EFTA00006066.pdf

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EFTA00006066

a Cower number 
0017 
66/188 
Vdd II 
omsmo.16466666188 
0017 
illiatlon 
numb. r CEIN) 
1 erepes,Ips.olia candenssien 
7890.65 
2 Federal Interne tax Wthheid s 
714.35 
c Employees name, address, and ZP code 
JEFFREY E. EPSTEIN 
3 SOON security want; 
7890.65 
4 Sethi *acuity tax wlfiteld 
489.22 
358 8L BRILLO WAY 
PALM BEACH, FL 33480 
s Medicate wages and Ups 
7890.65 
0 Medicare to vitinekt 
114.41 
7 Social security bps 
8 Allocated lips 
9 Advance EC payment 
10 Dependent care benefits 
. • ... 
Sup. 
11 Nonqualifled plans 
12a See Instructons for box 12 
: C 
I 
6.00 
13 tame 
Art 
Ir
pir 
12b 
MIAMI BEACH, FL 33139 
El 
fl 
ri 
I 
14 Other 
12c 
i 
I 
pd i
L 
I Employee's address and ZIP codo 
m..a.iiici4..it 
15 Sate 
Employers no illi weber 
VL
16 Slate %nos, tips. etc. 
17 Stale mccmo tax 
18 Lad wages, tips, etc. 
10 Local Sorra tax 
20 Wally rime 
W
0 
Wage and Tax 
- 2 
Statement 
‘--For Employer. 
2006 
D0p3nrilallt of the Trossury—Internal Parent* Service 
For Privacy Act and Paperwork Reduction 
Act Notice, ace back at Copy D. 
EFTA00006067

a C./mud number 
0017 66/18E 
Void O 
si 
c•Ae No. tS4S-0008 18E 
0017 
biliiiir 
number ono 
i 
Wasps. has. other compensation 
38536.47 
2 Federal income tax vrithhekl 
3463.23 
i...‘ EmplOyer's name, address, and ZIP code 
'JEFFREY E. EPSTEIN 
358 EL BRILLO WAY 
PALM BEACH, FL 33480 
3 Social security wages 
38536.47 
4 Social secunty tax witnheld 
2389.26 
5 Medicare wages end tips 
38536.47 
6 Medcare tax withheld 
558.78 
7 Sodal security tips 
8 Allocated tips 
o Advance BC payment 
10 Dependent care benefits 
• 
f Employee's address and ZIP code 
11 Norgualified plans 
12a See instructions, 
IC 
for box 12 
I 
28.62 
13 Se:iilg 
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n.
El 
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il 21)
iI 
14 Other 
12c 
12d 
A 
15 Su* 
Employer's mate ID number 
FL 
i 
___I 
16 $ale wages, lips. etc. 
17 State income lax 
18 Local vow, fee, etc 
19 Local income tax 
20 Locally name 
Form IN-2 
Wage and Tax 
Statement 
Copy 0-For Employer. 
2005 
Department of the Treasury—Internal Revenue Service 
For Privacy Act end Paperwork Reduction 
Act Notice, see back of Copy D. 
a Control number 
Void El 
OMB No. 1545-0008 
b Employer identification number (E/N) 
1 Wages. tips, other compernal0n 
2 Federal income tax 
relate! 
c Employer's name. address, and ZIP code 
3 Soda; socially wages 
4 Social security lax wittteld 
5 Medicare wages and tips 
6 Medicare tax withheld 
7 Soma security lips 
8 Allocated tips 
d Employee's social security number 
9 Advance SIC payment 
10 Dependent care benefits 
e Empbyee's lust nave and initial 
Last name 
f Employee's address and ZIP cede 
11 NOnquaGfred plans 
e12a See 1/1.5111.1C1i011S 
S 
for box 12 
1 
13 
anat. 
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win 
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El 
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nb 
c . 
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14 ()lbw 
12e 
c 
S 
I 
120 
c • 
77 
A 
15 Ste. 
Employer's slate ID number 
• 
16 Slam wagon, ups, etc. 117 State income tax 
f 
18 Local wages, tips. etc. 
, 
19 Local exam lax 
20 Locally name 
'1-2 
Wage and Tax 
Statement 
'or Employer. 
200.5 
Department of the Treasury—Imemal Revenue Serene 
For Privacy ...

Size: 122 x 29 pixels

Size: 68 x 14 pixels

Surrounding text: 66/18E a” " Employer's name, address, JEFFREY E. EPST

Size: 240 x 54 pixels

Surrounding text: MIAMI BEACH, FL 33139

Size: 70 x 12 pixels

Surrounding text: 0017 66/18E wployer's name, address, (OTEFFREY E. EPSTE

Size: 196 x 62 pixels