d Control number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control number 1 Wages, tips, other

Control number 1 Wages, tips, other compensation 2 Federal income tax withheld
13055 86623.14 13318.76 13055 86623.14 13318.76
OMB NO. 3 Social security wages 4 Social security tax withheld OMB NO. 3 Social security wages 4 Social security tax withheld
1545-0008 1545-0008
0.00 0.00 This information is 0.00 0.00
5 Medicare wages and tips 6 Medicare tax withheld being furnished to the 5 Medicare wages and tips 6 Medicare tax withheld
Internal Revenue
100339.99 1454.93 Service. 100339.99 1454.93
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code
STATE OF ALASKA STATE OF ALASKA
PO BOX 110204 PO BOX 110204
JUNEAU AK 99811 JUNEAU AK 99811
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 See instructions for box 12 10 Dependent care benefits 11 Nonqualified plans 12a
0.00 0.00 CODE G 7566.00 0.00 0.00 CODE G 7566.00
12b 12c 12d 12b 12c 12d
CODE DD 18660.00 CODE CODE CODE DD 18660.00 CODE CODE
b Employer identification number (EIN) a Employee's social security number b Employer identification number (EIN) a Employee's social security number
92-6001185 535-27-4439 92-6001185 535-27-4439
13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other
Employee Plan sick pay Employee Plan sick pay

X X

e Employee's name, address, and ZIP code This information is being e Employee's name, address, and ZIP code
furnished to the Internal
MEAGAN E NYE Revenue Service. If you are MEAGAN E NYE
PO BOX 34654 required to file a tax return, a PO BOX 34654
negligence penalty or other
sanction may be imposed on
you if this income is taxable
JUNEAU AK 99803-4654 and you fail to report it. JUNEAU AK 99803-4654

2019 15 State Employer's state ID No. 16 State wages, tips, etc.

0.00 2019 15 State Employer's state ID No. 16 State wages, tips, etc.
0.00
0.00 0.00
W-2 Wage and Tax
Statement
17 State income tax
0.00
18 Local wages, tips, etc.
0.00 W-2 Wage and Tax
Statement
17 State income tax
0.00
18 Local wages, tips, etc.
0.00
Form Form
0.00 0.00 0.00 0.00
Copy C-For 19 Local income tax 20 Locality name Copy B-To Be Filed 19 Local income tax 20 Locality name
EMPLOYEE'S RECORDS 0.00 with Employee's 0.00
(See Notice to Employee on the FEDERAL Tax Return
back of Copy B.) 0.00 0.00
Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service

d Control number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control number 1 Wages, tips, other compensation 2 Federal income tax withheld
13055 86623.14 13318.76 13055 86623.14 13318.76
OMB NO. 3 Social security wages 4 Social security tax withheld OMB NO. 3 Social security wages 4 Social security tax withheld
1545-0008 1545-0008
0.00 0.00 This information is 0.00 0.00
5 Medicare wages and tips 6 Medicare tax withheld being furnished to the 5 Medicare wages and tips 6 Medicare tax withheld
Internal Revenue
100339.99 1454.93 Service. 100339.99 1454.93
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code
STATE OF ALASKA STATE OF ALASKA
PO BOX 110204 PO BOX 110204
JUNEAU AK 99811 JUNEAU AK 99811
7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 10 Dependent care benefits 11 Nonqualified plans 12a
0.00 0.00 CODE G 7566.00 0.00 0.00 CODE G 7566.00
12b 12c 12d 12b 12c 12d
CODE DD 18660.00 CODE CODE CODE DD 18660.00 CODE CODE
b Employer identification number (EIN) a Employee's social security number b Employer identification number (EIN) a Employee's social security number
92-6001185 535-27-4439 92-6001185 535-27-4439
13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other
Employee Plan sick pay Employee Plan sick pay

X X

e Employee's name, address, and ZIP code e Employee's name, address, and ZIP code
MEAGAN E NYE MEAGAN E NYE
PO BOX 34654 PO BOX 34654

JUNEAU AK 99803-4654 JUNEAU AK 99803-4654

2019 15 State Employer's state ID No. 16 State wages, tips, etc.

0.00 2019 15 State Employer's state ID No. 16 State wages, tips, etc.
0.00
0.00 0.00
W-2 Wage and Tax
Statement
17 State income tax
0.00
18 Local wages, tips, etc.
0.00 W-2 Wage and Tax
Statement
17 State income tax
0.00
18 Local wages, tips, etc.
0.00
Form Form
0.00 0.00 0.00 0.00
Copy 2-To Be Filed With 19 Local income tax 20 Locality name Copy 2-To Be Filed With 19 Local income tax 20 Locality name
Employee's State, City, or 0.00 Employee's State, City, or 0.00
Local Income Tax Return. Local Income Tax Return.
0.00 0.00
Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service
Notice to Employee Box 12. The following list explains the codes shown in box 12. You may need this
information to complete your tax return. Elective deferrals (codes D, E, F, and S)
Do you have to file? and designated Roth contributions (codes AA, BB, and EE) under all plans are
Refer to the Form 1040 instructions to determine if you are required to file a tax generally limited to a total of $19,000 ($13,000 if you only have SIMPLE plans;
return. Even if you don’t have to file a tax return, you may be eligible for a refund if $22,000 for section 403(b) plans if you qualify for the 15-year rule explained in Pub.
box 2 shows an amount or if you are eligible for any credit. 571). Deferrals under code G are limited to $19,000. Deferrals under code H are
limited to $7,000.
Earned income credit (EIC). However, if you were at least age 50 in 2019, your employer may have allowed an
You may be able to take the EIC for 2019 if your adjusted gross income (AGI) is additional deferral of up to $6,000 ($3,000 for section 401(k)(11) and 408(p)
less than a certain amount. The amount of the credit is based on income and family SIMPLE plans). This additional deferral amount is not subject to the overall limit on
size. Workers without children could qualify for a smaller credit. You and any elective deferrals. For code G, the limit on elective deferrals may be higher for the
qualifying children must have valid social security numbers (SSNs). You can’t take last 3 years before you reach retirement age. Contact your plan administrator for
the EIC if your investment income is more than the specified amount for 2019 or if more information. Amounts in excess of the overall elective deferral limit must be
income is earned for services provided while you were an inmate at a penal included in income. See the instructions for Form 1040.
institution. For 2019 income limits and more information, visit www.irs.gov/EITC. Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made a make-
Also see Pub. 596, Earned Income Credit. Any EIC that is more than your tax up pension contribution for a prior year(s) when you were in military service. To
liability is refunded to you, but only if you file a tax return. figure whether you made excess deferrals, consider these amounts for the year
shown, not the current year. If no year is shown, the contributions are for the
Clergy or religious workers. current year.
If you aren’t subject to social security and Medicare taxes, see Pub. 517, Social A—Uncollected social security or RRTA tax on tips. Include this tax on Form 1040.
Security and Other Information for Members of the Clergy and Religious Workers. See the Form 1040 instructions.
B—Uncollected Medicare tax on tips. Include this tax on Form 1040. See the Form
Corrections.
1040 instructions.
If your name, SSN, or address is incorrect, correct Copies B, C, and 2 and ask your C—Taxable cost of group-term life insurance over $50,000 (included in boxes 1, 3
employer to correct your employment record. Be sure to ask the employer to file (up to social security wage base), and 5)
Form W-2c, Corrected Wage and Tax Statement, with the Social Security D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also
Administration (SSA) to correct any name, SSN, or money amount error reported to includes deferrals under a SIMPLE retirement account that is part of a section
the SSA on Form W-2. Be sure to get your copies of Form W-2c from your 401(k) arrangement.
employer for all corrections made so you may file them with your tax return. If your E—Elective deferrals under a section 403(b) salary reduction agreement
name and SSN are correct but aren’t the same as shown on your social security F—Elective deferrals under a section 408(k)(6) salary reduction SEP
card, you should ask for a new card that displays your correct name at any SSA G—Elective deferrals and employer contributions (including nonelective deferrals)
office or by calling 800-772-1213. You also may visit the SSA website at to a section 457(b) deferred compensation plan
www.SSA.gov. H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See
Cost of employer-sponsored health coverage (if such cost is the Form 1040 instructions for how to deduct.
provided by the employer). J—Nontaxable sick pay (information only, not included in box 1, 3, or 5)
K—20% excise tax on excess golden parachute payments. See the Form 1040
The reporting in box 12, using code DD, of the cost of employer-sponsored health
instructions.
coverage is for your information only. The amount reported with code DD is not
L—Substantiated employee business expense reimbursements (nontaxable)
taxable.
M—Uncollected social security or RRTA tax on taxable cost of group-term life
Credit for excess taxes. insurance over $50,000 (former employees only). See the Form 1040 instructions.
If you had more than one employer in 2019 and more than $8,239.80 in social N—Uncollected Medicare tax on taxable cost of group-term life insurance over
security and/or Tier 1 railroad retirement (RRTA) taxes were withheld, you may be $50,000 (former employees only). See the Form 1040 instructions.
able to claim a credit for the excess against your federal income tax. If you had P—Excludable moving expense reimbursements paid directly to a member of the
more than one railroad employer and more than $4,836.30 in Tier 2 RRTA tax was U.S. Armed Forces (not included in box 1, 3, or 5)
withheld, you also may be able to claim a credit. See your Form 1040 instructions Q—Nontaxable combat pay. See the instructions for Form 1040 for details on
and Pub. 505, Tax Withholding and Estimated Tax. reporting this amount.
R—Employer contributions to your Archer MSA. Report on Form 8853, Archer
(Also see Instructions for Employee.)
MSAs and Long-Term Care Insurance Contracts.
S—Employee salary reduction contributions under a section 408(p) SIMPLE plan
Instructions for Employee (not included in box 1)
(Also see Notice to Employees.) T—Adoption benefits (not included in box 1). Complete Form 8839, Qualified
Box 1. Enter this amount on the wages line of your tax return. Adoption Expenses, to compute any taxable and nontaxable amounts.
Box 2. Enter this amount on the federal income tax withheld line of your tax return. V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3 (up
Box 5. You may be required to report this amount on Form 8959, Additional to social security wage base), and 5). See Pub. 525, Taxable and Nontaxable
Medicare Tax. See the Form 1040 instructions to determine if you are required to Income, for reporting requirements.
complete Form 8959. W—Employer contributions (including amounts the employee elected to contribute
Box 6. This amount includes the 1.45% Medicare Tax withheld on all Medicare using a section 125 (cafeteria) plan) to your health savings account. Report on
wages and tips shown in box 5, as well as the 0.9% Additional Medicare Tax on Form 8889, Health Savings Accounts (HSAs).
any of those Medicare wages and tips above $200,000. Y—Deferrals under a section 409A nonqualified deferred compensation plan
Box 8. This amount is not included in box 1, 3, 5, or 7. For information on how to Z—Income under a nonqualified deferred compensation plan that fails to satisfy
report tips on your tax return, see your Form 1040 instructions. section 409A. This amount also is included in box 1. It is subject to an additional
You must file Form 4137, Social Security and Medicare Tax on Unreported Tip 20% tax plus interest. See the Form 1040 instructions.
Income, with your income tax return to report at least the allocated tip amount AA—Designated Roth contributions under a section 401(k) plan
unless you can prove that you received a smaller amount. If you have records that BB—Designated Roth contributions under a section 403(b) plan
show the actual amount of tips you received, report that amount even if it is more or DD—Cost of employer-sponsored health coverage. The amount reported with
less than the allocated tips. On Form 4137 you will calculate the social security and code DD is not taxable.
Medicare tax owed on the allocated tips shown on your Form(s) W-2 that you must EE—Designated Roth contributions under a governmental section 457(b) plan.
report as income and on other tips you did not report to your employer. By filing This amount does not apply to contributions under a tax-exempt organization
Form 4137, your social security tips will be credited to your social security record section 457(b) plan.
(used to figure your benefits). FF—Permitted benefits under a qualified small employer health reimbursement
Box 10. This amount includes the total dependent care benefits that your employer arrangement
paid to you or incurred on your behalf (including amounts from a section 125 GG—Income from qualified equity grants under section 83(i)
(cafeteria) plan). Any amount over $5,000 also is included in box 1. Complete Form HH—Aggregate deferrals under section 83(i) elections as of the close of the
2441, Child and Dependent Care Expenses, to compute any taxable and calendar year
nontaxable amounts. Box 13. If the “Retirement plan” box is checked, special limits may apply to the
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from amount of traditional IRA contributions you may deduct. See Pub. 590-A,
a nonqualified deferred compensation or nongovernmental section 457(b) plan, or Contributions to Individual Retirement Arrangements (IRAs).
(b) included in box 3 and/or 5 if it is a prior year deferral under a nonqualified or Box 14. Employers may use this box to report information such as state disability
section 457(b) plan that became taxable for social security and Medicare taxes this insurance taxes withheld, union dues, uniform payments, health insurance
year because there is no longer a substantial risk of forfeiture of your right to the premiums deducted, nontaxable income, educational assistance payments, or a
deferred amount. This box shouldn’t be used if you had a deferral and a distribution member of the clergy's parsonage allowance and utilities. Railroad employers use
in the same calendar year. If you made a deferral and received a distribution in the this box to report railroad retirement (RRTA) compensation, Tier 1 tax, Tier 2 tax,
same calendar year, and you are or will be age 62 by the end of the calendar year, Medicare tax and Additional Medicare Tax. Include tips reported by the employee
your employer should file Form SSA-131, Employer Report of Special Wage to the employer in railroad retirement (RRTA) compensation.
Payments, with the Social Security Administration and give you a copy. Note: Keep Copy C of Form W-2 for at least 3 years after the due date for filing
your income tax return. However, to help protect your social security benefits,
keep Copy C until you begin receiving social security benefits, just in case there is
a question about your work record and/or earnings in a particular year.