OMB No. 1545-0008 REISSUED STATEMENT OMB No.
1545-0008 REISSUED STATEMENT
d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld
35965.37 2556.33 35965.37 2556.33
b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld
52-0812977 35965.37 2229.85 52-0812977 35965.37 2229.85
a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld
220-95-1533 35965.37 521.50 220-95-1533 35965.37 521.50
c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code
BARRETT BUSINESS SERVICES INC BARRETT BUSINESS SERVICES INC
SUITE 150 SUITE 150
1760 CREEKSIDE OAKS DR 1760 CREEKSIDE OAKS DR
SACRAMENTO CA 95833 SACRAMENTO CA 95833
7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12 10 Dependent care benefits 11 Nonqualified plans 12a See instructions for box 12
Code
Code
12b 12c 12d 12b 12c 12d
Code
Code
Code
Code
Code
Code
13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other
employee plan sick pay CASDI 395.60 employee plan sick pay CASDI 395.60
e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code
SADIKI LUHANDE SADIKI LUHANDE
2446 WYDA WAY #3 2446 WYDA WAY #3
SACRAMENTO CA 95825 SACRAMENTO CA 95825
2022 2022
15 State Employer’s state I.D. no. 16 State wages, tips, etc. 15 State Employer’s state I.D. no. 16 State wages, tips, etc.
CA 114-2848-9 35965.37 CA 114-2848-9 35965.37
W-2 W-2
Form
Form
Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc. Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc.
Copy C - For EMPLOYEE’S 661.82 661.82
RECORDS (See Notice to Copy B - To Be Filed With
Employee on back of Copy B.) Employee’s FEDERAL Tax
This information is being furnished to the Return.
Internal Revenue Service. If you are required 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name
to file a tax return, a negligence penalty or This information is being furnished to the
other sanction may be imposed on you if this Internal Revenue Service.
income is taxable and you fail to report it.
Department of the Treasury – Department of the Treasury –
Internal Revenue Service Internal Revenue Service
OMB No. 1545-0008 REISSUED STATEMENT OMB No. 1545-0008 REISSUED STATEMENT
d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld
35965.37 2556.33 35965.37 2556.33
b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld
52-0812977 35965.37 2229.85 52-0812977 35965.37 2229.85
a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld
220-95-1533 35965.37 521.50 220-95-1533 35965.37 521.50
c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code
BARRETT BUSINESS SERVICES INC BARRETT BUSINESS SERVICES INC
SUITE 150 SUITE 150
1760 CREEKSIDE OAKS DR 1760 CREEKSIDE OAKS DR
SACRAMENTO CA 95833 SACRAMENTO CA 95833
7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9
10 Dependent care benefits 11 Nonqualified plans 12a 10 Dependent care benefits 11 Nonqualified plans 12a
Code
Code
12b 12c 12d 12b 12c 12d
Code
Code
Code
Code
Code
Code
13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other
employee plan sick pay CASDI 395.60 employee plan sick pay CASDI 395.60
e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code
SADIKI LUHANDE SADIKI LUHANDE
2446 WYDA WAY #3 2446 WYDA WAY #3
SACRAMENTO CA 95825 SACRAMENTO CA 95825
2022 15 State Employer’s state I.D. no.
CA 114-2848-9
16 State wages, tips, etc.
35965.37 2022 15 State Employer’s state I.D. no.
CA 114-2848-9
16 State wages, tips, etc.
35965.37
W-2 W-2
Form
Form
17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
Wage and Tax Statement Wage and Tax Statement
661.82 661.82
Copy 2 - To Be Filed With Copy 2 - To Be Filed With
Employee’s State, City, or Employee’s State, City, or
Local Income Tax Return. Local Income Tax Return.
19 Local income tax 20 Locality name 19 Local income tax 20 Locality name
Department of the Treasury – Department of the Treasury –
Internal Revenue Service Internal Revenue Service
