Copy B To Be Filed With Employee's OMB No. Copy 2 To Be Filed With Employee's State, OMB No.

FEDERAL Tax Return 2018 1545-0008

City, or Local Income Tax Return
2018 1545-0008
a Employee's soc sec no 1 Wages, tips, other comp. 2 Federal income tax withheld a Employee's soc sec no 1 Wages, tips, other comp. 2 Federal income tax withheld
15482.58 372.24 15482.58 372.24
xxx-xx-1476 xxx-xx-1476
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
b Employer ID number 15692.58 972.92 b Employer ID number 15692.58 972.92
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
93-6000508 93-6000508
15692.58 227.57 15692.58 227.57
c Employer's name, address, and zip code c Employer's name, address, and zip code
JACKSON COUNTY SCHOOL DISTRICT #6 JACKSON COUNTY SCHOOL DISTRICT #6
300 ASH STREET 300 ASH STREET
CENTRAL POINT OR 97502 CENTRAL POINT OR 97502

d Control number d Control number

HI11476 HI11476
e Employee's first name and initial Last name e Employee's first name and initial Last name
TONIA J HILL TONIA J HILL
570 BACHAND CIRCLE 570 BACHAND CIRCLE
CENTRAL POINT OR 97502 CENTRAL POINT OR 97502

f Employee's address and zip code f Employee's address and zip code
7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12
0.00 E 210.00 0.00 E 210.00
13 Statutory employee 14 Other 12b Code 13 Statutory employee 14 Other 12b Code
385.02 ER 403B MATCH 385.02 ER 403B MATCH
Retirement plan 8.27 ORSTTWH 12c Code Retirement plan 8.27 ORSTTWH 12c Code
X 274.43 OSEA DUES X 274.43 OSEA DUES
Third-party sick pay 12d Code Third-party sick pay 12d Code

OR 0503336-8 15482.58 795.89 OR 0503336-8 15482.58 795.89

15 State Emplr.'s state I.D. # 16 State wages, tips, etc. 17 State income tax 15 State Emplr.'s state I.D. # 16 State wages, tips, etc. 17 State income tax
18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

0.00
Form W-2 Wage and Tax Statement 41-1628061 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement 41-1628061 Dept. of the Treasury -- IRS
This information is being furnished to the Internal Revenue Service.

Copy C For EMPLOYEE'S RECORDS OMB No. Copy 2 To Be Filed With Employee's State, OMB No.
(See Notice to Employee on back of copy B.) 2018 1545-0008
City, or Local Income Tax Return 2018 1545-0008
a Employee's soc sec no 1 Wages, tips, other comp. 2 Federal income tax withheld a Employee's soc sec no 1 Wages, tips, other comp. 2 Federal income tax withheld
15482.58 372.24 15482.58 372.24
xxx-xx-1476 3 Social security wages 4 Social security tax withheld xxx-xx-1476 3 Social security wages 4 Social security tax withheld
b Employer ID number 15692.58 972.92 b Employer ID number 15692.58 972.92
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
93-6000508 93-6000508
15692.58 227.57 15692.58 227.57
c Employer's name, address, and zip code c Employer's name, address, and zip code
JACKSON COUNTY SCHOOL DISTRICT #6 JACKSON COUNTY SCHOOL DISTRICT #6
300 ASH STREET 300 ASH STREET
CENTRAL POINT OR 97502 CENTRAL POINT OR 97502

d Control number d Control number

HI11476 HI11476
e Employee's name, address, and zip code e Employee's name, address, and zip code
TONIA J HILL TONIA J HILL
570 BACHAND CIRCLE 570 BACHAND CIRCLE
CENTRAL POINT OR 97502 CENTRAL POINT OR 97502

f Employee's address and zip code f Employee's address and zip code
7 Social security tips 8 Allocated tips 9 Advance EIC payment 7 Social security tips 8 Allocated tips 9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12 10 Dependent care benefits 11 Nonqualified plans 12a Code See inst. for box 12
0.00 E 210.00 0.00 E 210.00
13 Statutory employee 14 Other 12b Code 13 Statutory employee 14 Other 12b Code
385.02 ER 403B MATCH 385.02 ER 403B MATCH
Retirement plan 8.27 ORSTTWH 12c Code Retirement plan 8.27 ORSTTWH 12c Code
X 274.43 OSEA DUES X 274.43 OSEA DUES
Third-party sick pay 12d Code Third-party sick pay 12d Code

OR 0503336-8 15482.58 795.89 OR 0503336-8 15482.58 795.89

15 State Emplr.'s state I.D. # 16 State wages, tips, etc. 17 State income tax 15 State Emplr.'s state I.D. # 16 State wages, tips, etc. 17 State income tax
18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name

Form W-2 Wage and Tax Statement 41-1628061 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement 41-1628061 Dept. of the Treasury -- IRS
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