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Employer:
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Employer Identification Number (EIN):262051970 |
SIGNAL BUTTE NNY RESTAURANT LLC | |
10000 N 31ST AVENUE SUITE 109B | |
PHOENIX, AZ 85051-0000 | |
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Employee:
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Employee's Social Security Number:
647-40-0297 |
CHANDLER KINSEY | |
11414 E. SOLINA AVE | |
MESA, AZ 85212-0000 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $619.00 |
Federal Income Tax Withheld: | $33.00 |
Social Security Wages: | $391.00 |
Social Security Tax Withheld: | $38.00 |
Medicare Wages and Tips: | $619.00 |
Medicare Tax Withheld: | $8.00 |
Social Security Tips: | $228.00 |
Allocated Tips: | $0.00 |
Dependent Care Benefits: | $0.00 |
Deferred Compensation: | $0.00 |
Code "Q" Nontaxable Combat Pay: | $0.00 |
Code "W" Employer Contributions to a Health Savings Account: | $0.00 |
Code "Y" Deferrals under a section 409A nonqualified Deferred Compensation plan: | $0.00 |
Code "Z" Income under section 409A on a nonqualified Deferred Compensation plan: | $0.00 |
Code "R" Employer's Contribution to MSA: | $0.00 |
Code "S" Employer's Contribution to Simple Account: | $0.00 |
Code "T" Expenses Incurred for Qualified Adoptions: | $0.00 |
Code "V" Income from exercise of non-statutory stock options: | $0.00 |
Code "AA" Designated Roth Contributions under a Section 401(k) Plan: | $0.00 |
Code "BB" Designated Roth Contributions under a Section 403(b) Plan: | $0.00 |
Code "DD" Cost of Employer-Sponsored Health Coverage: | $0.00 |
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b) Plan: | $0.00 |
Third Party Sick Pay Indicator: | Unanswered |
Retirement Plan Indicator: | Unanswered |
Statutory Employee: | Not Statutory Employee |
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Employer:
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Employer Identification Number (EIN):464196405 |
ARIZONA RESTAURANT COMPANY LLC | |
1515 N ACADEMY BLVD | |
COLORADO SPGS, CO 80909-0000 | |
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Employee:
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Employee's Social Security Number:
647-40-0297 |
CHANDLER S KINSEY | |
11414 E SOLINA AVE | |
MESA, AZ 85212-0000 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $2,896.00 |
Federal Income Tax Withheld: | $187.00 |
Social Security Wages: | $2,896.00 |
Social Security Tax Withheld: | $179.00 |
Medicare Wages and Tips: | $2,896.00 |
Medicare Tax Withheld: | $42.00 |
Social Security Tips: | $0.00 |
Allocated Tips: | $0.00 |
Dependent Care Benefits: | $0.00 |
Deferred Compensation: | $0.00 |
Code "Q" Nontaxable Combat Pay: | $0.00 |
Code "W" Employer Contributions to a Health Savings Account: | $0.00 |
Code "Y" Deferrals under a section 409A nonqualified Deferred Compensation plan: | $0.00 |
Code "Z" Income under section 409A on a nonqualified Deferred Compensation plan: | $0.00 |
Code "R" Employer's Contribution to MSA: | $0.00 |
Code "S" Employer's Contribution to Simple Account: | $0.00 |
Code "T" Expenses Incurred for Qualified Adoptions: | $0.00 |
Code "V" Income from exercise of non-statutory stock options: | $0.00 |
Code "AA" Designated Roth Contributions under a Section 401(k) Plan: | $0.00 |
Code "BB" Designated Roth Contributions under a Section 403(b) Plan: | $0.00 |
Code "DD" Cost of Employer-Sponsored Health Coverage: | $0.00 |
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b) Plan: | $0.00 |
Third Party Sick Pay Indicator: | Unanswered |
Retirement Plan Indicator: | Unanswered |
Statutory Employee: | Not Statutory Employee |