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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...