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3. Employee W-4 Profile. To change your Empl W-4 Profile Information, file a new W-4 with oll d
Social Security Number:
R 33404 Exemptions/Allowancas:
FEDERAL: a
STATE: 8
© 2008 AUTOUATIC DATA PROCESEING, IHS.
—ars ££ Fuld and Dame Harg = RL re tp mm mm el mm EL LS EE BE LES EE Te JE TRL
[TT Wages, tips, ciher comp. 2 Federal income fax withheld 1 Wages, lips, other comp. 2 Federal Income tax withheld
' 175323.08 20052.14 175323.09 29092.14
P|? Socisl secu es § Social fax withhal 3 Social security 4 Social tax withheld
! "90000. 00 Security Ins. 00 = 50000 ..00 Be 0. 00
"|S Medico ol 1; EB Medicare tax withheld 8 Medica d BE Medicare ta witkheld
; - 185323 53 "oo 26ET. 1B |} 353 09 * =687F.18
[a Central number Comp. Erplopar use only ja Control number "| Dept Com. Employes wea anky
0009 6B/TPW 19 0009  GETPW 19
“|e Employer's nome, address, and ZIP code © Employer's name, sddress, snd ZIP code
| NES LLC NES LLC
: 457 MADISON AVENUE 457 MADISON AVENUE
NEW YORK, NY 10022 NEW YORK, NY 10022

A Rr wre Be EF a a

7 Social security tps 2 a 7 Social security Ups : I

8 Advance BIC payment 10 Dependent care benelits 5 Advance BIC payment 10 Dependeni care benefits

| 11 Menquailiied plans 2a 11 Ka ified 1Za

1. Cc | 515.38 naualied plans cy 515.38

‘| 14 Other i EN 1000000 14 Other Hg 10000. 00
32.40 NYDD be 32.40 NYDD |_|

i lof Employes's nemo, address and ZIP code

; 33404

2d
[Foam Tp party sick perl rs party sick pay

off Employecs nome, address and ZIP coda

' 33404

's Ekali 10 State wages, ele
| 175323.08
B Local wages, tips, ste.

15 State ID no]i6 State wages, Ups, sic,
NY 175323.09

1H Local wages, lips, eto.

1 income tax

10 Local WAGE anc 20 Locality name

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: ASE

—————--— FOLD AND DEIAGH HERE

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EFTA00006070



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Refund. Even if d have io file a tax refurmn,
Ti Bo i Lat a IE thos til Ties
kee withheld or if you can the earmed

(FIC). You must fle a feo sstum

i: Wi you do

Earned income cradit
ary amount is shown in

THY TL TL
fing fori

If ans nol subject
Sana Publication 51 :

for Members of the

Corrections. If yous narhe, SSN, or address s income,
correct Copies Jour employes
comect your emgloyment record, Be sure 1o the
io file Form ap amectad Wa a and Tax
a ne Sah ay aren ad,
he 5A on Form W-2, If tr name and 55k are comact

Sand ary SSA ofhch or

tax was withh be able to claim
Ses Farm 30 oe Eom 10404, Ftmciions &

ication 505, Tax Withholding and Estimated Tas.
Instructions

Box 10. This amour is the tatal cane baredits
on your behalf

that your employer paid 16 YoU of Feared

a

* rtirerment account that is part of a section 401(K)

rapa

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71

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amounts for the shown, nf |
eat 110 year own he cons
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the current
for tha cumrent

A—Lncollacied soci or RATA
this tex on Fomn Ty hog a hela dad ot WF
. {

natruetion
B—Lncollected ha Include this tax
Form 1040, See “Total pry Sli )

C—T; of i over

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a

D—Elective deferrals to a section 401k) cash or defer!
ni. Also includes deferrals under a SIMPLE

meen. :

E—Elective deferrals under a section 4035) salary
agreement

reduction ;
deferrals under a section 403(K)(8) sslary

F=—=Fleclive
reduction SEP

* G—Eleclive deferrals and employer contributions neu

gnalective deferrals)
compensation plan

io & section 457) deferred 3

NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDE|

Department of the Treasury - intemal Reverie
Service

This information is being fumished to the intemal ;
Revenue Service. |

IMPORTANT NOTE:

In order to insure efficient processing,
attach this W-2 to your tax retum ke this
(following city or local instructions):

TAX RETURN

OTHER

FORM
W-2'5

Wea

“ut

NOTE: THESE ARE SUBSTITUTE WAGE AND
TAX STATEMENTS AND ARE ACCEPTABLE
FOR FILING WITH YOUR FEDERAL, STATE AND
LOCAL/CITY INCOME TAX RETURNS.

L

Departrnent of the Treasury - Internal Revenue
Service

This information i being fumished io the internal
Revenues Service,

IMPORTANT NOTE:

In order to insure efficient processing,
attach this W-2 to your tao return like this
{following state instructions):

TAX RETURN

NOTE: THESE ARE SUBSTITUTE WAGE AND
TAX STATEMENTS AND ARE ACCEPTABLE
FOR FILING WITH YOUR FEDERAL, STATE AND
LOCAL/CITY INCOME TAX RETURNS.

"

EFTA00006071

