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|
Employer:
| |
| Employer Identification Number (EIN):910425694 |
| THE BOEING COMPANY | |
| MAILCODE 6X5-15 | |
| SEATTLE, WA 98124-2207 | |
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|
Employee:
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| 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: | $121,797.00 |
| Federal Income Tax Withheld: | $19,206.00 |
| Social Security Wages: | $144,508.00 |
| Social Security Tax Withheld: | $8,959.00 |
| Medicare Wages and Tips: | $144,508.00 |
| Medicare Tax Withheld: | $2,095.00 |
| Social Security Tips: | $0.00 |
| Allocated Tips: | $0.00 |
| Dependent Care Benefits: | $0.00 |
| Deferred Compensation: | $22,711.00 |
| 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: | $4,288.00 |
| 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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|
Trustee:
| |
| Trustee/Issuer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
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Participant:
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| 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: | $0.00 |
| Roth Conversion Amount: | $0.00 |
| Recharacterized Contributions: | $0.00 |
| Fair Market Value of Account: | $99,288.00 |
| 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 |
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|
Trustee:
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| Trustee/Issuer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
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|
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: | $0.00 |
| Roth Conversion Amount: | $0.00 |
| Recharacterized Contributions: | $0.00 |
| Fair Market Value of Account: | $3,905.00 |
| 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 |
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|
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: | $224,529.00 |
| 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 |
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|
Recipient/Lender:
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| Recipient's Federal Identification Number (FIN):382603955 |
| ROCKET MORTGAGE LLC. | |
| 1050 WOODWARD AVENUE | |
| DETROIT, MI 48226-0000 | |
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|
Payer/Borrower:
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| 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): | $6,248.00 |
| Points Paid on Purchase of Principal Residence: | $0.00 |
| Refund of Overpaid Interest: | $0.00 |
| Mortgage Insurance Premiums: | $0.00 |
| Outstanding Mortgage Principle: | $285,199.00 |
| 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 |
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|
Payer:
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| Payer's Federal Identification Number (FIN):941737782 |
| CHARLES SCHWAB & CO., INC. | |
| 9800 SCHWAB WAY | |
| LONE TREE, CO 80124-0000 | |
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|
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: | $1.00 |
| 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 |
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Payer:
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| Payer's Federal Identification Number (FIN):823967259 |
| CHARLES SCHWAB TRUST BANK | |
| 11800 SCHWAB WAY | |
| AUSTIN, TX 78758-0000 | |
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|
Recipient:
| |
| Recipient's Identification Number:
607-17-0964 |
| PUSAPATI, RAJU | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 1302120 |
| 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: | 2021 |
| 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: | $2,526.00 |
| Taxable Amount: | $0.00 |
| Eligible Capital Gains: | $0.00 |
| Amount to IRR: | $0.00 |
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|
Payer:
| |
| Payer's Federal Identification Number (FIN):823967259 |
| CHARLES SCHWAB TRUST BANK | |
| 11800 SCHWAB WAY | |
| AUSTIN, TX 78758-0000 | |
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|
Recipient:
| |
| Recipient's Identification Number:
607-17-0964 |
| PUSAPATI, RAJU | |
| 1506 BRADEN CIRCLE | |
| FRANKLIN, TN 37067-0000 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | 975851 |
| 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: | $10,623.00 |
| Taxable Amount: | $0.00 |
| Eligible Capital Gains: | $0.00 |
| Amount to IRR: | $0.00 |
