

Form COPY C
W-2 For EMPLOYEE’S RECORDS
Wage and Tax
Statement
(See Notice to Employee on the back of
Employee Earnings Statement.) OMB No. 1545-0008 2024 EMPLOYEE EARNINGS STATEMENT
a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld This Earnings Statement provides you with more information pertaining to your W-2
o007 11023.37 and tax status. Also see the reverse side for IRS instructions.
b Employer’s EIN 3 Social security wages 4 Social security tax withheld
26-0748106 11023.37 683.45 1. W-4 information reflects data submitted to employer on Form W-4
d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld
130-25-3875 11023.37 159.86 Soc. Sec. No.: 130-25-3875 Exemptions
c Employer’s name, address and ZIP code Marital Status: Married
DINI WIGS LLC Federal: N/A
18 THIELLS MOUNT IVY ROAD State: 1
POMONA NY 10970 Local: N/A

13 Statutory employee Retirement plan Third-party sick pay 2. Taxable W-2 Wages

e Employee’s name, address and ZIP code

NEYDA F OJEDA Wages, Tips Soc. Sec. Medicare State
20 W HICKORY ST Other Comp. Wages Wages Wages
SPRING VALLEY NY 10977 Box 1 Box 3 Box 5 Box 16
Gross Pay 11023.37 11023.37 11023.37 11023.37
7 Social security tips 8 Allocated tips 9 Reported on W2 11023.37 11023.37 11023.37 11023.37

10 Dependent care benefits 11 Nonqualified plans

12 See instructions for box 12 14 Other

UI/DB 53.47

15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax
NY 260748106 11023.37 359.63

18 Local wages, tips, etc. 19 Local income tax 20 Locality name

This information is being furnished to the Internal Revenue Dept. of the Treasury - IRS
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.

 
Form Federal Filing Copy — COPY B Form State or Local Copy — COPY 2
W-2 To Be Filed With Employee’s
W-2 To Be Filed With Employee’s State,
Wage and Tax Wage and Tax
Statement FEDERAL Tax Return. OMB No. 1545-0008 Statement City, or Local Income Tax Return OMB No. 1545-0008
a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld a Control number 1 Wages, tips, other comp. 2 Federal income tax withheld
o007 11023.37 o007 11023.37
b Employer’s EIN 3 Social security wages 4 Social security tax withheld b Employer’s EIN 3 Social security wages 4 Social security tax withheld
26-0748106 11023.37 683.45 26-0748106 11023.37 683.45
d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld d Employee’s SSN 5 Medicare wages and tips 6 Medicare tax withheld
130-25-3875 11023.37 159.86 130-25-3875 11023.37 159.86
c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code
DINI WIGS LLC DINI WIGS LLC
18 THIELLS MOUNT IVY ROAD 18 THIELLS MOUNT IVY ROAD
POMONA NY 10970 POMONA NY 10970

13 Statutory employee Retirement plan Third-party sick pay 13 Statutory employee Retirement plan Third-party sick pay

e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code
NEYDA F OJEDA NEYDA F OJEDA
20 W HICKORY ST 20 W HICKORY ST
SPRING VALLEY NY 10977 SPRING VALLEY NY 10977

7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9

10 Dependent care benefits 11 Nonqualified plans 10 Dependent care benefits 11 Nonqualified plans

12 See instructions for box 12 14 Other 12 See instructions for box 12 14 Other
UI/DB 53.47 UI/DB 53.47

15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax 15 State Employer’s state ID no. 16 State wages, tips, etc. 17 State income tax
NY 260748106 11023.37 359.63 NY 260748106 11023.37 359.63

18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

This information is being furnished to the Internal Dept. of the Treasury - IRS Dept. of the Treasury - IRS
Revenue Service.

DINI WIGS LLC

18 THIELLS MOUNT IVY ROAD
POMONA NY 10970
4 BW2CSB2

o007-100

NEYDA F OJEDA
20 W HICKORY ST
NTF 2586396

SPRING VALLEY NY 10977

Notice to Employee
Do you have to file? Refer to the Form 1040 instructions to under code G are limited to $23,000. Deferrals under code H are limited
determine if you are required to file a tax return. Even if you to $7,000.
don’t have to file a tax return, you may be eligible for a refund if However, if you were at least age 50 in 2024, your employer may have
box 2 shows an amount or if you are eligible for any credit. allowed an additional deferral of up to $7,500 ($3,500 for section
401(k)(11) and 408(p) SIMPLE plans). This additional deferral amount is
Earned income tax credit (EITC). You may be able to take the not subject to the overall limit on elective deferrals. For code G, the limit
EITC for 2024 if your adjusted gross income (AGI) is less than a on elective deferrals may be higher for the last 3 years before you reach
certain amount. The amount of the credit is based on income retirement age. Contact your plan administrator for more information.
and family size. Workers without children could qualify for a Amounts in excess of the overall elective deferral limit must be included
smaller credit. You and any qualifying children must have valid in income. See the Form 1040 instructions.
social security numbers (SSNs). You can’t take the EITC if your Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made
investment income is more than the specified amount for 2024 a make-up pension contribution for a prior year(s) when you were in
or if income is earned for services provided while you were an military service. To figure whether you made excess deferrals, consider
inmate at a penal institution. For 2024 income limits and more these amounts for the year shown, not the current year. If no year is
information, visit [Link]/EITC. See also Pub. 596. Any shown, the contributions are for the current year.
EITC that is more than your tax liability is refunded to you, A—Uncollected social security or RRTA tax on tips. Include this tax on
but only if you file a tax return. Form 1040 or 1040-SR. See the Form 1040 instructions.
Employee’s social security number (SSN). For your B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or
protection, this form may show only the last four digits of your 1040-SR. See the Form 1040 instructions.
SSN. However, your employer has reported your complete SSN C—Taxable cost of group-term life insurance over $50,000 (included in
to the IRS and the Social Security Administration (SSA). boxes 1, 3 (up to the social security wage base), and 5)
Clergy and religious workers. If you aren’t subject to social D—Elective deferrals to a section 401(k) cash or deferred arrangement.
Also includes deferrals under a SIMPLE retirement account that is part
security and Medicare taxes, see Pub. 517.
of a section 401(k) arrangement.
Corrections. If your name, SSN, or address is incorrect, correct E—Elective deferrals under a section 403(b) salary reduction agreement
Copies B, C, and 2 and ask your employer to correct your
employment record. Be sure to ask the employer to file Form F—Elective deferrals under a section 408(k)(6) salary reduction SEP
W-2c, Corrected Wage and Tax Statement, with the SSA to G—Elective deferrals and employer contributions (including nonelective
correct any name, SSN, or money amount error reported to the deferrals) to a section 457(b) deferred compensation plan
SSA on Form W-2. Be sure to get your copies of Form W-2c H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization
from your employer for all corrections made so you may file plan. See the Form 1040 instructions for how to deduct.
them with your tax return. If your name and SSN are correct but J—Nontaxable sick pay (information only, not included in box 1, 3, or 5)
aren’t the same as shown on your social security card, you K—20% excise tax on excess golden parachute payments. See the
should ask for a new card that displays your correct name at Form 1040 instructions.
any SSA office or by calling 800-772-1213. You may also visit L—Substantiated employee business expense reimbursements
the SSA website at [Link]. (nontaxable)
Cost of employer-sponsored health coverage (if such cost is M—Uncollected social security or RRTA tax on taxable cost of group-
provided by the employer). The reporting in box 12, using term life insurance over $50,000 (former employees only). See the Form
code DD, of the cost of employer-sponsored health coverage is 1040 instructions.
for your information only. The amount reported with code DD N—Uncollected Medicare tax on taxable cost of group-term life
is not taxable. insurance over $50,000 (former employees only). See the Form 1040
Credit for excess taxes. If you had more than one employer in instructions.
2024 and more than $10,453.20 in social security and/or Tier 1 P—Excludable moving expense reimbursements paid directly to a
railroad retirement (RRTA) taxes were withheld, you may be able member of the U.S. Armed Forces (not included in box 1, 3, or 5)
to claim a credit for the excess against your federal income tax. Q—Nontaxable combat pay. See the Form 1040 instructions for details
See the Form 1040 instructions. If you had more than one on reporting this amount.
railroad employer and more than $6,129.90 in Tier 2 RRTA tax R—Employer contributions to your Archer MSA. Report on Form 8853.
was withheld, you may be able to claim a refund on Form 843. S—Employee salary reduction contributions under a section 408(p)
See the Instructions for Form 843. SIMPLE plan
T—Adoption benefits (not included in box 1). Complete Form 8839 to
Instructions for Employee figure any taxable and nontaxable amounts.
Box 1. Enter this amount on the wages line of your tax return. V—Income from exercise of nonstatutory stock option(s) (included in
Box 2. Enter this amount on the federal income tax withheld line of your boxes 1, 3 (up to the social security wage base), and 5). See Pub. 525
tax return. for reporting requirements.
Box 5. You may be required to report this amount on Form 8959. See W—Employer contributions (including amounts the employee elected to
the Form 1040 instructions to determine if you are required to complete contribute using a section 125 (cafeteria) plan) to your health savings
Form 8959. account. Report on Form 8889.
Box 6. This amount includes the 1.45% Medicare tax withheld on all Y—Deferrals under a section 409A nonqualified deferred compensation
Medicare wages and tips shown in box 5, as well as the 0.9% Additional plan
Medicare Tax on any of those Medicare wages and tips above Z—Income under a nonqualified deferred compensation plan that fails
$200,000. to satisfy section 409A. This amount is also included in box 1. It is
Box 8. This amount is not included in box 1, 3, 5, or 7. For information subject to an additional 20% tax plus interest. See the Form 1040
on how to report tips on your tax return, see the Form 1040 instructions. instructions.
You must file Form 4137 with your income tax return to report at least AA—Designated Roth contributions under a section 401(k) plan
the allocated tip amount unless you can prove with adequate records BB—Designated Roth contributions under a section 403(b) plan
that you received a smaller amount. If you have records that show the DD—Cost of employer-sponsored health coverage. The amount
actual amount of tips you received, report that amount even if it is more reported with code DD is not taxable.
or less than the allocated tips. Use Form 4137 to figure the social
security and Medicare tax owed on tips you didn’t report to your EE—Designated Roth contributions under a governmental section
employer. Enter this amount on the wages line of your tax return. By 457(b) plan. This amount does not apply to contributions under a tax-
filing Form 4137, your social security tips will be credited to your social exempt organization section 457(b) plan.
security record (used to figure your benefits). FF—Permitted benefits under a qualified small employer health
Box 10. This amount includes the total dependent care benefits that reimbursement arrangement
your employer paid to you or incurred on your behalf (including amounts GG—Income from qualified equity grants under section 83(i)
from a section 125 (cafeteria) plan). Any amount over your employer’s HH—Aggregate deferrals under section 83(i) elections as of the close of
plan limit is also included in box 1. See Form 2441. the calendar year
Box 11. This amount is (a) reported in box 1 if it is a distribution made to II—Medicaid waiver payments excluded from gross income under
you from a nonqualified deferred compensation or nongovernmental Notice 2014-7.
section 457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior
year deferral under a nonqualified or section 457(b) plan that became Box 13. If the “Retirement plan” box is checked, special limits may
taxable for social security and Medicare taxes this year because there is apply to the amount of traditional IRA contributions you may deduct.
no longer a substantial risk of forfeiture of your right to the deferred See Pub. 590-A.
amount. This box shouldn’t be used if you had a deferral and a Box 14. Employers may use this box to report information such as state
distribution in the same calendar year. If you made a deferral and disability insurance taxes withheld, union dues, uniform payments,
received a distribution in the same calendar year, and you are or will be health insurance premiums deducted, nontaxable income, educational
age 62 by the end of the calendar year, your employer should file Form assistance payments, or a member of the clergy’s parsonage allowance
SSA-131, Employer Report of Special Wage Payments, with the Social and utilities. Railroad employers use this box to report railroad
Security Administration and give you a copy. retirement (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax,
Box 12. The following list explains the codes shown in box 12. You may and Additional Medicare Tax. Include tips reported by the employee to
need this information to complete your tax return. Elective deferrals the employer in railroad retirement (RRTA) compensation.
(codes D, E, F, and S) and designated Roth contributions (codes AA, Note: Keep Copy C of Form W-2 for at least 3 years after the due date
BB, and EE) under all plans are generally limited to a total of $23,000 for filing your income tax return. However, to help protect your social
($16,000 if you only have SIMPLE plans; $26,000 for section 403(b) security benefits, keep Copy C until you begin receiving social security
plans if you qualify for the 15-year rule explained in Pub. 571). Deferrals benefits, just in case there is a question about your work record and/or
earnings in a particular year.