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0017 &6/18E OME Mo, 1545-0008 18E 0oL7
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fF | 7890.65 714.35
¢ Employer's nama, address, and ZIF code 3 Social security wages 4 Social security tax withheld
JEFFREY E. EPSTEIN 7890.65 4BO.22
358 EL BRILLO WAY 5 Medicare wages and ips 8 Medicare tax withhald
PALM BEACH, FL 33480 7890.65 114,41

7 Social security tips

8 Allocated ps

8 Advance BIC payment

10 Dependant cars benslits

MIAMI BEACH, FL 33139

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Department of the Treasury—Internal Ravens Service
For Privacy Act and Paperwork Reducton

Act Notice, see back of Gopy D.

EFTA00006067


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a Control number

*

I Employee's address and ZIP code

0017 &6/18E voia [] OMB No, 1545-0008 18E 0017

I Em or | i m——— (EIB) 1 Wagss. lips, other compensation 2 Federal income tax vathheld
Ch © 38536.47 3453,23

g Employer's name, address, and ZIP code 3 ESocial security Wages 4 Social secunty tax withheld
JEFFREY E. EPSTEIN 38536.47 2389,25
358 EL BRILLO WAY 5 Modicare wages and fips 6 Medicare tax withheld Nl
FALM BEACH, FL 33480 38536.47 358.78

T Social sacurity tips

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10 Dependant care benefits

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Wage and Tax
Farm W-2 Statement

Copy D—For Employer.

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Department of the Treesury—Internal Revenue Service
For Privacy Act and Paperwork Reduction

Act Maotice, see back of Copy D.

—
8 Ceniral number

oid [] OMB No. 1545-0008

b Employer identification number (EIN)

c Employer's name, address, and ZIP code

1 Wages, tips, other compensation

2 Federal income tax withhald

3 Soci# secwity wages

4 Social security 1ax withhald

=o Meadicare wages and lips

6 Madicare tax withheld

T Social sscuity Tips

8 Allocated fips

d Employee's social security number

¢ Advance EIC payment

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f Employee's address and ZIP code

e Employes’s first name and initial Last nama

11 Nongualifed plans 12a See instruciions for box 12
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15 Same Employers state ID number

17 State income Lax 18 Local wages, ups, ei,

V-9 Wage and Tax

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19 Local income tax 20 Locality nama

Ai EL LEE EE Fe ap p——

Department of the Treasury—iniemal Revenue Service
For Privacy Act and Paperwork Reduction

Act Notice, see back of Copy D,

EFTA00006068
