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<div class="w2-form">
<div class="copy-label">Copy B — To Be Filed With Employee's FEDERAL Tax Return</div>
<div class="form-grid">
<div class="cell">
<div class="cell-label">a Employee's social security number</div>
<div class="cell-value">XXX-XX-0211</div>
</div>
<div class="cell">
<div class="cell-label">1 Wages, tips, other compensation</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">b Employer identification number (EIN)</div>
<div class="cell-value">87-1017981</div>
</div>
<div class="cell">
<div class="cell-label">2 Federal income tax withheld</div>
<div class="cell-value">1,522.49</div>
</div>
<div class="cell cell-large" style="grid-row: span 2;">
<div class="cell-label">c Employer's name, address, and ZIP code</div>
<div class="cell-value">CAPITAL BOOKS<br>1011 K ST<br>SACRAMENTO, CA 95814</div>
</div>
<div class="cell">
<div class="cell-label">3 Social security wages</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">4 Social security tax withheld</div>
<div class="cell-value">1,981.58</div>
</div>
<div class="cell">
<div class="cell-label">d Control number</div>
<div class="cell-value"></div>
</div>
<div class="cell">
<div class="cell-label">5 Medicare wages and tips</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">6 Medicare tax withheld</div>
<div class="cell-value">463.44</div>
</div>
<div class="cell cell-large" style="grid-row: span 2;">
<div class="cell-label">e Employee's first name and initial Last name</div>
<div class="cell-value">JULIE BLUNT</div>
<div class="cell-label" style="margin-top:4px;">f Employee's address and ZIP code</div>
<div class="cell-value" style="font-size:7.5pt;">3910 SENATE AVE, NORTH HIGHLANDS, CA 95660</div>
</div>
<div class="cell">
<div class="cell-label">7 Social security tips</div>
</div>
<div class="cell">
<div class="cell-label">8 Allocated tips</div>
</div>
<div class="cell">
<div class="cell-label">9</div>
</div>
<div class="cell">
<div class="cell-label">10 Dependent care benefits</div>
</div>
<div class="cell">
<div class="cell-label">11 Nonqualified plans</div>
</div>
<div class="cell">
<div class="cell-label">12a See instructions for box 12</div>
</div>
<div class="cell" style="grid-column: 1 / -1; display: grid; grid-template-columns: 1fr 1fr 1fr;">
<div style="border-right: 1px solid #000; padding: 1px 3px;">
<div class="cell-label">13</div>
<div style="font-size:5.5pt;">☐ Statutory employee ☐ Retirement plan ☐ Third-party sick pay</div>
</div>
<div style="border-right: 1px solid #000; padding: 1px 3px;">
<div class="cell-label">12b</div>
</div>
<div style="padding: 1px 3px;">
<div class="cell-label">14 Other</div>
</div>
</div>
</div>
<div class="row-state">
<div class="cell"><div class="cell-label">15 State</div><div class="cell-value">CA</div></div>
<div class="cell"><div class="cell-label">Employer's state ID number</div><div class="cell-value">152-7601-7</div></div>
<div class="cell"><div class="cell-label">16 State wages, tips, etc.</div><div class="cell-value">31,961.00</div></div>
<div class="cell"><div class="cell-label">17 State income tax</div><div class="cell-value">444.53</div></div>
<div class="cell"><div class="cell-label">18 Local wages, tips, etc.</div></div>
<div class="cell"><div class="cell-label">19 Local income tax</div></div>
<div class="cell"><div class="cell-label">20 Locality name</div></div>
</div>
<div class="form-footer">
Form W-2 Wage and Tax Statement <b>2025</b> Department of the Treasury — Internal Revenue Service
</div>
</div>
<div class="separator"></div>
<div class="w2-form">
<div class="copy-label">Copy C — For EMPLOYEE'S RECORDS</div>
<div class="form-grid">
<div class="cell">
<div class="cell-label">a Employee's social security number</div>
<div class="cell-value">XXX-XX-0211</div>
</div>
<div class="cell">
<div class="cell-label">1 Wages, tips, other compensation</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">b Employer identification number (EIN)</div>
<div class="cell-value">87-1017981</div>
</div>
<div class="cell">
<div class="cell-label">2 Federal income tax withheld</div>
<div class="cell-value">1,522.49</div>
</div>
<div class="cell cell-large" style="grid-row: span 2;">
<div class="cell-label">c Employer's name, address, and ZIP code</div>
<div class="cell-value">CAPITAL BOOKS<br>1011 K ST<br>SACRAMENTO, CA 95814</div>
</div>
<div class="cell">
<div class="cell-label">3 Social security wages</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">4 Social security tax withheld</div>
<div class="cell-value">1,981.58</div>
</div>
<div class="cell">
<div class="cell-label">d Control number</div>
<div class="cell-value"></div>
</div>
<div class="cell">
<div class="cell-label">5 Medicare wages and tips</div>
<div class="cell-value">31,961.00</div>
</div>
<div class="cell">
<div class="cell-label">6 Medicare tax withheld</div>
<div class="cell-value">463.44</div>
</div>
<div class="cell cell-large" style="grid-row: span 2;">
<div class="cell-label">e Employee's first name and initial Last name</div>
<div class="cell-value">JULIE BLUNT</div>
<div class="cell-label" style="margin-top:4px;">f Employee's address and ZIP code</div>
<div class="cell-value" style="font-size:7.5pt;">3910 SENATE AVE, NORTH HIGHLANDS, CA 95660</div>
</div>
<div class="cell">
<div class="cell-label">7 Social security tips</div>
</div>
<div class="cell">
<div class="cell-label">8 Allocated tips</div>
</div>
<div class="cell">
<div class="cell-label">9</div>
</div>
<div class="cell">
<div class="cell-label">10 Dependent care benefits</div>
</div>
<div class="cell">
<div class="cell-label">11 Nonqualified plans</div>
</div>
<div class="cell">
<div class="cell-label">12a See instructions for box 12</div>
</div>
<div class="cell" style="grid-column: 1 / -1; display: grid; grid-template-columns: 1fr 1fr 1fr;">
<div style="border-right: 1px solid #000; padding: 1px 3px;">
<div class="cell-label">13</div>
<div style="font-size:5.5pt;">☐ Statutory employee ☐ Retirement plan ☐ Third-party sick pay</div>
</div>
<div style="border-right: 1px solid #000; padding: 1px 3px;">
<div class="cell-label">12b</div>
</div>
<div style="padding: 1px 3px;">
<div class="cell-label">14 Other</div>
</div>
</div>
</div>
<div class="row-state">
<div class="cell"><div class="cell-label">15 State</div><div class="cell-value">CA</div></div>
<div class="cell"><div class="cell-label">Employer's state ID number</div><div class="cell-value">152-7601-7</div></div>
<div class="cell"><div class="cell-label">16 State wages, tips, etc.</div><div class="cell-value">31,961.00</div></div>
<div class="cell"><div class="cell-label">17 State income tax</div><div class="cell-value">444.53</div></div>
<div class="cell"><div class="cell-label">18 Local wages, tips, etc.</div></div>
<div class="cell"><div class="cell-label">19 Local income tax</div></div>
<div class="cell"><div class="cell-label">20 Locality name</div></div>
</div>
<div class="form-footer">
Form W-2 Wage and Tax Statement <b>2025</b> Department of the Treasury — Internal Revenue Service
</div>
</div>
</body>
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