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ThisblueEarnings Summary section sect is included with youl w-2 to herp descrrbe porilons ln more dota Thereverse sideincludes reralinformation that you may also find helpful. general
1. The followlna lnf6rm.tl^h '6fr^-r

Cotp.I fmployenrse ofr 600100lllLz,P I ozossc B7 lT


I Dcpt
Emplrycr'! nanc, !ddles!, and Zlp codc

control numbr

'

Gross Pay

3225.70 2 2 11 2 .

Soclal Securltv ' Tax Withheld

KILLINGTON PICO SKI RESORT PARTNERS 4763 KILLINGTON RD KILLINGTONVT 05751 Batch #03128
ct Enptoye'! nanc, aodi---, iiE-ZiFEft!-

Box ofW-2 4
Fad, Income Tax Wlthheld

Box ofW-2 2
2. Your Gross Pav was

Medicare Tax Wlthheld

VT. State Income Tax Box 17 of W-2 SUIISDI Box 14 of W-2

7 1. 5 1

Box ofW-2 6
usted as fo follows to Wages, Tlps, other wa! Compensatlon Con Box 1 of W-2 VT. State Waoes. Tips, Etc. Box 16 of W-2

ANA BEGAZO CORNEJO URB EL ROSARIO K-10 CERR COLORADO AREOUIPA,PER


Empbyer'! FED lD numbl 20-nltn5?tt wagct, tlp!, other comp.
a .

Emptoye'!

009-92-8130
l-ederal incometaxwilhheld

SSA numbcr

Gross Pay Less Exempt Wages Reported W-2 Wages

3,225.70 N/A 3,225.7O

3,225.70 3,225.70 0.00

3,225.70 3,225.70 0.00

3,225.70 N/A 3,225.7O

3225.70
3 Sclal seurity wrge!
iloorcarc wag6 rnd lip! I 6 Sei.l leurity Medicrrc

221.12
tax wilhheld lax wilhhcld

scirl 9

seurity iip6 paymcnt

E Allcated tips lo Dcp'ndcnt care benefitirot mx lz

AdvrnccElC

W-4 Profile.

14 Olhct

lzc I t2d I I 3 Sbt emplRet phnprt plrty sicke.l

15 StarelEmptoycti *a-olo

A N A B E G A Z O C OR N E J O I URB EL ROSARIO I K.1O CERR COLORADO I AREQUIPA,PER

vT

14it0208485333F01
incomc tax

6 Stltc wages, taps, etc.

t7 s|!t
ll

3225.70
name

7 1. 5 1
L@al Incomc ilx

LErt wrges, tips, elc. ru Lerlity


o 20i0 aDP

SocialSecurityNumber:009-92-8130 TaxableMaritalStatus: SINGLE Exemptions/Allowances : FEDERAL: 1 STATE: 1 Single

w196,

l|p!,

other comp.

r{erat

3225.70
J Seaal asurlly wage3

Income iax withheld

221.12
{ S@ial ssurity lmyithheld 3
5

Waga, iipa, other cornp

rderat

3225.70
Seisl ssurity wage! ,l Scill
Medicarewagesandlipa

Income tax wilhheld

221.12
leu.tty
hx

tax withlrcld
whhhcld

Medice.c w"ga

4 S6ial seurity tax withhelJ 5 d Medicare wages and tips Conlrol numbr
Employer'e Medicare tax wilhheld

mE ilpa

D Mediclrc lrx withheld

Mcdicare

d Coni.ol numbcr I O+t


c

6001001I|LZP I ozoggc

Corp. I

Employer only use IT fi7

d c

Conkol number

I Dept

Employer'r name, rddlcs!, and Zlp code

600100 11lLzP | 070330

Corp. I Employer only use

KILLINGTON PICO SKI RESORT PARTNERS 4763 KILLINGTON RD KILLINGTON VT 057'1


Empbycr'! FED lD numbcl 20-8485333 S@isl ccurity tip6 r EIC paymaltr ilonqurliticd plrm 14 Olhcr

EDployer's name, address, and Zlp code

lr

fi7

600100 11lLzP
name, addrees, and Zlp code

Employer only use ' 137

KILLINGTONPICO SKI RESORT PARTNERS 4763 KILLINGTONRD KILLINGTONVT 05751


E JDA numEr

KILLINGTONPICO SKI RESORT PARTNERS 4763 KILLINGTON RD KILLINGTONVT 05751

Jye

ooq-qt-er"^
All@ated lo Dcpcndcnl lips

Employer's FEO D numUer

20-8485333
lipa

Employe's SSA nurnber


8 Allcaled tip!

S@aal lsurity

009-92-8130

catc bncfhs

Advance EIC paymenl

ru uependent care bnetits l2a

l2! Se instuclionc lot box f2


t2b l2c

11 Nonqualitiedpta;a
t4 Olhet

''o
l2c tzd

'--l
13 stlt enp,lRetptln Fd elrty;ick eay
e/l Empbyc'! namc, lddless rnd Zlp cqlc
I

ANA BEGAZO CORNEJO URB EL ROSARIO K-l0 CERR COLORADO AREQUIPA,PER


!7 Stdc income ilx

3 Strt emp.lRet phnl3d prrty sict pcj I I I e/t Employc's nane, addreaa and.lp-odE I I ANA BEGAZO CORNEJO I I URB EL ROSARIO
I

prrty oicl p!
name, rddres! and

'v?"" ';a35b1Pdi |fidiffi


U L@!l

K-10 CERR COLORADO AREQUIPA.PER

6 Slatc wag6, tipc, etc.

3225.70
lip!, etc,

wagcs,

'uui'"" ;59*i ln=iiil?6li


Slale income lax

ANA BEGAZO CORNEJO URB EL ROSARIO K.1O CERR COLORADO AREQUIPA.PER


Slal ) wages, lips, etc,

16 Shle LGat

wagec, lips, elc.

3225.70
wagea, tipg, elc. naDe ru L@alily

3225.70

71 .51
19 Leal income tu lU Lcllity name

7 1. 5 1
I9
I

L@al income tax

H;*;m#*H,mlp .W;?,Hj,H*i:ffil"e k*3g#i:*?pm


I I I I
I

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