EFTA00006066

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2 Control number 0017 + 66/18E OMB No, 1545-0008 18E a , 7890.65 714,35 Employer's name, address, and ZIP code Social security tax withheld JEFFREY E. EPSTEIN 7890.65 489.22 358 EL BRILLO WAY Medicare tax withheld | PALM BEACH, FL 33480 7890.65 114.41 71 ~Nonqualified plans box 12 13 Sauer Resenen ‘Third-party employee a oe MIAMI BEACH, FL 33139 |_| 1 Employee's address and ZIP codo 15 State Employor's state 1D number 16 State wages, tips, etc. 7L W 2 Wage and Tax c 0 0 L Department of the Treasury—Internal Revenue Service . ™, Statement For Privacy Act and Paperwork Reduction \—For Employer. Act Notice, see back of Copy D. EFTA00006067

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@ Control number 0017 66/18E OMB No, 1545-0008 18E 0017 bh i i number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld —— 8586.47 7 Employer's name, address, and ZIP code 3 Social security wages JEFFREY E. EPSTEIN 38536.47 2389.26 358 EL BRILLO WAY 5 Medicare wages and tips 6 Medicare tax withheld PALM BEACH, PL 39480 9 Advance EIC payment 11° Nonquslified plans 123 See instructions for box 12 3C 28.62 f Employee's address and ZIP code 16 State wages, tips, etc. | 47 State income tax W Wage and Tax Co 0 0 5 Department of the Treesury—intemal Revenue Service Form “£. Statement . For Privacy Act end Paperwork Reduction Copy D—For Employer. Act Notice, see back of Copy D. an T=] b Employer identification number (EIN) OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheld 3 Socia security wages 4 Social security tax withheld © Employer's name, address, and ZIP code 5S Medicare wages and tips 6 Medicare tax withheld _— ¢@ Employee's social security number 9 Advance EIC payment 10 Dependent care benefits @ Emptoyee’s first name and initial Last name 11 Nonqualifed plans 12a See instructions for box 12 i H a a 14 Other 16 State wages, ups, etc. 17 State income tax | | t i } i t Y 2? Wage and Tax - 0 0 5 Ocpariment of the Treasury—imemal Revenue Service “& Statement For Privacy Act and Paperwork Reduction ‘or Employer. Act Notice, see back of Copy D. EFTA00006068