1/20/2020

Federal Box 1 Soc. Sec. Box 3 & 7 Medicare Box 5

To the right is an explanation of the contents of the wage boxes on your W-2. Gross Wages 12613.48 12613.48 12613.48
Please note that the Gross amount shown may include adjustments. Txbl Benefits
Group Term Life
Adoption
Deferred Comp
Section 125
Other Pretax/Wage Limit (12613.48) (12613.48)
W-2 Wages 12613.48

000051534701 2019 12613.48 1283.18

84-0155150 048-33-0958

Broadmoor Hotel Inc

1 Lake Avenue
Colorado Springs CO 80906

George Vatamanu
NR24 Mihai Razea
Husi 735100
ROU

CO 00801986 12613.48 484.00

000051534701 2019 12613.48 1283.18

84-0155150 048-33-0958

Broadmoor Hotel Inc

1 Lake Avenue
Colorado Springs CO 80906

George Vatamanu
NR24 Mihai Razea
Husi 735100
ROU

CO 00801986 12613.48 484.00

2019

000051534701 2019 12613.48 1283.18

84-0155150 048-33-0958

Broadmoor Hotel Inc

1 Lake Avenue
Colorado Springs CO 80906

George Vatamanu
NR24 Mihai Razea
Husi 735100
ROU

CO 00801986 12613.48 484.00

2019

000051534701 2019 12613.48 1283.18

84-0155150 048-33-0958

Broadmoor Hotel Inc

1 Lake Avenue
Colorado Springs CO 80906

George Vatamanu
NR24 Mihai Razea
Husi 735100
ROU

CO 00801986 12613.48 484.00

2019