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Wage and Income Transcript Details

The document contains sensitive taxpayer data, including a Wage and Income Transcript for the tax period of December 2023, detailing wages, tax withheld, and other compensation for an employee. It also includes multiple Form 1099-B statements reporting proceeds from broker transactions, with various amounts and indicators related to tax withholding and gains or losses. The information is sensitive and should be handled accordingly.

Uploaded by

rachelflowers346
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
40 views11 pages

Wage and Income Transcript Details

The document contains sensitive taxpayer data, including a Wage and Income Transcript for the tax period of December 2023, detailing wages, tax withheld, and other compensation for an employee. It also includes multiple Form 1099-B statements reporting proceeds from broker transactions, with various amounts and indicators related to tax withholding and gains or losses. The information is sensitive and should be handled accordingly.

Uploaded by

rachelflowers346
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

This Product Contains Sensitive Taxpayer Data

Request Date: 07-14-2025


Response Date: 07-14-2025
Tracking Number: 108412153904

Wage and Income Transcript

SSN Provided: XXX-XX-9524


Tax Period Requested: December, 2023

Form W-2 Wage and Tax Statement

Employer:
Employer Identification Number (EIN):XXXXX3600
AADV
PO BOX

Employee:
Employee's Social Security Number:XXX-XX-9524
JERR D OVER
605 HC

Submission Type:.............................................Original document


Wages, Tips and Other Compensation:.................................$34,152.00
Federal Income Tax Withheld:.........................................$2,220.00
Social Security Wages:..............................................$37,121.00
Social Security Tax Withheld:........................................$2,301.00
Medicare Wages and Tips:............................................$37,121.00
Medicare Tax Withheld:.................................................$538.00
Social Security Tips:....................................................$0.00
Allocated Tips:..........................................................$0.00
Dependent Care Benefits:.................................................$0.00
Deferred Compensation:...............................................$2,969.00
Code "Q" Nontaxable Combat Pay:..........................................$0.00
Code "W" Employer Contributions to a Health Savings Account:.............$0.00
Code "Y" Deferrals under a section 409A nonqualified Deferred Compensation
plan:....................................................................$0.00
Code "Z" Income under section 409A on a nonqualified Deferred Compensation
plan:....................................................................$0.00
Code "R" Employer's Contribution to MSA:.................................$0.00
Code "S" Employer's Contribution to Simple Account:......................$0.00
Code "T" Expenses Incurred for Qualified Adoptions:......................$0.00
Code "V" Income from exercise of non-statutory stock options:............$0.00
Code "AA" Designated Roth Contributions under a Section 401(k) Plan:.....$0.00
Code "BB" Designated Roth Contributions under a Section 403(b) Plan:.....$0.00
Code "DD" Cost of Employer-Sponsored Health Coverage:....................$0.00
Code "EE" Designated ROTH Contributions Under a Governmental Section 457(b)
Plan:....................................................................$0.00
Code "FF" Permitted benefits under a qualified small employer health
reimbursement arrangement:...............................................$0.00
Code "GG" Income from Qualified Equity Grants Under Section 83(i):.......$0.00
Code "HH" Aggregate Deferrals Under Section 83(i) Elections as of the Close
of the Calendar Year:....................................................$0.00
Third Party Sick Pay Indicator:.....................................Unanswered
Retirement Plan Indicator:...............................Yes - retirement plan
Statutory Employee:.....................................Not Statutory Employee
W2 Submission Type:...................................................Original
W2 WHC SSN Validation Code:........................................Correct SSN

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX38T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$46.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX40T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$50.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX42T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$50.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX44T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$48.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX46T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$4.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX48T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$56.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX50T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$50.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX52T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$8.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX54T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$16.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX56T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$8.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX58T2
Date Sold or Disposed:..............................................11-19-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:...............................................................$56.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HC

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX90T1
Date Sold or Disposed:..............................................11-22-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$4.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HI

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX91T2
Date Sold or Disposed:..............................................10-29-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$9.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

Form 1099-B Proceeds From Broker and Barter Exchange Transactions

Payer:
Payer's Federal Identification Number (FIN):XXXXX9876
BLOC
1955 B

Recipient:
Recipient's Identification Number:XXX-XX-9524
JERR DO OVER
605 HI

Submission Type:.............................................Original document


Account Number (Optional):.........................................XXXXXXX92T2
Date Sold or Disposed:..............................................10-29-2023
CUSIP Number:....................................................0000000000000
Gross Proceeds:................................................Nothing checked
Bartering:...............................................................$0.00
Federal Income Tax Withheld:.............................................$0.00
Proceeds:................................................................$1.00
Aggregate Profit or (Loss):..............................................$0.00
Realized Profit or (Loss):...............................................$0.00
Unrealized Profit or (Loss) 12/31 Prior Year:............................$0.00
Unrealized Profit or (Loss) 12/31 Current Year:..........................$0.00
Cost or Basis:...........................................................$0.00
Wash Sale Loss Disallowed:...............................................$0.00
Accrued Market Discount Amount:..........................................$0.00
Description:............................................................SEE DE
Second Notice Indicator:......................................No Second Notice
Date Acquired:......................................................00-00-0000
Noncovered Security Indicator:...Noncovered Security Basis not reported to IRS
Type of Gain or Loss Code:....................................................
Applicable Check Box on Form 8949:
Transaction if you cannot determine whether the recipient should check Box B
or Box E on Form 8949 because the holding period is unknown
Loss Not Allowed Indicator:...................................................
FATCA Filing Requirement:................Box not checked no Filing Requirement
Proceeds from:.................................................Box not checked

This Product Contains Sensitive Taxpayer Data

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