W2 INSTRUCTIONS

*** W2 INSTRUCTIONS ***

Page 1 ? Special message from the founders of Dunder Mifflin Page 2 ? Your 2012 W2

To all employees: Dunder Mifflin is pleased to announce new employee benefit packages for 2013! After a thorough evaluation, we've chosen a new healthcare package provided by Aetna. Each plan has been customized specifically for Dunder Mifflin and provides the best coverage available on the market. Open enrollment into the new Aetna healthcare plan will begin on March 1st. To introduce the new healthcare packages, we'll be holding employee orientation sessions in February. Members of the Aetna team along with our own Human Resources team will be available to answer any questions. Please join us for one of the following sessions:

Friday February 8th at 10:00 AM Thursday February 14th at 2:30 PM We're excited about this change to the Dunder Mifflin employee benefit program. We're also pleased to announce that healthcare will be fully subsidized by the company. You will not be responsible to contribute to the monthly premium, even if you're on a full family plan. Once again, thank you for your hard work and for making Dunder Mifflin a success.

Sincerely,

Robert Dundin and Robert Mifflin Founders Dunder Mifflin, Inc Scranton, PA

Copy B--To Be Filed With Employee's FEDERAL Tax Return.

a Employee's soc. sec. no. 1 Wages, tips, other comp.

41029.60

292-34-2213 3 Social security wages

b Employer ID number (EIN)

52787.00

12-3456789 5 Medicare wages and tips

52787.00

c Employer's name, address, and ZIP code

HUSKER, INC.

1234 MEMORIAL DRIVE

FAIRFAX,, VA 22030

38-2099803 OMB No. 1545-0008 2 Fed. income tax withheld

3730.02

4 Soc. sec. tax withheld

3272.79

6 Medicare tax withheld

765.41

Copy 2--To Be Filed With Employee's State, City, or Local Income Tax Return.

a Employee's soc. sec. no. 1 Wages, tips, other comp.

41029.60

292-34-2213 3 Social security wages

b Employer ID number (EIN)

52787.00

12-3456789 5 Medicare wages and tips

52787.00

c Employer's name, address, and ZIP code

HUSKER, INC.

1234 MEMORIAL DRIVE

FAIRFAX,, VA 22030

38-2099803 OMB No. 1545-0008 2 Fed. income tax withheld

3730.02

4 Soc. sec. tax withheld

3272.79

6 Medicare tax withheld

765.41

d Control number

VA00051

e Employee's name, address, and ZIP code

SUE BLANCHARD 6734 BOONE BLVD MCLEAN, VA 22102

d Control number

VA00051

e Employee's name, address, and ZIP code

SUE BLANCHARD 6734 BOONE BLVD MCLEAN, VA 22102

7 Social security tips

8 Allocated tips

9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 13 Statutory employee 14 Other

12a Code See inst. for box 12

D 11757.40

12b Code

Retirement plan

X

Third-party sick pay

12c Code 12d Code

VA 30-123456789F-001

41029.60

2049.45

15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax

18 Local wages, tips, etc. 19 Local income tax

20 Locality name

7 Social security tips

8 Allocated tips

9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 13 Statutory employee 14 Other

12a Code

D 11757.40

12b Code

Retirement plan

X

Third-party sick pay

12c Code 12d Code

VA 30-123456789F-001

41029.60

2049.45

15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax

18 Local wages, tips, etc. 19 Local income tax

20 Locality name

Form W-2 Wage and Tax Statement

2010

Dept. of the Treasury -- IRS

This information is being furnished to the Internal Revenue Service.

0 BW24UP NTF 2574387

DTEhisMinYformation is being furnished to IRS. If you are required to file a tax return, a negligence

penalty/other sanction may be imposed on you if this income is taxable & you fail to report it.

Copy C--For EMPLOYEE'S RECORDS (See Notice 38-2099803

to Employee.)

OMB No. 1545-0008

a Employee's soc. sec. no. 1 Wages, tips, other comp. 2 Fed. income tax withheld

41029.60

3730.02

292-34-2213 3 Social security wages 4 Soc. sec. tax withheld

b Employer ID number (EIN)

52787.00

3272.79

12-3456789 5 Medicare wages and tips 6 Medicare tax withheld

52787.00

765.41

c Employer's name, address, and ZIP code

HUSKER, INC.

1234 MEMORIAL DRIVE

FAIRFAX,, VA 22030

Form W-2 Wage and Tax Statement

2010

Dept. of the Treasury -- IRS

10US_W24UP-B2C2 Copyright 2010 Greatland/Nelco

Copy 2--To Be Filed With Employee's State, City, or Local Income Tax Return.

a Employee's soc. sec. no. 1 Wages, tips, other comp.

41029.60

292-34-2213 3 Social security wages

b Employer ID number (EIN)

52787.00

12-3456789 5 Medicare wages and tips

52787.00

c Employer's name, address, and ZIP code

HUSKER, INC.

1234 MEMORIAL DRIVE

FAIRFAX,, VA 22030

38-2099803 OMB No. 1545-0008 2 Fed. income tax withheld

3730.02

4 Soc. sec. tax withheld

3272.79

6 Medicare tax withheld

765.41

d Control number

VA00051

e Employee's name, address, and ZIP code

SUE BLANCHARD 6734 BOONE BLVD MCLEAN, VA 22102

d Control number

VA00051

e Employee's name, address, and ZIP code

SUE BLANCHARD 6734 BOONE BLVD MCLEAN, VA 22102

7 Social security tips

8 Allocated tips

9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 13 Statutory employee 14 Other

12a Code See inst. for box 12

D 11757.40

12b Code

Retirement plan

X

Third-party sick pay

12c Code 12d Code

VA 30-123456789F-001

41029.60

2049.45

15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax

18 Local wages, tips, etc. 19 Local income tax

20 Locality name

7 Social security tips

8 Allocated tips

9 Advance EIC payment

10 Dependent care benefits 11 Nonqualified plans 13 Statutory employee 14 Other

12a Code

D 11757.40

12b Code

Retirement plan

X

Third-party sick pay

12c Code 12d Code

VA 30-123456789F-001

41029.60

2049.45

15 State Employer's state ID no. 16 State wages, tips, etc. 17 State income tax

18 Local wages, tips, etc. 19 Local income tax

20 Locality name

Form W-2 Wage and Tax Statement

2010

Dept. of the Treasury -- IRS

Form W-2 Wage and Tax Statement

2010

Dept. of the Treasury -- IRS

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