Transaction No. 35

Complete Form W-2,Wage and Tax Statement, for each employee using the employee's earnings records to obtain the information needed to complete the forms. The two plant workers (Bonno and Ryan) have had $121.00 in union dues withheld during the year. In addition to union dues withheld, include the Pennsylvania State Unemployment Tax (SUTA) withheld in Box 14.

Hint: Box 1 - contributions to SIMPLE plans and payments to an estate are not subject to FIT. Box 3 - remember the maximum earnings subject to OASDI, Box 14 is used to provide additional information to the employee (see Figure 4.9 instructions).

Figure 4.8andFigure 4.9

If an amount box does not require an entry, leave it blank. Round your answers to two decimal place.

Click here to access the Wage-Bracket Method Tables.

22222Void aEmployee's social security number

000-00-3481For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 1

2Federal income tax withheld

$fill in the blank 2

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 3

4Social security tax withheld

$fill in the blank 4

5Medicare wages and tips

$fill in the blank 5

6Medicare tax withheld

$fill in the blank 6

7Social security tips

$fill in the blank 7

8Allocated tips

$fill in the blank 8

dControl number910Dependent care benefits

$fill in the blank 9

eEmployee's first name and initial

Anthony V.Last name

BonnoSuff.11Nonqualified plans

fill in the blank 10

12aSee instructions for box 12

694 BRISTOL AVENUE

PHILADELPHIA, PA 19135-0617

fEmployee's address and ZIP code13

Code$fill in the blank 12

12b14Other

Code$fill in the blank 14

12cCode$fill in the blank 15

12dCode$fill in the blank 16

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 17

17State income tax

$fill in the blank 18

18Local wages, tips, etc.

$fill in the blank 19

19Local income tax

$fill in the blank 20

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-8645For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 21

2Federal income tax withheld

$fill in the blank 22

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 23

4Social security tax withheld

$fill in the blank 24

5Medicare wages and tips

$fill in the blank 25

6Medicare tax withheld

$fill in the blank 26

7Social security tips

$fill in the blank 27

8Allocated tips

$fill in the blank 28

dControl number910Dependent care benefits

$fill in the blank 29

eEmployee's first name and initial

James C.Last name

FergusonSuff.11Nonqualified plans

fill in the blank 30

12aSee instructions for box 12

808 SIXTH STREET

PHILADELPHIA, PA 19106-0995

fEmployee's address and ZIP code13

Code

$fill in the blank 33

12b14Other

Code$fill in the blank 35

12cCode$fill in the blank 36

12dCode$fill in the blank 37

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 38

17State income tax

$fill in the blank 39

18Local wages, tips, etc.

$fill in the blank 40

19Local income tax

$fill in the blank 41

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-4567For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 42

2Federal income tax withheld

$fill in the blank 43

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 44

4Social security tax withheld

$fill in the blank 45

5Medicare wages and tips

$fill in the blank 46

6Medicare tax withheld

$fill in the blank 47

7Social security tips

$fill in the blank 48

8Allocated tips

$fill in the blank 49

dControl number910Dependent care benefits

$fill in the blank 50

eEmployee's first name and initial

Catherine L.Last name

FordSuff.11Nonqualified plans

fill in the blank 51

12aSee instructions for box 12

18 DUNDEE AVENUE

PHILADELPHIA, PA 19151-1919

fEmployee's address and ZIP code13

Code$fill in the blank 53

12b14Other

Code$fill in the blank 55

12cCode$fill in the blank 56

12dCode$fill in the blank 57

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 58

17State income tax

$fill in the blank 59

18Local wages, tips, etc.

$fill in the blank 60

19Local income tax

$fill in the blank 61

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-9352For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 62

2Federal income tax withheld

$fill in the blank 63

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 64

4Social security tax withheld

$fill in the blank 65

5Medicare wages and tips

$fill in the blank 66

6Medicare tax withheld

$fill in the blank 67

7Social security tips

$fill in the blank 68

8Allocated tips

$fill in the blank 69

dControl number910Dependent care benefits

$fill in the blank 70

eEmployee's first name and initial

Dewey W.Last name

MannSuff.11Nonqualified plans

fill in the blank 71

12aSee instructions for box 12

3007 BISQUE DRIVE

PHILADELPHIA, PA 19199-0718

fEmployee's address and ZIP code13

Code

$fill in the blank 74

12b14Other

Code$fill in the blank 76

12cCode$fill in the blank 77

12dCode$fill in the blank 78

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 79

17State income tax

$fill in the blank 80

18Local wages, tips, etc.

$fill in the blank 81

19Local income tax

$fill in the blank 82

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-1534For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 83

2Federal income tax withheld

$fill in the blank 84

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 85

4Social security tax withheld

$fill in the blank 86

5Medicare wages and tips

$fill in the blank 87

6Medicare tax withheld

$fill in the blank 88

7Social security tips

$fill in the blank 89

8Allocated tips

$fill in the blank 90

dControl number910Dependent care benefits

$fill in the blank 91

eEmployee's first name and initial

Joseph T.Last name

O'NeillSuff.11Nonqualified plans

fill in the blank 92

12aSee instructions for box 12

2100 BROAD STREET

PHILADELPHIA, PA 19121-7189

fEmployee's address and ZIP code13

Code

$fill in the blank 95

12b14Other

Code$fill in the blank 97

12cCode$fill in the blank 98

12dCode$fill in the blank 99

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 100

17State income tax

$fill in the blank 101

18Local wages, tips, etc.

$fill in the blank 102

19Local income tax

$fill in the blank 103

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-1223For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 104

2Federal income tax withheld

$fill in the blank 105

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 106

4Social security tax withheld

$fill in the blank 107

5Medicare wages and tips

$fill in the blank 108

6Medicare tax withheld

$fill in the blank 109

7Social security tips

$fill in the blank 110

8Allocated tips

$fill in the blank 111

dControl number910Dependent care benefits

$fill in the blank 112

eEmployee's first name and initial

Norman A.Last name

RyanSuff.11Nonqualified plans

fill in the blank 113

12aSee instructions for box 12

7300 HARRISON STREET

PHILADELPHIA, PA 19124-6699

fEmployee's address and ZIP code13

Code

$fill in the blank 116

12b14Other

Code$fill in the blank 118

12cCode$fill in the blank 119

12dCode$fill in the blank 120

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 121

17State income tax

$fill in the blank 122

18Local wages, tips, etc.

$fill in the blank 123

19Local income tax

$fill in the blank 124

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-8832For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 125

2Federal income tax withheld

$fill in the blank 126

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 127

4Social security tax withheld

$fill in the blank 128

5Medicare wages and tips

$fill in the blank 129

6Medicare tax withheld

$fill in the blank 130

7Social security tips

$fill in the blank 131

8Allocated tips

$fill in the blank 132

dControl number910Dependent care benefits

$fill in the blank 133

eEmployee's first name and initial

Thomas J.Last name

SokowskiSuff.11Nonqualified plans

fill in the blank 134

12aSee instructions for box 12

133 CORNWELLS STREET

PHILADELPHIA, PA 19171-5718

fEmployee's address and ZIP code13

Code$fill in the blank 136

12b14Other

Code$fill in the blank 138

12cCode$fill in the blank 139

12dCode$fill in the blank 140

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 141

17State income tax

$fill in the blank 142

18Local wages, tips, etc.

$fill in the blank 143

19Local income tax

$fill in the blank 144

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 145

2Federal income tax withheld

$fill in the blank 146

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 147

4Social security tax withheld

$fill in the blank 148

5Medicare wages and tips

$fill in the blank 149

6Medicare tax withheld

$fill in the blank 150

7Social security tips

$fill in the blank 151

8Allocated tips

$fill in the blank 152

dControl number910Dependent care benefits

$fill in the blank 153

eEmployee's first name and initial

STUDENTLast nameSuff.11Nonqualified plans

fill in the blank 154

12aSee instructions for box 12

7018 ERDRICK STREET

PHILADELPHIA, PA 19135-8517

fEmployee's address and ZIP code13

Code$fill in the blank 156

12b14Other

Code$fill in the blank 158

12cCode$fill in the blank 159

12dCode$fill in the blank 160

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 161

17State income tax

$fill in the blank 162

18Local wages, tips, etc.

$fill in the blank 163

19Local income tax

$fill in the blank 164

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-1587For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 165

2Federal income tax withheld

$fill in the blank 166

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 167

4Social security tax withheld

$fill in the blank 168

5Medicare wages and tips

$fill in the blank 169

6Medicare tax withheld

$fill in the blank 170

7Social security tips

$fill in the blank 171

8Allocated tips

$fill in the blank 172

dControl number910Dependent care benefits

$fill in the blank 173

eEmployee's first name and initial

Beth A.Last name

WoodsSuff.11Nonqualified plans

fill in the blank 174

12aSee instructions for box 12

8102 FRANKLIN COURT

PHILADELPHIA, PA 19105-0915

fEmployee's address and ZIP code13

Code$fill in the blank 176

12b14Other

Code$fill in the blank 178

12cCode$fill in the blank 179

12dCode$fill in the blank 180

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 181

17State income tax

$fill in the blank 182

18Local wages, tips, etc.

$fill in the blank 183

19Local income tax

$fill in the blank 184

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.

22222Void aEmployee's social security number

000-00-6057For Official Use Only

OMB No. 1545-0008bEmployer identification number (EIN)

00-00006601Wages, tips, other compensation

$fill in the blank 185

2Federal income tax withheld

$fill in the blank 186

cEmployer's name, address, and ZIP code

Glo-Brite Paint Company

2215 Salvador Street

Philadelphia, PA 19175-0682

3Social security wages

$fill in the blank 187

4Social security tax withheld

$fill in the blank 188

5Medicare wages and tips

$fill in the blank 189

6Medicare tax withheld

$fill in the blank 190

7Social security tips

$fill in the blank 191

8Allocated tips

$fill in the blank 192

dControl number910Dependent care benefits

$fill in the blank 193

eEmployee's first name and initial

Paul W.Last name

YoungSuff.11Nonqualified plans

fill in the blank 194

12aSee instructions for box 12

7936 HOLMES DRIVE

PHILADELPHIA, PA 19107-0007

fEmployee's address and ZIP code13

Code$fill in the blank 196

12b14Other

Code$fill in the blank 198

12cCode$fill in the blank 199

12dCode$fill in the blank 200

15State

PAEmployer's state ID number

000-0-330016State wages, tips, etc.

$fill in the blank 201

17State income tax

$fill in the blank 202

18Local wages, tips, etc.

$fill in the blank 203

19Local income tax

$fill in the blank 204

20Locality name

PHILA.FormW-2 Wage and Tax Statement20--Department of the TreasuryInternal Revenue Service

For Privacy Act and Paperwork Reduction

Act Notice, see the separate instructions.

Cat. No. 10134DCopy A For Social Security Administration Send this entire page with

Form W-3 to the Social Security Administration; photocopies arenotacceptable.