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2022 W-2 and EARNINGS SUMMARY
Employee Reference Copy

W-2 2022
This blue section is your Earnings Summary which provides more detailed
Wage and Tax information on the generation of your W-2 statement. The reverse side
Statement OMB No. 1545-0008 includes instructions and other general information.
Copy C for employee’srecords.
d Control number Dept. Corp. Employer use only
A 1
c Employer’s name, address, and ZIP code
CONCEPT INTEGRATION INC
10 HILLSIDE DRIVE LANE
COHASSET, MA 02025

1. Your Gross Pay was adjusted as follows to produce your W-2 Statement.
Batch #93218
Wages, Tips, other Social Security Medicare MA. 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
ALGIRDES VEITAS
10 HILLSIDE DRIVE LANE Gross Pay
COHASSET, MA 02025 Plus S-Corp 2% Medical Premium
Reported W-2 Wages 108,677.00 85,000.00 85,000.00 108,677.00
b Employer’s FED ID number a Employee’s SSA number
33-0943494 XXX-XX-7248
1 Wages, tips, other comp. 2 Federal income tax withheld
108677.00 17920.00
3 Social security wages 4 Social security tax withheld
85000.00 5270.00
5 Medicare wages and tips 6 Medicare tax withheld
85000.00 1232.50
7 Social security tips 8 Allocated tips

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

11 Nonqualified plans 12a See instructionsfor box 12

ALGIRDES VEITAS
14 Other
12b
12c 10 HILLSIDE DRIVE LANE
292.40 MAPFML
23677.00 S-CORP 12d COHASSET, MA 02025
13 Stat emp. Ret. plan 3rd party sick pay

15 State Employer’s state ID no. 16 State wages, tips, etc.

MA WTH-10650286-003 108677.00
17 State income tax 18 Local wages, tips, etc.
4170.00
19 Local income tax 20 Locality name 2022 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
108677.00 17920.00 108677.00 17920.00 108677.00 17920.00
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
85000.00 5270.00 85000.00 5270.00 85000.00 5270.00
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
85000.00 1232.50 85000.00 1232.50 85000.00 1232.50
d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only d Control number Dept. Corp. Employer use only

A 1 A 1 A 1
c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code

CONCEPT INTEGRATION INC CONCEPT INTEGRATION INC CONCEPT INTEGRATION INC

10 HILLSIDE DRIVE LANE 10 HILLSIDE DRIVE LANE 10 HILLSIDE DRIVE LANE
COHASSET, MA 02025 COHASSET, MA 02025 COHASSET, MA 02025

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
33-0943494 XXX-XX-7248 33-0943494 XXX-XX-7248 33-0943494 XXX-XX-7248
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

14 Other 12b 14 Other 12b 14 Other 12b

12c 12c 12c

292.40 MAPFML 292.40 MAPFML 292.40 MAPFML
23677.00 S-CORP 12d 23677.00 S-CORP 12d 23677.00 S-CORP 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

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

ALGIRDES VEITAS ALGIRDES VEITAS ALGIRDES VEITAS

10 HILLSIDE DRIVE LANE 10 HILLSIDE DRIVE LANE 10 HILLSIDE DRIVE LANE
COHASSET, MA 02025 COHASSET, MA 02025 COHASSET, MA 02025

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.
MA WTH-10650286-003 108677.00 MA WTH-10650286-003 108677.00 MA WTH-10650286-003 108677.00
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.
4170.00 4170.00 4170.00
19 Local income tax 20 Locality name 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name

Federal Filing Copy MA.State Reference Copy MA.State Filing Copy

W-2 Wage and Tax

Statement
Copy B to be filed with employee’s
OMB
2022 W-2
No. 1545-0008
Federal IncomeTax Return.
Wage and Tax
Statement
Copy 2 to be filed with employee’sState IncomeTax Return.
2022 W-2
OMB No. 1545-0008
Wage and Tax
Statement OMB
2022
Copy 2 to be filed with employee’sState IncomeTax Return.
No. 1545-0008
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2022 W-2 and EARNINGS SUMMARY
Employee Reference Copy

W-2 Wage and Tax

Statement
Copy C for employee’srecords.
OMB No.
2022 1545-0008
COMPANY JF6 1
2
Total
Total
Employees
Forms Count
P

d Control number Dept. Corp. Employer use only 0 Total eForms

2 2 Total Forms Processed
c Employer’s name, address, and ZIP code

JF6
e/f Employee’s name, address, and ZIP code
292.40
23,677.00
MAPFML
S-CORP
(Box 14)
(Box 14)

b Employer’s FED ID number a Employee’s SSA number

33-0943494
1 Wages, tips, other comp. 2 Federal income tax withheld
108677.00 17920.00
3 Social security wages 4 Social security tax withheld
85000.00 5270.00
5 Medicare wages and tips 6 Medicare tax withheld
85000.00 1232.50
7 Social security tips 8 Allocated tips

9 10 Dependent care benefits

11 Nonqualified plans 12a See instructionsfor box 12

12b
14 Other
12c
12d
13 Stat emp. Ret. plan 3rd party sick pay
************ T O T A L S ************
For : BATCH NO. 2022/4/93218
15 State Employer’s state ID no. 16 State wages, tips, etc. For : COMPANY KW/JF6
108677.00
17 State income tax 18 Local wages, tips, etc. * * * * * * * * * * * * * * * * * *
4170.00
19 Local income tax 20 Locality name 2022 ADP, Inc.
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