8-3 ST. THOMAS , 00902 d Employee's social murky renter 580-06-2353 aatr i"mrslad IVRIAN GORDON 13215 WHITE MOON COURT CHARLOTTE, NC 28213 f Emobvee's address and ZIP code Form Copy 1-For Ol Bureau of Internal Revenue or Copy O-For Employer VII-2111 WePes. tiPA other rempehsatIon 35487.81 3