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d-4793Dept. of JusticeFinancial Record

sislesteses [EFTA00006069]

Date
December 19, 2025
Source
Dept. of Justice
Reference
EFTA 00006069
Pages
1
Persons
1

Summary

sislesteses ir04iii 1310.01 2005 W-2 and E za rce- afiV-2 ^'r 184,807.7.1 115;i23.09 3- Employee:eV/4 Profile. To change your Employee W-4 Profile Information, filo a new W-4 with your payroll dept. Social Security Number: imp Taxable Marital Status: Exemptions/Allowances: FEDERAL: 8 STATE: 0 2C0...

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EFTA Disclosure
Text extracted via OCR from the original document. May contain errors from the scanning process.
sislesteses 
EFTA00006069

• 
ir04iii 
1310.01 
v 
2005 W-2 and E 
za rce-
cts.* 
14004
-1.' 
afiV-2 
^'r 184,807.7.1 
515.* 
N/A 
115;i23.09 
3- Employee:eV/4 Profile. To change your Employee W-4 Profile Information, filo a new W-4 with your payroll dept. 
Social Security Number: imp 
Taxable Marital Status: 
MM.. 
33404 
Exemptions/Allowances: 
FEDERAL: 8 
STATE: 
8 
0 2C05 AUTOMATIC DATA AMOCESUNG. 
r 
H.2 "I' 
• 1 
Wages, tips. other comp. 
175323.09 
1 Federal income tax withheld 
29092.14 
3 SocIal security wages 
90000.00 
4 Social sithuritytex Withhold 
5580.00 
5 Medicare wages and Ups 
185323.09 
6 Medium tax withheld 
2687.18 
1 • 
Control number 
0009 
66/TPW 
Dept. 
Corp. 
Employer,.._ only 
19 
o EMployer's name, address, and ZIP cod 
NES LLC 
457 MADISON AVENUE 
NEW YORK, NY 10022 
b E.Wit 
bar 
d Em 
' 
. / 
&Mel securitytips 
8 Allem. 
cis 
• 11 Advance MC payment 
i 
10 Dependent we benefit* 
I 
1 
nN
simpithlied plans 
12a ,C
I 
515.38 
14 Other 
• 
32.40 NVDD 
la 0 I 
10000.00 
tho 
I 
12d 
i 
13 Slat esm Rarer 
lietlY OA PS 
ol Employeee nem*, addrcon and ZIP code 
I 
I 
, 
33404 
 1 16N itte I 
. 
• • 
te ID no. 
/ 
Y
16 State wain. Ups, etc. 
175323.09 
t 
Slate income tax 
I 
II Local wages, ups. etc. 
• 16 LOW Melo* lot 
• 
20 Loma/ name 
0-adefEC 
-5S-s;t3 
int 
• ,•,'c 
9,.. 
2lithe.
I 
Wades, thss, other comp 
175323.09 
2 Federal Income taX withheld 
29092.14 
3 Social (acorn), wages 
90000.00 
4 Social security tax withheld 
5580.00 
S Medicare wages end tips 
185323.09 
6 Medicare tax withheld 
2687.18 
• 
Control number 
0009 
66/TPW 
Dept. 
Corp. 
Employee use only 
19 
c Employees name, address. and ZIP code 
NES LW 
457 MADISON AVENUE 
NEW YORK, NY 10022 
ilfr 
b Empltber 
d Empl 
er 
nodal 
security tips 
8 Allocated bPS 
a Advance EIC payment 
10 Dependent core benefits 
11 Nonqueldied plans 
12a 
C I 
515.38 
14 Other 
32.40 NYCO 
1265 1 
10000.00 
12e 
i
12d
13 Stet empratrird lefty ekk pri 
ell Employcea no me. address and 2/P code 
33404 
15 Stole 
' 
re ID note 
NY 
sum aim. tips, etc. 
175323.09 
Pate Income lax 
IS Lothl wages, Ups, etc. 
19 Local looms* tex 
20 Locality name 
EFTA00006070

• 
Refund. Even if yai do not have to Rea tax return, you 
should Re to got a refund if box 2 shows federal income 
tax withheld or if you can take the earned income credit. 
Earned Income credit (EIC). You must file a tax return if 
any amount is shown in box 9. 
You may be able to take the EC for 2005 W: (a) you do 
not have a qt4ifying child and year earned less than 
$11 750 ($13,750 if married fling jointly), lb) you have one 
qua .1'412 child and you earnediess than $31 (330 (533,030 
mare 
fling lantlY), or (c) you have more than one 
guarding chid and you earned less than 535253 ($37263 
if married Ming j'ointly). You and any qualifying children 
must have valid social security numbers -MNs). You 
cannot take the EIC if yourinvestment incomes more than 
$2/00. Any EIC that is morn than your tax liability is 
refunded to you, but only if you file atier return. El ycu 
have at least one qualifying dead, you may get as rntr-h as 
$1,597 of the EC rn advance b/ completing Form W-5, 
Ea rod Income Credit Acvarre Payment Certificate, and 
giving it to your empoyer. 
Clergy and migious workers. If you are not suited to 
Social secur
and Medicare taxes, see publication 517, 
Social Security and Dine' Information for Members of the 
Clergy and Religious Workers. 
Corrections. U your name. SSN, or address is incorrect. 
correct Copies 8 C, and 2 and ask your employer to 
correct your elloyment record. Be sure to ask the
to fileForm W-2c, Corrected Wage and Tax 
Sertnact)Arnt, with the Social Security AdmInietration (SSA) to 
correct any name, SSN or money amount error reported to 
the SSA on Fonn W-2. If your name and SSN are correct 
but are not the same as 
own on your Waal Seculty 
card you should ask for a new card at any SSA office or 
cal 1-800-772-1213. 
Credit for excess taxes. If you had more than one 
emptioc 
Tie 
in 2005 and moo than $5580.00 in cooly 
sccuri and/or 
r I railroad retirement (RFITA) taxes wae 
withho , you may be able to claim a credit for the excess 
against your federal hcome tax. If you had more than one 
railroad employer and more than $2,943.60 in Tree II RRTA 
tax was withheld. you also may be able to claim a credit. 
See your Form 1040 or Form 1040A instructions and 
Pubfcation 505, Tax Withholdirg and Estimated Tax. 
Instructions 
Box 1. Enter.this acquit on the wages line of your tax 
return. 
Box 2. Enter ttis amount on the federal income tax 
withheld fine of your tax return. 
Box 8. This amens Is not included in boxes 1, 3, 5. or 7. 
For information on how to report tips on your tax return. 
see your Form 1040 instrucbons. 
Box 9. Enter his amount on the advance earned Income 
credit payments line of you Form 1040 or Form 1040A. 
Box 10. This amount is the total dependent care benefits 
that your employer paid to you or knosred an our behalf 
(including amens from a section 125 (cafeteria) plan). 
amount over_ 
 5S,000 also is hcluded in box 1. Yee must 
complete Schedule 2 (Form 1040A) or Farm 2441, Chid 
and Nporident Cale Evenies, to compute any taxable 
and nontaxable amounts. 
Box 11. This amount is: (a) reported in box 1 if it is a 
distribution made to you from a nonquadfied deferred 
compensation Cr nongovernmental section 457(0) plan 
(b) InMded in box 3 and/or 5 it m is a pea year deferral 
under a nonqualiged cr section 457(b) plan that became 
taxeb's for social sexany and Med cam taxes this year 
becaµse there is no longer a substantial risk of I 
your right to the deferred amount. 
Box 12. The following list explains the codes shown In 
12. You may need this information to complete your tat 
return. Elective deferrals (codes D. E, F. and S) under 
or section 403 ) plans if you qualify for the 15-year 
are genelly linked to a total of 314.000017 
explained in F . 571). Deferrals under code G are fire 
to $14,000. Deferrals under code H are kneed to $7 
However, if you were at least age 50 in 2005, your 
employer may have mowed an additional defend of u 
$4.000 ($2,000 for section 401(1)(11) and 408(p) SIM 
plans). Ins addtional deferral amount s not subject to 
34
overal limit on elective deorrals. For code G the knit 4 _ 
elective deferrals may be higher for the last three years 
• 
before you reach retirement age. Contact your plan 
• • 
administrator to' more information. Frown% In excess 
the overall elective deferrer knit must be included Si 
income. See the "Wages, Salaries, Tops, etc." line 
,r‘ 
instructions for Form 1040. 
mefrt-up pcmicer contribution for a prior 
when yt 
Note. Ha year foilows code D, E, F, 0, H. or S 
maC, 
were in miNtary service. To figure whether you made arc 
deferrals, consider these arrsounts for The year shown n 
the current year lino year is sewn, the contributions ar, 
for the anent yea: 
A—Uncollected social securitya RRTA tax on bps Include'. 
tWs tax on Form 1040. See 'Total Tar in the Form 1040 
instructions. 
8—Uncollected Medicare lex on Ups. Include this tax of 
Form 1040. See "Total Tax" in the Form 1040 ham 
0—Taxable cost of group-term fife insurance over 
and
011abled in barns 1.3 (up to soda! security wage 
51 
D--Elective deferrals to a section 401(k) cash or defiant 
: arrangement. Also includes deferrals under a SIMPLE' 
PatirCl/XIII account that is part of a section 401(1) 
arrangement. 
E—Elective deferrals under a section 403(0) salary 
reduction agreement 
F—Elective deferrals under a section 40881(6) salary : 
reduction SEP 
G—Elective deferrals and employer centributiorts (ache 
nonelective deferrals) to a section 4570o) deferred 
. 
compensation plan 
NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDB 
Department of the Then, ay • hernal Revenue 
Service 
This informant:in is being furnished to the Internal 
Revenue Set 
IMPORTANT NOTE: 
In order to enure efficient processing, 
attach this W-2 to my tax return like this 
(following city or Idol Instructtons): 
Department of the litastny - Internal Revenue 
Service 
This information is being furnished to the Internal 
Revenue Service. 
IMPORTANT NOTE 
In order to insure efficient processeig, 
attach this W-2 to your tax return like this 
(followhg state Instructions): 
TAX RETURN 
TAX RETURN 
TIM 
THIS 
FORM 
OTHER) 
FORM 
OTHER 
004 
 was 
W-2 
 W-25 
NOTE: THESE ARE SUBSTTTUTE WAGE AND 
TM STATEMENTS AND ARE ACCEPTABLE 
FOR FIUNG WITH YOUR FEDERAL. STATE AND 
LOCAL/CITY INCOME TAX RETURNS. 
NOTE THESE ARE SUBSTITUTE WAGE AND 
TAX STATEMENTS AND ARE ACCEPTABLE 
FOR FIUNG WITH YOUR FEDERAL. STATE ANO 
LOCAL/CITY INCOME TM RETURNS. 
EFTA00006071

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