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L BRILLO WAY PALM BEACH, FL 33480 3 Social security wages 38536.47 4 Social secunty tax witnheld 2389.26 5 Medicare wages end tips 38536.47 6 Medcare tax withheld 558.78 7 Sodal security tips 8 Allocated tips o Advance BC payment 10 Dependent care benefits • f Employee's address and ZIP code
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