Wage and Tax Statement: Gipson JR Eric L
Wage and Tax Statement: Gipson JR Eric L
Wage and Tax Statement: Gipson JR Eric L
If you
619-03-7222 OMB No. 1545-0008 are required to file a tax return, a negligence penalty or other sanction
may be imposed on you if this income is taxable and you fail to report it.
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
84-3534276 213302.46 47096.29
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
GIPSOL LLC
3505 CADILLAC AVE 213302.46 9114.00
UNIT O-105 5 Medicare wages and tips 6 Medicare tax withheld
3
COSTA MESA CA 92626 213302.46 212.61
7 Social security tips 8 Allocated tips
e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12
Eric L Gipson Jr C
o
d
e
13 Statutory Retirement Third-party 12b
employee plan sick pay C
o
d
e
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
CA 84-3534276 213302.46 18032.01
W-2
Department of the Treasury—Internal Revenue Service
Wage and Tax
Form Statement
Copy C—For EMPLOYEE’S RECORDS (See Notice to
2022 Safe, accurate,
FAST! Use