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Wage and Income Transcript

Request Date: 06-14-2024
Response Date: 06-14-2024
Tracking Number: 106130510095

SSN Provided: 647-40-0297
Tax Period Requested: December, 2018

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):203754038
VIVINT INC
4931 NORTH 300 WEST
PROVO, UT 84604-0000

Employee:

Employee's Social Security Number: 647-40-0297
CHANDLER S KINSEY
5135 E EVERGREEN ST UN
MESA, AZ 85205-0000

Submission Type:Original document
Wages, Tips and Other Compensation:$19,888.00
Federal Income Tax Withheld:$2,317.00
Social Security Wages:$19,888.00
Social Security Tax Withheld:$1,233.00
Medicare Wages and Tips:$19,888.00
Medicare Tax Withheld:$288.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:Unanswered
Statutory Employee:Not Statutory Employee
W2 Submission Type:
W2 WHC SSN Validation Code:Correct SSN

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):273411457
GREEN MANGO PEST CONTROL
2440 E GERMANN RD STE
CHANDLER, AZ 85286-0000

Employee:

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

Submission Type:Original document
Wages, Tips and Other Compensation:$1,640.00
Federal Income Tax Withheld:$109.00
Social Security Wages:$1,640.00
Social Security Tax Withheld:$101.00
Medicare Wages and Tips:$1,640.00
Medicare Tax Withheld:$23.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:Unanswered
Statutory Employee:Not Statutory Employee
W2 Submission Type:
W2 WHC SSN Validation Code:Correct SSN

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:$9,824.00
Federal Income Tax Withheld:$0.00
Social Security Wages:$10,127.00
Social Security Tax Withheld:$627.00
Medicare Wages and Tips:$10,127.00
Medicare Tax Withheld:$146.00
Social Security Tips:$0.00
Allocated Tips:$0.00
Dependent Care Benefits:$0.00
Deferred Compensation:$302.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$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 W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):943327894
WEB COM GROUP INC
12808 GRAN BAY PKWY
JACKSONVILLE, FL 32258-0000

Employee:

Employee's Social Security Number: 647-40-0297
CHANDLER S KINSEY
5135 E EVERGREEN
MESA, AZ 85206-0000

Submission Type:Original document
Wages, Tips and Other Compensation:$12,287.00
Federal Income Tax Withheld:$562.00
Social Security Wages:$12,422.00
Social Security Tax Withheld:$770.00
Medicare Wages and Tips:$12,422.00
Medicare Tax Withheld:$180.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:Unanswered
Statutory Employee:Not Statutory Employee
W2 Submission Type:
W2 WHC SSN Validation Code:Correct SSN

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):943327894
WEB COM GROUP INC
12808 GRAN BAY PKWY
JACKSONVILLE, FL 32258-0000

Employee:

Employee's Social Security Number: 647-40-0297
CHANDLER S KINSEY
5135 E EVERGREEN
MESA, AZ 85206-0000

Submission Type:Amended document
Wages, Tips and Other Compensation:$12,422.00
Federal Income Tax Withheld:$0.00
Social Security Wages:$0.00
Social Security Tax Withheld:$0.00
Medicare Wages and Tips:$0.00
Medicare Tax Withheld:$0.00
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
Code "FF" Permitted benefits under a qualified small employer health reimbursement arrangement:$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close of the Calendar Year:$0.00
Third Party Sick Pay Indicator:Unanswered
Retirement Plan Indicator:No Correction
Statutory Employee:No Correction
W2 Submission Type:
W2 WHC SSN Validation Code:Correct SSN

Form 1099-INT

Payer:

Payer's Federal Identification Number (FIN):134994650
JPMORGAN CHASE BANK, N.A.
P.O. BOX 182051
COLUMBUS, OH 43218-2051

Recipient:

Recipient's Identification Number: 647-40-0297
CHANDLER SCOTT KINSEY
5135 E EVERGREEN ST UNIT 1250
MESA, AZ 85205-5313

Submission Type:Original document
Account Number (Optional):AZ303397597
Interest:$300.00
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

Form 1099-R Distributions from Pensions, Annuities, Retire or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.

Payer:

Payer's Federal Identification Number (FIN):416257133
RETIREMENT SERVICES
550 S. 4TH STREET, N9310-08J
MINNEAPOLIS, MN 55415-1529

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):65000012932531T1
Distribution Code Value:Early Distribution, no known exception (in most cases, under age 59 1/2)
Distribution Code:1
Distribution Code Value:Not significant
Distribution Code:Blank
Tax Amount Undetermined Code:Not checked
Total Distribution Code:Total Distribution
First Year Roth Contribution:0000
SEP Indicator:IRA/SEP/SIMP box not checked
FATCA Indicator:not FATCA
Date of Payment for Reportable Death Benefits under Section 6050Y:00-00-0000
Tax Withheld:$541.00
Total Employee Contributions:$0.00
Unrealized Appreciation:$0.00
Other Income:$0.00
Gross Distribution:$2,706.00
Taxable Amount:$2,706.00
Eligible Capital Gains:$0.00
Amount to IRR:$0.00

This Product Contains Sensitive Taxpayer Data