Copy B To Be Filed With Employee's 41-0852411 Copy 2 To Be Filed With Employee's 41-0852411

Federal Tax Return OMB No. 1545-0008 State, City, or Local Income Tax Return OMB No. 1545-0008
a Employee's soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld a Employee's soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld
3736.97 245.13 3736.97 245.13
313-98-3108 313-98-3108 3 Social security wages 4 Social security tax withheld
3 Social security wages 4 Social security tax withheld
b Employer ID number (EIN) 0.00 0.00 b Employer ID number (EIN) 0.00 0.00
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
72-6001304 72-6001304
4123.97 59.80 4123.97 59.80
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code

ST TAMMANY PARISH GOVERNMENT ST TAMMANY PARISH GOVERNMENT

P.O. BOX 628 P.O. BOX 628
COVINGTON, LA 70434 COVINGTON, LA 70434

d Control number d Control number

e Employee's name, address, and ZIP code Suff. e Employee's name, address, and ZIP code Suff.

JOHN BELL JOHN BELL

37093 HOWARD OBERRY RD 37093 HOWARD OBERRY RD
PEARL RIVER, LA 70452 PEARL RIVER, LA 70452

7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
0.00 0.00 0.00 0.00
10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a
0.00 0.00 DD 726.90 0.00 0.00 DD 726.90
13 Statutory 14 Other 12b Code 13 Statutory 14 Other 12b Code
employee FSA DEN VIS COL - 19.78 employee FSA DEN VIS COL - 19.78
Retirement RETIREMENT - 387.00 12c Code Retirement RETIREMENT - 387.00 12c Code
plan plan
X X
Third-party sick 12d Code Third-party sick 12d Code
pay pay

LA 1394709001 3736.97 152.60 LA 1394709001 3736.97 152.60

15 State Employer's state ID number 16 State wages, tips, etc. 17 State income tax 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 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 2020 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement 2020 Dept. of the Treasury -- IRS
This information is being furnished to the Internal Revenue Service www.irs.gov/efile

Copy C For EMPLOYEE'S RECORDS (See 41-0852411 Copy 2 To Be Filed With Employee's 41-0852411
Notice to Employee on back of Copy B.) OMB No. 1545-0008 State, City, or Local Income Tax Return OMB No. 1545-0008
a Employee's soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld a Employee's soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld
3736.97 245.13 3736.97 245.13
313-98-3108 3 Social security wages 4 Social security tax withheld
313-98-3108 3 Social security wages 4 Social security tax withheld
b Employer ID number (EIN) 0.00 0.00 b Employer ID number (EIN) 0.00 0.00
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
72-6001304 72-6001304
4123.97 59.80 4123.97 59.80
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code

ST TAMMANY PARISH GOVERNMENT ST TAMMANY PARISH GOVERNMENT

P.O. BOX 628 P.O. BOX 628
COVINGTON, LA 70434 COVINGTON, LA 70434

d Control number d Control number

e Employee's name, address, and ZIP code Suff. e Employee's name, address, and ZIP code Suff.

JOHN BELL JOHN BELL

37093 HOWARD OBERRY RD 37093 HOWARD OBERRY RD
PEARL RIVER, LA 70452 PEARL RIVER, LA 70452

7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
0.00 0.00 0.00 0.00
10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a
0.00 0.00 DD 726.90 0.00 0.00 DD 726.90
13 Statutory 14 Other 12b Code 13 Statutory 14 Other 12b Code
employee FSA DEN VIS COL - 19.78 employee FSA DEN VIS COL - 19.78
Retirement RETIREMENT - 387.00 12c Code Retirement RETIREMENT - 387.00 12c Code
plan plan
X X
Third-party sick 12d Code Third-party sick 12d Code
pay pay

LA 1394709001 3736.97 152.60 LA 1394709001 3736.97 152.60

15 State Employer's state ID number 16 State wages, tips, etc. 17 State income tax 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 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 2020 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement 2020 Dept. of the Treasury -- IRS
This information is being furnished to the IRS.
If you 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.
 Instructions for Employee Y - Deferrals under a section 409A
nonqualified deferred compensation plan
(continued from back of Copy C) Z - Income under a nonqualified deferred
compensation plan that fails to satisfy section
Box 12 (continued) 409A. This amount is also included in box 1. It
F - Elective deferrals under a section 408(k)(6) is subject to an additional 20% tax plus
salary reduction SEP interest. See the Instructions for Forms 1040
G - Elective deferrals and employer and 1040-SR.
contributions (including nonelective deferrals) to AA - Designated Roth contributions under a
a section 457(b) deferred compensation plan section 401(k) plan
H - Elective deferrals to a section 501(c)(18)(D) BB - Designated Roth contributions under a
tax-exempt organization plan. See the section 403(b) plan
Instructions for Forms 1040 and 1040-SR for DD - Cost of employer-sponsored health
how to deduct. coverage. The amount reported with code
J - Nontaxable sick pay (information only, not DD is not taxable.
included in box 1, 3, or 5) EE - Designated Roth contributions under a
K - 20% excise tax on excess golden parachute governmental section 457(b) plan. This amount
payments. See the Instructions for Forms 1040 does not apply to contributions under a tax-
and 1040-SR.
exempt organization section 457(b) plan.
L - Substantiated employee business expense
FF - Permitted benefits under a qualified small
reimbursements (nontaxable)
M - Uncollected social security or RRTA tax on employer health reimbursement arrangement
taxable cost of group-term life insurance over GG - Income from qualified equity grants under
$50,000 (former employees only). See the section 83(i)
Instructions for Forms 1040 and 1040-SR. HH - Aggregate deferrals under section 83(i)
N - Uncollected Medicare tax on taxable cost of elections as of the close of the calendar year
group-term life insurance over $50,000 (former
employees only). See the Instructions for Forms Box 13. If the “Retirement plan” box is
1040 and 1040-SR. checked, special limits may apply to the
P - Excludable moving expense reimbursements amount of traditional IRA contributions you
paid directly to a member of the U.S. Armed may deduct. See Pub. 590-A, Contributions to
Forces (not included in box 1, 3, or 5) Individual Retirement Arrangements (IRAs).
Q - Nontaxable combat pay. See the Instructions
for Forms 1040 and 1040-SR for details on Box 14. Employers may use this box to report
reporting this amount. information such as state disability insurance
R - Employer contributions to your Archer MSA. taxes withheld, union dues, uniform payments,
Report on Form 8853, Archer MSAs and Long- health insurance premiums deducted,
Term Care Insurance Contracts. nontaxable income, educational assistance
S - Employee salary reduction contributions payments, or a member of the clergy’s
under a section 408(p) SIMPLE plan (not parsonage allowance and utilities. Railroad
included in box 1) employers use this box to report railroad
T - Adoption benefits (not included in box 1). retirement (RRTA) compensation, Tier 1 tax,
Complete Form 8839, Qualified Adoption Tier 2 tax, Medicare tax, and Additional
Expenses, to compute any taxable and Medicare Tax. Include tips reported by the
nontaxable amounts. employee to the employer in railroad
V - Income from exercise of nonstatutory stock retirement (RRTA) compensation.
option(s) (included in boxes 1, 3 (up to social
security wage base), and 5). See Pub. 525, Note: Keep Copy C of Form W-2 for at least 3
Taxable and Nontaxable Income, for reporting
years after the due date for filing your income
requirements.
tax return. However, to help protect your
W - Employer contributions (including amounts
the employee elected to contribute using a social security benefits, keep Copy C until
section 125 (cafeteria) plan) to your health you begin receiving social security benefits,
savings account. Report on Form 8889, Health just in case there is a question about your work
Savings Accounts (HSAs). record and/or earnings in a particular year.

Instructions for Employee Box 12. The following list explains the codes shown
in box 12. You may need this information to complete
Notice to Employee
(See also Notice to Employee on the back of
your tax return. Elective deferrals (codes D, E, F, and
Copy B.) Do you have to file? Refer to the Instructions for Forms 1040 and 1040-SR
S) and designated Roth contributions (codes AA, BB,
Box 1. Enter this amount on the wages line of your and EE) under all plans are generally limited to a to determine if you are required to file a tax return. Even if you don’t have to
tax return. total of $19,500 ($13,500 if you only have SIMPLE file a tax return, you may be eligible for a refund if box 2 shows an amount or
plans; $22,500 for section 403(b) plans if you qualify if you are eligible for any credit.
Box 2. Enter this amount on the federal income tax for the 15-year rule explained in Pub. 571). Deferrals
withheld line of your tax return. under code G are limited to $19,500. Deferrals under
code H are limited to $7,000. Earned income credit (EIC). You may be able to take the EIC for 2020 if
Box 5. You may be required to report this amount on
Form 8959, Additional Medicare Tax. See the your adjusted gross income (AGI) is less than a certain amount. The amount
Instructions for Forms 1040 and 1040-SR to However, if you were at least age 50 in 2020, your of the credit is based on income and family size. Workers without children
determine if you are required to complete Form 8959. employer may have allowed an additional deferral of could qualify for a smaller credit. You and any qualifying children must have
up to $6,500 ($3,000 for section 401(k)(11) and valid social security numbers (SSNs). You can’t take the EIC if your
Box 6. This amount includes the 1.45% Medicare 408(p) SIMPLE plans). This additional deferral
Tax withheld on all Medicare wages and tips shown
amount is not subject to the overall limit on elective investment income is more than the specified amount for 2020 or if income is
in box 5, as well as the 0.9% Additional Medicare
Tax on any of those Medicare wages and tips above deferrals. For code G, the limit on elective deferrals earned for services provided while you were an inmate at a penal institution.
$200,000. may be higher for the last 3 years before you reach For 2020 income limits and more information, visit www.irs.gov/EITC. See
retirement age. Contact your plan administrator for also Pub. 596, Earned Income Credit. Any EIC that is more than your tax
Box 8. This amount is not included in box 1, 3, 5, or more information. Amounts in excess of the overall
7. For information on how to report tips on your tax elective deferral limit must be included in income.
liability is refunded to you, but only if you file a tax return.
return, see the Instructions for Forms 1040 and See the Instructions for Forms 1040 and 1040-SR.
1040-SR. Clergy and religious workers. If you aren’t subject to social security and
You must file Form 4137, Social Security and Note: If a year follows code D through H, S, Y, AA, Medicare taxes, see Pub. 517, Social Security and Other Information for
Medicare Tax on Unreported Tip Income, with your BB, or EE, you made a make-up pension contribution Members of the Clergy and Religious Workers.
income tax return to report at least the allocated tip for a prior year(s) when you were in military service.
amount unless you can prove with adequate records To figure whether you made excess deferrals,
that you received a smaller amount. If you have consider these amounts for the year shown, not the Corrections. If your name, SSN, or address is incorrect, correct Copies B,
records that show the actual amount of tips you C, and 2 and ask your employer to correct your employment record. Be sure
received, report that amount even if it is more or less current year. If no year is shown, the contributions
than the allocated tips. Use Form 4137 to figure the are for the current year. to ask the employer to file Form W-2c, Corrected Wage and Tax Statement,
social security and Medicare tax owed on tips you with the Social Security Administration (SSA) to correct any name, SSN, or
didn’t report to your employer. Enter this amount on A - Uncollected social security or RRTA tax on tips.
the wages line of your tax return. By filing Form Include this tax on Form 1040 or 1040-SR. See the
money amount error reported to the SSA on Form W-2. Be sure to get your
4137, your social security tips will be credited to your Instructions for Forms 1040 and 1040-SR. copies of Form W-2c from your employer for all corrections made so you
social security record (used to figure your benefits). may file them with your tax return. If your name and SSN are correct but
Box 10. This amount includes the total dependent B - Uncollected Medicare tax on tips. Include this tax aren’t the same as shown on your social security card, you should ask for a
care benefits that your employer paid to you or on Form 1040 or 1040-SR. See the Instructions for new card that displays your correct name at any SSA office or by calling
incurred on your behalf (including amounts from a Forms 1040 and 1040-SR. 800-772-1213. You may also visit the SSA website at www.SSA.gov.
section 125 (cafeteria) plan). Any amount over
$5,000 is also included in box 1. Complete Form C - Taxable cost of group-term life insurance over
2441, Child and Dependent Care Expenses, to $50,000 (included in boxes 1, 3 (up to social security Cost of employer-sponsored health coverage (if such cost is provided
compute any taxable and nontaxable amounts.
wage base), and 5) by the employer). The reporting in box 12, using code DD, of the cost of
Box 11. This amount is (a) reported in box 1 if it is a employer-sponsored health coverage is for your information only. The
distribution made to you from a nonqualified deferred D - Elective deferrals to a section 401(k) cash or amount reported with code DD is not taxable.
compensation or nongovernmental section 457(b) deferred arrangement. Also includes deferrals under
plan, or (b) included in box 3 and/or 5 if it is a prior a SIMPLE retirement account that is part of a section
year deferral under a nonqualified or section 457(b) 401(k) arrangement. Credit for excess taxes. If you had more than one employer in 2020 and
plan that became taxable for social security and
Medicare taxes this year because there is no longer more than $8,537.40 in social security and/or Tier 1 railroad retirement
a substantial risk of forfeiture of your right to the E - Elective deferrals under a section 403(b) salary (RRTA) taxes were withheld, you may be able to claim a credit for the excess
deferred amount. This box shouldn’t be used if you reduction agreement against your federal income tax. If you had more than one railroad employer
had a deferral and a distribution in the same calendar
year. If you made a deferral and received a (continued on back of Copy 2) and more than $5,012.70 in Tier 2 RRTA tax was withheld, you may also be
distribution in the same calendar year, and you are or able to claim a credit. See the Instructions for Forms 1040 and 1040-SR and
will be age 62 by the end of the calendar year, your Pub. 505, Tax Withholding and Estimated Tax.
employer should file Form SSA-131, Employer
Report of Special Wage Payments, with the Social
Security Administration and give you a copy. (See also Instructions for Employee on the back of Copy C.)