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1. Skylar and Walter Black have been married for 5 years. They live at 883 Scrub Brush Street, Apt. 52B, Las Vegas, NV 89125. Skylar

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1. Skylar and Walter Black have been married for 5 years. They live at 883 Scrub Brush Street, Apt. 52B, Las Vegas, NV 89125. Skylar is a homemaker and Walt is a high school teacher. Skylar's Social Security number is 222-43-7690 and Walt's is 700-01-0002. Walt's earnings from teaching are: Safe, accurate, isit the IRS wobeite at e file 700-01-0002 OMB No. 1545-0008 FASTI Uso 50,674.00 50,674.00 0,674.00 4,700.00 3,141.79 734.77 31-1238967 c Employer's name, address, and 2P code Las Vegas School District 2234 Vegas Valley Drive Las Vegas, NV 89169 6 Modicare wages and tips 6 Medicare tax withhold security tips 8 Allocated ips d Control numbor 9 Varification code 10 Dependont care benefits 11 Nonqualified plans 12a See instructions for box 12 Walter Black 883 Scrub Brush Street, Apt# 52B Las Vegas, NV 89125 P 550.00 DD |7,800.00 12b 14 Othar 120 12d f Employee's address and Z1P code 15 St Employer's state O nurmber 16 State wages, tips, etc. 17 State incorme tax 18 Local wages, tips, etco.19 Local income tax 20 Locaityna Wage and Tax tatement ax 2017 Department of the Tresary-Irfemal Revenue Service LStatement Copy B-To Be Filed With Employee's FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. The Blacks incurred the following expenses during their move from Maine to Nevada in January of 2017 Cost of moving furniture Travel (2,988 miles at $0.17) Lodging en route Meals en route House-hunting trip before the move $4,775 508 520 90 750

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