Form W-2vi - U.s. Virgin Islands Wage And Tax Statement - 2012 Page 8

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a Employee’s social security number
Void
OMB No. 1545-0008
b Employer identification number (EIN)
1 Wages, tips, other compensation
2 VI income tax withheld
c Employer’s name, address, and ZIP code
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
7 Social security tips
8
d Control number
9
10
e Employee’s first name and initial
11 Nonqualified plans
12a See instructions for box 12
Last name
Suff.
C
o
d
e
13
Statutory
Retirement
Third-party
12b
employee
plan
sick pay
C
o
d
e
14 Other
12c
C
o
d
e
12d
C
o
f Employee’s address and ZIP code
d
e
W-2VI
U.S. Virgin Islands
2012
Department of the Treasury—Internal Revenue Service
Wage and Tax Statement
Form
For Privacy Act and Paperwork Reduction Act
Notice, see the separate instructions.
Copy D—For Employer

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