OMB No.

1545-0008
Form W-2 Wage and Tax Statement 2022 7 Social Security Tips 1 Wages, tips, other comp. 2 Federal income tax withheld
c Employer's name, address, and ZIP code d Control number 466.48 .00
8 Allocated tips 3 Social security wages 4 Social security tax withheld
ADMINISTRATIVE ONESOURCE, LLC 466.48 28.92
2200 VETERANS MEMORIAL STE 213 9 Verification code 5 Medicare wages and tips 6 Medicare tax withheld

KENNER LA 70062 466.48 6.76

10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12

e Employee's name, address, and ZIP code

13 Statutory Retirement Third-Party 14 Other 12b -12d Codes
BAILEY WHITLEY Employee Plan Sick Pay
380 STONEBRIDGE LOOP
b Employer ID number
SLIDELL, LA 70458
20-0714959
a Employee's social security number
661-07-5216
15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
LA 2904506001 466.48 8.63

Copy B To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Dept. of the Treasury -- IRS
This information is being furnished to IRS. If you are required to file a tax return, a negligence penalty/other sanction may be imposed on you if this income is taxable & you fail to report it.
Form W-2 Wage and Tax Statement 7 Social Security Tips 1 Wages, tips, other comp. 2 Federal income tax withheld
c Employer's name, address, and ZIP code d Control number 466.48 .00
ADMINISTRATIVE ONESOURCE, LLC 8 Allocated tips 3 Social security wages 4 Social security tax withheld
466.48 28.92
KENNER LA 70062 9 Verification code 5 Medicare wages and tips 6 Medicare tax withheld
466.48 6.76
e Employee's name, address, and ZIP code 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12

BAILEY WHITLEY
13 Statutory Retirement Third-Party 14 Other 12b -12d Codes
380 STONEBRIDGE LOOP Employee Plan Sick Pay

SLIDELL, LA 70458
b Employer ID number
20-0714959
a Employee's social security number
661-07-5216
15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
LA 2904506001 466.48 8.63

Copy C For EMPLOYEE'S RECORDS. (See Notice to Employee).

OMB No. 1545-0008 Dept. of the Treasury -- IRS
Form W-2 Wage and Tax Statement 7 Social security tips 1 Wages, tips, other comp. 2 Federal income tax withheld

c Employer's name, address, and ZIP code d Control number 466.48 .00
ADMINISTRATIVE ONESOURCE, LLC 8 Allocated tips 3 Social security wages 4 Social security tax withheld
2200 VETERANS MEMORIAL STE 213 466.48 28.92
KENNER LA 70062 9 Verification code 5 Medicare wages and tips 6 Medicare tax withheld
466.48 6.76
10 Dependent care benefits 11 Non qualified plans 12a Code See inst. for box 12
e Employee's name, address, and ZIP code
13 Statutory Retirement Third-Party 14 Other 12b -12d Codes
BAILEY WHITLEY Employee Plan Sick-Pay
380 STONEBRIDGE LOOP
SLIDELL, LA 70458 b Employer ID number
20-0714959
a Employee's social security number
661-07-5216
15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
LA 2904506001 466.48 8.63

Copy 2 to be filed with Employee's State, City or Local Income Tax Return Dept. of the Treasury -- IRS
OMB No. 1545-0008
7 Social security tips 1 Wages, tips, other comp. 2 Federal income tax withheld
Form W-2 Wage and Tax Statement 2022
c Employer's name, address, and ZIP code d Control number 466.48 .00
8 Allocated tips 3 Social security wages 4 Social security tax withheld
ADMINISTRATIVE ONESOURCE, LLC
466.48 28.92
2200 VETERANS MEMORIAL STE 213 9 Verification code 5 Medicare wages and tips 6 Medicare tax withheld
KENNER LA 70062
466.48 6.76
10 Dependent care benefits 11 Non qualified plans 12a Code See inst. for box 12

e Employee's name, address and ZIP code 13 Statutory Retirement Third-Party 14 Other 12b -12d Codes
Employee Plan Sick-Pay
BAILEY WHITLEY
380 STONEBRIDGE LOOP b Employer ID number
SLIDELL, LA 70458 20-0714959
a Employee's social security number
661-07-5216
15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
LA 2904506001 466.48 8.63

Copy 2 to be filed with Employee's State, City or Local Income Tax Return