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[2 Fedealncone arith 615-31- 36833. 32 3633.19 a 36833.32 ‘ 257317682413 Socarancanny wages] 4 Socal seoay ts wiht 61573176824 _TsSaciarsecuiy wages | 4 Socal socriy tox witha 'b Employer ID number (EIN) 36833. 2283.67 |b Employer 10 number EIN) 6833 283.67 ee ante ‘B Medeare wages and tine | @ Medicare tax withheld ‘B hadicare wages and tps | @ Medicare tax witrets 36833. 32 534.08 ee eetiet 36833.32 534.08 © Employers name, address, and ZP code © Employers name, address, and ZIP code | TheKey Management LLC TheKey Management LLC | 3 7777 Fay Ste 210 7777 Fay Ste 210 | E La Jolla, CA 92037 La Jolla, CA 92037 a Cant Tamer a Contr mimbor ‘2 Exployaes name, oasrens, and 2P code ‘@ Employee's name, adress, and ZP code Thelma Ungab Thelma Ungab 1663 Bonaire Circle 1663 Bonaire Circle Stockton, CA 95210 Stockton, CA 95210 Seal secu ps Aiossted tee ® 7 Socal secur tos oes ® Dependent care benais [7 Nonqualfed pans [faa Goce See inst forbor 12 | 10 Dependent care boneits it Nonqvaified lane Hida Code Dp 10305.36 0 0305.36 Siatuion employes [ia Other [73 Sianaary employee 14 On H?a Coae Caspr ‘ Fatrement par lide Goae | ec pany sek pay Thid-party sick pay fied Coae al 168-3196-8 36833.32 748.64 ca] 168-3196-8 36833.32 ae_Employer’s state 1D number|16 State wages, [7 State income tax 1 sisw_ Employer’ state 10 number|16 State wages, ti, ete. cal wages ps, ete 0 Locality name [8 Local wages tps, te. ‘19 Local income tax Dept. ofthe Treasury -IRS Form W-2 Wage and Tax Statement 2023 Dept. ofthe Treasury - IRS you ial Sropor h BW24UP NTF 2585808 © 3 BW24UPT Wages: ipa, other comp. — [2 Federal income tax wield 1218741 rs ‘iia con Feral oe WASTE Miia? rt 753. 3 Sodial secur wa 2965.34 [5 Wedicare wages and tps "12865034 < Goniroinamber | Dot 1901408 SANF /T9F 000004) ener ae tn ie CARE INDEED INC 890 SANTA CRUZ AVE MENLO PARK CA 94025 Epler use only 901408 SANF/TSF: A 427 © Employer's name, address, and ZP code CARE INDEED INC 890 SANTA CRUZ AVE MENLO PARK CA 94025 CARE INDEED INC 890 SANTA CRUZ AVE MENLO PARK CA 94025 i Enployes's SSA number le EReigr FED nanor Eagar SSA paar "5723187996. HX 6884 FOXX 6824 77 SoaaT secu tps ator ps eae te cae [io Dependent care Denes TTT Dependent care Bata Ha Dependent care bnafia 1 Nangulod lass TS OETORT DSE 3) Tir 83 777.93 4 Omer re moose ea CASO. peer 1 Saito BRT ia ial dala [FRAT | | [SY EraployecT name, adarass and ZIP code THELMA UNGAB 1663 BONAIRE CIRCLE a Enplayes's name, edareas and ZP code THELMA UNGAB 1663 BONAIRE CIRCLE 3 Einployees name, address and iP code THELMA UNGAB 1663 BONAIRE CIRCLE STOCKTON CA 95210 STOCKTON CA 95210 |. |STOCKTON CA 95210 [SS apg 1m ate won x ce) (TE Se Epa one TO vl Swan Ta 5 Gate Employers trie to na] cA (e587 woaee Sos sha7.a1 || "ca" ptd- 765 "ater. CA pis-7658 7 eases ee coe TE Losat wages io, te 17 St income x 161.32 161.32 [a cay name 5 Local Tncome tax 1 Local inome t E Fed ! W- 023) com Bote ater Hoon || TA-State Reference C Oy 023)1 Wages, tpn ier com eee toe 7886 85 Social ooo i Soci wary 368.05 T eaiare woos snd 256785 F Weare wegen [& Control number 1202061 SANF/U14| Dept ']a02081_ SANE /U14)000001 [a Contr mamber | Dept Je Employer's name, adress, and Zi code CARE INDEED HOME HEALTH CARE INC 1935 DIVISADERO ST SAN FRANCISC CARE INDEED HOME HEALTH SAN FRANCISCO CA 94115 fe Employers name, acres, and iP code 1935 DIVISADERO ST 1 CARE INDEED HOME HEALTH || CARE INC SAN FRANCISCO CA 94115 SSSh nant XK 6824 1 Aivsated tina | a i Enployens hae, adres bod DP code ' THELMA UNGAB \|THELMA UNGAB 1663 BONAIRE CIRCLE 1663 BONAIRE CIRCLE |[1663 BONAIRE CIRCLE STOCKTON CA 95210 |STOCKTON CA 95210 a rE FT late ncome tax J Cosa waar ie ete 84.02 TH Teer one I Local mame CAState Reference Coy 1 W- Wage and Tax Statement | TAState Filing =) |[com2te wetted wis employers Siateacons Tax nate "= (SE 023 aOS TT: ral income tax withheld ‘Wages, tips, other comp. 7 Fedoral income tax withheld ee 260.39 11278.55 260. 39 EE lee ee Peers | Seer at ime Ler are | 'F Medicare wages and tips | 6 Medicare tax withhold ‘Medicare wages and ips 6 Medicare tox nine i ra canrar number | bak | Corp | Employer use ony coooooors2tst | 190.nu|DPJP |_C S 9856 [= Employers name, address, and ZIP code PEAR HOLDINGS LLC 1609 TROUSDALE DRI BURLINGAME, CA 94010 coooeaars2 tsi__|130.Nu[ppyp | CS 9956. Employers name, adaress, and ZIP code PEAR HOLDINGS LLC | 1609 TROUSDALE DRIVE BURLINGAME, CA 94010 fe Employers name, er PEAR HOLDINGS LLC. 1609 TROUSDALE DRIVE BURLINGAME, CA 94010 5 _e Epo FED 1 inba] = EOV B TRA ‘BEraploygrs_ FED 10 number Employee's SGA number — | '37°1769929 “6024 3T- 1929 XXX-XX-6824 Toei toe 1 j Taioced tps TO Dependent cae Bonaé (9 Dependent care Benelits i ae ost CA sol ae pa oe % 13 Sten at pa para fae 15 Sa ene pl pw py ot Eons sine“ era te THELMA, UNGAB {eed BONAIRE CIncLe || tesseouaine circu {63 BONAIRE CIRCLE STOCKTON, CA s5210 4] Stocicron, ca seato Srocieron, cA se210 {Sera eagap TN Te —| ei sors “byes | THELMA UNGAB a a, ao aT a RT sae a | ' [5 Sia [Empioyors eta 1 no CA | owes 3 7 Sia come 53.63 9 Toal nso Tar Tossing ame [ie Loser wages ps, ee.) 53.63. | | 9 Localincometax [20 Locally ame |W. ‘eens? “3923, \copy 2 tobe fied with employee's State Income Pax ASuien”""* | [copy 2 tobe fled wih employee's City or Local came tak ota deral Filing Copy w-2"*cee" 2023 Federal incor —