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Wage and Income Transcript

Request Date: 10-24-2023
Response Date: 10-24-2023
Tracking Number: 105110422319

SSN Provided: 219-19-2163
Tax Period Requested: December, 2014

Form W-2 Wage and Tax Statement

Employer:

Employer Identification Number (EIN):232084784
COMCAST CC OF WILLOW GROVE
1701 JF KENNEDY BLVD
PHILADELPHIA, PA 19103-0000

Employee:

Employee's Social Security Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-0000

Submission Type:Original document
Wages, Tips and Other Compensation:$128,778.00
Federal Income Tax Withheld:$411.00
Social Security Wages:$117,000.00
Social Security Tax Withheld:$7,254.00
Medicare Wages and Tips:$134,915.00
Medicare Tax Withheld:$1,956.00
Social Security Tips:$0.00
Allocated Tips:$0.00
Dependent Care Benefits:$0.00
Deferred Compensation:$6,136.00
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:$13,782.00
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

Form 3922: Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)

Corporation:

Corporation's Federal Identification Number (FIN):270000798
COMCAST CORPORATION
1701 JFK BOULEVARD
PHILADELPHIA, PA 19103-0000

Employee:

Employee's Identification Number: 219-19-2163
LERMER MICHAEL SCOTT
1466 ARGYLE DRIVE
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):DZ6Z66FGMI
Exercise Price per Share:$42.00
Fair Market Value per Share on Exercise Date:$53.00
Fair Market Value per Share on Grant Date:$49.00
Exercise price per share determined as if the option was exercised on the date shown in box 1:$42.00
Date Option Exercised:06-30-2014
Date Option Granted:04-01-2014
Number of Shares Transferred:0000000000023
Date Legal Title Transferred:06-30-2014

Form 3922: Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)

Corporation:

Corporation's Federal Identification Number (FIN):270000798
COMCAST CORPORATION
1701 JFK BOULEVARD
PHILADELPHIA, PA 19103-0000

Employee:

Employee's Identification Number: 219-19-2163
LERMER MICHAEL SCOTT
1466 ARGYLE DRIVE
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):ES5LB2N209
Exercise Price per Share:$44.00
Fair Market Value per Share on Exercise Date:$58.00
Fair Market Value per Share on Grant Date:$52.00
Exercise price per share determined as if the option was exercised on the date shown in box 1:$44.00
Date Option Exercised:12-31-2014
Date Option Granted:10-01-2014
Number of Shares Transferred:0000000000021
Date Legal Title Transferred:12-31-2014

Form 3922: Transfer of Stock Acquired Through an Employee Stock Purchase Plan Under Section 423(c)

Corporation:

Corporation's Federal Identification Number (FIN):270000798
COMCAST CORPORATION
1701 JFK BOULEVARD
PHILADELPHIA, PA 19103-0000

Employee:

Employee's Identification Number: 219-19-2163
LERMER MICHAEL SCOTT
1466 ARGYLE DRIVE
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):E28UXC9NM0
Exercise Price per Share:$45.00
Fair Market Value per Share on Exercise Date:$53.00
Fair Market Value per Share on Grant Date:$54.00
Exercise price per share determined as if the option was exercised on the date shown in box 1:$45.00
Date Option Exercised:09-30-2014
Date Option Granted:07-01-2014
Number of Shares Transferred:0000000000018
Date Legal Title Transferred:09-30-2014

Form 5498 SA

Trustee:

Trustee's Federal Identification Number (FIN):941687665
BANK OF AMERICA N.A.
BENEFIT SOLUTIONS HSA
PO BOX 25165
LEHIGH VALLEY, PA 18002-5165

Participant:

Participant's Identification Number: 219-19-2163
MICHAEL LERMER
16081 VIA SOLERA CIR APT 104 104
FORT MYERS, FL 33908-3776

Submission Type:Original document
Account Number (Optional):K6301000006739997601
MSA Contributions:$0.00
Current Contributions:$0.00
Future Contributions:$0.00
Rollover MSA Contributions:$0.00
MSA Fair Market Value:$375.00
HSA Indicator:HSA Box Checked
Archer MSA Indicator:Archer MSA Box Not Checked
MA MSA Indicator:Not Checked

Form 5498 Individual Retirement Arrangement Contribution Information

Trustee:

Trustee/Issuer's Federal Identification Number (FIN):911905424
CAPITAL ONE SHAREBUILDER INC.
83 SOUTH KING STREET SUITE 700
SEATTLE, WA 98104-0000

Participant:

Participant's Identification Number: 219-19-2163
MICHAEL LERMER
1466 ARGYLE DR
FT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):0002481744_1111
IRA Contributions:$0.00
Rollover Contributions:$0.00
Roth Conversion Amount:$0.00
Recharacterized Contributions:$0.00
Fair Market Value of Account:$90.00
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:
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

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):043523567
NATIONAL FINANCIAL SERVICES LLC
499 WASHINGTON BLVD
JERSEY CITY, NJ 07310-0000

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-1734

Submission Type:Original document
Account Number (Optional):BX78227121E3UDZECGZB
Date Sold or Disposed:11-17-2014
CUSIP Number:20030N101
Gross Proceeds:Gross proceeds
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$1,008.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Adjustments:$0.00
Description:COMCAST CORP NEW CL A
Second Notice Indicator:
Date Acquired:00-00-0000
Noncovered Security Indicator:Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:
Code, if Any:
Applicable Check Box on Form 8949:Short term transaction for which the cost or other basis is not being reported to the IRS
Loss Not Allowed Indicator:

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):454526070
PROSPER FUNDING LLC
221 MAIN STREET SUITE 300
SAN FRANCISCO, CA 94105-0000

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):126688T1
Date Sold or Disposed:01-14-2014
CUSIP Number:37299-141 REC
Gross Proceeds:Nothing checked
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$0.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Adjustments:$0.00
Description:
Second Notice Indicator:
Date Acquired:09-30-2008
Noncovered Security Indicator:Nothing checked
Type of Gain or Loss Code:Long-term
Code, if Any:
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:

Payer's Federal Identification Number (FIN):454526070
PROSPER FUNDING LLC
221 MAIN STREET SUITE 300
SAN FRANCISCO, CA 94105-0000

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):457661T1
Date Sold or Disposed:07-18-2014
CUSIP Number:37299-141 REC
Gross Proceeds:Nothing checked
Bartering:$0.00
Federal Income Tax Withheld:$0.00
Proceeds:$1.00
Aggregate Profit or (Loss):$0.00
Realized Profit or (Loss):$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:$0.00
Unrealized Profit or (Loss) 12/31 Current Year:$0.00
Cost or Basis:$0.00
Adjustments:$0.00
Description:
Second Notice Indicator:
Date Acquired:09-30-2008
Noncovered Security Indicator:Nothing checked
Type of Gain or Loss Code:Long-term
Code, if Any:
Applicable Check Box on Form 8949:Transactions that do not flow to Form 8949
Loss Not Allowed Indicator:

Form 1099-DIV

Payer:

Payer's Federal Identification Number (FIN):043523567
NATIONAL FINANCIAL SERVICES LLC
499 WASHINGTON BLVD
JERSEY CITY, NJ 07310-0000

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-1734

Submission Type:Original document
Account Number (Optional):DX78227121
Tax Withheld:$0.00
Capital Gains:$0.00
Non-Dividend Distribution:$0.00
Cash Liquidation Distribution:$0.00
Non-Cash Liquidation Distribution:$0.00
Investment Expense:$0.00
Ordinary Dividend:$5.00
Collectibles (28%) Gain:$0.00
Unrecaptured Section 1250 Gain:$0.00
Section 1202 Gain:$0.00
Foreign Tax Paid:$0.00
Qualified Dividends:$5.00
Second Notice Indicator:No Second Notice
Exempt Interest Dividends:$0.00
Specified Private Activity Bond Interest Dividend:$0.00

Form 1099-DIV

Payer:

Payer's Federal Identification Number (FIN):462538416
ACORNS SECURITIES LLC
4600 CAMPUS DR STE 110
NEWPORT BEACH, CA 92660-1877

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):00000282520802
Tax Withheld:$0.00
Capital Gains:$0.00
Non-Dividend Distribution:$0.00
Cash Liquidation Distribution:$0.00
Non-Cash Liquidation Distribution:$0.00
Investment Expense:$0.00
Ordinary Dividend:$0.00
Collectibles (28%) Gain:$0.00
Unrecaptured Section 1250 Gain:$0.00
Section 1202 Gain:$0.00
Foreign Tax Paid:$0.00
Qualified Dividends:$0.00
Second Notice Indicator:No Second Notice
Exempt Interest Dividends:$0.00
Specified Private Activity Bond Interest Dividend:$0.00

Form 1099-OID

Payer:

Payer's Federal Identification Number (FIN):454526070
PROSPER FUNDING LLC
221 MAIN STREET SUITE 300
SAN FRANCISCO, CA 94105-0000

Recipient:

Recipient's Identification Number: 219-19-2163
MICHAEL S LERMER
1466 ARGYLE DR
FORT MYERS, FL 33919-0000

Submission Type:Original document
Account Number (Optional):13375T1
Interest:$0.00
Tax Withheld:$0.00
Investment Expenses:$0.00
Interest Forfeiture:$0.00
Original Issue Discount:$20.00
Original Issue Discount on Treasury Obligations:$0.00
Market Discount:$0.00
Acquisition Premium:$0.00
Description:ORIGINAL ISSUE DISCOUNT FOR 2014
Second Notice Indicator:No Second Notice

Form 1099-R Distributions from Pensions, Annuities, Retire or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.

Payer:

Payer's Federal Identification Number (FIN):046568107
FIDELITY INVESTMENTS
100 MAGELLAN WAY KW1C
COVINGTON, KY 41015-0000

Recipient:

Recipient's Identification Number: 219-19-2163
LERMER, MICHAEL
16000 VIA SOLERA CIRCLE 104
FT MYERS, FL 33908-0000

Submission Type:Original document
Account Number (Optional):20150110040900885588
Distribution Code Value:Early Distribution, no known exception (in most cases, under age 59 1/2)
Distribution Code:1
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
Tax Withheld:$0.00
Total Employee Contributions:$0.00
Unrealized Appreciation:$0.00
Other Income:$0.00
Gross Distribution:$42.00
Taxable Amount:$42.00
Eligible Capital Gains:$0.00
Amount to IRR:$0.00

This Product Contains Sensitive Taxpayer Data