Form

2014

W-2 Wage and Tax Statement

1A L99

c Employers name, address, and ZIP code

UNIVERSITY OF TEXAS, TYLER

3900 UNIVERSITY BLVD.
TYLER TX 75799

2 Federal income tax withheld

34480.85
8 Allocated tips

3 Social security wages

5 Medicare wages and tips

10 Dependent care benefits

11 Nonqualified plans

4380.57
4 Social security tax withheld

2288.83
6 Medicare tax withheld

36916.66
13

RAMSEY M WILLIAMS
5614 BERKELEY DR
TYLER TX 75707-6194
Employers state ID number

1 Wages, tips, other compensation

36916.66

e Employees name, address, and ZIP code

15 State

7 Social security tips

Statutory
employee

Retirement
plan

Third-party
sick pay

C
o
d
e

12c

b Employer identification number (EIN)

C
o
d
e

12d

a Employees social security number

C
o
d
e

455-97-2038

Copy B-To Be Filed With Employees FEDERAL Tax Return

17 State income tax

6053.76

DD

12b

14 Other

75-1396988

16 State wages, tips, etc.

535.29
12a See instructions for box 12
C
o
d
e

18 Local wages, tips, etc.

19 Local income tax

20 Locality name

Dept. of the Treasury - IRS

This information is being furnished to the Internal Revenue Service.

Visit the IRS website at www.irs.gov/efile.

OMB No. 1545-0008

This information is being furnished to the Internal Revenue Service. If you are required to file a tax return, a
negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.

2014

W-2 Wage and Tax Statement

c Employers name, address, and ZIP code

UNIVERSITY OF TEXAS, TYLER

3900 UNIVERSITY BLVD.
TYLER TX 75799

7 Social security tips

1 Wages, tips, other compensation

8 Allocated tips

3 Social security wages

5 Medicare wages and tips

10 Dependent care benefits

11 Nonqualified plans

13

Statutory
employee

Retirement
plan

Third-party
sick pay

12c
C
o
d
e

12d

a Employees social security number

17 State income tax

2014

C
o
d
e

18 Local wages, tips, etc.

19 Local income tax

Visit the IRS website at www.irs.gov/efile.

7 Social security tips

1 Wages, tips, other compensation

3 Social security wages

UNIVERSITY OF TEXAS, TYLER

3900 UNIVERSITY BLVD.
TYLER TX 75799

5 Medicare wages and tips

10 Dependent care benefits

11 Nonqualified plans

13

Statutory
employee

Retirement
plan

Third-party
sick pay

12c
C
o
d
e

12d

a Employees social security number

C
o
d
e

18 Local wages, tips, etc.

Copy 2-To Be Filed With Employees State, City, or Local Income Tax Return

2014

c Employers name, address, and ZIP code

8403000753

19 Local income tax

Dept. of the Treasury - IRS

OMB No. 1545-0008

7 Social security tips

20 Locality name

1 Wages, tips, other compensation

2 Federal income tax withheld

4380.57

34480.85
8 Allocated tips

3 Social security wages

5 Medicare wages and tips

10 Dependent care benefits

11 Nonqualified plans

4 Social security tax withheld

2288.83

36916.66

UNIVERSITY OF TEXAS, TYLER

3900 UNIVERSITY BLVD.
TYLER TX 75799

6 Medicare tax withheld

535.29

36916.66
Statutory
employee

Retirement
plan

e Employees name, address, and ZIP code

13

RAMSEY M WILLIAMS
5614 BERKELEY DR
TYLER TX 75707-6194

75-1396988

Employers state ID number

6053.76

C
o
d
e

b Employer identification number (EIN)

17 State income tax

DD

12b

14 Other

75-1396988

16 State wages, tips, etc.

535.29
12a
C
o
d
e

455-97-2038

15 State

2288.83
6 Medicare tax withheld

36916.66

RAMSEY M WILLIAMS
5614 BERKELEY DR
TYLER TX 75707-6194

W-2 Wage and Tax Statement

4380.57
4 Social security tax withheld

36916.66

e Employees name, address, and ZIP code

Form

2 Federal income tax withheld

34480.85
8 Allocated tips

Employers state ID number

20 Locality name

Dept. of the Treasury - IRS

OMB No. 1545-0008

c Employers name, address, and ZIP code

15 State

6053.76

C
o
d
e

75-1396988

16 State wages, tips, etc.

DD

12b

14 Other

b Employer identification number (EIN)

Copy C-For EMPLOYEES RECORDS (See Notice to Employee on the back of Copy B.)

W-2 Wage and Tax Statement

535.29
12a See instructions for box 12
C
o
d
e

455-97-2038

Form

2288.83
6 Medicare tax withheld

36916.66

RAMSEY M WILLIAMS
5614 BERKELEY DR
TYLER TX 75707-6194
Employers state ID number

4380.57
4 Social security tax withheld

36916.66

e Employees name, address, and ZIP code

15 State

2 Federal income tax withheld

34480.85

Third-party
sick pay

14 Other

b Employer identification number (EIN)

17 State income tax

Copy 2-To Be Filed With Employees State, City, or Local Income Tax Return

DD

6053.76

12b
C
o
d
e

12c
C
o
d
e

12d

a Employees social security number

C
o
d
e

455-97-2038
16 State wages, tips, etc.

12a
C
o
d
e

18 Local wages, tips, etc.

OMB No. 1545-0008

19 Local income tax

20 Locality name

Dept. of the Treasury - IRS

FORM # LW28700

Form