Wage and Tax Statement: Copy C-For EMPLOYEE'S RECORDS (See Notice To On The Back of Copy B.)
Wage and Tax Statement: Copy C-For EMPLOYEE'S RECORDS (See Notice To On The Back of Copy B.)
Wage and Tax Statement: Copy C-For EMPLOYEE'S RECORDS (See Notice To On The Back of Copy B.)
If you
625-80-4805 are required to file a tax return, a negligence penalty or other sanction may
OMB No. 1545-0008 be imposed on you if this income is taxable and you fail to report it.
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
74-2782655 132353.33 25027.30
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
BICH NGUYEN o
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C 762.12
13 Statutory
employee
Retirement Third-party 12b
plan sick pay C
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D 4712.03
14 12c
724 Shard Ct C
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DD
D D 28230.12
VPDI 937.10 d
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Fremont, CA 94539 12d
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d
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W-2
Department of the Treasury—Internal Revenue Service
Wage and Tax
Form Statement
Copy C—For EMPLOYEE’S RECORDS (See Notice to
2019 Safe, accurate,
FAST! Use
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