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EMPLOYEE S NAME SOCIAL SECURITY NUMBER HOME ADDRESS CITY DAYTIME TELEPHONE NUMBER OCCUPATION STATE ZIP CODE IF PARTIAL YEAR PROVIDE DATES From EMPLOYER To EMPLOYER IDENTIFICATION NUMBER EIN PLACE OF EMPLOYMENT 1. Gross Compensation per W-2 A. Non-Taxable Stock Options included in Line 1 Must reflect on W-2 B. Adjusted Gross Compensation Subtract Line 1A from Line 1 2. Computation of taxable compensation and/or allowable expenses A. Number of Days/Hours Include overtime from Line 2C 366 Days/292 ...

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