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Wage and Income Transcript

Request Date: 02-23-2024
Response Date: 02-23-2024
Tracking Number: 105595412257

SSN Provided: 301-74-8062
Tax Period Requested: December, 2019

Wage & Income Summary

Federal Tax Withheld:$4,333.00
Wages:$39,897.00
Allocated Tips:$0.00
Interest:$0.00
Mortgage Interest Paid:$0.00
Points Paid:$0.00
Prior Year Refund:$0.00
Savings Bonds:$0.00
Dividends:$0.00
Pensions and Annuities:$0.00
IRA Contributions:$0.00
Non-employee Compensation:$0.00
Capital Gains:$0.00
Real Estate Sales:$0.00
Gross Distributions:$0.00
Taxable Amount:$0.00
Deferred Compensation:$150.00
Dependent Care:$2,496.00
FICA Tax Withheld:$2,742.00
Medicare Withheld:$641.00
Medicare Wages:$44,236.00
Taxable FICA Wages:$44,236.00
Code "W" Employer Contributions to a Health Savings Account:$500.00
Current Contributions:$500.00
MSA Gross Distribution:$601.00
QTP Gross Distribution:$2,587.00
QTP Earnings:-$12.00
QTP Basis:$2,600.00
Code "DD" Cost of Employer-Sponsored Health Coverage:$11,643.00

This Product Contains Sensitive Taxpayer Data