2020 W-2 and EARNINGS SUMMARY

Employee Reference Copy

This blue section is your Earnings Summary which provides more detailed
Wage and Tax
W-2 Statement
Copy C for employee’s records.
2020
OMB No. 1545-0008
information on the generation of your W-2 statement. The reverse side
includes instructions and other general information.
d Control number Dept. Corp. Employer use only
713534 NCT2/UF4 221W77 A
c Employer’s name, address, and ZIP code
ROYALE CONCIERGE INC
68 JAY STREET # 423
BROOKLYN NY 11201

1. Your Gross Pay was adjusted as follows to produce your W-2 Statement.
Batch #00778
Wages, Tips, other Social Security Medicare NY. State Wages, NYC RES
e/f Employee’s name, address, and ZIP code Compensation Wages Wages Tips, Etc. Local Wages,
Box 1 of W-2 Box 3 of W-2 Box 5 of W-2 Box 16 of W-2 Tips, Etc.
SIPIN SAPKOTA Box 18 of W-2
28 KOSSUTH PL Gross Pay 8,829.92 8,829.92 8,829.92 8,829.92 8,829.92
BROOKLYN NY 11221 Reported W-2 Wages 8,829.92 8,829.92 8,829.92 8,829.92 8,829.92
b Employer’s FED ID number a Employee’s SSA number
14-1980956 XXX-XX-7959
1 Wages, tips, other comp. 2 Federal income tax withheld
8829.92 414.54
3 Social security wages 4 Social security tax withheld
8829.92 547.46
5 Medicare wages and tips 6 Medicare tax withheld
8829.92 128.03
7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 2. Employee Name and Address.

11 Nonqualified plans 12a See instructions for box 12

12b
SIPIN SAPKOTA
14 Other
12c 28 KOSSUTH PL
7.20 SDI
23.85 NY PFL 12d BROOKLYN NY 11221
13 Stat emp. Ret. plan 3rd party sick pay

15 State Employer’s state ID no. 16 State wages, tips, etc.

NY 14-1980956 8829.92
17 State income tax 18 Local wages, tips, etc.
365.95 8829.92
19 Local income tax 20 Locality name ¤ 2020 ADP, Inc.
255.36 NYC RES

1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld
8829.92 414.54 8829.92 414.54 8829.92 414.54
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
8829.92 547.46 8829.92 547.46 8829.92 547.46
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
8829.92 128.03 8829.92 128.03 8829.92 128.03
d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only
713534 NCT2/UF4 221W77 A 713534 NCT2/UF4 221W77 A 713534 NCT2/UF4 221W77 A
c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code
ROYALE CONCIERGE INC ROYALE CONCIERGE INC ROYALE CONCIERGE INC
68 JAY STREET # 423 68 JAY STREET # 423 68 JAY STREET # 423
BROOKLYN NY 11201 BROOKLYN NY 11201 BROOKLYN NY 11201

b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number
14-1980956 XXX-XX-7959 14-1980956 XXX-XX-7959 14-1980956 XXX-XX-7959
7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 9 10 Dependent care benefits 9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a
12 11 Nonqualified plans 12a

14 Other 12b 14 Other 12b 14 Other 12b

12c 12c 12c
7.20 SDI 7.20 SDI 7.20 SDI
23.85 NY PFL 12d 23.85 NY PFL 12d 23.85 NY PFL 12d
13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay

e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code
SIPIN SAPKOTA SIPIN SAPKOTA SIPIN SAPKOTA
28 KOSSUTH PL 28 KOSSUTH PL 28 KOSSUTH PL
BROOKLYN NY 11221 BROOKLYN NY 11221 BROOKLYN NY 11221

15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc.
NY 14-1980956 8829.92 NY 14-1980956 8829.92 NY 14-1980956 8829.92
17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
365.95 8829.92 365.95 8829.92 365.95 8829.92
19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name
255.36 NYC RES 255.36 NYC RES 255.36 NYC RES
Federal Filing Copy NY.State Filing Copy City or Local Filing Copy
Wage and Tax Wage and Tax Wage and Tax
W-2 Statement
Copy B to be filed with employee’s
OMB No. 1545-0008
2020
Federal Income Tax Return.
W-2 Statement 2020
OMB No. 1545-0008
Copy 2 to be filed with employee’s State Income Tax Return.
W-2 Statement OMB No. 1545-0008
2020
Copy 2 to be filed with employee’s City or Local Income Tax Return.
Instructions for Employee in Pub. 571). Deferrals under code G are limited to $19,500. Deferrals R—Employer contributions to your Archer MSA. Report on Form 8853,
under code H are limited to $7,000. Archer MSAs and Long-Term Care Insurance Contracts.
Box 1. Enter this amount on the wages line of your tax return. However, if you were at least age 50 in 2020, your employer may S—Employee salary reduction contributions under a section 408(p)
Box 2. Enter this amount on the federal income tax withheld line of have allowed an additional deferral of up to $6,500 ($3,000 for section SIMPLE plan (not included in box 1)
your tax return. 401(k)(11) and 408(p) SIMPLE plans). This additional deferral amount T—Adoption benefits (not included in box 1). Complete Form 8839, Qualified
Box 5. You may be required to report this amount on Form 8959, is not subject to the overall limit on elective deferrals. For code G, the Adoption Expenses, to compute any taxable and nontaxable amounts.
Additional Medicare Tax. See the Instructions for Forms 1040 and limit on elective deferrals may be higher for the last 3 years before you V—Income from exercise of nonstatutory stock option(s) (included in
1040-SR to determine if you are required to complete Form 8959. reach retirement age. Contact your plan administrator for more boxes 1, 3 (up to social security wage base), and 5). See Pub. 525,
Box 6. This amount includes the 1.45% Medicare Tax withheld on all information. Amounts in excess of the overall elective deferral limit must Taxable and Nontaxable Income, for reporting requirements.
Medicare wages and tips shown in box 5, as well as the 0.9% be included in income. See the Instructions for Forms 1040 and
1040-SR. W—Employer contributions (including amounts the employee elected to
Additional Medicare Tax on any of those Medicare wages and tips contribute using a section 125 (cafeteria) plan) to your health savings
above $200,000. Note: If a year follows code D through H, S, Y, AA, BB, or EE, you account. Report on Form 8889, Health Savings Accounts (HSAs).
Box 8. This amount is not included in box 1, 3, 5, or 7. For made a make-up pension contribution for a prior year(s) when you were Y—Deferrals under a section 409A nonqualified deferred compensation plan
information on how to report tips on your tax return, see the in military service. To figure whether you made excess deferrals,
Instructions for Forms 1040 and 1040-SR. consider these amounts for the year shown, not the current year. If no Z—Income under a nonqualified deferred compensation plan that fails to
year is shown, the contributions are for the current year. satisfy section 409A. This amount is also included in box 1. It is subject
You must file Form 4137, Social Security and Medicare Tax on to an additional 20% tax plus interest. See the Instructions for Forms
Unreported Tip Income, with your income tax return to report at least A—Uncollected social security or RRTA tax on tips. Include this tax on 1040 and 1040-SR.
the allocated tip amount unless you can prove with adequate records Form 1040 or 1040-SR. See the Instructions for Forms 1040 and 1040-SR.
AA—Designated Roth contributions under a section 401(k) plan
that you received a smaller amount. If you have records that show B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or
the actual amount of tips you received, report that amount even if it 1040-SR. See the Instructions for Forms 1040 and 1040-SR. BB—Designated Roth contributions under a section 403(b) plan
is more or less than the allocated tips. Use Form 4137 to figure the C—Taxable cost of group-term life insurance over $50,000 (included in DD—Cost of employer-sponsored health coverage. The amount
social security and Medicare tax owed on tips you didn’t report to reported with code DD is not taxable.
boxes 1, 3 (up to social security wage base), and 5)
your employer. Enter this amount on the wages line of your tax EE—Designated Roth contributions under a governmental section
return. By filing Form 4137, your social security tips will be credited D—Elective deferrals to a section 401(k) cash or deferred arrangement. 457(b) plan. This amount does not apply to contributions under a
to your social security record (used to figure your benefits). Also includes deferrals under a SIMPLE retirement account that is part tax-exempt organization section 457(b) plan.
of a section 401(k) arrangement.
Box 10. This amount includes the total dependent care benefits that FF—Permitted benefits under a qualified small employer health
your employer paid to you or incurred on your behalf (including E—Elective deferrals under a section 403(b) salary reduction agreement reimbursement arrangement
amounts from a section 125 (cafeteria) plan). Any amount over F—Elective deferrals under a section 408(k)(6) salary reduction SEP GG—Income from qualified equity grants under section 83(i)
$5,000 is also included in box 1. Complete Form 2441, Child and G—Elective deferrals and employer contributions (including nonelective HH—Aggregate deferrals under section 83(i) elections as of the close
Dependent Care Expenses, to compute any taxable and nontaxable deferrals) to a section 457(b) deferred compensation plan of the calendar year
amounts. H—Elective deferrals to a section 501(c)(18)(D) tax-exempt Box 13. If the “Retirement plan” box is checked, special limits may apply
Box 11. This amount is (a) reported in box 1 if it is a distribution organization plan. See the Instructions for Forms 1040 and 1040-SR for to the amount of traditional IRA contributions you may deduct. See Pub.
made to you from a nonqualified deferred compensation or how to deduct. 590-A, Contributions to Individual Retirement Arrangements (IRAs).
nongovernmental section 457(b) plan, or (b) included in box 3 and/or J—Nontaxable sick pay (information only, not included in box 1, 3, or 5) Box 14. Employers may use this box to report information such as
5 if it is a prior year deferral under a nonqualified or section 457(b) state disability insurance taxes withheld, union dues, uniform payments,
plan that became taxable for social security and Medicare taxes this K—20% excise tax on excess golden parachute payments. See the
Instructions for Forms 1040 and 1040-SR. health insurance premiums deducted, nontaxable income, educational
year because there is no longer a substantial risk of forfeiture of your assistance payments, or a member of the clergy’s parsonage allowance
right to the deferred amount. This box shouldn’t be used if you had a L—Substantiated employee business expense reimbursements
(nontaxable) and utilities. Railroad employers use this box to report railroad
deferral and a distribution in the same calendar year. If you made a retirement (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax,
deferral and received a distribution in the same calendar year, and M—Uncollected social security or RRTA tax on taxable cost of and Additional Medicare Tax. Include tips reported by the employee to
you are or will be age 62 by the end of the calendar year, your group-term life insurance over $50,000 (former employees only). See the employer in railroad retirement (RRTA) compensation.
employer should file Form SSA-131, Employer Report of Special the Instructions for Forms 1040 and 1040-SR.
Wage Payments, with the Social Security Administration and give Note: Keep Copy C of Form W-2 for at least 3 years after the due date
N—Uncollected Medicare tax on taxable cost of group-term life for filing your income tax return. However, to help protect your social
you a copy. insurance over $50,000 (former employees only). See the Instructions security benefits, keep Copy C until you begin receiving social
Box 12. The following list explains the codes shown in box 12. You for Forms 1040 and 1040-SR. security benefits, just in case there is a question about your work
may need this information to complete your tax return. Elective P—Excludable moving expense reimbursements paid directly to a record and/or earnings in a particular year.
deferrals (codes D, E, F, and S) and designated Roth contributions member of the U.S. Armed Forces (not included in box 1, 3, or 5)
(codes AA, BB, and EE) under all plans are generally limited to a Q—Nontaxable combat pay. See the Instructions for Forms 1040 and
total of $19,500 ($13,500 if you only have SIMPLE plans; $22,500 1040-SR for details on reporting this amount.
for section 403(b) plans if you qualify for the 15-year rule explained
Department of the Treasury - Internal Revenue Service

NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDERAL, STATE AND LOCAL/CITY INCOME TAX RETURNS.

This information is being furnished to the Internal

Revenue Service. If you are required to file a tax Notice to Employee
return, a negligence penalty or other sanction may
be imposed on you if this income is taxable and Do you have to file? Refer to the Instructions for Forms W-2. Be sure to get your copies of Form W-2c from your
you fail to report it.
1040 and 1040-SR to determine if you are required to file employer for all corrections made so you may file them
IMPORTANT NOTE: a tax return. Even if you don’t have to file a tax return, you with your tax return. If your name and SSN are correct but
In order to insure efficient processing,
may be eligible for a refund if box 2 shows an amount or if aren’t the same as shown on your social security card, you
attach this W-2 to your tax return like this
you are eligible for any credit. should ask for a new card that displays your correct name
Earned income credit (EIC). You may be able to take the at any SSA office or by calling 800-772-1213. You may also
(following agency instructions):
EIC for 2020 if your adjusted gross income (AGI) is less visit the SSA website at www.SSA.gov.
than a certain amount. The amount of the credit is based Cost of employer-sponsored health coverage (if such
on income and family size. Workers without children could cost is provided by the employer). The reporting in box
qualify for a smaller credit. You and any qualifying children 12, using code DD, of the cost of employer-sponsored
must have valid social security numbers (SSNs). You can’t health coverage is for your information only. The amount
take the EIC if your investment income is more than the reported with code DD is not taxable.
TAX RETURN specified amount for 2020 or if income is earned for Credit for excess taxes. If you had more than one
services provided while you were an inmate at a penal employer in 2020 and more than $8,537.40 in social
institution. For 2020 income limits and more information, security and/or Tier 1 railroad retirement (RRTA) taxes
visit www.irs.gov/EITC. See also Pub. 596, Earned Income were withheld, you may be able to claim a credit for the
THIS Credit. Any EIC that is more than your tax liability is excess against your federal income tax. If you had more
OTHER refunded to you, but only if you file a tax return.
FORM than one railroad employer and more than $5,012.70 in
W-2’S
W-2 Clergy and religious workers. If you aren’t subject to Tier 2 RRTA tax was withheld, you may also be able to
social security and Medicare taxes, see Pub. 517, Social claim a credit. See the Instructions for Forms 1040 and
Security and Other Information for Members of the Clergy 1040-SR and Pub. 505, Tax Withholding and Estimated
and Religious Workers. Tax.
Corrections. If your name, SSN, or address is incorrect,
correct Copies B, C, and 2 and ask your employer to correct
your employment record. Be sure to ask the employer to file
Form W-2c, Corrected Wage and Tax Statement, with the
Social Security Administration (SSA) to correct any name,
SSN, or money amount error reported to the SSA on Form

Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service