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ependent care Innards a Employee's lint name and initial last name Suff. 11 Nonqualltled pans 12a Sae Instructions for box 12 ?, I 13 g1121. W.,'"' liter n n n p-tai I 14 Other 12c ? I 12d 1 Employee's address end ZIP coda leSue Employers state ID number I. 10 Slate wages, lips,
rvenve (service Whore To File Copy A Sand the eats Bret pogo of this form (Copy P) whh the entire Copy A page of Porn W-2AS, W-2CM. or W-2VI to: Sooty' Security AdmInlatreflon Data Operations Center Wilkes-Bane, PA 18709.9001 Note: If you arse -CortiEed Mell" to hie, Menge the ZIP code to "18769-
2 mentions1 same-page
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eduction Act None, an pegs 2. Cn No 102203 kern W..4 (sole EFTA00606121
one of this ton" to **IRS. 01.4011b.1546-0074 2014 I You ea sae and moot nits Last name ACCI i turd 3 iN Singe 0 Monied 0 Na. II medal, tut Sooty wont re acme a. emotion as dock w lope kw 4 Isar last some tapes bee tot oboe on yew sada soca ewe, dwelt hwy. You mat call 1400-772-1213 fora ► 0
2 mentions1 same-page
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5 EFTA00054607 cute: 0311912019 Tine: 10:27.W. Federal Bureau of Prisons TRUINTEL. Log Entrie
7/18•2019 550 PM NYM SHIP - Summary Tent Completed. Serviceable. Housing Unit Special (SW) 9 SOUTH SHU 7/19/20194:50 PM Evenirg TF49363 CC Sooty Check 7/192019 &SO PM NYM SI4LI - Summary Text: Radio Number: 608. Housing Unit, Special (SHU) 9 SOUTH SHU 7/19/2019 4:50 PM Evening TF49363
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