EFTA00006069

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3. Employee W-4 Profile. To change your Employee W-4 Profile Information, file a new W-4 with your payroll dept. Ben = Taxable Marital Status: ’ 33404 Exemptions/Allowances: FEDERAL: 8 STATE: 8 © 2005 AUTOMATIC DATA PROCESSING, INC. a P Wages, ti oe oer oe ithheld Sa ee ae nO 2 nea] = =e zooea.1 ITS” Social wages q J saat agree | 3 marae 4 maroon EE a | Seeley OO | § Medicare and 6 Medicare tax withheld Medicare wages and 6 Medicare tax withheld 18 3323.09 2687.18 maces, 2687.18 coos eonpwi fo | 0009 66/TPW 19 |!|0009 66/TPW 19 ¢ Employer's nome, address, and ZIP code S Employer's name, address, and ZIP code by LLC NES LLC 457 MADISON AVENUE 457 MADISON AVENUE NEW YORK, NY 10022 NEW YORK, NY 10022 EFTA00006070

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+ Even if have to fle a tax return, Soul foto gels rtrd t box 2 shows fcr brne tax withheld or if you can take the earned income Earned income credit ‘You must file a tax return if ‘any ammount is shown in 3. ENC for FE: @) you do . may be ear @narried on if you are not subject to Bec nd Otyar iormation for Members of the $ nate, SON. cr is incorrect, oT ace cord ae to file W- and Tax gare an pane, SSR or Money encur grr reported 1 the SSA on Form 2M your and SSN but are not the as on your card, should ask fora new at ary office or call 1-800-772-1213. Credit for excess if you had more one in. ‘and more $5,580.00 in social ae may be able to a credit for the excess gains! your tax. had more than one wale, ou alo may be sie fo dim a cod. peep roan, of Form 10a0A ingtructions si 505, Tax Withholding and Estimated Tax. For information on how return, foe your Form 1040 vishuctons. Box 9, Enter this amount on the income Box 10, this amount i tho total dependent penal to you or incurred on your behalf Department of the Treasury - intemal Revenue Service This information is being furnished to the intemal Revenue Service. } IMPORTANT NOTE: In order to insure efficient processing, attach this W-2 to your tax return like this _ (following city or local instructions): ” NOTE: THESE ARE SUBSTITUTE WAGE AND ‘TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDERAL, STATE AND LOCAL/CITY INCOME TAX RETURNS. ° nontaxable "lation ce to you toma naa {deere tna ponaualed or i 4570) ln dear ye es aes your right to the 12. The oaponee! [ NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDE) 5 PPR A RE oe CS Amounts Note. ifa year follows code D, E, F, G, H, or a tether nee RE ceeeN ene - the Garr yao yer sown, Ow controle for this tax on Form 1040, See 1 oo ine te instructions, ] Feat a SSNS Rr agers Ss PRG TNE D—Elective doterrals to a section 401(K) cash or defer jus Galera ders SLE 4 fi account that is part of a section 407(K) : arrangement. rie Caterale under a section 4030) salary Fo Diaclive cleferras ender = section 4008)—9 enlmry : i Tonslecive dt Sa Ca SCAOCaETE ceed hoe | * Department of the Treasury - Internal Revenue Service This information is being fumished to the Internal Revenue Service. a IMPORTANT NOTE: In order to insure efficient processing, attach this W-2 to your tax return like this (lollowing state instructions): NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDERAL, STATE AND LOCAL/CITY INCOME TAX RETURNS. EFTA00006071