Page 1 of 2
vJ - 7- Pkitaten,er
•••••••• •In•
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
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 Loc