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1A. Maria Tallchief is a single taxpayer (birthdate May 18, 1994) living at 543 Space Drive, Houston, TX 77099. Her Social Security number is

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1A. Maria Tallchief is a single taxpayer (birthdate May 18, 1994) living at 543 Space Drive, Houston, TX 77099. Her Social Security number is 466-33-1234. For 2021, Maria has no dependents, and her W-2, from her job at a local restaurant where she is a cashier, contains the following information: b Employer identification number (ON) 33-1235672 Employee's social security number 466-33-1234 e Employer's name, address, and ZIP code Burger Box 1234 Mountain Road. Houston, TX 77099 d Control number Employee's first name and initial Maria Tallchief 543 Space Drive Houston, TX 77099 Safe, accurate, OMB No. 1545-0008 FASTI Use e-file 1 Wages, tipe, other compensation 21,500.00 3 Social secunty wag 21,500.00 5 Medicare wages and Sps 21,500.00 7 Social security tipe Veit the IRS website at www.irs.govlefie 2 Federal income tax withheld 1,207.81 4 Social secunty tax withheld 1,333.00 6 Medicare tax withheld 311.75 Allocated tips 10 Dependent care benefits Last name Suff 11 Nonqualified plans 12a See instructions for box 12 13 14 Other 120 Employee's address and 2P code 15 Date Employer's state ID number TX 124 10 State wages, spa, etc 17 State noose a 18 Local wages, spe, et 19 Losal income tax 20 Lady Form W-2 Wage and Tax Statement Copy B-To Be Filled With Employee's FEDERAL Tax Return This information is being furnished to the Internal Revenue Service 2021 Department of the Treasury-Internal Revenue Service

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