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Employer:
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| 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 | |
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| Submission Type: | Original document |
| Wages, Tips and Other Compensation: | $124,459.00 |
| Federal Income Tax Withheld: | $19,742.00 |
| Social Security Wages: | $145,719.00 |
| Social Security Tax Withheld: | $9,034.00 |
| Medicare Wages and Tips: | $145,719.00 |
| Medicare Tax Withheld: | $2,112.00 |
| Social Security Tips: | $0.00 |
| Allocated Tips: | $0.00 |
| Dependent Care Benefits: | $0.00 |
| Deferred Compensation: | $21,260.00 |
| 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: | $8,481.00 |
| 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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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): | $5,875.00 |
| Points Paid on Purchase of Principal Residence: | $0.00 |
| Refund of Overpaid Interest: | $0.00 |
| Mortgage Insurance Premiums: | $0.00 |
| Outstanding Mortgage Principle: | $268,784.00 |
| 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):626001445 |
| STATE OF TENNESSEE | |
| TA> TENNESSEE CONSOLIDATED RETIREMENT SYSTEM | |
| 15TH FLOOR ANDREW JACKSON BUILDING | |
| NASHVILLE, TN 37243-0234 | |
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Recipient:
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| Recipient's Identification Number:
607-17-0964 |
| PUSAPATI RAJU | |
| 1506 BRADEN CIR | |
| FRANKLIN, TN 37067-8595 | |
| |
| Submission Type: | Original document |
| Account Number (Optional): | TCRS-00002596324REGL |
| Distribution Code Value: | Normal distribution |
| Distribution Code: | 7 |
| Distribution Code Value: | Not significant |
| Distribution Code: | Blank |
| Tax Amount Undetermined Code: | Not checked |
| Total Distribution Code: | Not checked |
| 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: | $612.00 |
| Total Employee Contributions: | $0.00 |
| Unrealized Appreciation: | $0.00 |
| Other Income: | $0.00 |
| Gross Distribution: | $13,581.00 |
| Taxable Amount: | $13,581.00 |
| Eligible Capital Gains: | $0.00 |
| Amount to IRR: | $0.00 |
