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Copy B-To Be Filed With Employee's FEDERAL Tax Return

This document is a W-2 form for Tara G Hand reporting wages and tax withholdings from Midwest Waffles, Inc. in 2020. It shows that Tara earned $3362.86 in wages, $18,909.40 in Social Security wages, and $22,272.26 in total wages. It also lists tax amounts withheld for Federal, Social Security, and Medicare taxes.

Uploaded by

Kyle im taken by cailey hand Hand
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
976 views5 pages

Copy B-To Be Filed With Employee's FEDERAL Tax Return

This document is a W-2 form for Tara G Hand reporting wages and tax withholdings from Midwest Waffles, Inc. in 2020. It shows that Tara earned $3362.86 in wages, $18,909.40 in Social Security wages, and $22,272.26 in total wages. It also lists tax amounts withheld for Federal, Social Security, and Medicare taxes.

Uploaded by

Kyle im taken by cailey hand Hand
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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253-91-0348 8015002.2021010590408.

97802

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, Tips, other compensation 2 Federal Income Tax Withheld

W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21


c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax Withheld
.00 18909.40 1380.86
9 5 Medicare Wages and Tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number (EIN) 12c

TARA G HAND 27-4092761


PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
253-91-0348 1833.93
CLEVES OH 45002-9016
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
KY 318940 1524.96 59.29 .00 .00
KY 318940 .00 .00 1652.95 23.97 HEBRON
Copy B-To be filed with employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
Visit the IRS Web Site at www.irs.gov/efile

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, Tips, other compensation 2 Federal Income Tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax Withheld
.00 18909.40 1380.86
9 5 Medicare Wages and Tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number (EIN) 12c


TARA G HAND 27-4092761
PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93

15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
KY 318940 1524.96 59.29 .00 .00
KY 318940 .00 .00 1652.95 23.97 HEBRON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, Tips, other compensation 2 Federal Income Tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax Withheld
.00 18909.40 1380.86
9 5 Medicare Wages and Tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071
.00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number (EIN) 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
KY 318940 1524.96 59.29 .00 .00
KY 318940 .00 .00 1652.95 23.97 HEBRON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

This information is being furnished to the Internal Revenue 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.
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, Tips, other compensation 2 Federal Income Tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax Withheld
.00 18909.40 1380.86
9 5 Medicare Wages and Tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54

*97802*
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
97802 employee Plan Sick Pay

b Employer Identification Number (EIN) 12c

TARA G HAND 27-4092761 PLAN-P125


5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
1833.93
CLEVES OH 45002-9016 253-91-0348
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
KY 318940 1524.96 59.29 .00 .00
KY 318940 .00 .00 1652.95 23.97 HEBRON
Copy C for Employee’s Records (See Notice to Employee on back of Copy B.) OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
253-91-0348
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 20747.30 365.15 .00 .00
OH 52774536 .00 .00 412.06 8.66 ANDERSON
Copy B-To be filed with employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
Visit the IRS Web Site at www.irs.gov/efile

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 20747.30 365.15 .00 .00
OH 52774536 .00 .00 412.06 8.66 ANDERSON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 12a See instructions for box 12
11 Nonqualified plans
NORCROSS GA 30071 .00 2758.54
.00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 20747.30 365.15 .00 .00
OH 52774536 .00 .00 412.06 8.66 ANDERSON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

This information is being furnished to the Internal Revenue 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.
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761 PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 1833.93
253-91-0348
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 20747.30 365.15 .00 .00
OH 52774536 .00 .00 412.06 8.66 ANDERSON
Copy C for Employee’s Records (See Notice to Employee on back of Copy B.) OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
253-91-0348
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 136.65 1.37 HARRISON
OH 52774536 .00 .00 31.60 .35 MASON
Copy B-To be filed with employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
Visit the IRS Web Site at www.irs.gov/efile

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 136.65 1.37 HARRISON
OH 52774536 .00 .00 31.60 .35 MASON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 136.65 1.37 HARRISON
OH 52774536 .00 .00 31.60 .35 MASON
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

This information is being furnished to the Internal Revenue 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.
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761 PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 1833.93
253-91-0348
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 136.65 1.37 HARRISON
OH 52774536 .00 .00 31.60 .35 MASON
Copy C for Employee’s Records (See Notice to Employee on back of Copy B.) OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
253-91-0348

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 133.27 2.00 SHARONVILL
OH 52774536 .00 .00 49.56 .74 SPRINGBORO
Copy B-To be filed with employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
Visit the IRS Web Site at www.irs.gov/efile

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 133.27 2.00 SHARONVILL
OH 52774536 .00 .00 49.56 .74 SPRINGBORO
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 133.27 2.00 SHARONVILL
OH 52774536 .00 .00 49.56 .74 SPRINGBORO
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

This information is being furnished to the Internal Revenue 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.
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761 PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 1833.93
253-91-0348
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 133.27 2.00 SHARONVILL
OH 52774536 .00 .00 49.56 .74 SPRINGBORO
Copy C for Employee’s Records (See Notice to Employee on back of Copy B.) OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
253-91-0348

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 20758.55 415.15 SPRINGDALE
OH 52774536 .00 .00 364.35 8.39 WOODLAWN
Copy B-To be filed with employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service
Visit the IRS Web Site at www.irs.gov/efile

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR
10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 2758.54
.00 .00 DD
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761
5932 RAINBOW HILL DR PLAN-P125
a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 253-91-0348 1833.93
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 20758.55 415.15 SPRINGDALE
OH 52774536 .00 .00 364.35 8.39 WOODLAWN
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c

TARA G HAND 27-4092761


PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
253-91-0348 1833.93
CLEVES OH 45002-9016
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 20758.55 415.15 SPRINGDALE
OH 52774536 .00 .00 364.35 8.39 WOODLAWN
Copy 2- To be filed with employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

This information is being furnished to the Internal Revenue 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.
CORRECTED( If checked) d Control Number 7 Social Security Tips 1 Wages, tips, other compensation 2 Federal Income tax Withheld
W-2 Wage And Tax Statement 2020 3362.86 22272.26 1495.21
c Employer’s Name, Address, and ZIP code 8 Allocated Tips 3 Social Security Wages 4 Social Security Tax withheld
.00 18909.40 1380.86
9 5 Medicare Wages and tips 6 Medicare Tax Withheld
MIDWEST WAFFLES, INC. 22272.26 323.03
5986 FINANCIAL DR 10 Dependent Care Benefits 11 Nonqualified plans 12a See instructions for box 12
NORCROSS GA 30071 .00 .00 DD 2758.54
e Employee’s Name, Address, and ZIP code 13 Statutory Retirement Third Party 14 Other 12b
employee Plan Sick Pay

b Employer Identification Number 12c


TARA G HAND 27-4092761 PLAN-P125
5932 RAINBOW HILL DR a Employee’s Social Security Number 12d
CLEVES OH 45002-9016 1833.93
253-91-0348
15 State Employer’s State ID Number 16 State Wages, Tips,etc. 17 State Income Tax 18 Local Wages, Tips,etc. 19 Local Income Tax 20 Locality Name
OH 52774536 .00 .00 20758.55 415.15 SPRINGDALE
OH 52774536 .00 .00 364.35 8.39 WOODLAWN
Copy C for Employee’s Records (See Notice to Employee on back of Copy B.) OMB No. 1545-0008 Department of the Treasury - Internal Revenue Service

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