m MX withheld 68.00 4 Social vecodty tax withhold 40.30 d Empkyereo soolel co0uty nuntor 580-23-1452 Ihriployaole list nem and InICal UM name TEQUASI 0 HENDRICKS PO BOX 672 ST. JOHN, USVI, 00831 f emninveree %Arleen and 235 node Form W-2111 U.S. Virgin islands Wage and Tax Statement Copy 1-For