2002 Virginia Schedule INC/CG
*VASINC102999*
Report all W2’s and 1099’s with Virginia Withholding
000000000
SIXTEEN4FRSTNAME M TWENTYFORLASTNAMEIII SFX
Your/
Virginia
Employer
Federal
Wages, tips,
Spouse SSN
Withholding
FEIN
Withholding
other comp.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
000000000
000000000.
XX-XXXXXXX
000000000.
000000000.
Total Virgina Withholding:
YOUR TOTAL WITHHOLDING
000000000
000000000.
SPOUSE’S TOTAL WITHHOLDING
000000000
000000000.
AVOID DELAYS in processing your return! Be sure to enter all information including Employer’s FEIN.