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Employer:
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| Employer Identification Number (EIN):860850417 |
| GODADDY COM LLC | |
| 14455 N HAYDEN RD STE | |
| SCOTTSDALE, AZ 85260-0000 | |
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Employee:
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| Employee's Social Security Number:
647-40-0297 |
| CHANDLER S KINSEY | |
| 1361 S GREENFIELD RD # | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):352167612 |
| E TRADE SECURITIES LLC | |
| PO BOX 484 | |
| JERSEY CITY, NJ 07303-0484 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| CHANDLER S KINSEY | |
| 1361 S GREENFIELD RD 2060 | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):800429876 |
| SQUARE INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 1361 SOUTH GREENFIELD ROAD | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):800429876 |
| SQUARE INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 1361 SOUTH GREENFIELD ROAD | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):800429876 |
| SQUARE INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 1361 SOUTH GREENFIELD ROAD | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):866004791 |
| ARIZONA DEPARTMENT OF REVENUE | |
| 1600 W MONROE | |
| PHOENIX, AZ 85007-0000 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| KINSEY CHANDLER | |
| 5210 E HAMPTON AVE APT 1124 | |
| MESA, AZ 85206-0000 | |
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| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):870172956 |
| MOUNTAIN AMERICA CREDIT UNION | |
| 7181 S CAMPUS VIEW DR | |
| WEST JORDAN, UT 84084-0000 | |
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Recipient:
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| Recipient's Identification Number:
647-40-0297 |
| KINSEY CHANDLER S | |
| 1361 S GREENFIELD RD APT 2060 | |
| MESA, AZ 85206-0000 | |
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| 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 |
