Form 6559 - Transmitter Report And Summary Of Magnetic Media Page 3
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4OMB No. 1545-0441
6559-A
Form
Continuation Sheet for Form 6559
(Rev. June 2003)
(Transmitter Report and Summary of Magnetic Media)
Tax Year (19
or 20
Page
Department of the Treasury
Internal Revenue Service
of
See Form 6559 for instructions on how to complete this continuation sheet
. Name and address of transmitter
Employer identification number (EIN) of
transmitter ( must be enter)
11. Employer Summary of Form W-2 Magnetic Media
11. Employer Summary of Form W-2 Magnetic Media
Wage and Tip Information
Wage and Tip Information
Name of employer
Check if
Check if
Name of employer
MQGE
MQGE
Other EIN
Employer identification number
Employer identification number
Other EIN
Total Amount of Form W-2 Fields
Total Amount of Form W-2 Fields
Number of Forms W-2
Number of Forms W-2
Social security wages
$
Social security wages
$
Social security tips
Social security tips
$
$
Wages, tips, other compensation
$
Wages, tips, other compensation
$
Federal income tax withheld
Federal income tax withheld
$
$
Social security tax withheld
$
Social security tax withheld
$
Medicare wages and tips
$
Medicare wages and tips
$
Medicare tax withheld
Medicare tax withheld
$
$
Advance Earned Income Credit
Advance Earned Income Credit
$
$
11. Employer Summary of Form W-2 Magnetic Media
11. Employer Summary of Form W-2 Magnetic Media
Wage and Tip Information
Wage and Tip Information
Name of employer
Check if
Name of employer
Check if
MQGE
MQGE
Employer identification number
Other EIN
Employer identification number
Other EIN
Total Amount of Form W-2 Fields
Total Amount of Form W-2 Fields
Number of Forms W-2
Number of Forms W-2
Social security wages
$
Social security wages
$
Social security tips
$
Social security tips
$
Wages, tips, other compensation
$
Wages, tips, other compensation
$
Federal income tax withheld
Federal income tax withheld
$
$
Social security tax withheld
$
Social security tax withheld
$
Medicare wages and tips
Medicare wages and tips
$
$
Medicare tax withheld
$
Medicare tax withheld
$
Advance Earned Income Credit
Advance Earned Income Credit
$
$
6559-A
Cat. No. 43444U
Form
(Rev. 6-2003)
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