t end Paperwork Reduction Act Nonce end Instruction', ace Form WeliSS. FTC[1014 EFTA00233128 a Control number 22222 Vold OMB No. 1645-0O18 b Empecyor Identlecetion number mem b‘btlee. Cps ether compemol/on 38196.15 2 Vito:erne tax withheld 3250.00 it Social security tax withheld 2546.30 e Mn04taramz .50