Publication 1436 (Rev. 10-2012) - Internal Revenue Service

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Formulario Form 499R-2/W-2PR Rev. 09.12 222 222 1. Nombre - First Name Apellido(s) - Surname(s) GOBIERNO DE PUERTO RICO - GOVERNMENT OF PUERTO RICO DEPARTAMENTO DE HACIENDA - DEPARTMENT OF THE TREASURY COMPROBANTE DE RETENCION - WITHHOLDING STATEMENT Dirección Postal del Empleado - Employee's Mailing Address 2. Edgard Pino URB Royal Oak 123 Calle 1 Bayamon PR 00961-0123 Nombre y Dirección Postal del Patrono Employer's Name and Mailing Address Zabila LTD URB Royal Oak 924 Calle 1 Bayamon PR 00961-0123 3. Núm. Seguro Social Social Security No. 400-00-1041 4 . Núm. de Ident. Patronal Employer Ident. No. (EIN) 69-0000055 INFORMACION PARA EL DEPARTAMENTO DE HACIENDA DEPARTMENT OF THE TREASURY INFORMATION 7. Sueldos - Wages 8. Comisiones - Commissions 5. Fecha en que comenzó a recibir la pensión - Date on which you started 9. Concesiones - Allowances 0 to receive the pension 10. Propinas - Tips Número de Teléfono del Patrono 939-555-2030 Employer's Telephone Number Fecha Cese de Operaciones: Día Mes Año Cease of Operations Date: Day ______ Month ______ Year ______ Original Envíe a: - Send to: Social Security Adm. Wilkes-Barre D.O.C. Wilkes-Barre, PA 18769-0001 Número Control - Control Number Con la With the W-3PR Año: Year: 2012 Fecha de radicación: 31 de enero - Filing date: January 31 Instrucciones al dorso de Copia D - Instructions on back of Copy D Día Mes Año Day _____ Month _____ Year _____ 11. Total = 7 + 8 + 9 + 10 6. Costo de Pensión o Anualidad 19,458.00 Cost of Pension or Annuity 0 12. Gastos Reemb. y Beneficios Marginales 6A. Costo de cubierta de salud auspiciada Reimb. Expenses and Fringe Benefits por el patrono - Cost of employersponsored health coverage 13. Cont. Retenida - Tax Withheld 0 6B. Donativos Charitable Contributions 0 138 0 0 14. Fondo de Retiro Gubernamental Governmental Retirement Fund 0 15. Aportaciones a Planes Cualific. Contributions to CODA PLANS 00 16. Salarios bajo Ley 324-2004 Salaries under Act 324-2004 0 16A. Aportaciones al Programa Ahorra y Duplica tu Dinero - Contributions to the Save and Double your Money Program 0 19,458.00 1,858.00 INFORMACION PARA EL SEGURO SOCIAL SOCIAL SECURITY INFORMATION 17. 18. 19. 20. 21. 22. Seguro Social no Retenido en Propinas - Uncollected Social Security Tax on Tips 23. 0 Total Sueldos Seguro Social Social Security Wages 19,458.00 Seguro Social Retenido Social Security Tax Withheld 818.00 Total Sueldos y Pro. Medicare Medicare Wages and Tips 19,458.00 Contrib. Medicare Retenida Medicare Tax Withheld Propinas Seguro Social Social Security Tips 0 0 282.00 Contrib. Medicare no Retenida en Propinas - Uncollected Medicare Tax on Tips
ATS Test Scenario 12 Taxpayer: Susan Snapdragon SSN: 400-00-1042 PAYMENT INFORMATION ROUTING TRANSIT NUMBER 012345672 BANK ACCOUNT NUMBER: 1234567 BANK ACCOUNT TYPE: CHECKING PAYMENT AMOUNT: 1,945 PHONE NUMBER: 800-555-6658 PAYMENT DUE DATE April 1, 2013 139
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Procedures Test Package for the for
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INTRODUCTION…………………
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INTRODUCTION This Publication will
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Test Process Are there Differences
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WHO MUST TEST? The Submission Proce
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SOFTWARE DEVELOPER ACCEPTANCE PROCE
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The IRS will only accept these SSNs
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Form 1040 Department of the Treasur
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Employer identification number (EIN
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SCHEDULE B (Form 1040A or 1040) Dep
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Form Department of the Treasury—I
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Form 2441 (2012) Part III Dependent
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SCHEDULE 8812 (Form 1040A or 1040)
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Version A, Cycle 3 Form 8880 Depart
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Enclose, but do not attach, any pay
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Tax Year 2012 Assurance Testing Sys
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Forms and schedules that may be fil
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WHAT IS TESTED? The test package fo
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PRACTIONER PIN Taxpayers using an E
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SOCIAL SECURITY RANGE FOR STATE RET
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Form 2555 (2012) Page 3 Part V All
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Version A, Cycle 5 Form 1040 For (2
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Form 8938 (November 2012) Departmen
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ATS Test Scenario 3 Taxpayer: Sam a
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Version A, Cycle 5 Form 1040 For (2
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SCHEDULE C (Form 1040) Profit or Lo
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SCHEDULE EIC (Form 1040A or 1040) D
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Form 8862 (Rev. December 2012) Depa
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Version A, Cycle 1 Form 8867 (2012)
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CORRECTED (if checked) PAYER’S na
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Version A, Cycle 2 Schedule E (Form
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SCHEDULE J (Form 1040) Department o
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DRAFT AS OF 9 Chemicals. . . . . .
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ATS Test Scenario 05 Taxpayer: Zeus
Page 91 and 92: Version A, Cycle 5 Form 1040 For (2
Page 93 and 94: CORRECTED (if checked) PAYER’S na
Page 95 and 96: Version A, Cycle 2 SCHEDULE A (Form
Page 97 and 98: Part III Complete this DRAFT part t
Page 99 and 100: Form 6198 At-Risk Limitations OMB N
Page 101 and 102: DRAFT AS OF 5 Meals and entertainme
Page 103 and 104: Form 1040 Department of the Treasur
Page 105 and 106: Employer identification number (EIN
Page 107 and 108: Form 1040 Department of the Treasur
Page 111 and 112: CORRECTED (if checked) PAYER’S na
Page 115 and 116: ATS/PATS Test Scenario 8 Taxpayer:
Page 117 and 118: Version A, Cycle 5 Form 1040 For (2
Page 123 and 124: Version A, Cycle 5 Form 1040A (2012
Page 125 and 126: Form 2441 Child and Dependent Care
Page 127 and 128: SCHEDULE EIC (Form 1040A or 1040) D
Page 129 and 130: Version B, Cycle 6 Schedule 8812 (F
Page 131 and 132: Form 8863 (2012) Page 2 Name(s) sho
Page 137 and 138: ATS Test Scenario 11 Taxpayer: Edga
Page 139 and 140: Section A—Farm Income—Cash Meth
Page 141: DRAFT AS OF b Multiply line 5a by 9
Page 145 and 146: ATS Test Scenario 13 Taxpayer: Apri
Page 147 and 148: Form 9465 ATS Test Scenario 14 Taxp
Page 149 and 150: ATS Test Scenario 15 Taxpayer: Lind
Page 151 and 152: Test Scenario 16 Taxpayer: Joann Bi
Page 153: Form 56 (Rev. 12-2011) Page 2 Part
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Publication 1436 (Rev. 10-2012) - Internal Revenue Service

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