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SUMMARY VILLAGE GREEN HOLDING LLC 44859.84 4723.65 30833 NORTHWESTERN HIGHWAY STE. 300 3 Social security wages 4 Social security tax FARMINGTON HILLS, MI 48334 46089.93 2857.62 Wage and Tax Statement 5 Medicare wages and tips 6 Medicare tax withheld Copy B to be filed with Employee's Federal Income Tax Return. b Employer's identification number d Control Number 46089.93 668.31 Federal Filing Copy VILLAGE GREEN HOLDING LLC 45 - 3536429 56323 22056 7 Social security tips 8 Allocated tips 30833 NORTHWESTERN HIGHWAY STE. 3 e Employee's name and address 9 Advanced EIC payment 10 Dependent care benefits FARMINGTON HILLS, MI 48334 KEVIN JOHNSON 11 Nonqualified plans 12 See instrs. for box 12 13 COURIER DRIVE D 1230.09 TANEYTOWN, MD 21787 13 Stat emp. Ret. Plan 3 Party Sick DD 3685.92 X 14 Other KEVIN JOHNSON W2 1314-3797-2093-032 15 State & Employer's state ID 16 State wages, tips, etc 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name Filing Status Exemptions MD 14723005 44859.84 3407.35 FITWH M 0 MD H 0 MD320 M 0 a Employee's social security number OMB No. 1545-0008 2015 055-56-8391 c Employer's name, address, and ZIP code 1 Wages, tips, other compensation 2 Federal income tax
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