5a Taxable social security wages . . . . . . . . . . . fill in the blank 4 of 25\ x 0.124 = fill in the blank 5 of 25\ \ 5a (i) Qualified sick leave wages . . . . . . . . . . . fill in the blank 6 of 25\ x 0.062 = fill in the blank 7 of 25\ \ 5a (ii) Qualified family leave wages . . . . . . . . . fill in the blank 8 of 25\ x 0.062 = fill in the blank 9 of 25\ \ 5b Taxable social security tips . . . . . . . . . . . . . fill in the blank 10 of 25\ x 0.124 = fill in the blank 11 of 25\ \ 5c Taxable Medicare wages & tips . . . . . . . . . . fill in the blank 12 of 25\ x 0.029 = fill in the blank 13 of 25\ \ 5d Taxable wages & tips subject to\ Additional Medicare Tax withholding fill in the blank 14 of 25\ x 0.009 = fill in the blank 15 of 25