| |
|
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 | |
| 2160 S KEENE | |
| MESA, AZ 85209-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $11,264.00 |
| Federal Income Tax Withheld: | $71.00 |
| Social Security Wages: | $11,264.00 |
| Social Security Tax Withheld: | $698.00 |
| Medicare Wages and Tips: | $11,264.00 |
| Medicare Tax Withheld: | $163.00 |
| 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 |
| |
|
Employer:
| |
| Employer Identification Number (EIN):861915037 |
| HOWARD ET AL V WEBCOM GROUP INC | |
| 14751 PLAZA DR STE J | |
| TUSTIN, CA 92780-8011 | |
| |
|
Employee:
| |
| Employee's Social Security Number:
647-40-0297 |
| CHANDLER S KINSEY | |
| 5135 E EVERGREEN 1250 | |
| MESA, AZ 85206-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $74.00 |
| Federal Income Tax Withheld: | $16.00 |
| Social Security Wages: | $74.00 |
| Social Security Tax Withheld: | $4.00 |
| Medicare Wages and Tips: | $74.00 |
| Medicare Tax Withheld: | $1.00 |
| 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 |
| |
|
Employer:
| |
| Employer Identification Number (EIN):943312731 |
| 3D TECHNOLOGY SERVICES | |
| 11365 SUNRISE GOLD CIR | |
| RANCHO CORDOVA, CA 95742-0000 | |
| |
|
Employee:
| |
| Employee's Social Security Number:
647-40-0297 |
| CHANDLER S KINSEY | |
| 5135 E EVERGREEN STREE | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $45,712.00 |
| Federal Income Tax Withheld: | $5,025.00 |
| Social Security Wages: | $45,712.00 |
| Social Security Tax Withheld: | $2,834.00 |
| Medicare Wages and Tips: | $45,712.00 |
| Medicare Tax Withheld: | $662.00 |
| 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 |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):455356564 |
| DRIVEWEALTH, LLC | |
| 15 EXCHANGE PLACE | |
| JERSEY CITY, NJ 07302-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER KINSEY | |
| 5135 E EVERGREEN | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 5710731 |
| Date Sold or Disposed: | 06-08-2021 |
| CUSIP Number: | 00206R102 |
| Gross Proceeds: | Gross proceeds |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $10.00 |
| 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: | $11.00 |
| Wash Sale Loss Disallowed: | $0.00 |
| Accrued Market Discount Amount: | $0.00 |
| Description: | 0.38022813 AT&T INC COM |
| Second Notice Indicator: | No Second Notice |
| Date Acquired: | 06-08-2021 |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):464364776 |
| ROBINHOOD CRYPTO LLC | |
| 85 WILLOW ROAD | |
| MENLO PARK, CA 94025-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER KINSEY | |
| 5135 E EVERGREEN ST 1250 | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 9520324 |
| Date Sold or Disposed: | 02-05-2021 |
| CUSIP Number: | DOGEUSD |
| Gross Proceeds: | Net Proceeds |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $14.00 |
| 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: | 321 DOGECOIN TO US DOLLAR |
| Second Notice Indicator: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| Noncovered Security Indicator: | Noncovered Security Basis not reported to IRS |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):464364776 |
| ROBINHOOD CRYPTO LLC | |
| 85 WILLOW ROAD | |
| MENLO PARK, CA 94025-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER KINSEY | |
| 5135 E EVERGREEN ST 1250 | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 9520329 |
| Date Sold or Disposed: | 07-27-2021 |
| CUSIP Number: | DOGEUSD |
| Gross Proceeds: | Net Proceeds |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $5.00 |
| 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: | 28 DOGECOIN TO US DOLLAR |
| Second Notice Indicator: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| Noncovered Security Indicator: | Noncovered Security Basis not reported to IRS |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):800429876 |
| BLOCK, INC. | |
| F/K/A SQUARE, INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 5135 EAST EVERGREEN STREET | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 26615407T7 |
| Date Sold or Disposed: | 12-22-2021 |
| CUSIP Number: | 0000000000000 |
| Gross Proceeds: | Nothing checked |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $19.00 |
| 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: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):800429876 |
| BLOCK, INC. | |
| F/K/A SQUARE, INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 5135 EAST EVERGREEN STREET | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 26616981T7 |
| Date Sold or Disposed: | 12-13-2021 |
| CUSIP Number: | 0000000000000 |
| Gross Proceeds: | Nothing checked |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $1.00 |
| 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: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):800429876 |
| BLOCK, INC. | |
| F/K/A SQUARE, INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 5135 EAST EVERGREEN STREET | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 26618948T7 |
| Date Sold or Disposed: | 06-25-2021 |
| CUSIP Number: | 0000000000000 |
| Gross Proceeds: | Nothing checked |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $9.00 |
| 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: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):800429876 |
| BLOCK, INC. | |
| F/K/A SQUARE, INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 5135 EAST EVERGREEN STREET | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 26620890T7 |
| Date Sold or Disposed: | 07-16-2021 |
| CUSIP Number: | 0000000000000 |
| Gross Proceeds: | Nothing checked |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $9.00 |
| 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: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| 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: | Box not checked |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):800429876 |
| BLOCK, INC. | |
| F/K/A SQUARE, INC. | |
| 1455 MARKET STREET | |
| SAN FRANCISCO, CA 94103-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
647-40-0297 |
| CHANDLER SCOTT KINSEY | |
| 5135 EAST EVERGREEN STREET | |
| MESA, AZ 85205-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 26623793T7 |
| Date Sold or Disposed: | 03-25-2021 |
| CUSIP Number: | 0000000000000 |
| Gross Proceeds: | Nothing checked |
| Bartering: | $0.00 |
| Federal Income Tax Withheld: | $0.00 |
| Proceeds: | $9.00 |
| 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: | No Second Notice |
| Date Acquired: | 00-00-0000 |
| 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: | Box not checked |
