2023 W-2 and EARNINGS SUMMARY

Employee Reference Copy

This blue section is your Earnings Summary which provides more detailed
Wage and Tax
W-2 Statement
Copy C for employee’s records.
2023
OMB No. 1545-0008
information on the generation of your W-2 statement. The reverse side
includes instructions and other general information.
d Control number Dept. Corp. Employer use only
479750 LOS2/AAJ 109200 T
c Employer’s name, address, and ZIP code
AMAZON COM SERVICES LLC
PO BOX 80726
SEATTLE WA 98108

1. Your Gross Pay was adjusted as follows to produce your W-2 Statement.
Batch #02964
Wages, Tips, other Social Security Medicare CA. State Wages,
e/f Employee’s name, address, and ZIP code Compensation Wages Wages Tips, Etc.
Box 1 of W-2 Box 3 of W-2 Box 5 of W-2 Box 16 of W-2
MATTHEW X RUSSELL
2341 LANGHORN ST Gross Pay 2,143.99 2,143.99 2,143.99 2,143.99
LANCASTER CA 93535 Plus GTL (C-Box 12) 1.08 1.08 1.08 1.08
Less 401(k) (D-Box 12) 214.40 N/A N/A 214.40
b Employer’s FED ID number a Employee’s SSA number
Reported W-2 Wages 1,930.67 2,145.07 2,145.07 1,930.67
82-0544687 XXX-XX-1704
1 Wages, tips, other comp. 2 Federal income tax withheld
1930.67 159.68
3 Social security wages 4 Social security tax withheld
2145.07 132.98
5 Medicare wages and tips 6 Medicare tax withheld
2145.07 31.10
7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 2. Employee Name and Address.

11 Nonqualified plans 12a See instructions for box 12

12b D
C 1.08 MATTHEW X RUSSELL
14 Other 214.40 2341 LANGHORN ST
12c M .01
19.29 SDI
12d LANCASTER CA 93535
13 Stat emp. Ret. plan 3rd party sick pay
X
15 State Employer’s state ID no. 16 State wages, tips, etc.
CA 011-5094 5 1930.67
17 State income tax 18 Local wages, tips, etc.
52.89
19 Local income tax 20 Locality name ¤ 2023 ADP, Inc.

1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld 1 Wages, tips, other comp. 2 Federal income tax withheld
1930.67 159.68 1930.67 159.68 1930.67 159.68
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
2145.07 132.98 2145.07 132.98 2145.07 132.98
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
2145.07 31.10 2145.07 31.10 2145.07 31.10
d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only
479750 LOS2/AAJ 109200 T 479750 LOS2/AAJ 109200 T 479750 LOS2/AAJ 109200 T
c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code
AMAZON COM SERVICES LLC AMAZON COM SERVICES LLC AMAZON COM SERVICES LLC
PO BOX 80726 PO BOX 80726 PO BOX 80726
SEATTLE WA 98108 SEATTLE WA 98108 SEATTLE WA 98108

b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number b Employer’s FED ID number a Employee’s SSA number
82-0544687 XXX-XX-1704 82-0544687 XXX-XX-1704 82-0544687 XXX-XX-1704
7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips

9 10 Dependent care benefits 9 10 Dependent care benefits 9 10 Dependent care benefits

11 Nonqualified plans 12a See instructions for box 12 11 Nonqualified plans 12a
12 11 Nonqualified plans 12a
C 1.08 C 1.08 C 1.08
14 Other 12b D 214.40 14 Other 12b D 214.40 14 Other 12b D 214.40
12c M .01 12c M .01 12c M .01
19.29 SDI 19.29 CA SDI 19.29 CA SDI
12d 12d 12d
13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay 13 Stat emp. Ret. plan 3rd party sick pay
X X X
e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code e/f Employee’s name, address and ZIP code
MATTHEW X RUSSELL MATTHEW X RUSSELL MATTHEW X RUSSELL
2341 LANGHORN ST 2341 LANGHORN ST 2341 LANGHORN ST
LANCASTER CA 93535 LANCASTER CA 93535 LANCASTER CA 93535

15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc. 15 State Employer’s state ID no. 16 State wages, tips, etc.
CA 011-5094 5 1930.67 CA 011-5094 5 1930.67 CA 011-5094 5 1930.67
17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 17 State income tax 18 Local wages, tips, etc.
52.89 52.89 52.89
19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name

Federal Filing Copy CA.State Reference Copy CA.State Filing Copy

Wage and Tax Wage and Tax Wage and Tax
W-2 Statement
Copy B to be filed with employee’s
OMB
2023 No. 1545-0008
Federal Income Tax Return.
W-2 Statement 2023
OMB No. 1545-0008
Copy 2 to be filed with employee’s State Income Tax Return.
W-2 Statement OMB
2023
Copy 2 to be filed with employee’s State Income Tax Return.
No. 1545-0008
Instructions for Employee However, if you were at least age 50 in 2023, your employer may have S—Employee salary reduction contributions under a section 408(p)
allowed an additional deferral of up to $7,500 ($3,500 for section 401(k) SIMPLE plan (not included in box 1)
Box 1. Enter this amount on the wages line of your tax return. (11) and 408(p) SIMPLE plans). This additional deferral amount is not T—Adoption benefits (not included in box 1). Complete Form 8839 to
Box 2. Enter this amount on the federal income tax withheld line of your subject to the overall limit on elective deferrals. For code G, the limit on figure any taxable and nontaxable amounts.
tax return. elective deferrals may be higher for the last 3 years before you reach
retirement age. Contact your plan administrator for more information. V—Income from exercise of nonstatutory stock option(s) (included in
Box 5. You may be required to report this amount on Form 8959. See Amounts in excess of the overall elective deferral limit must be included boxes 1, 3 (up to the social security wage base), and 5). See Pub. 525
the Form 1040 instructions to determine if you are required to complete in income. See the Form 1040 instructions. for reporting requirements.
Form 8959. W—Employer contributions (including amounts the employee elected to
Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made
Box 6. This amount includes the 1.45% Medicare tax withheld on all a make-up pension contribution for a prior year(s) when you were in contribute using a section 125 (cafeteria) plan) to your health savings
Medicare wages and tips shown in box 5, as well as the 0.9% Additional military service. To figure whether you made excess deferrals, consider account. Report on Form 8889.
Medicare Tax on any of those Medicare wages and tips above $200,000. these amounts for the year shown, not the current year. If no year is Y—Deferrals under a section 409A nonqualified deferred compensation
shown, the contributions are for the current year. plan
Box 8. This amount is not included in box 1, 3, 5, or 7. For information
on how to report tips on your tax return, see the Form 1040 instructions. A—Uncollected social security or RRTA tax on tips. Include this tax on Z—Income under a nonqualified deferred compensation plan that fails to
Form 1040 or 1040-SR. See the Form 1040 instructions. satisfy section 409A. This amount is also included in box 1. It is subject
You must file Form 4137 with your income tax return to report at least the to an additional 20% tax plus interest. See the Form 1040 instructions.
allocated tip amount unless you can prove with adequate records that B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or
you received a smaller amount. If you have records that show the actual 1040-SR. See the Form 1040 instructions. AA—Designated Roth contributions under a section 401(k) plan
amount of tips you received, report that amount even if it is more or less C—Taxable cost of group-term life insurance over $50,000 (included in BB—Designated Roth contributions under a section 403(b) plan
than the allocated tips. Use Form 4137 to figure the social security and boxes 1, 3 (up to the social security wage base), and 5)
Medicare tax owed on tips you didn’t report to your employer. Enter this DD—Cost of employer-sponsored health coverage. The amount
amount on the wages line of your tax return. By filing Form 4137, your D—Elective deferrals to a section 401(k) cash or deferred arrangement. reported with code DD is not taxable.
social security tips will be credited to your social security record (used to Also includes deferrals under a SIMPLE retirement account that is part of EE—Designated Roth contributions under a governmental section 457(b)
figure your benefits). a section 401(k) arrangement. plan. This amount does not apply to contributions under a tax-exempt
E—Elective deferrals under a section 403(b) salary reduction agreement organization section 457(b) plan.
Box 10. This amount includes the total dependent care benefits that your
employer paid to you or incurred on your behalf (including amounts from F—Elective deferrals under a section 408(k)(6) salary reduction SEP FF—Permitted benefits under a qualified small employer health
a section 125 (cafeteria) plan). Any amount over your employer’s plan G—Elective deferrals and employer contributions (including nonelective reimbursement arrangement
limit is also included in box 1. See Form 2441. deferrals) to a section 457(b) deferred compensation plan GG—Income from qualified equity grants under section 83(i)
Box 11. This amount is (a) reported in box 1 if it is a distribution made H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization HH—Aggregate deferrals under section 83(i) elections as of the close of
to you from a nonqualified deferred compensation or nongovernmental plan. See the Form 1040 instructions for how to deduct. the calendar year
section 457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior
J—Nontaxable sick pay (information only, not included in box 1, 3, or 5) Box 13. If the “Retirement plan” box is checked, special limits may apply
year deferral under a nonqualified or section 457(b) plan that became
to the amount of traditional IRA contributions you may deduct. See Pub.
taxable for social security and Medicare taxes this year because K—20% excise tax on excess golden parachute payments. See the 590-A.
there is no longer a substantial risk of forfeiture of your right to the Form 1040 instructions.
deferred amount. This box shouldn’t be used if you had a deferral and Box 14. Employers may use this box to report information such as state
L—Substantiated employee business expense reimbursements disability insurance taxes withheld, union dues, uniform payments,
a distribution in the same calendar year. If you made a deferral and (nontaxable)
received a distribution in the same calendar year, and you are or will be health insurance premiums deducted, nontaxable income, educational
age 62 by the end of the calendar year, your employer should file Form M—Uncollected social security or RRTA tax on taxable cost of group- assistance payments, or a member of the clergy’s parsonage allowance
SSA-131, Employer Report of Special Wage Payments, with the Social term life insurance over $50,000 (former employees only). See the Form and utilities. Railroad employers use this box to report railroad retirement
Security Administration and give you a copy. 1040 instructions. (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax, and Additional
N—Uncollected Medicare tax on taxable cost of group-term life insurance Medicare Tax. Include tips reported by the employee to the employer in
Box 12. The following list explains the codes shown in box 12. You may railroad retirement (RRTA) compensation.
need this information to complete your tax return. Elective deferrals over $50,000 (former employees only). See the Form 1040 instructions.
(codes D, E, F, and S) and designated Roth contributions (codes AA, P—Excludable moving expense reimbursements paid directly to a Note: Keep Copy C of Form W-2 for at least 3 years after the due date
BB, and EE) under all plans are generally limited to a total of $22,500 member of the U.S. Armed Forces (not included in box 1, 3, or 5) for filing your income tax return. However, to help protect your social
($15,500 if you only have SIMPLE plans; $25,500 for section 403(b) security benefits, keep Copy C until you begin receiving social security
Q—Nontaxable combat pay. See the Form 1040 instructions for details benefits, just in case there is a question about your work record and/or
plans if you qualify for the 15-year rule explained in Pub. 571). Deferrals
on reporting this amount. earnings in a particular year.
under code G are limited to $22,500. Deferrals under code H are limited
to $7,000. R—Employer contributions to your Archer MSA. Report on Form 8853. Department of the Treasury - Internal Revenue Service

NOTE: THESE ARE SUBSTITUTE WAGE AND TAX STATEMENTS AND ARE ACCEPTABLE FOR FILING WITH YOUR FEDERAL, STATE AND LOCAL/CITY INCOME TAX RETURNS.

This information is being furnished to the Internal Notice to Employee

Revenue Service. If you are required to file a tax
return, a negligence penalty or other sanction may Do you have to file? Refer to the Form 1040 instructions Corrections. If your name, SSN, or address is incorrect,
be imposed on you if this income is taxable and to determine if you are required to file a tax return. Even correct Copies B, C, and 2 and ask your employer to
you fail to report it. if you don’t have to file a tax return, you may be eligible correct your employment record. Be sure to ask the
for a refund if box 2 shows an amount or if you are employer to file Form W-2c, Corrected Wage and Tax
IMPORTANT NOTE:
eligible for any credit. Statement, with the SSA to correct any name, SSN, or
In order to insure efficient processing,
Earned income credit (EIC). You may be able to money amount error reported to the SSA on Form W-2.
attach this W-2 to your tax return like this
(following agency instructions): take the EIC for 2023 if your adjusted gross income Be sure to get your copies of Form W-2c from your
(AGI) is less than a certain amount. The amount of the employer for all corrections made so you may file them
credit is based on income and family size. Workers with your tax return. If your name and SSN are correct but
without children could qualify for a smaller credit. You aren’t the same as shown on your social security card, you
TAX RETURN and any qualifying children must have valid social should ask for a new card that displays your correct name
security numbers (SSNs). You can’t take the EIC if your at any SSA office or by calling 800-772-1213. You may
investment income is more than the specified amount for also visit the SSA website at www.SSA.gov.
THIS 2023 or if income is earned for services provided while Cost of employer-sponsored health coverage (if such
FORM
OTHER you were an inmate at a penal institution. cost is provided by the employer). The reporting in
W-2
W-2’S For 2023 income limits and more information, visit box 12, using code DD, of the cost of employer-sponsored
www.irs.gov/EITC. See also Pub. 596. Any EIC that is health coverage is for your information only.
more than your tax liability is refunded to you, but The amount reported with code DD is not taxable.
only if you file a tax return.
Credit for excess taxes. If you had more than one
Employee’s social security number (SSN). For your employer in 2023 and more than $9,932.40 in social
protection, this form may show only the last four digits security and/or Tier 1 railroad retirement (RRTA) taxes
of your SSN. However, your employer has reported were withheld, you may be able to claim a credit for the
your complete SSN to the IRS and the Social Security excess against your federal income tax. See the Form
Administration (SSA). 1040 instructions. If you had more than one railroad
Clergy and religious workers. If you aren’t subject to employer and more than $5,821.20 in Tier 2 RRTA tax was
social security and Medicare taxes, see Pub. 517. withheld, you may be able to claim a refund on Form 843.
See the Instructions for Form 843.

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