tate wages. tics. We. 175323.09 17 State moome tax II Local wage:slips. ale. 1 19 Local inmate lax 20 Locally name i ,tej t .:?..t la n;f 1.; 61tt7 C; 3" • - , , 4 -c. . lc - I ---- ' • r .S bsEsr.:;lanc:§0111#11 . itsisaCA Social Security Number gi p Taxable Mantel Status: Exemp