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Wage and Income Transcript

Request Date: 06-14-2024
Response Date: 06-14-2024
Tracking Number: 106130510083

SSN Provided: 647-40-0297
Tax Period Requested: December, 2017

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):860850417
GODADDY COM LLC
14455 N HAYDEN RD STE
SCOTTSDALE, AZ 85260-0000

Employee:

Employee's Social Security Number: 647-40-0297
CHANDLER S KINSEY
1361 S GREENFIELD RD #
MESA, AZ 85206-0000

Submission Type:Original document
Wages, Tips and Other Compensation:$85,156.00
Federal Income Tax Withheld:$2,050.00
Social Security Wages:$87,364.00
Social Security Tax Withheld:$5,416.00
Medicare Wages and Tips:$87,364.00
Medicare Tax Withheld:$1,266.00
Social Security Tips:$0.00
Allocated Tips:$0.00
Dependent Care Benefits:$0.00
Deferred Compensation:$2,208.00
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:$219.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:Yes - retirement plan
Statutory Employee:Not Statutory Employee
W2 Submission Type:
W2 WHC SSN Validation Code:Correct SSN

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):352167612
E TRADE SECURITIES LLC
PO BOX 484
JERSEY CITY, NJ 07303-0484

Recipient:

Recipient's Identification Number: 647-40-0297
CHANDLER S KINSEY
1361 S GREENFIELD RD 2060
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):3736527168010250
Date Sold or Disposed:11-16-2017
CUSIP Number:380237107
Gross Proceeds:Gross proceeds
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$669.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$464.00
Wash Sale Loss Disallowed:$0.00
Accrued Market Discount Amount:$0.00
Description:GODADDY INC CL A
Second Notice Indicator:
Date Acquired:11-15-2017
Noncovered Security Indicator:Nothing checked
Type of Gain or Loss Code:Short-term
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:
FATCA Filing Requirement:Box not checked no Filing Requirement
Proceeds from Collectibles:Box not checked not reporting

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):800429876
SQUARE INC.
1455 MARKET STREET
SAN FRANCISCO, CA 94103-0000

Recipient:

Recipient's Identification Number: 647-40-0297
CHANDLER SCOTT KINSEY
1361 SOUTH GREENFIELD ROAD
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):2490538T3
Date Sold or Disposed:12-12-2017
CUSIP Number:0000000000000
Gross Proceeds:Nothing checked
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$182.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Wash Sale Loss Disallowed:$0.00
Accrued Market Discount Amount:$0.00
Description:SEE DETAIL STATEMENT
Second Notice Indicator:
Date Acquired:01-01-1900
Noncovered Security Indicator:Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:
FATCA Filing Requirement:Box not checked no Filing Requirement
Proceeds from Collectibles:Box not checked not reporting

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):800429876
SQUARE INC.
1455 MARKET STREET
SAN FRANCISCO, CA 94103-0000

Recipient:

Recipient's Identification Number: 647-40-0297
CHANDLER SCOTT KINSEY
1361 SOUTH GREENFIELD ROAD
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):2491167T3
Date Sold or Disposed:12-14-2017
CUSIP Number:0000000000000
Gross Proceeds:Nothing checked
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$451.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Wash Sale Loss Disallowed:$0.00
Accrued Market Discount Amount:$0.00
Description:SEE DETAIL STATEMENT
Second Notice Indicator:
Date Acquired:01-01-1900
Noncovered Security Indicator:Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:
FATCA Filing Requirement:Box not checked no Filing Requirement
Proceeds from Collectibles:Box not checked not reporting

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):800429876
SQUARE INC.
1455 MARKET STREET
SAN FRANCISCO, CA 94103-0000

Recipient:

Recipient's Identification Number: 647-40-0297
CHANDLER SCOTT KINSEY
1361 SOUTH GREENFIELD ROAD
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):2491579T3
Date Sold or Disposed:12-15-2017
CUSIP Number:0000000000000
Gross Proceeds:Nothing checked
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$343.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Wash Sale Loss Disallowed:$0.00
Accrued Market Discount Amount:$0.00
Description:SEE DETAIL STATEMENT
Second Notice Indicator:
Date Acquired:01-01-1900
Noncovered Security Indicator:Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:
FATCA Filing Requirement:Box not checked no Filing Requirement
Proceeds from Collectibles:Box not checked not reporting

Form 1099-G

Payer:

Payer's Federal Identification Number (FIN):866004791
ARIZONA DEPARTMENT OF REVENUE
1600 W MONROE
PHOENIX, AZ 85007-0000

Recipient:

Recipient's Identification Number: 647-40-0297
KINSEY CHANDLER
5210 E HAMPTON AVE APT 1124
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):201702125662
RTAA Payments:$0.00
Tax Withheld:$0.00
Taxable Grants:$0.00
Unemployment Compensation:$0.00
Agricultural Subsidies:$0.00
Prior Year Refund:$321.00
Market gain on Commodity Credit Corporation loans repaid:$0.00
Year of Refund:2016
1099G Offset:Not Refund, Credit, or Offset for Trade or Business

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN):870172956
MOUNTAIN AMERICA CREDIT UNION
7181 S CAMPUS VIEW DR
WEST JORDAN, UT 84084-0000

Recipient:

Recipient's Identification Number: 647-40-0297
KINSEY CHANDLER S
1361 S GREENFIELD RD APT 2060
MESA, AZ 85206-0000

Submission Type:Original document
Account Number (Optional):0010674972647400297
Interest:$250.00
Tax Withheld:$0.00
Savings Bonds:$0.00
Investment Expense:$0.00
Interest Forfeiture:$0.00
Foreign Tax Paid:$0.00
Tax-Exempt Interest:$0.00
Specified Private Activity Bond Interest:$0.00
Market Discount:$0.00
Bond Premium:$0.00
Bond Premium on Tax Exempt Bond:$0.00
Bond Premium on Treasury Obligations:$0.00
Second Notice Indicator:No Second Notice
Foreign Country or US Possession:
CUSIP Number:
FATCA Filing Requirement:Box not checked no Filing Requirement

This Product Contains Sensitive Taxpayer Data