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ocal wages, Ice, ales. 19 Local income tax 20 Lotaley name t I Wage and Tax Form1111c Statement Copy El—For Employer. 2005 Deportment of the Treesury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see beck of Copy D. E1004 EFTA00176009 co ris.4 -"r 696 9 OMB N
111 2006 4 Sottol security tax withhold 2952.07 6 thedlootolax withheld 690.40 la Soo Farm W.OSS instructions 1 S 11627.89 2b C 140.82 old Department of the Tressuni—triternai Revenue Servion Por PrIvooy Act And Paperwork RoduatIon Act Notice and mstruotionS, see Ponti W-0$$. PUNE EFTA00176017 a ContrdnuMber
onS p 126.60 13 er03% it ilrICIOt War WI El la I 14 Other 770 i i 12d A inic2iin U.S. Virgin Islands Form Wage and Tex Statement 2005 Department of the Troacury—inlemel Revenue Service Por Of}igiev Ant and Pennaaatde !forlorn... An tln..n• Copy 1-For VI Bureau of Internal Revenue or Copy b•For Employer FTC
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Forms 480, for is reporting information. It is the practice Of UBS to (lie the apOrcaNe tat reporting forms nub the us internal Revenue Service and PR Treasury Department and in such forms accurately clarity chide net andra interest a tax carrot or taxable income. Pleat consult your Indridual tar preparer. Your l3 n
ial Services ax. 1200 natio Boulevard Weehawken NJ 07086 This statement represents the on& off icial record of you LBS Financial Services account Olher records, except Alicial lay documents, centering calf lictng data shoal nor be relied open. Oro believe there is an error or motion pleas* report
e Forms 480, fix lac reporting information his the practice of UBS to file the aPpliCeilie to reporting forms vAth the US Interco Revenue Senate and PR TleaSury Department and in such fawn arrulatery clasIfy °velem% fl y lefties' as lax exempt or vocals* irons. neat (omit your inclvdual tin preparers June 2018(3) Ye
LIES inane! Services IX 1200 Harbor Boulevard Winnariken, W 07086 1.1,4 statement Menemthe onk official record of you U3S Fruncol Services scared Olher rends, MeV Oka la docunents, contanng carictng data should not be relied upon II you lotieve there is an ens or amnion please report ii immediatel
581 343,294 STATEMENT 4 PART XV. LINE CONTRIBUTIONS PAW 05/03/99 World Economic Forum $3,000 EFTA00224296 • Form 2758 (Rev. Juno 1998) . Department of pie Treasury “•temni Revenue Service Application for Extension of Time to File Certain Excise, Income, Information, and Other Returns IP File a separate appli
fil c< (loss) (allach schekile) 11 Othor meorno (aftach acheAde) 12 Total Aud lines 1 Inn:mett 11 i 13 Componeetton ot ~ro nedom trues sto 14 Olher employee selanes and ringes 15 Pension plans, employoe banefits „ 18a Legal Res (attach schodale) b Accounling feos (altach schedule) c Other es
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