a Employee's social security number
735-13-6994
b Employer identification number (EIN)
c Employer's name, address, and ZIP code
, TX
e Employee's first name and initial Last name Suff.
Este Ofori
3 SOUTH ALTWOOD CIRCLE
SPRING, TX 77382
1 Wages, tips, other compensation
$5170.34
2 Federal income tax withheld
$602.05
3 Social security wages
$5170.34
4 Social security tax withheld
$320.56
5 Medicare wages and tips
$5170.34
6 Medicare tax withheld
$74.97
7 Social security tips
$0.00
10 Dependent care benefits
$0.00
11 Nonqualified plans
$0.00
12a See instructions for box 12
13
☐ Statutory employee
☐ Retirement plan
☐ Third-party sick pay
17 State income tax
$0.00
Form W-2 • 2026 • OMB No. 1545-0008