1 Wages, tips, other compensation 2 Federal Income tax withheld 1 Wages, tips, other compensation 2 Federal Income tax

es, tips, other compensation 2 Federal Income tax withheld

47284.41 3974.33 47284.41 3974.33
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
49563.78 3072.95 49563.78 3072.95
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
49563.78 718.67 49563.78 718.67
a Employee's SSA number Employer use only a Employee's SSA number Employer use only

XXX-XX-6777 XXX-XX-6777
b Employer's FED ID number d Control number b Employer's FED ID number d Control number
59-6000589 00045415 59-6000589 00045415
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code

Duval County Public Schools Duval County Public Schools

1701 Prudential Drive 1701 Prudential Drive
Jacksonville FL 32207 Jacksonville FL 32207

7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a See instructions for box 12
DD 8200.09 DD 8200.09
13 Statutory Retirement Third-Party 12b 13 Statutory Retirement Third-Party 12b
Employee plan Sick pay Employee plan Sick pay
E 850.00 E 850.00
14 Other FRS 414(h) EE Contribu 1429.37 12c 14 Other FRS 414(h) EE Contribu 12c
1429.37
12d 12d

e Employee's first name and initial Last name Suff. e Employee's first name and initial Last name Suff.
MARIE D CAMPBELL MARIE D CAMPBELL
9906 FAWN BROOK DR 9906 FAWN BROOK DR
JACKSONVILLE FL 32256 JACKSONVILLE FL 32256

f Employee's address and ZIP code f Employee's address and ZIP code
15 State Employer's state ID 18 Local wages, tips, etc 15 State Employer's state ID 18 Local wages, tips, etc

16 State wages, tips, etc. 19 Local income tax 16 State wages, tips, etc. 19 Local income tax

17 State income tax 20 Locality name 17 State income tax 20 Locality name

Form OMB. No. 1545-0008 Dept. of the Treasury - Internal Revenue Form OMB. No. 1545-0008 Dept. of the Treasury - Internal Revenue
W-2 Wage and Tax
Statement 2020
Service. This information is being furnished to
the IRS. If you are required to file a tax return,
a negligence penalty or other sanction may be
W-2 Wage and Tax
Statement 2020 Service
imposed on you if this income is taxable and
Copy C for Employee's records you fail to report it. Copy 2 To Be Filed With Employee's STATE Income Tax Return

1 Wages, tips, other compensation 2 Federal Income tax withheld 1 Wages, tips, other compensation 2 Federal Income tax withheld
47284.41 3974.33 47284.41 3974.33
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
49563.78 3072.95 49563.78 3072.95
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
49563.78 718.67 49563.78 718.67
a Employee's SSA number Employer use only a Employee's SSA number Employer use only

XXX-XX-6777 XXX-XX-6777
b Employer's FED ID number d Control number b Employer's FED ID number d Control number
59-6000589 00045415 59-6000589 00045415
c Employer's name, address, and ZIP code c Employer's name, address, and ZIP code

Duval County Public Schools Duval County Public Schools

1701 Prudential Drive 1701 Prudential Drive
Jacksonville FL 32207 Jacksonville FL 32207

7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a See instructions for box 12
DD 8200.09 DD 8200.09
13 Statutory Retirement Third-Party 12b 13 Statutory Retirement Third-Party 12b
Employee plan Sick pay E 850.00 Employee plan Sick pay E 850.00
14 Other FRS 414(h) EE Contribu 1429.37 12c 14 Other FRS 414(h) EE Contribu 1429.37 12c
12d 12d

e Employee's first name and initial Last name Suff. e Employee's first name and initial Last name Suff.
MARIE D CAMPBELL MARIE D CAMPBELL
9906 FAWN BROOK DR 9906 FAWN BROOK DR
JACKSONVILLE FL 32256 JACKSONVILLE FL 32256

f Employee's address and ZIP code f Employee's address and ZIP code
15 State Employer's state ID 18 Local wages, tips, etc 15 State Employer's state ID 18 Local wages, tips, etc

16 State wages, tips, etc. 19 Local income tax 16 State wages, tips, etc. 19 Local income tax

17 State income tax 20 Locality name 17 State income tax 20 Locality name

Form OMB. No. 1545-0008 Dept. of the Treasury - Internal Revenue Form OMB. No. 1545-0008
Dept. of the Treasury - Internal Revenue
W-2 Wage and Tax
Statement 2020 Service
W-2 Wage and Tax
Statement 2020 Service

Copy B To Be Filed With Employee's FEDERAL Tax Return Copy 2 To Be Filed With Employee's CITY or LOCAL Income Tax Return