EFTA01700740

vJ -2- c44€.,.a.is EFTA01700740 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. EFTA01700741 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 or /tor n. El n 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. m saan/ efrobste win w El n n nb c . I 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 Act and Paperwork Reduction Act Notice. see back of Copy D. EFTA01700742