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2014 W-2 and EARNINGS SUMMARY
Employee
Reference
Wage and Tax
Statement

Copy

W-2

2014

Control number

076861 c Dept.

1. The following information reflects your final 2014 pay stub plus any adjustments submitted by your employer.

OMB No. 1545-0008

Copy C for employee’s records.

d

This blue Earnings Summary section is included with your W-2 to help describe portions in more detail.
The reverse side includes general information that you may also find helpful.

Corp.

Employer use only

Gross Pay

A

LOS2/NDY 310116

Social Security
Tax Withheld
Box 4 of W-2

20269.22

Employer’s name, address, and ZIP code

EMERITUS CORPORATION
3131 ELLIOTT AVE STE 500
SEATTLE WA 98121-1032

Fed. Income
Tax Withheld
Box 2 of W-2

Wages, Tips, other
Compensation
Box 1 of W-2

e/f Employee’s name, address, and ZIP code

b

Employer’s FED ID number

1

Wages, tips, other comp.

3

Social security wages

5

Medicare wages and tips

7

Social security tips

293.90

2. Your Gross Pay was adjusted as follows to produce your W-2 Statement.

Batch #01531
MANOUCHKA LOUIS-JEAN
115 SOUTH ATLANTIC DRIVE WEST
BOYNTON BEACH FL 33435

Medicare Tax
Withheld
Box 6 of W-2

1525.95

FL. State Income Tax
Box 17 of W-2
SUI/SDI
Box 14 of W-2

1256.69

Gross Pay

Social Security
Wages
Box 3 of W-2

20,269.22

Less 401(k) (D-Box 12)
Reported W-2 Wages

Medicare
Wages
Box 5 of W-2

20,269.22

297.62

20,269.22

N/A

19,971.60

FL. State Wages,
Tips, Etc.
Box 16 of W-2

N/A

20,269.22

20,269.22

a Employee’s SSA number

91-1605464

157-11-8315
2 Federal income tax withheld

19971.60

1525.95
4 Social security tax withheld

20269.22

1256.69
6 Medicare tax withheld

20269.22

293.90
8 Allocated tips

9

10 Dependent care benefits

11 Nonqualified plans

12a See instructions for box 12

D

3. Employee W-4 Profile. To change your Employee W-4 Profile Information, file a new W-4 with your payroll dept.
Social Security Number:157-11-8315
Taxable Marital Status: SINGLE

MANOUCHKA LOUIS-JEAN
115 SOUTH