 64128
COLLIERVILLE, TN 38017
34-1441019
KION L MITCHELL
3727 E28ST
Wage and Tax
KANSAS MISSOURI, MO 64128
All States
Statement
Federal Filing Copy
W-2
Copy B to be filed with employee’s Federal Income Tax Return. d Control number Dept. Corp. Employer use only
c Employer’s name, address, and ZIP code
e/f Employee’s name, address, and ZIP code
b Employer’s FED ID number a Employee’s SSA number 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
9 10 Dependent care benefits
11 Nonqualified plans 12a See instructions for box 12 12b
14 Other 12c
12d
13 Stat emp. Ret. plan 3rd party sick pay
15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
19 Local income tax 20 Locality name 2021 ADP, Inc. 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 d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 9 10 Dependent care benefits 9 10 Dependent care benefits 9 10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a 11 Nonqualified plans 12a 14 Other 12b 14 Other 12b 14 Other 12b
12c 12c 12c
12d 12d 12d
13 Stat emp.Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name PAGE 02 OF 02
889.98 17.90
889.98 17.90
889.98 17.90
889.98 55.18
889.98 55.18
889.98 55.18
889.98 12.90
889.98 12.90
889.98 12.90
4291474 W9Z P659 N
4291474 W9Z P659 N 197463
4291474 W9Z P659 N 197***-******
FEDEX GROUND PKG SYSTEM INC
FEDEX GROUND PKG SYSTEM INC FEDEX GROUND PKG SYSTEM INC 30 FEDEX PARKWAY
BATCH# N 1990
30 FEDEX PARKWAY
BATCH# N 1990
30 FEDEX PARKWAY
BATCH# N 1990
2ND FLOOR HORIZONTAL
XXX-XX-1535
2ND FLOOR HORIZONTAL
XXX-XX-1535
2ND FLOOR HORIZONTAL
COLLIERVILLE, TN 38017
31.60
COLLIERVILLE, TN 38017
31.60
COLLIERVILLE, TN 38017
34-1441019
ALL LOCALS
34-1441019
31.60
34-1441019 XXX-XX-1535
KION L MITCHELL
2021
KION L MITCHELL
KANSAS CTY
KION L MITCHELL
31.60
3727 E28ST
Wage and Tax
OMB No. 1545-0008
3727 E28ST
Wage and Tax 2021
3727 E28ST
KANSAS MISSOURI, MO 64128
197463
KANSAS MISSOURI, MO 64128 KANSAS MISSOURI, MO 64128 MO 12454915
Statement
17.90
MO 12454915
Statement OMB No. 1545-0008
MO. State Reference Copy
.32
MO 12454915
31.60
W-2
55.18
City or Local Reference Copy
.32 KANSAS CTY
Copy 2 to be filed with employee’s State Income Tax Return. W-2
City or Local Filing Copy
889.98
12.90
Copy 2 to be filed with employee’s City or Local Income Tax Return. Wage and Tax
889.98
N
OMB No. 1545-0008 Statement
889.98
W-2 2021
4291474 W9Z P659
BATCH# N 1990
Copy 2 to be filed with employee’s City or Local Income Tax Return. FEDEX GROUND PKG SYSTEM INC
OMB No. 1545-0008
30 FEDEX PARKWAY
XXX-XX-1535
2021 W-2 and EARNINGS SUMMARY
2ND FLOOR HORIZONTAL
31.60
KION L MITCHELL Social Security Number:
COLLIERVILLE, TN 38017
2021
3727 E28ST
XXX-XX-1535
34-1441019
ALL LOCALS
KANSAS MISSOURI, MO 64128
KION L MITCHELL
3727 E28ST
Wage and Tax
KANSAS MISSOURI, MO 64128
MO 12454915
Statement
MO. State Filing Copy
W-2
Copy 2 to be filed with employee’s State Income Tax Return. This information is being furnished to the Internal Revenue Service. 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.
IMPORTANT NOTE:
In order to insure efficient processing,
attach this W-2 to your tax return like this
(following agency instructions):
Notice to Employee
NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDERAL, STATE AND LOCAL/CITY INCOME TAX RETURNS. Department of the Treasury - Internal Revenue Service Instructions for Employee
Do you have to file? Refer to the Instructions for Forms 1040 and 1040-SR 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 2021 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 2021 or if income is earned for services provided while you were an inmate at a penal institution. For 2021 income limits and more information, visit www.irs.gov/EITC. See also Pub. 596, Earned Income Credit. 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 SSA.
Clergy and religious workers. If you aren’t subject to social security and Medicare taxes, see Pub. 517, Social Security and Other Information for Members of the Clergy and Religious Workers.
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 Social Security Administration (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 2021 and more than $8,853.60 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. If you had more than one railroad employer and more than $5,203.80 in Tier 2 RRTA tax was withheld, you may also be able to claim a credit. See the Instructions for Forms 1040 and 1040-SR and Pub. 505, Tax Withholding and Estimated Tax.
Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service However, if you were at least age 50 in 2021, your employer may have allowed an additional deferral of up to $6,500 ($3,000 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 Instructions for Forms 1040 and 1040-SR.
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 Instructions for Forms 1040 and 1040-SR. B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or 1040-SR. See the Instructions for Forms 1040 and 1040-SR. 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 Instructions for Forms 1040 and 1040-SR 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 Instructions for Forms 1040 and 1040-SR.
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 Instructions for Forms 1040 and 1040-SR.
N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (former employees only). See the Instructions for Forms 1040 and 1040-SR.
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 Instructions for Forms 1040 and 1040-SR for details on reporting this amount.
R—Employer contributions to your Archer MSA. Report on Form 8853, Archer MSAs and Long-Term Care Insurance Contracts. Department of the Treasury - Internal Revenue Service 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, Qualified Adoption Expenses, 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, Taxable and Nontaxable Income, 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, Health Savings Accounts (HSAs). 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 Instructions for Forms 1040 and 1040-SR.
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, Contributions to Individual Retirement Arrangements (IRAs). 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.
TAX RETURN
THIS
FORM
W-2
OTHER
W-2’S
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, Additional Medicare Tax. See the Instructions for Forms 1040 and 1040-SR 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 Instructions for Forms 1040 and 1040-SR.
You must file Form 4137, Social Security and Medicare Tax on Unreported Tip Income, 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 $19,500 ($13,500 if you only have SIMPLE plans; $22,500 for section 403(b) plans if you qualify for the 15-year rule explained in Pub. 571). Deferrals under code G are limited to $19,500. Deferrals under code H are limited to $7,000.
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