7 Social security tips 1 Wages, tips, other compensation 2 Federal income tax withheld

Form W-2 Wage and Tax Statement 2020 144165.86 31108.06

c Employer’s name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheld
UNIVERSITY OF CALIFORNIA
1A L99

14350-1 MERIDIAN PARKWAY 9 5 Medicare wages and tips 6 Medicare tax withheld
153434.12 2224.79
RIVERSIDE CA 92518 10 Dependent care benefits 11 Nonqualified plans C
12a See instructions for box 12
o
d
e
Statutory Retirement Third-party
e Employee’s name, address, and ZIP code 13 employee plan sick pay 14 Other 12b
C
o
d
e

NICANOR M CREER b Employer identification number (EIN)

DCP 9268.26 12c
C
o

1100 HOWE AVE 94-3067788 d

e

a Employee’s social security number 12d

#143 616-78-0124
C
o
d
e

SACRAMENTO CA 95825
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
CA 91029645 144165.86 11175.04
Copy B-To Be Filed With Employee’s FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. Dept. of the Treasury - IRS
OMB No. 1545-0008 Visit the IRS website at www.irs.gov/efile.

This information is being furnished to the Internal Revenue Service. If you are required to file a tax return, a
negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.
7 Social security tips 1 Wages, tips, other compensation 2 Federal income tax withheld
Form W-2 Wage and Tax Statement 2020 144165.86 31108.06
c Employer’s name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheld
UNIVERSITY OF CALIFORNIA
9 5 Medicare wages and tips 6 Medicare tax withheld
14350-1 MERIDIAN PARKWAY 2224.79
153434.12
RIVERSIDE CA 92518 10 Dependent care benefits 11 Nonqualified plans C
12a See instructions for box 12
o
d
e
Statutory Retirement Third-party
e Employee’s name, address, and ZIP code 13 employee plan sick pay 14 Other 12b
C
o

NICANOR M CREER DCP 9268.26 d

e

b Employer identification number (EIN) 12c

C

1100 HOWE AVE 94-3067788

o
d
e

a Employee’s social security number 12d

#143 C
o
616-78-0124 d
e
SACRAMENTO CA 95825
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
CA 91029645 144165.86 11175.04

Copy C-For EMPLOYEE’S RECORDS (See Notice to Employee on the back of Copy B.) OMB No. 1545-0008 Dept. of the Treasury - IRS
Visit the IRS website at www.irs.gov/efile.

7 Social security tips 1 Wages, tips, other compensation 2 Federal income tax withheld
Form W-2 Wage and Tax Statement 2020 144165.86 31108.06
c Employer’s name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheld
UNIVERSITY OF CALIFORNIA
9 5 Medicare wages and tips 6 Medicare tax withheld
14350-1 MERIDIAN PARKWAY 153434.12 2224.79
RIVERSIDE CA 92518 10 Dependent care benefits 11 Nonqualified plans 12a
C
o
d
e
Statutory Retirement Third-party
e Employee’s name, address, and ZIP code 13 employee plan sick pay 14 Other 12b
C
o
d
e

NICANOR M CREER DCP 9268.26 12c

b Employer identification number (EIN) C
o
1100 HOWE AVE 94-3067788 d
e

a Employee’s social security number 12d

#143 C
o
616-78-0124 d
e
SACRAMENTO CA 95825
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
CA 91029645 144165.86 11175.04

Copy 2-To Be Filed With Employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Dept. of the Treasury - IRS

7 Social security tips 1 Wages, tips, other compensation 2 Federal income tax withheld
Form W-2 Wage and Tax Statement 2020 144165.86 31108.06
c Employer’s name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheld
UNIVERSITY OF CALIFORNIA
14350-1 MERIDIAN PARKWAY 9 5 Medicare wages and tips 6 Medicare tax withheld
153434.12 2224.79
RIVERSIDE CA 92518 10 Dependent care benefits 11 Nonqualified plans 12a
C
o
d
e
Statutory Retirement Third-party
e Employee’s name, address, and ZIP code 13 employee plan sick pay 14 Other 12b
C
o
d

NICANOR M CREER DCP 9268.26 e

b Employer identification number (EIN) 12c

C
1100 HOWE AVE 94-3067788 o
d
e

#143 a Employee’s social security number 12d

FORM # LW28700

C
8403000753

SACRAMENTO CA 95825 616-78-0124 d

e

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
CA 91029645 144165.86 11175.04

Copy 2-To Be Filed With Employee’s State, City, or Local Income Tax Return OMB No. 1545-0008 Dept. of the Treasury - IRS