W 2
W 2
W 2
2011
5978.31
3 Social security wages 5 Medicare wages and tips 11 Nonqualified plans 14 Other 6 Medicare tax withheld
475.85
4 Social security tax withheld
12b
C o d e
RAJHANS HASMUKHBHAI SHARMA G-116 YOGIDARSHAN DUPLEX, DARBAR CHOKDI,OPP MANJALPUR VADODARA 390011 INDIA
15 State
Employers state ID number
12c
C o d e
15-0532081
a Employees social security number
12d
C o d e
071-02-3211
17 State income tax
NY
150532081
5978.31
68.00
20 Locality name
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.
Form
2011
1 Wages, tips, other compensation 3 Social security wages 5 Medicare wages and tips 11 Nonqualified plans 14 Other
5978.31
2 Federal income tax withheld 4 Social security tax withheld 6 Medicare tax withheld
475.85
12b
C o d e
RAJHANS HASMUKHBHAI SHARMA G-116 YOGIDARSHAN DUPLEX, DARBAR CHOKDI,OPP MANJALPUR VADODARA 390011 INDIA
15 State
Employers state ID number
12c
C o d e
15-0532081
a Employees social security number
12d
C o d e
071-02-3211
17 State income tax
NY
150532081
5978.31
68.00
20 Locality name
Copy C-For EMPLOYEES RECORDS (See Notice to Employee on the back of Copy B.)
Form
2011
5978.31
3 Social security wages 5 Medicare wages and tips 11 Nonqualified plans 14 Other 6 Medicare tax withheld
12a
C o d e
475.85
4 Social security tax withheld
12b
C o d e
RAJHANS HASMUKHBHAI SHARMA G-116 YOGIDARSHAN DUPLEX, DARBAR CHOKDI,OPP MANJALPUR VADODARA 390011 INDIA
15 State
Employers state ID number
12c
C o d e
15-0532081
a Employees social security number
12d
C o d e
071-02-3211
17 State income tax
NY
150532081
5978.31
68.00
20 Locality name
Copy 2-To Be Filed With Employees State, City, or Local Income Tax Return
Form
2011
1 Wages, tips, other compensation 3 Social security wages 5 Medicare wages and tips 11 Nonqualified plans 14 Other
5978.31
2 Federal income tax withheld 4 Social security tax withheld 6 Medicare tax withheld
12a
C o d e
475.85
12b
C o d e
071-02-3211
17 State income tax
C o d e
NY
15 State
150532081
5978.31
68.00
20 Locality name
Copy 2-To Be Filed With Employees State, City, or Local Income Tax Return
FORM # LW28700
RAJHANS HASMUKHBHAI SHARMA G-116 YOGIDARSHAN DUPLEX, DARBAR CHOKDI,OPP MANJALPUR VADODARA 390011 INDIA
12c
C o d e
15-0532081
a Employees social security number
12d