TN 5 (09-82)

RM 03146.099 Exhibits

A. Trust Fund Statistics Sysout

1. Page 1

TRUST FUND STATISTICS

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

REGULAR

1998

0

$

.00

REGULAR

1997

0

$

.00

REGULAR

1996

0

$

.00

REGULAR

1995

0

$

.00

REGULAR

1994

0

$

.00

REGULAR

1993

0

$

.00

REGULAR

1992

0

$

.00

REGULAR

1991

0

$

.00

REGULAR

1990

0

$

.00

REGULAR

1989

0

$

.00

REGULAR

1988

0

$

.00

REGULAR

1987

0

$

.00

REGULAR

1986

0

$

.00

REGULAR

1985

0

$

.00

REGULAR

1984

0

$

.00

REGULAR

1983

0

$

.00

REGULAR

1982

0

$

.00

REGULAR

1981

0

$

.00

REGULAR

1980

0

$

.00

REGULAR

1979

0

$

.00

REGULAR

1978

0

$

.00

REGULAR

1977

0

$

.00

REGULAR

1976

0

$

.00

REGULAR

1975

0

$

.00

REGULAR

1974

0

$

.00

REGULAR

1973

0

$

.00

REGULAR

1972

0

$

.00

REGULAR

1971

0

$

.00

REGULAR

197;

0

$

.00

REGULAR

1969

0

$

.00

REGULAR

1968

0

$

.00

REGULAR

1967

0

$

.00

REGULAR

1966

0

$

.00

REGULAR

1963 - 1965

0

$

.00

REGULAR

1962

0

$

.00

REGULAR

1960 - 1961

0

$

.00

REGULAR

1959

0

$

.00

REGULAR

1957 - 1958

0

$

.00

REGULAR

1954 - 1956

0

$

.00

REGULAR

1950 - 1953

0

$

.00

REGULAR

1937 - 1949

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

 

2. Page 2

TRUST FUND STATISTICS

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

TIPS

1998

0

$

.00

TIPS

1997

0

$

.00

TIPS

1996

0

$

.00

TIPS

1995

0

$

.00

TIPS

1994

0

$

.00

TIPS

1993

0

$

.00

TIPS

1992

0

$

.00

TIPS

1991

0

$

.00

TIPS

1990

0

$

.00

TIPS

1989

0

$

.00

TIPS

1988

0

$

.00

TIPS

1987

0

$

.00

TIPS

1986

0

$

.00

TIPS

1985

0

$

.00

TIPS

1984

0

$

.00

TIPS

1983

0

$

.00

TIPS

1982

0

$

.00

TIPS

1981

0

$

.00

TIPS

1980

0

$

.00

TIPS

1979

0

$

.00

TIPS

1978

0

$

.00

TIPS

1977

0

$

.00

TIPS

1976

0

$

.00

TIPS

1975

0

$

.00

TIPS

1974

0

$

.00

TIPS

1973

0

$

.00

TIPS

1972

0

$

.00

TIPS

1971

0

$

.00

TIPS

1970

0

$

.00

TIPS

1969

0

$

.00

TIPS

1968

0

$

.00

TIPS

1967

0

$

.00

TIPS

1966

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

3. Page 3

TRUST FUND STATISTICS

 

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

AGRICULTURAL

1998

0

$

.00

AGRICULTURAL

1997

0

$

.00

AGRICULTURAL

1996

0

$

.00

AGRICULTURAL

1995

0

$

.00

AGRICULTURAL

1994

0

$

.00

AGRICULTURAL

1993

0

$

.00

AGRICULTURAL

1992

0

$

.00

AGRICULTURAL

1991

0

$

.00

AGRICULTURAL

1990

0

$

.00

AGRICULTURAL

1989

0

$

.00

AGRICULTURAL

1988

0

$

.00

AGRICULTURAL

1987

0

$

.00

AGRICULTURAL

1986

0

$

.00

AGRICULTURAL

1985

0

$

.00

AGRICULTURAL

1984

0

$

.00

AGRICULTURAL

1983

0

$

.00

AGRICULTURAL

1982

0

$

.00

AGRICULTURAL

1981

0

$

.00

AGRICULTURAL

1980

0

$

.00

AGRICULTURAL

1979

0

$

.00

AGRICULTURAL

1978

0

$

.00

AGRICULTURAL

1977

0

$

.00

AGRICULTURAL

1976

0

$

.00

AGRICULTURAL

1975

0

$

.00

AGRICULTURAL

1974

0

$

.00

AGRICULTURAL

1973

0

$

.00

AGRICULTURAL

1972

0

$

.00

AGRICULTURAL

1971

0

$

.00

AGRICULTURAL

1970

0

$

.00

AGRICULTURAL

1969

0

$

.00

AGRICULTURAL

1968

0

$

.00

AGRICULTURAL

1967

0

$

.00

AGRICULTURAL

1966

0

$

.00

AGRICULTURAL

1963 - 1965

0

$

.00

AGRICULTURAL

1962

0

$

.00

AGRICULTURAL

1960 - 1961

0

$

.00

AGRICULTURAL

1959

0

$

.00

AGRICULTURAL

1957 - 1958

0

$

.00

AGRICULTURAL

1955 - 1956

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

4. Page 4

TRUST FUND STATISTICS

 

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

SELF EMPLOYMENT

1998

0

$

.00

SELF EMPLOYMENT

1997

0

$

.00

SELF EMPLOYMENT

1996

0

$

.00

SELF EMPLOYMENT

1995

0

$

.00

SELF EMPLOYMENT

1994

0

$

.00

SELF EMPLOYMENT

1993

0

$

.00

SELF EMPLOYMENT

1992

0

$

.00

SELF EMPLOYMENT

1991

0

$

.00

SELF EMPLOYMENT

1990

0

$

.00

SELF EMPLOYMENT

1989

0

$

.00

SELF EMPLOYMENT

1988

0

$

.00

SELF EMPLOYMENT

1987

0

$

.00

SELF EMPLOYMENT

1986

0

$

.00

SELF EMPLOYMENT

1985

0

$

.00

SELF EMPLOYMENT

1984

0

$

.00

SELF EMPLOYMENT

1983

0

$

.00

SELF EMPLOYMENT

1982

0

$

.00

SELF EMPLOYMENT

1981

0

$

.00

SELF EMPLOYMENT

1980

0

$

.00

SELF EMPLOYMENT

1979

0

$

.00

SELF EMPLOYMENT

1978

0

$

.00

SELF EMPLOYMENT

1977

0

$

.00

SELF EMPLOYMENT

1976

0

$

.00

SELF EMPLOYMENT

1975

0

$

.00

SELF EMPLOYMENT

1974

0

$

.00

SELF EMPLOYMENT

1973

0

$

.00

SELF EMPLOYMENT

1972

0

$

.00

SELF EMPLOYMENT

1971

0

$

.00

SELF EMPLOYMENT

1970

0

$

.00

SELF EMPLOYMENT

1969

0

$

.00

SELF EMPLOYMENT

1968

0

$

.00

SELF EMPLOYMENT

1967

0

$

.00

SELF EMPLOYMENT

1966

0

$

.00

SELF EMPLOYMENT

1965

0

$

.00

SELF EMPLOYMENT

1964

0

$

.00

SELF EMPLOYMENT

1963

0

$

.00

SELF EMPLOYMENT

1962

0

$

.00

SELF EMPLOYMENT

1961

0

$

.00

SELF EMPLOYMENT

1960

0

$

.00

SELF EMPLOYMENT

1959

0

$

.00

SELF EMPLOYMENT

1958

0

$

.00

SELF EMPLOYMENT

1957

0

$

.00

SELF EMPLOYMENT

1956

0

$

.00

SELF EMPLOYMENT

1955

0

$

.00

SELF EMPLOYMENT

1954

0

$

.00

SELF EMPLOYMENT

1953

0

$

.00

SELF EMPLOYMENT

1952

0

$

.00

SELF EMPLOYMENT

1951

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

5. Page 5

TRUST FUND STATISTICS

 

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

 

 

 

 

 

MILITARY

1998

0

$

.00

MILITARY

1997

0

$

.00

MILITARY

1996

0

$

.00

MILITARY

1995

0

$

.00

MILITARY

1994

0

$

.00

MILITARY

1993

0

$

.00

MILITARY

1992

0

$

.00

MILITARY

1991

0

$

.00

MILITARY

1990

0

$

.00

MILITARY

1989

0

$

.00

MILITARY

1988

0

$

.00

MILITARY

1987

0

$

.00

MILITARY

1986

0

$

.00

MILITARY

1985

0

$

.00

MILITARY

1984

0

$

.00

MILITARY

1983

0

$

.00

MILITARY

1982

0

$

.00

MILITARY

1981

0

$

.00

MILITARY

1980

0

$

.00

MILITARY

1979

0

$

.00

MILITARY

1978

0

$

.00

MILITARY

1977

0

$

.00

MILITARY

1976

0

$

.00

MILITARY

1975

0

$

.00

MILITARY

1974

0

$

.00

MILITARY

1973

0

$

.00

MILITARY

1972

0

$

.00

MILITARY

1971

0

$

.00

MILITARY

1970

0

$

.00

MILITARY

1969

0

$

.00

MILITARY

1968

0

$

.00

MILITARY

1967

0

$

.00

MILITARY

1966

0

$

.00

MILITARY

1965

0

$

.00

MILITARY

1964

0

$

.00

MILITARY

1963

0

$

.00

MILITARY

1962

0

$

.00

MILITARY

1961

0

$

.00

MILITARY

1960

0

$

.00

MILITARY

1959

0

$

.00

MILITARY

1958

0

$

.00

MILITARY

1957

0

$

.00

MILITARY

1956

0

$

.00

MILITARY

1955

0

$

.00

MILITARY

1954

0

$

.00

MILITARY

1953

0

$

.00

MILITARY

1952

0

$

.00

MILITARY

1951

0

$

.00

MILITARY

1950

0

$

.00

MILITARY

1949

0

$

.00

MILITARY

1948

0

$

.00

MILITARY

1947

0

$

.00

MILITARY

1946

0

$

.00

MILITARY

1945

0

$

.00

MILITARY

1944

0

$

.00

MILITARY

1943

0

$

.00

MILITARY

1942

0

$

.00

MILITARY

1941

0

$

.00

MILITARY

1940

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

6. Page 6

TRUST FUND STATISTICS

 

 

 

VAMAS RUN NUMBER: 41

TYPE OF EMPLOYMENT:

TAX RATE PERIODS

ITEMS

 

EARNINGS

MILITARY

1939

0

$

.00

MILITARY

1938

0

$

.00

MILITARY

1937

0

$

.00

 

 

 

 

 

ALL YEARS COMBINED

 

0

$

.00

 

 

 

 

 

STATE & LOCAL

 

0

$

.00

 

 

 

 

 

NON-TAXABLE

 

0

$

.00

 

 

 

 

 

IMPOSS PER REGULAR

 

0

$

.00

 

 

 

 

 

IMPOSS PERIOD S-E

 

0

$

.00

 

 

 

 

 

TRUST FUND TOTALS

 

0

$

.00

 

B. ERTRUST Sysout

 

INTERIM TRUST FUND ADJUSTMENT DATA FROM THE IRS-941 TAPE FILES (TS0 – TS1) FOR AQ – 02

--- 06/02/81 ---

 

* * * * QUARTERLY BREAKDOWNS * * * * *

 

QUARTER ENDING

REGULAR WAGES

CASH TIPS WAGES

THERE ARE NO QUARTERLY AGRICULTURAL WAGES

TIPS

DEEMED TO BE WAGES

MARCH 31, 1981

223.37

 

 

 

DECEMBER 31, 1980

100,287,939,867.18

11,700,501.44

 

101,029,763.65

SEPTEMBER 30, 1980

18,121.21

157.21

 

47.16

JUNE 30, 1980

 

 

 

 

 

 

 

 

 

 

*****MONEY TOTALS NOT INCLUDED IN ABOVE QUARTERLY BREAKDOWNS *****

 

QUARTER ENDING

REGULAR WAGES

CASH TIPS WAGES

THERE ARE NO QUARTERLY AGRICULTURAL WAGES

TIPS

DEEMED TO BE WAGES

1978

 

 

900,000.00

 

1979

1,001.20

.10

 

 

1980

14,271.06

154.63

 

7.83-

1981

 

 

 

 

1982

 

 

 

 

1983

 

 

 

 

1984

 

 

 

 

1985

271,387,136.41

 

 

 

 

 

 

 

 

 

 

 

VALIDATION TEST OUTPUT

SR 3414

 

 

C. Trust Fund Ledgers

1. SSA-7775

a. Page 1

 

STATEMENT OF TOTAL EMPLOYEE WAGES (Forms 941 and 942) UNDER THE FEDERAL CONTRIBUTIONS ACT
AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

 

ACCOUNTING QUARTER _____

CURRENT AND PREVIOUS
QUARTERS

ALL OTHER QUARTERS BY TAX RATE PERIOD (DOES NOT INCLUDE
CURRENT OR PREVIOUS QUARTER)

Month
And
Day

(1)
Current
A/Q _____

(2)
PREVIOUS
A/Q ___ (Quarter preceding current quarter)

(3)

(4)

(5)

(6)

(7)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

Form SSA-7775 (4-82) Formerly CO-8027) Page 1 of 4

 

b. Page 2

STATEMENT OF TOTAL EMPLOYEE WAGES (Forms 941 and 942) UNDER THE FEDERAL CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

ALL OTHER QUARTERS BY TAX RATE PERIOD (DOES NOT INCLUDE CURRENT OR PREVIOUS QUARTER)

Month
And
Day

(8)

(9)

(10)
1974

(11)
1973

(12)
1972

(13)
1971

(14)
1970

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

Form SSA-7775 (4-82) Formerly CO-8027) Page 2 of 4

c. Page 3

STATEMENT OF TOTAL EMPLOYEE WAGES (Forms 941 and 942) UNDER THE FEDERAL CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

ALL OTHER QUARTERS BY TAX RATE PERIOD (DOES NOT INCLUDE CURRENT OR PREVIOUS QUARTER)

Month
And
Day

(15)
1989

(16)
1988

(17)
1987

(18)
1986

(19)
1985-1983

(20)
1982

(21)
1981-1980

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

Form SSA-7775 (4-82) Formerly CO-8027) Page 3 of 4

d. Page 4

STATEMENT OF TOTAL EMPLOYEE WAGES (Forms 941 and 942) UNDER THE FEDERAL CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

ALL OTHER QUARTERS BY TAX RATE PERIOD (DOES NOT INCLUDE CURRENT OR PREVIOUS QUARTER)

Month
And
Day

(22)
1959

(23)
1958-1957

(24)
1956-1954

(25)
1953-1950

(26)
1949-1937

(27)
TO - DATE
Col. 1 thru 26

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

Form SSA-7775 (4-82) Formerly CO-8027) Page 4 of 4

2. SSA-7776

a. Page 1

STATEMENT OF TOTAL EMPLOYEE TIPS REPORTED UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

CURRENT AND PREVIOUS
QUARTERS

ALL OTHERS BY TAX RATE PERIOD (Does not include current or previous quarter)

Month
And
Day

(28)
Current
A/Q ______

(29)
PREVIOUS
A/Q _____
(Quarter preceding
current
quarter)

(30)

(31)

(32)

(33)

(34)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

Form SSA-7776 (4-82) (formerly CO-8027a) Page 1 of 3

b. Page 2

STATEMENT OF TOTAL EMPLOYEE TIPS REPORTED UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

ALL OTHERS BY TAX RATE PERIOD (Does not include current or previous quarter)

Month
And
Day

(35)

(36)

(37)

(38)
1974

(39)
1973

(40)
1972

(41)
1971

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

 

Form SSA-7776 (4-82) (formerly CO-8027a) Page 2 of 3

c. Page 3

STATEMENT OF TOTAL EMPLOYEE TIPS REPORTED UNDER THE FEDERAL INSURANCE CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

ACCOUNTING QUARTER _____

ALL OTHERS BY TAX RATE PERIOD (Does not include current or previous quarter)

Month
And
Day

(42)
1970

(43)
1989

(44)
1988

(45)
1987

(46)
1966

(47)
TO - DATE
Col. 28 thru 46

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TOTAL

 

 

 

 

 

 

Form SSA-7776 (4-82) (formerly CO-8027a) Page 3 of 3

3. SSA-7777

a. Page 1

STATEMENT OF TOTAL SELF EMPLOYED (Calendar, Adjustment, Short and Fiscal Year)
EARNINGS UNDER THE
FEDERAL CONTRIBUTIONS ACT AS RECORDED BY THE SOCIAL SECURITY ADMINISTRATION

Accounting Quarter _____

YEARS

Month
And
Day

(74)

(75)

(76)

(77)

(78)

(79)

(80)

(81)

(82)