| |
Employer:
| |
Employer Identification Number (EIN):460224588 |
AUGUSTANA UNIVERSITY | |
2001 S SUMMIT AVE | |
SIOUX FALLS, SD 57197-0000 | |
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Employee:
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Employee's Social Security Number:
301-74-8062 |
HUNTER BOY SUMMERS | |
123 S PRAIRIE AVE | |
SIOUX FALLS, SD 57104-0000 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $94.00 |
Federal Income Tax Withheld: | $0.00 |
Social Security Wages: | $94.00 |
Social Security Tax Withheld: | $5.00 |
Medicare Wages and Tips: | $94.00 |
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 |
Third Party Sick Pay Indicator: | Unanswered |
Retirement Plan Indicator: | Unanswered |
Statutory Employee: | Not Statutory Employee |
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Employer:
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Employer Identification Number (EIN):460398554 |
SIOUX MERCHANT PATROL INC. | |
1501 N CLEVELAND AVE | |
SIOUX FALLS, SD 57103-0000 | |
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Employee:
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Employee's Social Security Number:
301-74-8062 |
HUNTER B SUMMERS | |
123 S PRAIRIE AVE | |
SIOUX FALLS, SD 57104-0000 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $546.00 |
Federal Income Tax Withheld: | $0.00 |
Social Security Wages: | $546.00 |
Social Security Tax Withheld: | $33.00 |
Medicare Wages and Tips: | $546.00 |
Medicare Tax Withheld: | $7.00 |
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 |
Third Party Sick Pay Indicator: | Unanswered |
Retirement Plan Indicator: | Unanswered |
Statutory Employee: | Not Statutory Employee |
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Employer:
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Employer Identification Number (EIN):466000364 |
STATE OF SOUTH DAKOTA | |
500 E CAPITOL AVE | |
PIERRE, SD 57501-5007 | |
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Employee:
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Employee's Social Security Number:
301-74-8062 |
HUNTER B SUMMERS | |
5904 W TECUMSEH CT | |
SIOUX FALLS, SD 57106-0435 | |
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Submission Type: | Original document |
Wages, Tips and Other Compensation: | $39,608.00 |
Federal Income Tax Withheld: | $5,086.00 |
Social Security Wages: | $43,401.00 |
Social Security Tax Withheld: | $2,690.00 |
Medicare Wages and Tips: | $43,401.00 |
Medicare Tax Withheld: | $629.00 |
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: | $10,322.00 |
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b) Plan: | $0.00 |
Third Party Sick Pay Indicator: | Unanswered |
Retirement Plan Indicator: | Yes - retirement plan |
Statutory Employee: | Not Statutory Employee |
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Recipient/Lender:
| |
Recipient's Federal Identification Number (FIN):134994650 |
JPMORGAN CHASE BANK N.A. | |
3415 VISION DRIVE OH4 7214 | |
COLUMBUS, OH 43219-6009 | |
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Payer/Borrower:
| |
Payer's Social Security Number:
301-74-8062 |
HUNTER B SUMMERS | |
TRACY SUMMERS | |
123 S PRAIRIE AVE | |
SIOUX FALLS, SD 57104-0000 | |
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Submission Type: | Original document |
Account Number (Optional): | 201793752945 |
Mortgage Interest Received from Payer(s)/Borrower(s): | $5,321.00 |
Points Paid on Purchase of Principal Residence: | $0.00 |
Refund of Overpaid Interest: | $0.00 |