a Employee's social security number
000-00-0000
b Employer identification number (EIN)
1 Wages, tips, other compensation
0.00
2 Federal income tax withheld
0.00
c Employer's name, address, and ZIP code
3 Social security wages
0.00
4 Social security tax withheld
0.00
5 Medicare wages and tips
0.00
6 Medicare tax withheld
0.00
10 Dependent care benefits
e Employee's first name and initial Last name Suff.
f Employee's address and ZIP code
15 State Employer's state ID number
16 State wages, tips, etc.
18 Local wages, tips, etc.