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Wage and Tax Statement: Statutory Employee Retirement Plan Third-Party Sick Pay
Wage and Tax Statement: Statutory Employee Retirement Plan Third-Party Sick Pay
e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a
C
o
d D $2,233.02
Casey Smith e
13 Statutory Retirement Third-party 12b
4321 Fake Dr employee plan sick pay C
Augusta, GA 30909 ✘
o
d
e
DD $2,687.04
14 Other 12c
C
o
d
e
12d
C
o
d
e