Form COPY C
W-2 For EMPLOYEE’S RECORDS
Wage and Tax
Statement
(See Notice to Employee on the back of
Employee Earnings Statement.) OMB No. 1545-0008 2022 EMPLOYEE EARNINGS STATEMENT
a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld This Earnings Statement provides you with more information pertaining to your W-2
1584 70913.52 4823.45 and tax status. Also see the reverse side for IRS instructions.
b Employer’s EIN 3 Social security wages 4 Social security tax withheld
45-2453239 70913.52 4396.69 1. W-4 information reflects data submitted to employer on Form W-4
d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld
154-21-7063 70913.52 1028.25 Soc. Sec. No.: 154-21-7063 Exemptions
c Employer’s name, address and ZIP code Marital Status: Married
JPC MERGER SUB LLC Federal: N/A
853 NOTTINGHAM WAY State: 0
TRENTON NJ 08638 Local: N/A
13 Statutory employee Retirement plan Third-party sick pay 2. Taxable W-2 Wages
e Employee’s name, address and ZIP code
AHSAN ALAM Wages, Tips Soc. Sec. Medicare State
1313 INDIANA AVENUE Other Comp. Wages Wages Wages
LAWRENCEVILLE NJ 08648 Box 1 Box 3 Box 5 Box 16
Gross Pay 70913.52 70913.52 70913.52 70913.52
7 Social security tips 8 Allocated tips 9 Reported on W2 70913.52 70913.52 70913.52 70913.52
10 Dependent care benefits 11 Nonqualified plans
12 See instructions for box 12 14 Other
UI/WF/SWF- 169.15
DI- 99.27
FLI 99.27
15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax
NJ 452-453-239/000 70913.52 1463.94
18 Local wages, tips, etc. 19 Local income tax 20 Locality name
This information is being furnished to the Internal Revenue Dept. of the Treasury - IRS
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 Federal Filing Copy — COPY B Form State or Local Copy — COPY 2
W-2 To Be Filed With Employee’s
W-2 To Be Filed With Employee’s State,
Wage and Tax Wage and Tax
Statement FEDERAL Tax Return. OMB No. 1545-0008 Statement City, or Local Income Tax Return OMB No. 1545-0008
a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld
1584 70913.52 4823.45 1584 70913.52 4823.45
b Employer’s EIN 3 Social security wages 4 Social security tax withheld b Employer’s EIN 3 Social security wages 4 Social security tax withheld
45-2453239 70913.52 4396.69 45-2453239 70913.52 4396.69
d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld
154-21-7063 70913.52 1028.25 154-21-7063 70913.52 1028.25
c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code
JPC MERGER SUB LLC JPC MERGER SUB LLC
853 NOTTINGHAM WAY 853 NOTTINGHAM WAY
TRENTON NJ 08638 TRENTON NJ 08638
13 Statutory employee Retirement plan Third-party sick pay 13 Statutory employee Retirement plan Third-party sick pay
e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code
AHSAN ALAM AHSAN ALAM
1313 INDIANA AVENUE 1313 INDIANA AVENUE
LAWRENCEVILLE NJ 08648 LAWRENCEVILLE NJ 08648
7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
10 Dependent care benefits 11 Nonqualified plans 10 Dependent care benefits 11 Nonqualified plans
12 See instructions for box 12 14 Other 12 See instructions for box 12 14 Other
UI/WF/SWF- 169.15 UI/WF/SWF- 169.15
DI- 99.27 DI- 99.27
FLI 99.27 FLI 99.27
15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax
NJ 452-453-239/000 70913.52 1463.94 NJ 452-453-239/000 70913.52 1463.94
18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
This information is being furnished to the Internal Dept. of the Treasury - IRS Dept. of the Treasury - IRS
Revenue Service.
JPC MERGER SUB LLC
853 NOTTINGHAM WAY
TRENTON NJ 08638
2 BW2CSB2
1584-100
AHSAN ALAM
1313 INDIANA AVENUE
NTF 2585254
LAWRENCEVILLE NJ 08648
Notice to Employee (codes D, E, F, and S) and designated Roth contributions (codes AA,
BB, and EE) under all plans are generally limited to a total of $20,500
Do you have to file? Refer to the Form 1040 instructions to ($14,000 if you only have SIMPLE plans; $23,500 for section 403(b)
determine if you are required to file a tax return. Even if you plans if you qualify for the 15-year rule explained in Pub. 571). Deferrals
don’t have to file a tax return, you may be eligible for a refund if under code G are limited to $20,500. Deferrals under code H are limited
box 2 shows an amount or if you are eligible for any credit. to $7,000.
Earned income credit (EIC). You may be able to take the EIC However, if you were at least age 50 in 2022, your employer may have
for 2022 if your adjusted gross income (AGI) is less than a allowed an additional deferral of up to $6,500 ($3,000 for section
certain amount. The amount of the credit is based on income 401(k)(11) and 408(p) SIMPLE plans). This additional deferral amount is
and family size. Workers without children could qualify for a not subject to the overall limit on elective deferrals. For code G, the limit
smaller credit. You and any qualifying children must have valid on elective deferrals may be higher for the last 3 years before you reach
retirement age. Contact your plan administrator for more information.
social security numbers (SSNs). You can’t take the EIC if your Amounts in excess of the overall elective deferral limit must be included
investment income is more than the specified amount for 2022 in income. See the Form 1040 instructions.
or if income is earned for services provided while you were an
Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made
inmate at a penal institution. For 2022 income limits and more a make-up pension contribution for a prior year(s) when you were in
information, visit [Link]/EITC. See also Pub. 596, Earned military service. To figure whether you made excess deferrals, consider
Income Credit. Any EIC that is more than your tax liability is these amounts for the year shown, not the current year. If no year is
refunded to you, but only if you file a tax return. shown, the contributions are for the current year.
Employee’s social security number (SSN). For your A—Uncollected social security or RRTA tax on tips. Include this tax on
protection, this form may show only the last four digits of your Form 1040 or 1040-SR. See the Form 1040 instructions.
SSN. However, your employer has reported your complete SSN B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or
to the IRS and the Social Security Administration (SSA). 1040-SR. See the Form 1040 instructions.
Clergy and religious workers. If you aren’t subject to social C—Taxable cost of group-term life insurance over $50,000 (included in
security and Medicare taxes, see Pub. 517, Social Security and boxes 1, 3 (up to the social security wage base), and 5)
Other Information for Members of the Clergy and Religious D—Elective deferrals to a section 401(k) cash or deferred arrangement.
Workers. Also includes deferrals under a SIMPLE retirement account that is part
correct of a section 401(k) arrangement.
Corrections. If your name, SSN, or address is incorrect, E—Elective deferrals under a section 403(b) salary reduction agreement
Copies B, C, and 2 and ask your employer to correct your
employment record. Be sure to ask the employer to file Form F—Elective deferrals under a section 408(k)(6) salary reduction SEP
W-2c, Corrected Wage and Tax Statement, with the SSA to G—Elective deferrals and employer contributions (including nonelective
correct any name, SSN, or money amount error reported to the deferrals) to a section 457(b) deferred compensation plan
SSA on Form W-2. Be sure to get your copies of Form W-2c H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization
from your employer for all corrections made so you may file plan. See the Form 1040 instructions for how to deduct.
them with your tax return. If your name and SSN are correct but J—Nontaxable sick pay (information only, not included in box 1, 3, or 5)
aren’t the same as shown on your social security card, you K—20% excise tax on excess golden parachute payments. See the
should ask for a new card that displays your correct name at Form 1040 instructions.
any SSA office or by calling 800-772-1213. You may also visit L—Substantiated employee business expense reimbursements
the SSA website at [Link]. (nontaxable)
Cost of employer-sponsored health coverage (if such cost is M—Uncollected social security or RRTA tax on taxable cost of group-
provided by the employer). The reporting in box 12, using term life insurance over $50,000 (former employees only). See the Form
code DD, of the cost of employer-sponsored health coverage is 1040 instructions.
for your information only. The amount reported with code DD N—Uncollected Medicare tax on taxable cost of group-term life
is not taxable. insurance over $50,000 (former employees only). See the Form 1040
Credit for excess taxes. If you had more than one employer in instructions.
2022 and more than $9,114 in social security and/or Tier 1 P—Excludable moving expense reimbursements paid directly to a
railroad retirement (RRTA) taxes were withheld, you may be able member of the U.S. Armed Forces (not included in box 1, 3, or 5)
to claim a credit for the excess against your federal income tax. Q—Nontaxable combat pay. See the Form 1040 instructions for details
See the Form 1040 instructions. If you had more than one on reporting this amount.
railroad employer and more than $5,350.80 in Tier 2 RRTA tax R—Employer contributions to your Archer MSA. Report on Form 8853,
was withheld, you may be able to claim a refund on Form 843. Archer MSAs and Long-Term Care Insurance Contracts.
See the Instructions for Form 843. S—Employee salary reduction contributions under a section 408(p)
SIMPLE plan (not included in box 1)
T—Adoption benefits (not included in box 1). Complete Form 8839,
Instructions for Employee Qualified Adoption Expenses, to figure any taxable and nontaxable
Box 1. Enter this amount on the wages line of your tax return. amounts.
Box 2. Enter this amount on the federal income tax withheld line of your
tax return. V—Income from exercise of nonstatutory stock option(s) (included in
boxes 1, 3 (up to the social security wage base), and 5). See Pub. 525,
Box 5. You may be required to report this amount on Form 8959, Taxable and Nontaxable Income, for reporting requirements.
Additional Medicare Tax. See the Form 1040 instructions to determine if
you are required to complete Form 8959. contribute
W—Employer using a section 125
contributions (cafeteria)
(including plan) tothe
amounts your health savings
employee elected to
account. Report on Form 8889, Health Savings Accounts (HSAs).
Box 6. This amount includes the 1.45% Medicare Tax withheld on all Y—Deferrals under a section 409A nonqualified deferred compensation plan
Medicare wages and tips shown in box 5, as well as the 0.9% Additional
Medicare Tax on any of those Medicare wages and tips above Z—Income under a nonqualified deferred compensation plan that fails to
$200,000. satisfy section 409A. This amount is also included in box 1. It is subject
to an additional 20% tax plus interest. See the Form 1040 instructions.
Box 8. This amount is not included in box 1, 3, 5, or 7. For information
on how to report tips on your tax return, see the Form 1040 instructions. AA—Designated Roth contributions under a section 401(k) plan
You must file Form 4137, Social Security and Medicare Tax on BB—Designated Roth contributions under a section 403(b) plan
Unreported Tip Income, with your income tax return to report at least DD—Cost of employer-sponsored health coverage. The amount
the allocated tip amount unless you can prove with adequate records reported with code DD is not taxable.
that you received a smaller amount. If you have records that show the EE—Designated Roth contributions under a governmental section
actual amount of tips you received, report that amount even if it is more 457(b) plan. This amount does not apply to contributions under a tax-
or less than the allocated tips. Use Form 4137 to figure the social exempt organization section 457(b) plan.
security and Medicare tax owed on tips you didn’t report to your
employer. Enter this amount on the wages line of your tax return. By FF—Permitted benefits under a qualified small employer health
filing Form 4137, your social security tips will be credited to your social reimbursement arrangement
security record (used to figure your benefits). GG—Income from qualified equity grants under section 83(i)
Box 10. This amount includes the total dependent care benefits that HH—Aggregate deferrals under section 83(i) elections as of the close of
your employer paid to you or incurred on your behalf (including amounts the calendar year
from a section 125 (cafeteria) plan). Any amount over your employer’s Box 13. If the “Retirement plan” box is checked, special limits may apply
plan limit is also included in box 1. See Form 2441. to the amount of traditional IRA contributions you may deduct. See Pub.
Box 11. This amount is (a) reported in box 1 if it is a distribution made to 590-A, Contributions to Individual Retirement Arrangements (IRAs).
you from a nonqualified deferred compensation or nongovernmental Box 14. Employers may use this box to report information such as state
section 457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior disability insurance taxes withheld, union dues, uniform payments,
year deferral under a nonqualified or section 457(b) plan that became health insurance premiums deducted, nontaxable income, educational
taxable for social security and Medicare taxes this year because there is assistance payments, or a member of the clergy’s parsonage allowance
no longer a substantial risk of forfeiture of your right to the deferred and utilities. Railroad employers use this box to report railroad
amount. This box shouldn’t be used if you had a deferral and a retirement (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax,
distribution in the same calendar year. If you made a deferral and and Additional Medicare Tax. Include tips reported by the employee to
received a distribution in the same calendar year, and you are or will be the employer in railroad retirement (RRTA) compensation.
age 62 by the end of the calendar year, your employer should file Form
SSA-131, Employer Report of Special Wage Payments, with the Social Note: Keep Copy C of Form W-2 for at least 3 years after the due date
Security Administration and give you a copy. for filing your income tax return. However, to help protect your social
security benefits, keep Copy C until you begin receiving social security
Box 12. The following list explains the codes shown in box 12. You may benefits, just in case there is a question about your work record and/or
need this information to complete your tax return. Elective deferrals earnings in a particular year.
