3/26/2021 2020 - PMA

2020 - PMA
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W-2 Wage and Tax

Statement 2020 a Employee's social security number 1. Wages, tips, other comp.
667-22-9150 10036.80
2. Federal income tax withheld 3. Social security wages
100
c Employer's name, address, and ZIP code 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
622.27 10036.80 1
Pezold Management Associates, In
600 Brookstone Centre Parkway 7 Social security tips 8 Allocated tips 9

Columbus GA 31904 10 Dependent care benefits 11 Nonqualified plans 12a

e/f Employee's name, address, and ZIP code 13 Statutory Retirement plan Third-partysick 14 Other 12b
employee pay

LANIYA ROSS
107 BELK STREET b Employer identification number EIN 12c
58-1179998
LAGRANGE GA 30241 d Control number 12d

15 State Employer's state I.D. no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
GA 4940648-QU 10036.80

Copy B To Be Filed with Employee's Federal Income Tax Return

W-2 Wage and Tax

Statement 2020 a Employee's social security number 1. Wages, tips, other comp.
667-22-9150 10036.80
2. Federal income tax withheld 3. Social security wages
100
c Employer's name, address, and ZIP code 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
622.27 10036.80 1
Pezold Management Associates, In
600 Brookstone Centre Parkway 7 Social security tips 8 Allocated tips 9

Columbus GA 31904 10 Dependent care benefits 11 Nonqualified plans 12a

e/f Employee's name, address, and ZIP code 13 Statutory Retirement plan Third-partysick 14 Other 12b
employee pay

LANIYA ROSS
107 BELK STREET b Employer identification number EIN 12c
58-1179998
LAGRANGE GA 30241 d Control number 12d

15 State Employer's state I.D. no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
GA 4940648-QU 10036.80

Copy C For Employee Records

W-2 Wage and Tax

Statement 2020 a Employee's social security number 1. Wages, tips, other comp.
667-22-9150 10036.80
2. Federal income tax withheld 3. Social security wages
100
c Employer's name, address, and ZIP code 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
622.27 10036.80 1
Pezold Management Associates, In
600 Brookstone Centre Parkway 7 Social security tips 8 Allocated tips 9

Columbus GA 31904 10 Dependent care benefits 11 Nonqualified plans 12a

e/f Employee's name, address, and ZIP code 13 Statutory Retirement plan Third-partysick 14 Other 12b
employee pay

LANIYA ROSS
107 BELK STREET b Employer identification number EIN 12c
58-1179998
LAGRANGE GA 30241 d Control number 12d

15 State Employer's state I.D. no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
GA 4940648-QU 10036.80

Copy 1 For State, City, or Local Tax Department

W-2 Wage and Tax

Statement 2020 a Employee's social security number 1. Wages, tips, other comp.
667-22-9150 10036.80
2. Federal income tax withheld 3. Social security wages
100
c Employer's name, address, and ZIP code 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
622.27 10036.80 1
Pezold Management Associates, In
600 Brookstone Centre Parkway 7 Social security tips 8 Allocated tips 9

Columbus GA 31904 10 Dependent care benefits 11 Nonqualified plans 12a

e/f Employee's name, address, and ZIP code 13 Statutory Retirement plan Third-partysick 14 Other 12b
employee pay

LANIYA ROSS
107 BELK STREET b Employer identification number EIN 12c
58-1179998
LAGRANGE GA 30241 d Control number 12d

15 State Employer's state I.D. no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
GA 4940648-QU 10036.80

Copy 2 To Be Filed With Employee's State, City or Local Income Tax Return

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