| |
|
Employer:
| |
| Employer Identification Number (EIN):208672375 |
| CREST SECURITY ASSURANCE | |
| 12905 LARKMEADE LN | |
| WOODBRIDGE, VA 22193-0000 | |
| |
|
Employee:
| |
| Employee's Social Security Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $44,456.00 |
| Federal Income Tax Withheld: | $6,763.00 |
| Social Security Wages: | $53,913.00 |
| Social Security Tax Withheld: | $3,342.00 |
| Medicare Wages and Tips: | $53,913.00 |
| Medicare Tax Withheld: | $781.00 |
| Social Security Tips: | $0.00 |
| Allocated Tips: | $0.00 |
| Dependent Care Benefits: | $0.00 |
| Deferred Compensation: | $9,456.00 |
| 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 |
| |
|
Employer:
| |
| Employer Identification Number (EIN):630956857 |
| QUANTUM RESEARCH INTERNAT | |
| 991 DISCOVERY DRIVE | |
| HUNTSVILLE, AL 35806-0000 | |
| |
|
Employee:
| |
| Employee's Social Security Number:
607-17-0964 |
| RAJU PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $34,525.00 |
| Federal Income Tax Withheld: | $2,581.00 |
| Social Security Wages: | $46,858.00 |
| Social Security Tax Withheld: | $2,905.00 |
| Medicare Wages and Tips: | $46,858.00 |
| Medicare Tax Withheld: | $679.00 |
| Social Security Tips: | $0.00 |
| Allocated Tips: | $0.00 |
| Dependent Care Benefits: | $0.00 |
| Deferred Compensation: | $12,332.00 |
| 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: | $3,320.00 |
| 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 |
| |
|
Employer:
| |
| Employer Identification Number (EIN):910425694 |
| THE BOEING COMPANY | |
| MAILCODE 6X5-15 | |
| SEATTLE, WA 98124-2207 | |
| |
|
Employee:
| |
| Employee's Social Security Number:
607-17-0964 |
| RAJU PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $10,019.00 |
| Federal Income Tax Withheld: | $1,934.00 |
| Social Security Wages: | $10,692.00 |
| Social Security Tax Withheld: | $662.00 |
| Medicare Wages and Tips: | $10,692.00 |
| Medicare Tax Withheld: | $155.00 |
| Social Security Tips: | $0.00 |
| Allocated Tips: | $0.00 |
| Dependent Care Benefits: | $0.00 |
| Deferred Compensation: | $673.00 |
| 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: | $134.00 |
| 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 |
| |
|
Trustee:
| |
| Trustee/Issuer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
| |
|
Participant:
| |
| Participant's Identification Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 91473648 |
| IRA Contributions: | $0.00 |
| Rollover Contributions: | $3,899.00 |
| Roth Conversion Amount: | $0.00 |
| Recharacterized Contributions: | $0.00 |
| Fair Market Value of Account: | $3,899.00 |
| Life Insurance Cost Included in Box 1: | $0.00 |
| SEP Code: | Not Checked |
| IRA Code: | Not Checked |
| Simple Code: | Not Checked |
| Roth IRA Code: | Checked |
| RMD For Subsequent Year: | RMD box not checked |
| RMD Date: | 00-00-0000 |
| Year: | |
| Postponed Contribution Code: | |
| Repayments Code: | |
| Fair Market Value of certain specified assets: | N/A |
| SEP Contributions: | $0.00 |
| SIMPLE Contributions: | $0.00 |
| Roth IRA Contributions: | $0.00 |
| Required Minimum Distribution Amount: | $0.00 |
| Postponed Contributions: | $0.00 |
| Repayment of a qualified reservist distribution or federally designated disaster withdrawal repayment: | $0.00 |
| Fair Market Value of Certain Specified Assets: | $0.00 |
| |
|
Trustee:
| |
| Trustee/Issuer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
| |
|
Participant:
| |
| Participant's Identification Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 95483118 |
| IRA Contributions: | $0.00 |
| Rollover Contributions: | $0.00 |
| Roth Conversion Amount: | $0.00 |
| Recharacterized Contributions: | $0.00 |
| Fair Market Value of Account: | $256,806.00 |
| Life Insurance Cost Included in Box 1: | $0.00 |
| SEP Code: | Not Checked |
| IRA Code: | Checked |
| Simple Code: | Not Checked |
| Roth IRA Code: | Not Checked |
| RMD For Subsequent Year: | RMD box not checked |
| RMD Date: | 00-00-0000 |
| Year: | |
| Postponed Contribution Code: | |
| Repayments Code: | |
| Fair Market Value of certain specified assets: | N/A |
| SEP Contributions: | $0.00 |
| SIMPLE Contributions: | $0.00 |
| Roth IRA Contributions: | $0.00 |
| Required Minimum Distribution Amount: | $0.00 |
| Postponed Contributions: | $0.00 |
| Repayment of a qualified reservist distribution or federally designated disaster withdrawal repayment: | $0.00 |
| Fair Market Value of Certain Specified Assets: | $0.00 |
| |
|
Trustee:
| |
| Trustee/Issuer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
| |
|
Participant:
| |
| Participant's Identification Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 62720304 |
| IRA Contributions: | $0.00 |
| Rollover Contributions: | $14,485.00 |
| Roth Conversion Amount: | $0.00 |
| Recharacterized Contributions: | $0.00 |
| Fair Market Value of Account: | $143,523.00 |
| Life Insurance Cost Included in Box 1: | $0.00 |
| SEP Code: | Not Checked |
| IRA Code: | Checked |
| Simple Code: | Not Checked |
| Roth IRA Code: | Not Checked |
| RMD For Subsequent Year: | RMD box not checked |
| RMD Date: | 00-00-0000 |
| Year: | |
| Postponed Contribution Code: | |
| Repayments Code: | |
| Fair Market Value of certain specified assets: | N/A |
| SEP Contributions: | $0.00 |
| SIMPLE Contributions: | $0.00 |
| Roth IRA Contributions: | $0.00 |
| Required Minimum Distribution Amount: | $0.00 |
| Postponed Contributions: | $0.00 |
| Repayment of a qualified reservist distribution or federally designated disaster withdrawal repayment: | $0.00 |
| Fair Market Value of Certain Specified Assets: | $0.00 |
| |
|
Recipient/Lender:
| |
| Recipient's Federal Identification Number (FIN):382603955 |
| ROCKET MORTGAGE LLC. | |
| 1050 WOODWARD AVENUE | |
| DETROIT, MI 48226-0000 | |
| |
|
Payer/Borrower:
| |
| Payer's Social Security Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIR | |
| FRANKLIN, TN 37067-8595 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | MTG3485518255 |
| Mortgage Interest Received from Payer(s)/Borrower(s): | $1,383.00 |
| Points Paid on Purchase of Principal Residence: | $0.00 |
| Refund of Overpaid Interest: | $0.00 |
| Mortgage Insurance Premiums: | $0.00 |
| Outstanding Mortgage Principle: | $288,300.00 |
| Mortgage Origination Date: | 09-09-2021 |
| Property Address Verification: | |
| Address of property securing Mortgage: | 1506 BRADEN CIR |
| Other information from recipient: | FRANKLIN TN 37067 |
| The number of mortgaged properties: | 000000000000 |
| Mortgage Acquisition Date: | 00-00-0000 |
| |
|
Recipient/Lender:
| |
| Recipient's Federal Identification Number (FIN):941687665 |
| BANK OF AMERICA N.A. | |
| PO BOX 31785 | |
| TAMPA, FL 33631-3785 | |
| |
|
Payer/Borrower:
| |
| Payer's Social Security Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIR | |
| FRANKLIN, TN 37067-8595 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | MTG0272414629 |
| Mortgage Interest Received from Payer(s)/Borrower(s): | $9,636.00 |
| Points Paid on Purchase of Principal Residence: | $0.00 |
| Refund of Overpaid Interest: | $0.00 |
| Mortgage Insurance Premiums: | $0.00 |
| Outstanding Mortgage Principle: | $287,692.00 |
| Mortgage Origination Date: | 05-18-2017 |
| Property Address Verification: | |
| Address of property securing Mortgage: | 1506 BRADEN CIR |
| Other information from recipient: | FRANKLIN TN 37067-8595 |
| The number of mortgaged properties: | 000000000000 |
| Mortgage Acquisition Date: | 00-00-0000 |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
607-17-0964 |
| RAJU S PUSAPATI | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 91216345 |
| Interest: | $0.00 |
| 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 |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):941687665 |
| BANK OF AMERICA, N.A. | |
| P.O. BOX 1551 | |
| PENNINGTON, NJ 08534-0737 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
607-17-0964 |
| PUSAPATI RAJU | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 202022-1 |
| Distribution Code Value: | Direct rollover of distribution from a designated Roth account to a Roth IRA |
| Distribution Code: | H |
| Distribution Code Value: | Not significant |
| Distribution Code: | Blank |
| Tax Amount Undetermined Code: | Not checked |
| Total Distribution Code: | Total Distribution |
| First Year Roth Contribution: | 2020 |
| 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: | $0.00 |
| Total Employee Contributions: | $3,633.00 |
| Unrealized Appreciation: | $0.00 |
| Other Income: | $0.00 |
| Gross Distribution: | $3,899.00 |
| Taxable Amount: | $0.00 |
| Eligible Capital Gains: | $0.00 |
| Amount to IRR: | $0.00 |
| |
|
Payer:
| |
| Payer's Federal Identification Number (FIN):941687665 |
| BANK OF AMERICA, N.A. | |
| P.O. BOX 1551 | |
| PENNINGTON, NJ 08534-0737 | |
| |
|
Recipient:
| |
| Recipient's Identification Number:
607-17-0964 |
| PUSAPATI RAJU | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 202022-1 |
| Distribution Code Value: | Direct rollover and rollover contribution |
| Distribution Code: | G |
| 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: | $0.00 |
| Total Employee Contributions: | $0.00 |
| Unrealized Appreciation: | $0.00 |
| Other Income: | $0.00 |
| Gross Distribution: | $14,485.00 |
| Taxable Amount: | $0.00 |
| Eligible Capital Gains: | $0.00 |
| Amount to IRR: | $0.00 |
