I need help filling out a 1040 form with this part 2

22222 Void a Employee's social security number 535-44-2255 For Official Use Only OMB No. 1545-0008 b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld 91-0001003 36,825.00 3,350.00 c Employer's name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Small World Elementary School 39,925.00 2,475.35 333 Tiny Tot Lane 5 Medicare wages and tips 6 Medicare tax withheld 39,925.00 Henderson, NV 89053 578.91 7 Social security tips 8 Allocated tips d Control number 9 Verification code 10 Dependent care benefits e Employee's first name and initial Last name Suff. 11 Nonqualified plans 12a See instructions for box 12 Jennifer Hamilton 3,100 13 Statutory Retirement Third-party employee plan sick pay 12b 3678 Blue Sky Drive 14 Other Henderson, NV 89052 12d f Employee's address and ZIP code 15 State Employer's state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. |19 Local income tax 20 Locality name NV 123456789 36,825.00 0.00 Act Nate Winds Form W-2 Wage and Tax Statement 2018 Department of the Treasury-Internal Revenue Service For Privacy Act and Paperwork Reduction