2018 W-2 and EARNINGS SUMMARY

Employee Reference Copy This blue Earnings Summary section is included with your W-2 to help describe portions in more detail.
Wage and Tax
W-2 Statement
Copy C for employee’s records.
2018
OMB No. 1545-0008
The reverse side includes general information that you may also find helpful.
1. The following information reflects your final 2018 pay stub plus any adjustments submitted by your employer.
d Control number Dept. Corp. Employer use only Gross Pay Social Security NY. State Income Tax
22273.69 1343.46 572.71
000055 RZ/WY9 A 105 Tax Withheld Box 17 of W-2
c Employer’s name, address, and ZIP code Box 4 of W-2 Local Income Tax 414.79
MACC RELATED LLC Box 19 of W-2
Fed. Income 1089.22 Medicare Tax 314.20
109 HARDSCRABBLE LAKE DRIVE Tax Withheld Withheld SUI/SDI/FLI
CHAPPAQUA, NY 10514 Box 2 of W-2 Box 6 of W-2 Box 14 of W-2

2. Your Gross Pay was adjusted as follows to produce your W-2 Statement.
Batch #96232
Wages, Tips, other Social Security Medicare NY. State Wages, NYC RES
e/f Employee’s name, address, and ZIP code Compensation Wages Wages Tips, Etc. Local Wages,
Box 1 of W-2 Box 3 of W-2 Box 5 of W-2 Box 16 of W-2 Tips, Etc.
MARK JONES Box 18 of W-2
666 PARK PL Gross Pay 22,273.69 22,273.69 22,273.69 22,273.69 22,273.69
APT 4L Less Transportation-SalaryReduction 605.00 605.00 605.00 605.00 605.00
BROOKLYN, NY 11216 Reported W-2 Wages 21,668.69 21,668.69 21,668.69 21,668.69 21,668.69
b Employer’s FED ID number a Employee’s SSA number
82-3142426 388-15-4090
1 Wages, tips, other comp. 2 Federal income tax withheld
21668.69 1089.22
3 Social security wages 4 Social security tax withheld
21668.69 1343.46
5 Medicare wages and tips 6 Medicare tax withheld
21668.69 314.20
7 Social security tips 8 Allocated tips

9 Verification Code 10 Dependent care benefits 3. Employee W-4 Profile. To change your Employee W-4 Profile Information, file a new W-4 with your payroll dept.

11 Nonqualified plans 12a See instructions for box 12

12b
MARK JONES Social Security Number:388-15-4090
14 Other 666 PARK PL Taxable Marital Status: SINGLE
12c
28.11 NY PFL
605.00 TRPASS 12d APT 4L Exemptions/Allowances:
____________________
29.40 VPDI 13 Stat emp. Ret. plan 3rd party sick pay BROOKLYN, NY 11216 FEDERAL: 2
STATE: 2
15 State Employer’s state ID no. 16 State wages, tips, etc.
LOCAL: 2
NY 82-3142426 21668.69
17 State income tax 18 Local wages, tips, etc.
572.71 21668.69
19 Local income tax 20 Locality name ¤ 2018 ADP, LLC
414.79 NYC RES

1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld
21668.69 1089.22 21668.69 1089.22 21668.69 1089.22
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
21668.69 1343.46 21668.69 1343.46 21668.69 1343.46
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
21668.69 314.20 21668.69 314.20 21668.69 314.20
d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only
000055 RZ/WY9 A 105 000055 RZ/WY9 A 105 000055 RZ/WY9 A 105
c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code
MACC RELATED LLC MACC RELATED LLC MACC RELATED LLC
109 HARDSCRABBLE LAKE DRIVE 109 HARDSCRABBLE LAKE DRIVE 109 HARDSCRABBLE LAKE DRIVE
CHAPPAQUA, NY 10514 CHAPPAQUA, NY 10514 CHAPPAQUA, NY 10514

b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number
82-3142426 388-15-4090 82-3142426 388-15-4090 82-3142426 388-15-4090
7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips

9 Verification Code 10 Dependent care benefits 9 Verification Code 10 Dependent care benefits 9 Verification Code 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a
12 11 Nonqualified plans 12a

14 Other 12b 14 Other 12b 14 Other 12b

12c 12c 12c
28.11 NY PFL 28.11 NY PFL 28.11 NY PFL
605.00 TRPASS 12d 605.00 TRPASS 12d 605.00 TRPASS 12d
29.40 VPDI 29.40 VPDI 29.40 VPDI
13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay

e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code
MARK JONESE MARK JONES MARK JONES
666 PARK PL 666 PARK PL 666 PARK PL
APT 4L APT 4L APT 4L
BROOKLYN, NY 11216 BROOKLYN, NY 11216 BROOKLYN, NY 11216
15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc.
NY 82-3142426 21668.69 NY 82-3142426 21668.69 NY 82-3142426 21668.69
17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
572.71 21668.69 572.71 21668.69 572.71 21668.69
19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name
414.79 NYC RES 414.79 NYC RES 414.79 NYC RES
Federal Filing Copy [Link] Filing Copy City or Local Filing Copy
Wage and Tax Wage and Tax Wage and Tax
W-2 Statement
Copy B to be filed with employee’s
OMB No. 1545-0008
2018
Federal Income Tax Return.
W-2 Statement 2018
OMB No. 1545-0008
Copy 2 to be filed with employee’s State Income Tax Return.
W-2 Statement OMB No. 1545-0008
2018
Copy 2 to be filed with employee’s City or Local Income Tax Return.