| |
Employer:
| |
Employer Identification Number (EIN):203754038 |
VIVINT INC | |
4931 NORTH 300 WEST | |
PROVO, UT 84604-0000 | |
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Employee:
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Employee's Social Security Number:
647-40-0297 |
CHANDLER S KINSEY | |
2217 N POWER RD | |
MESA, AZ 85215-0000 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $42,225.00 |
Federal Income Tax Withheld: | $110.00 |
Social Security Wages: | $42,764.00 |
Social Security Tax Withheld: | $2,651.00 |
Medicare Wages and Tips: | $42,764.00 |
Medicare Tax Withheld: | $620.00 |
Social Security Tips: | $0.00 |
Allocated Tips: | $0.00 |
Dependent Care Benefits: | $0.00 |
Deferred Compensation: | $538.00 |
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: | $20.00 |
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 |
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Employer:
| |
Employer Identification Number (EIN):464389868 |
DESERT MOUNTAIN CO OF PHOENIX LLC | |
190 S MCQUEEN RD SU | |
GILBERT, AZ 85233-0000 | |
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Employee:
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Employee's Social Security Number:
647-40-0297 |
CHANDLER S KINSEY | |
37363 N GARY ROAD 1006 | |
QUEEN CREEK, AZ 85142-0000 | |
| |
Submission Type: | Original document |
Wages, Tips and Other Compensation: | $14,924.00 |
Federal Income Tax Withheld: | $454.00 |
Social Security Wages: | $15,164.00 |
Social Security Tax Withheld: | $940.00 |
Medicare Wages and Tips: | $15,164.00 |
Medicare Tax Withheld: | $219.00 |
Social Security Tips: | $0.00 |
Allocated Tips: | $0.00 |
Dependent Care Benefits: | $0.00 |
Deferred Compensation: | $240.00 |
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 |
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Employer:
| |
Employer Identification Number (EIN):860950231 |
BULWARK EXTERMINATING LLC | |
5810 S SOSSAMAN ROAD | |
MESA, AZ 85212-0000 | |
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Employee:
| |
Employee's Social Security Number:
647-40-0297 |
CHANDLER SCOTT KINSEY | |
37363 N GARY ROAD | |
QUEEN CREEK, AZ 85142-0000 | |
| |
Submission Type: | Original document |
Wages, Tips and Other Compensation: | $1,277.00 |
Federal Income Tax Withheld: | $74.00 |
Social Security Wages: | $1,277.00 |
Social Security Tax Withheld: | $79.00 |
Medicare Wages and Tips: | $1,277.00 |
Medicare Tax Withheld: | $18.00 |
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 |