--- title: "DOJ Epstein Files, Data Set 9 (EFTA00175998)" source: "DOJ Epstein Files, Data Set 9" sourceUrl: "https://huggingface.co/datasets/ishumilin/epstein-files-ocr-complete" date: "2026-01-01" category: "DOJ Data Set" eftaNumber: "EFTA00175998" ocrPages: 0 ocrChars: 209285 ocrElapsed: 0.0 parseTier: "external" engine: "ishumilin OCR pipeline (engine undisclosed; CC0 mirror)" externalSource: "ishumilin-ocr-complete" externalLicense: "CC0-1.0" externalCredit: "ishumilin/epstein-files-ocr-complete (Hugging Face)" externalUrl: "https://huggingface.co/datasets/ishumilin/epstein-files-ocr-complete" --- EFTA00175998 # LAW OFFICES OF GERALD B. LEFCOURT, P.C. A PROFESSIONAL CORPORATION 148 EAST 78TH STREET NEW YORK, NEW YORK 10021 GERALD B. LEFCOURT lefcourt@lefcourtlaw.com | Name | Contact Information | | :--- | :--- | | SHERYL E. REICH | reich@lefcourtlaw.com | | RENATO C. STABILE | stabile@lefcourtlaw.com | | FAITH A. FRIEDMAN | ffriedman@lefcourtlaw.com | June 12, 2007 ## BY FEDERAL EXPRESS A. Marie Villafaña, Esq. Assistant United States Attorney Office of the United States Attorney Southern District of Florida 500 South Australian Avenue, Suite 400 West Palm Beach, Florida 33401 Subpoenas dated May 31, 2007, to J. Epstein Virgin Islands Foundation, Inc., J. Epstein & Co., Inc.; Epstein Interests; and Financial Trust Company, Inc. Dear Ms. Villafana: I write to respond to the subpoenas served on the above entities all dated May 31, 2007. Each of the subpoenas has a substantively identical Attachment to Subpoena describing the documents requested. Be advised that J. Epstein & Co., Inc., executed a certificate of dissolution in December 2000 and therefore could not have any documents responsive to the subpoena. Please be further advised that no entity has any documents responsive to Request Nos.1,3,4 and 5. We are still in the process of ascertaining whether documents responsive to Request No.2 exist, and will provide them to you, assuming they do exist, as soon as we are able to do so. Finally, we have enclosed for your review all documents we believe to be responsive to Request No.6, including a schedule of the corporate directors, board members and shareholders of each entity, to the extent the question is applicable to each entity. The documents provided bear the following production numbers, which we note were placed on said documents for control purposes only and do not appear on the documents in the normal course: Schedule of Corporate Directors, Board Members, Shareholders J. Epstein Virgin Islands Foundation, Inc. JEVIF 0001 EFTA00175999 LAW OFFICES OF GERALD B. LEFCOURT, P.C. A. Marie Villafaña, Esq. Assistant United States Attorney Office of the United States Attorney Southern District of Florida June 12, 2007 Page 2
IRS Form 1096 J. Epstein Virgin Islands Foundation, Inc.2004JEVIF 0002
IRS Form 1099 J. Epstein Virgin Islands Foundation,Inc.2004JEVIF 0003
IRS Form 1096 J. Epstein Virgin Islands Foundation,Inc.2003JEVIF 0004
IRS Form 1099 J. Epstein Virgin Islands Foundation,Inc.2003JEVIF 0005
Schedule of Corporate Directors, Board Members, Shareholders
Epstein InterestsEI 0001
IRS Forms W2 Epstein Interests 2006EI 0002-0003
IRS Form W2 Epstein Interests 2005EI 0004
IRS Form 1096 Epstein Interests 2005EI 0005
IRS Form 1099 Epstein Interests 2005EI 0006
Financial Trust Co., Inc.FTC 0001
IRS Form W3 Financial Trust Co., Inc.2006FTC 0002
IRS Form W2 Financial Trust Co., Inc.2006FTC 0003-0008
IRS Form W3 Financial Trust Co., Inc.2005FTC 0009
IRS Form W2 Financial Trust Co., Inc.2005FTC 0010-0015
IRS Form W3 Financial Trust Co., Inc.2004FTC 0016
IRS Form W2 Financial Trust Co., Inc.2004FTC 0017-0022
IRS Form W3 Financial Trust Co., Inc.2003FTC 0023
IRS Form W2 Financial Trust Co., Inc.2003FTC 0024-0030
IRS Form 1096 Financial Trust Co., Inc.2006FTC 0031
IRS Form 1099 Financial Trust Co., Inc.2006FTC 0032-0033
IRS Form 1096 Financial Trust Co., Inc.2005FTC 0034
IRS Form 1099 Financial Trust Co., Inc.2005FTC 0035-0036
IRS Form 1096 Financial Trust Co., Inc.2004FTC 0037
IRS Form 1099 Financial Trust Co., Inc.2004FTC 0038-0041
IRS Form 1096 Financial Trust Co., Inc.2003FTC 0042
IRS Form 1099 Financial Trust Co., Inc.2003FTC 0043-0045
EFTA00176000 LAW OFFICES OF GERALD B. LEFCOURT, P.C. A. Marie Villafaña, Esq. Assistant United States Attorney Office of the United States Attorney Southern District of Florida June 12, 2007 If you have any questions, please do not hesitate to call. Very truly yours, Russell Lefcourt Gerald B. Lefcourt cc: Special Agent Nesbitt Kuyrkendall Lilly Ann Sanchez, Esq. ```markdown EFTA00176001 ``` Response to Request No. 6 to Subpoena dated May 31, 2007, to J. Epstein Virgin Islands Foundation, Inc. J. Epstein Virgin Islands Foundation, Inc. Corporate Directors/Board Members: Jeffrey Epstein, Cecile De Jongh, Darren Indyke No Shareholders JEVIF001 EFTA00176002 ```markdown ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsCust No. 1846-0115
2004
Form 1099-MISC
Miscellaneous Income
2 Royalties
3 Other Income
PAYER'S Federal identification numberRECIPIENT'S Identification number8 Flashing boat proceeds8 Medical and health care paymentsCopy C
For Payer or State Copy
66-058537966-0436649$$
RECIPIENT'S name, address, and ZIP code
PAUL HOFFMAN P.C.
E. VI 00804-0870
7 Nonemployee compensation$25000.008 Substitute payments in lieu of dividends or interestFor Privacy Act and Paperwork Reduction Act Notice, see the 2004 General Instructions for Forms 1099, 1098, 5498, and W-2G.
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (replaced) for resale ▷$10 Crop insurance proceeds
11$12
13 Excess golden parachute payments$14 Gross proceeds paid to an attorney
1518 State tax withheld17 State/Payer's state no.18 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2004
Form 1099-MISC
Miscellaneous Income
2 Royalties
3 Other Income4 Federal income tax withheld
5 Fishing boat proceeds6 Medical and health care payments
PAYER'S Federal identification numberRECIPIENT'S Identification number6 Fishing boat proceeds6 Medical and health care paymentsCopy C
For Payer or State Copy
RECIPIENT'S name, address, and ZIP code7 Nonemployee compensation0 Substitute payments in lieu of dividends or interestFor Privacy Act and Paperwork Reduction Act Notice, see the 2004 General Instructions for Forms 1099, 1098, 5498, and W-2G.
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▷10 Crop insurance proceeds
1112
Account number (optional)2nd TIN not.13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1516 State tax withheld17 State/Payer's state no.18 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service JEVIF003 | EFTA00176003 | | :--- | :--- ## Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Under perallitos of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. ```markdown Signature ▶ ``` COLLECTION & DEPOSIT SECTION - No. 2 ## Instructions Date > 2/11/04 Purpose of form. Use this form to transmit paper Forms 1099, 1098, 5498, and W-2G for National Revenue Service. Do not use Form 1096 to transmit electronic calls or magnetically. For magnetic media, see Form 4804. Transmission of information Returns Reported Magnetically; for electronic submissions, see Pub. 1220, Specifications for Filing Forms 1098, 1099, 5498 and W-2G Electronically or Magnetically. Who must file. The name, address, and TIN of the filer on this form must be the same as those you enter in the upper left area of Forms 1099, 1098, 5498, or W-2G. A filer includes a payer; a recipient of mortgage Interest payments (including points) or student loan Interest; an educational institution; a broker; a barter exchange; a creditor; a person reporting real estate transactions; a trustee or issuer of any Individual retirement arrangement, a Coverdell ESA, an Archer MSA (including a Medicare+Choice MSA); certain corporations; and a lender who acquires an interest in secured property or who has reason to know that the property has been abandoned. Preaddressed Form 1098, If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. If any of the preprinted information is incorrect, make corrections on the form. If you are not using a preaddressed form, enter the filer's name, address (including room, suite, or other unit number), and TIN in the spaces provided on the form. When to file. File Form 1096 with Forms 1099, 1098, or W-2G by March 1, 2004. File Form 1096 with Forms 5498, 5498-ESA, and 5498-MSA by May 31, 2004. ## Where To File Send all information returns filed on paper with Form 1096 to the following: If your principal business, office or agency, or legal residence in the case of an individual, is located in Use the following Internal Revenue Service Center address: ```markdown Alabama, Arizona, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Texas, Austin, TX 7330 ``` | Location | City | State | | :--- | :--- | :--- | | Arkansas, Connecticut, Delaware, Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, West | Cincinnati, OH 4598 | | | Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Wisconsin | | :--- | Kansas City, MO 6496 For more Information and the Privacy Act and Paperwork Reduction Act Notice, see the 2003 General Instructions for Forms 1098, 1098, 5498, and W-2G. Cat. No. 14400O Form 1096 (201 JEVÍF004 EFTA00176004
PAYER's name, street address, city, state, ZIP code, and telephone no. ENHANCED EDUCATION (J. CUPSTEIN VIRGIN ESTATE FOUNDATION INC.) 6100 RED BOOK STREET, B3 ST. THOMAS, U.S.VI 00802-13481 RentsOMB No. 1645-0115
Form 1099-MISC
Miscellaneous Income
$
$
2 Royalties
3 Other incomeState Copy or Extra File Copy
$
PAYER'S Federal identification numberRECIPIENT'S Identification number5 Pishing boat proceeds
66-055537966-0436649$
RECIPIENT'S name, address, (including apt. no.), city, state, and ZIP code PAUL HOFFMAN P.O.
P.O. BOX 870
CHARLOTTE AMALIE, 00804-0970
7 Nonemployer compensation$ 25,000.00
9 Payer made direct sales of 35,000 or more of consumer products to a buyer (recipient) for resale
11
13 Excess golden parachute payments
Account number (optional)14 Gross proceeds paid to an attorney
1516 State tax withhold
$
```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1. RentsOMB No. 1545-0115
2003
Form 1099-MISC
Miscellaneous Income
2. Royalties
3. Other income4. Federal income tax withholdState Copy or Extra File Copy
PAYER'S Federal Identification numberRECIPIENT'S Identification number5. Flashing boat proceeds8. Medical and health care payments
RECIPIENT'S name, address, (including apt, no.), city, state, and ZIP code7. Nonemployee compensation8. Substitute payments in lieu of dividends or interest
9. Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▶10. Crop insurance proceeds
11.12.
Account number (optional)13. Excess golden parachute payments14. Gross proceeds paid to an attorney
1516. State tax withheld17. State/Payer's state no.18. State Income
Department of the Treasury - Internal Revenue Service Form 1099-MISC JEVIF005 | EFTA00176005 | | :--- | :--- | This is a simple Markdown document with no headings or paragraphs. It contains a single line of text. Response to Request No. 6 to Subpoena dated May 31, 2007, to Epstein Interests Epstein Interests No Shareholders, Board Members or Corporate Directors E1001 EFTA00176006
b. Employee identification number (EIN)
13-3643429
1 Wages, tips, other compensation
60000.00
2 Federal income tax withheld
6065.04
c. Employer's name, address, and ZIP code
EPSTEIN INTERESTS
457 MADISON AVENUE
NEW YORK, NY 10022
3 Social security wages
60000.00
4 Social security tax withheld
3720.00
5 Medicare wages and tips
60000.00
6 Medicare tax withhold
870.00
7 Social security tips8 Allocated tips
d. Employee's social security number9 Advance EIC payment10 Dependent care benefits
e. Employee's first name and initial Last name Suff.11 Nonqualified plans12a See instructions for box 12
Statutory employeeRetirement planThird-party安保12b
f. Employee's address and ZIP code14 Other12c
15 State Employer's state ID number16 State wages, tips, etc.17 State Income tax18 Local wages, tips, etc.19 Local income tax20 Locality name
Department of the Treasury—Internal Revenue Service Copy D—For Employer.
TOTALS
For: Batch No. 2006/4/008591 TOTAL EMPLOYEES
For: Company 66/LMB31.20NYDD (Box 14)
1 FORMS
60,000.00 State Wages (Box 16)
3,063.96 State Income Tax (Box 17)
E1002 EFTA00176007 | OMB No. 1645-0008 LMB
b Employer identification number (EIN)
13-3643429
1 Wages, tips, other compensation
60000.00
2 Federal income tax withheld
6065.04
c Employee's name, address, and ZIP code
EPSTEIN INTERESTS
457 MADISON AVENUE
NEW YORK, NY 10022
3 Social security wages
60000.00
4 Social security tax withheld
3720.00
5 Medicare wages and tips
60000.00
6 Medicare tax withhold
870.00
7 Social security tips
d Employee's social security number
451-11-5768
9 Advance EIC payment10 Dependent care benefits
e Employee's first name and initial
LESLEY
GROFF
120 OAK STREET
NEW CANAAN, CT 06840
11 Nonqualified plans12a See instructions for box 12
13 Senior employeeRetirement planThird-party sick pay12b
14 Other
31.20 NYDD
12c
12d
f Employee's address and ZIP code
15 State
NY
Employer's state ID number
13-3643429
16 State wages, tips, etc.
60000.00
17 State Income tax
3063.96
18 Local wages, tips, etc.19 Local income tax20 Locality name
Form W-2 Wage and Tax Statement Department of the Treasury—Internal Revenue Service Copy D—For Employer. For Privacy Act and Paperwork Reduction Act Notice, see back of Copy D.
a Control numberVoidOMB No. 1545-0008
b Employer identification number (EIN)1 Wages, tips, other compensation2 Federal income tax withheld
c Employer's name, address, and ZIP code3 Social security wages4 Social security tax withheld
5 Medicare wages and tips6 Medicare tax withheld
7 Social security tips8 Allocated tips
d Employee's social security number9 Advance EIC payment10 Dependent care benefits
e Employee's first name and initial Last name Suff.11 Nonqualified plans12a See Instructions for box 12
13 Statutory employeeRetirement planThird party sick pay12b
14 Other12c
12d
f Employee's address and ZIP code
StateEmployer's state ID number16 State wages, tips, etc.17 State income tax18 Local wages, tips, etc.19 Local income tax20 Locality name
For Employer. Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see back of Copy D. E1003 EFTA00176008
a Control number
0001 66/LMB
VoidOMB No. 1545-0008 LMB0001
b Employer identification number (EIN)
13-3643429
1 Wages, tips, other compensation
60000.00
2 Federal income tax withheld
6834.27
c Employer's name, address, end ZIP code
EPSTEIN INTERESTS
457 MADISON AVENUE
NEW YORK, NY 10022
3 Social security wages
60000.00
4 Social security tax withheld
3720.00
5 Medicare wages and tips
60000.00
6 Medicare tax withhold
870.00
7 Social security tips8 Allocated tips
9 Advance EIC payment10 Dependent care benefits
d Employee's social security number
451-11-5768
11 Nonqualified plans12a See instructions for box 12
13 Statutory employees
□
Retirement plan
□
Third-party sick pay12b
e Employee's first name and initial
LESLEY
GROFF
120 OAK STREET
NEW CANAAN, CT 06840
14 Other
28.80 NYDD
12c
f Employee's address and ZIP code12d
15 State Employer's state ID number
NY 13-3643429
16 State wages, tips, etc.
60000.00
17 State income tax
3173.41
18 Local wages, tips, etc.19 Local income tax20 Locality name
Form W-2 Wage and Tax Statement Department of the Treasury—Internal Revenue Service 2005 For Privacy Act and Paperwork Reduction Act Notice, see back of Copy D. Copy D—For Employer.
a Control numberVoidOMB No. 1546-0008
b Employer identification number (EIN)1 Wages, tips, other compensation2 Federal income tax withheld
c Employer's name, address, and ZIP code3 Social security wages4 Social security tax withheld
5 Medicare wages and tips6 Medicare tax withheld
7 Social security tips8 Allocated tips
d Employee's social security number9 Advance EIC payment10 Dependent care benefits
e Employee's first name and Initial Last name
f Employee's address and ZIP code
11 Nonqualified plans12a See Instructions for box 12
13 State only Retirement plan Third-party tax pay12b
12c
14 Other12d
15 State Employer's state ID number16 State wages, tips, etc.17 State income tax18 Local wages, tips, etc.19 Local income tax20 Locality name
Form W-2 Wage and Tax Statement ## 2005 Copy D—For Employer. Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see back of Copy D. E1004 EFTA00176009 Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. ```markdown Signature ▶ Title ▶ Date ▶ ``` ## Instructions Purpose of form. Use this form to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. Do not use Form 1096 to transmit electronically or magnetically. For magnetic media, see Form 4804, Transmission of Information Returns Reported Magnetically; for electronic submissions, see Pub. 1220, Specifications for Filing Forms 1098,1099, 5498 and W-2G Electronically or Magnetically. Who must file. The name, address, and TIN of the filer on this form must be the same as those you enter in the upper left area of Forms 1099, 1098, 5498, or W-2G. A filer includes a payer; a recipient of mortgage interest payments (including points) or student loan Interest; an educational institution; a broker; a barter exchange; a creditor; a person reporting real estate transactions; a trustee or issuer of any individual retirement arrangement; a Coverdell ESA, an HSA, an Archer MSA (Including a Medicare Advantage MSA); certain corporations; certain donees of motor vehicles, boats, and airplanes; and a lender who acquires an interest in secured property or who has reason to know that the property has been abandoned. Preaddressed Form 1096. If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. If any of the preprinted Information is Incorrect, make corrections on the form. If you are not using a preaddressed form, enter the filer's name, address (including room, suite, or other unit number), and TIN In the spaces provided on the form. ## Where To File Send all information returns filed on paper with Form 1096 to the following: When to file. File Form 1096 with Forms 1099, 1098, or W-2G by February 26, 2006. File Form 1096 with Forms 5498, 5498-ESA, and 5498-SA by May 31, 2006.
If your principal business, office or agency, or legal residence in the case of an individual, is located inUse the following Internal Revenue Service Center address
Alabama, Arizona, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, TexasAustin, TX 73301
Arkansas, Connecticut, Delaware, Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, WestCincinnati, OH 45999
Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, WisconsinKansas City, MO 64999
For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2005 General Instructions for Forms 1099, 1098, 5498, and W-2G. 49-0971237 Form 1096 (Rev. 3-2005) E1005 EFTA00176010
PAYER'S name, street address, city, state, ZIP code, and telephone no.
EPSTEIN INTERESTS
457 MADISON AVENUE
NEW YORK, NY 10022
1 RentsOMC no. 1546-0115
2005
Form 1099-MISC
Miscellaneous Income
$
$
3 Other income$4 Federal income tax withheldCopy A
For Internal Revenue Service Center
File with Form 1096.
PAYER'S Federal Identification number
13-3643429
RECIPIENT'S identification number
13-2842281
5 Fishing boat proceeds$
RECIPIENT'S name
ASSOCIATES
7 Nonemployee compensation
$ 6673.00
8 Substitute payments in lieu of dividends or interestFor Privacy Act and Paperwork Reduction Act Notice, see the 2005 General Instructions for Forms 1099, 1098, 5498, and W-2G.
Street address (including apt. no.)
110 EAST 59TH STREET
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▷10 Crop insurance proceeds
City, state, and ZIP code
NEW YORK, NY 10022
1112
Account number (see instructions)2nd TIN not.
□
13 Excess golden parachute payments14 Gross proceeds paid to an attorney
15a Section 409A deferrals
$
15b Section 409A Income
$
16 State tax withheld
$
17 State/Payer's state no.18 State income
$
Form 1099-MISC Department of the Treasury - Internal Revenue Service Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page ```markdown 9595 □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2005
Form 1099-MISC
Miscellaneous Income
$
2 Royalties
3 Other Income4 Federal income tax withheldCopy A
For Internal Revenue Service Center
File with Form 1096.
PAYER'S Federal Identification numberRECIPIENT'S identification number5 Fishing boat proceeds6 Medical and health care payments
RECIPIENT'S name7 Nonemployee compensation8 Substitute payments in lieu of dividends or interestFor Privacy Act and Paperwork Reduction Act Notice, see the 2005 General Instructions for Forms 1099, 1098, 5498, and W-2G.
Street address (including apt. no.)9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale □10 Crop insurance proceeds
City, state, and ZIP code1112
Account number (see instructions)2nd TIN not.13 Excess golden parachute payments14 Gross proceeds paid to an attorney
15a Section 409A deferrals15b Section 409A Income16 State tax withhold17 State/Payer's state no.18 State Income
$$$$$
Form 1099-MISC Department of the Treasury - Internal Revenue E1006 Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page EFTA00176011 Response to Request No. 6 to Subpoena dated May 31, 2007, to Financial Trust Company, Inc. Financial Trust Company, Inc. Corporate Directors/Board Members: Jeffrey Epstein, Cecile DeJongh, Ghislaine Maxwell Shareholders: Jeffrey Epstein FTCO001 EFTA00176012
a Control number33333For Official Use Only ► OMB No. 1545-0008
b Kind of Payer941-SS Military 943 Third-party slok pay1 Wages, tips, other compensation770439.002 Income tax withheld 128484.00
3 Social security wages587136.844 Social security tax withheld 36402.49
5 Medicare wages and tips810384.626 Medicare tax withheld 11750.58
c Total number of Forms W-2 11d Establishment number
e Employer Identification number (EIN) 66-05674187 Social security tips8
f Employer's name FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QUARTER B-3 ST. THOMAS 008029 Advance EIC payments10
11 Nonqualified plans12 Deferred compensation 39945.62
13 For third-party slok pay use only
14 Income tax withheld by payer of third-party slok pay
g Employer's address and ZIP code
h Other EIN used this year
i Employer's territorial ID number
Contact person JEANNE BRENNANTelephone number (340) 775-2525For Official Use Only
E-mail addressFax number (340) 775-2528
## Form W-3SS Transmittal of Wage and Tax Statements Department of the Treasury Internal Revenue Service Contact the Division of Revenue and Taxation, Commonwealth of the Northern Mariana Islands, for the address to send Copy 1 of Forms W-2OM and W-3SS. Shipping and mailing. If you file more than one type of form, please group forms of the same type with a separate Form W-3SS for each type. For example, send Forms W-2GU with one Form W-9SS and Forms W-2AS with a second Form W-9SS. Forms W-2AS, W-2GU, W-2CM, or W-2VI are printed two forms to a page. Send the whole page of Copies A and 1 even if one of the forms is blank or "Void." Prepare and file Forms W-2 either alphabetically by employees' last names or numerically by employees' social security numbers. Do not staple or tape the forms together and do not fold them. Send the forms in a flat mailing. ## General Instructions for Forms W-2 W-2GU, W-2CM, and W-2VI Furnishing Copies B and C to employees. Furnish Copies B and C of Forms W-0248, W-0249, W-0250 and W-0251. Forms W-2AS, W-2GU, W-2CM, and W-2VI to your employer by January 31, 2007. If employment ends before December 31, 2008, you may furnish the copies any time after employment ends but no later than January 31, 2007. If the employee asks for the form, furnish him or her the completed copies within 60 days of the request or within 30 days of the last wage payment, whichever is later. If an employee loses a form, write "REISSUED STATEMENT" on the new copy (unless it was furnished electronically), but do not send Copy A of the reissued statement to the SSA. Employers are not prohibited (by the Internal Revenue Code) from charging a fee for the issuance of a duplicate Form W-2AS, W-2GU, W-2CM, or W-2VI. Extension to furnish Forms W-2 to employees. You may request an extension of time to furnish Forma W-2 to employees by sending a letter to: ```markdown IRS Enterprise Computing Center—Mertinsburg Information Reporting Program Attn: Extension of Time Coordinator 240 Murail Drive Keameysville, WV 25430 ``` Mail your letter on or before the due date for furnishing Forms W-2 to employees. It must include: - Your name and address, - Your employer identification number (EIN). - A statement that you are requesting an extension to furnish "Forma W-2" to employees, - Reason for delay, and - Your signature or that of your authorized agent. Undeliverable forms. Keep for 4 years any employee copies of Forms W-2AS, W-2GU, W-2OM, or W-2VI that you tried to deliver but could not. Do not send undeliverable Forms W-2 to the SSA. Calendar year basis. Base all entries on Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS on a calendar year. Use the correct year form. Electronic reporting. If you are required to file 280 or more Forms W-2AS, W-2GU, W-2OM, or W-2VI, you must file them electronically. You can get specifications for filing this information electronically by visiting Social Security's Employer Reporting Instructions and Information website at www.socialsecurity.gov/employer or by contacting an SSA Employer Services Liaison Officer (BSLO) at for the U.S. Virgin Islands or 610-970-8247 for Guam and American Samoa. SSA will no longer accept any type of physical media (magnetic tape, cartridge, diskette, etc.) submissions of Form W-2 reports. FTC0002 EFTA00176013
aControl number22222VoidOMB No. 1545-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
95701.00
2 VI income tax withheld
10920.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS 00802
3 Social security wages
94200.00
4 Social security tax withheld
5840.40
5 Medicare wages and tips
105701.00
6 Medicare tax withheld
1532.66
7 Social security tips8
d Employee's social security number
150-46-4746
9 Advance EIC payment10
e Employee's first name and initial
DEANNE
6501 RED HOOK PLAZA STE.
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-3SS instructions
S 10000.00
13 Ministry employeeStatment SMNThird-party work site
14 Other12b C 193.31
12c
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer ## 2006 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS.
a Control number22222VoidOMB No. 1645-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
44771.16
2 VI Income tax withheld
4649.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
49713.02
4 Social security tax withheld
3082.21
5 Medicare wages and tips
49713.02
6 Medicare tax withhold
720.84
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-03-9952
11 Nonqualified plans12a See Form W-SSS Instructions
S | 4941.86
e Employee's first name and initial
LEON A CASEX, SR.
P.O. BOX 503032
ST. THOMAS, VI, 00805
12b C | 294.58
14 Other12o
f Employee's address and ZIP code
Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. ```markdown FTC0003 ``` EFTA00176014
a Control number22222VoidOMB No. 1848-0098
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
36501.04
2 VI income tax withheld
5365.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
39716.53
4 Social security tax withhold
2462.42
5 Medicare wages and tips
39716.53
6 Medicare tax withhold
575.89
7 Social security tips8
d Employee's social security number
580-13-4697
9 Advance EIC payment
e Employee's first name and initial
JAMIE I CORNELIUS
6501 RED HOOK PLAZA
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-385 instructions
S 3215.49
13 Staffy employee plan12b C 53.17
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2006 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS.
a Control number22222VoidOMB No. 1548-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
149125.48
2 VI income tax withheld
28186.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS □, 00802
3 Social security wages
94200.00
4 Social security tax withheld
5840.40
5 Medicare wages and tips
159125.48
6 Medicare tax withheld
2307.32
7 Social security tips8
9 Advance EO payment10
d Employee's social security number
580-06-1538
11 Nonqualified plans12a See Form W-3SS Instructions
C | 184.73
e Employee's first name and initial
CECILE R DE JONGH
P.O. BOX 8361
ST. THOMAS, VI, 00801
13 Insurance employee plan12b S | 10000.00
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notices and Instructions, see Form W-3SS. FTC0004 EFTA00176015
a Control number22222VoidOMB No. 1545-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
241021.30
2 VI Income tax withheld
65182.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
8 Social security wages
94200.00
4 Social security tax withhold
5840.40
5 Medicare wages and tips
241021.30
6 Medicare tax withhold
3494.81
7 Social security tips8
d Employee's social security number
090-44-3348
9 Advance EIC payment10
e Employee's first name and initial
JEFFREY E EPSTEIN
C/O AMERICAN YACHT HARBOR
6100 RED HOOK, SUITE 2
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-3SS Instructions
C 1021.28
10 Railway employeeRetirement planThird party sick pay12b
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2006 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3$$.
a Control number22222VoidOMB No. 1545-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
20380.75
2 VI Income tax withheld
2264.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS I, 00802
3 Social security wages
20380.75
4 Social security tax withhold
1263.61
5 Medicare wages end tips
20380.75
6 Medicare tax withhold
295.52
7 Social security tips8
d Employee's social security number
580-23-1452
10
e Employee's first name and initial Last name Suff.
TEQUASI O HENDRICKS
PO BOX 672
ST. JOHN, USVI, 00831
11 Nonqualified plans12a See Form W-3SS Instructions
16 Railway analysis12b
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. EFTA00176016
a Control number22222VoidOMB No. 1548-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
22766.07
2 VI Income tax withheld
2108.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
24063.91
4 Social security tax withhold
1491.96
5 Medicoaro wages and tips
24063.91
6 Medicare tax withhold
348.93
7 Social security tips8
d Employee's social security number
580-29-3823
9 Advance EIC payment10
e Employee's first name and initial LORETTA MCDONALD MORRELL PO BOX 306077 ST. THOMAS, VI, 0080311 Nonqualified plans12n See Form W-2SS Instructions S 1297.84
13 Staffy employee
[ ] Bulmeng plan [X] Workday sick pay
12b
12c
f Employee's address and ZIP code14 Other12d
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3SS.
a. Control number822222VoidOMB No. 1545-0008
b. Employer identification number (EIN)
66-0567418
1 Wage, tips, other compensation
45986.10
2 VI Income tax withheld
1657.00
c. Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
47613.99
4 Social security tax withheld
2952.07
5 Medicare wages and tips
47613.99
6 Medicare tax withhold
690.40
7 Social security tips8
9 Advance EIC payment10
d. Employee's social security number
580-11-2937
11 Nonqualified plans12a See Form W-SSS Instructions
S | 1627.89
e. Employee's first name and initial
UNA R PASCAL
HIDDEN VALLEY BLDG. 13 APT. 239
ST. THOMAS, VI, 00802
13 Secretary employee13b C | 40.82
14 Other12c
12d
f. Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-099. FTC0006 EFTA00176017
a Control number22222VoidOMB No. 1545-008B
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
32443.47
2 VI Income tax withheld
203.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
33689.36
4 Social security tax withheld
2088.74
5 Medicare wages and tips
33689.36
6 Medicare tax withhold
488.50
7 Social security tips8
d Employee's social security number
066-64-1041
9 Advance EIC payment10
e Employee's first name and initial Last name Suft
ANN M RODRIGUEZ
6014 ESTATE SMITHBAY
ST. THOMAS, VI 00802
11 Nonqualified plans12a See Form W-8BS Instructions
S 1245.89
13 Malayalam employee14 Malayalam employee
14 Other12b C 7.15
12o
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2006 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS.
a Control number22222VoidOMB No. 1548-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
40174.72
2 VI income tax withheld
3502.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
43275.92
4 Social security tax withheld
2683.11
5 Medicare wages and tips
43275.92
6 Medicare tax withhold
627.50
7 Social security tips8
d Employee's social security number
580-15-5038
9 Advance EIO payment10
a Employee's first name and initial Last name Suff.
JERMAINE A RUAN
UVI FAC. E. APT.1 BLDG. 3.
ST. THOMAS, VI, 00804
11 Nonqualified plans12a See Form 3368 Instructions
S 3101.20
13 Military employee14 Participant visa12b C 28.34
14 Other12c
12d
f Employee's address and ZIP code.
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-28S. EFTA00176018
a Control number222222VoidDMB No. 1846-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
41567.91
2 VI Income tax withheld
4448.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS 00802
3 Social security wages
46083.36
4 Social security tax withheld
2857.17
5 Medicare wages and tips
46083.36
6 Medicare tax withhold
668.21
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-17-3729
e Employee's first name and initial
DAFNE L WALLACE
P.O. BOX 11184
ST. THOMAS, USVI, 00801
11 Nonqualified plans12a See Form W-39S Instructions
S 4515.45
13 Emergency plan12b C 33.61
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2006 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3SS.
a Control number22222VoidCMB No. 1845-0008
b Employer identification number (EIN)1 Wages, tips, other compensation2 VI income tax withheld
c Employee's name, address, and ZIP code3 Social security wages4 Social security tax withheld
5 Medicare wages and tips6 Medicare tax withheld
7 Social security tips8
d Employee's social security number9 Advance EIC payment10
e Employee's first name and initial Last name Suff.11 Nonqualified plans12a See Form W-8SS Instructions
13 Retirement plan12b
14 Other12o
12d
f Employee's address and ZIP code
Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. FTC0008 EFTA00176019 ```markdown DO NOT STAPLE OR FOLD ```
aControl numberFor Official Use Only ► OMB No. 1545-0008
bKind of Payer841-SS Military Medicare govt. cmp. Third-party slok pay1 Wages, tips, other compensation 717905.562 Income tax withheld 116884.00
3 Social security wages 583483.314 Social security tax withheld 36175.97
cTotal number of Forms W-2 12d Establishment number5 Medicare wages and tips 751782.068 Medicare tax withhold 10900.85
e Employer identification number (EIN) 66-05674187 Social security tips8
f Employer's name FINANCIAL TRUST COMPANY, INC.9 Advance EIC payments10
6100 RED HOOK QUARTER B-3 ST. THOMAS .I, 0080211 Nonqualified plans12 Deferred compensation 33876.50
13 For third-party slok pay use only
14 Income tax withheld by payer of third-party slok pay
g Employer's address and ZIP code
h Other EIN used this year
i Employer's territorial ID number
...
Contact person JEANNE BRENNAN
E-mail addressTelephone number (340) 775-2525For Official Use Only
Fax number (340) 775-2528
Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. ```markdown Signature ▶ ``` Title > PRESIDENT ```markdown Dalo > 2/7/06 ``` ## Form W-3SS Transmittal of Wage and Tax Statements Department of the Treasury Internal Revenue Service General Instructions for Forms W-2AS, W-2GU, W-2CM, and W-2VI Furnishing Copies B and C of Forms W-2AS, W-2GU, W-2CM, and W-2VI to your employees by January 31, 2006. If employment ends before December 31, 2005, you may furnish the copies any time after employment ends but no later than January 31, 2006. If the employee asks for the form, furnish him or her the completed copies within 30 days of the request or within 30 days of the last wage payment, whichever is later. If an employee loses a form, write "REISSUED STATEMENT" on the new copy (unless it was furnished electronically), but do not send Copy A of the released statement to the SSA. Employers are not prohibited by the Internal Revenue Service No. 2 charging a fee for the issuance of a duplicate Form W-2AS, W-2GU, W-2CM, or W-2VI. Extension to furnish Forms W-2 to employees. You may request an extension of time to provide Forms W-2 to employees by sending a letter to: IRS Enterprise Computing Information Reporting Program Attn: Extension of Time Coordinator 240 Murall Drive Kearneyville, WV 28420 Mail your letter on or before the due date for furnishing Forms W-2 to employees, it must include: ```markdown = Your name and address, ``` - A statement that you are requesting an extension to furnish Forms W-2 - Your employer identification number (EIN), Undeliverable forms. Keep for 4 years any employee copies of Forms W-2AS, W-2GU, W-2CM, or W-2VI that you tried to deliver but could not. Do not send undeliverable forms to the SSA. Calendar year baals. Base all entries on Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS on a calendar year. Use the current year form. Magnetic media/electronic reporting. If you file 250 or more Forms W-2AS, W-2GU, W-2CM, or W-2VI, you must file them on magnetic media or electronically. You can get specifications for filing this information on magnetic media or electronically by visiting Social Security's Employer Reporting Instructions and Information website at www.eocialsecurity.gov/employer or by contacting an SSA Employer Services Liaison Officer (ESLO) at 787-766-5574 for the U.S. Virgin Islands or 510-970-8247 for Guam and Amagasan Samoa. SSA will not accept magnetic tape and cartridge submissions beginning with the 2005 Form W-2 reports that are due to SSA in calendar year 2005. If you file on magnetic diskette or electronically, do not file the same returns on paper. - Reeson for delay, and to employees, Note: You are encouraged to file on magnetic diskette or electronically Veven if you file fewer than 250 Forms W-2. - Your signature or that of your authorized agent. You may request a waiver on Form 8508, Request for Waver From Filling Information Returns Magnetically, Submit Form 8508 to the IRS at least 45 days before the due date of Form W-2, See Form 8508 for filling information. Taxpayer identification numbers. Employers use an employer identification number (EIN) (0D-00000000). Employees use a social security number (SSN) (000-00-0000): When you list a number, separate the nine digits properly to show the kind of number. Social security numbers are used to record employee earnings for future social security and Medicare benefits. You must show the correct social security number in box d on the Form W-2AS, W-2GU, or W-2VI. Page 3 FTC0009 EFTA00176020
e Control number22222VoidOMB No. 1846-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
35487.81
2 VI Income tax withheld
3837.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS
, 00802
3 Social security wages
39426.92
4 Social security tax withhold
2444.47
5 Medicare wages and tips
39426.92
6 Medicare tax withhold
571.69
7 Social security tips8
9 Advance EIO payment10
d Employee's social security number
580-06-2353
11 Nonqualified plans12a See Form W-SSS Instructions
S 3939.11
13 Holiday employees
X X
14 Other12b 35.82
12c
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement 2005 Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3SS.
a Control number22222VoidOMB No. 1845-0008
b Employer Identification number (EIN)
66-0567418
1 Wages, tips, other compensation
85718.27
2 VI Income tax withheld
8549.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS
, 00802
8 Social security wages
90000.00
4 Social security tax withhold
5580.00
5 Medicare wages and tips
91180.46
6 Medicare tax withhold
1322.12
7 Social security tips8
d Employee's social security number
150-46-4746
9 Advance EIO payment10
e Employee's first name and initial
JEANNE
6501 RED HOOK PLAZA STE.
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-3SS Instructions
5462.19
13 Salary employee
Relieving plan
Third-party risk pay
12b 145.04
14 Other12c
12d
f Employee's address and ZIP code
W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. FTCOOIO EFTA00176021
a Control number22222VoidOMB No. 1848-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
43574.16
2 VI Income tax withheld
4506.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.V.I, 00802
3 Social security wages
48390.99
4 Social security tax withheld
3000.24
5 Medicare wages and tips
48390.99
6 Medicare tax withhold
701.67
7 Social security tips8
d Employer's social security number
580-03-9952
9 Advance BIQ payment10
e Employee's first name and initial
LEON A CASEY, SR.
P.O. BOX 503032
ST. THOMAS, VI, 00805
11 Nonqualified plans12a See Form W-395 Instructions
4816.83
13 Industry employee
☐ ☐ ☐
12b C 222.21
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement 2005 Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-8SS.
a Control number22222VoidOMB No. 1846-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
41913.27
2 VI income tax withheld
5754.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS I, 00802
3 Social security wages
44630.48
4 Social security tax withheld
2767.09
8 Medicare wages and tips
44630.48
0 Medicare tax withhold
647.14
7 Social security tips8
d Employee's social security number
580-13-4697
9 Advance EIC payment10
e Employee's first name and initial
JAMIE I CORNELIUS
6501 RED HOOK PLAZA
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a Sea Form W-3SS Instructions
2717.21
13 Military employee12b
48.10
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-SSS. FTCOOII EFTA00176022
aControl number22222VoidOMB No. 1845-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
99216.23
2 VI income tax withheld
18661.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
90000.00
4 Social security tax withhold
5580.00
5 Medicare wages and tips
106096.99
6 Medicare tax withhold
1538.41
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-06-1538
e Employee's first name and initial Last name
CECILE R DE JONGH
P.O. BOX 8361
ST. THOMAS, VI, 00801
11 Nonqualified plans12a Sos Form W-388 Instructions
6880.76
13 Summary analysis12b 177.95
14 Other12a
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3SS.
a Control number22222VoldOMB No. 1545-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
241021.30
2 VI income tax withheld
65631.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
90000.00
4 Social security tax withhold
5580.00
5 Medicare wages and tips
241021.30
6 Medicare tax withhold
3494.81
7 Social security tips8
9 Advance EIO payment10
d Employee's social security number
090-44-3348
e Employee's first name and initial
JEFFREY E EPSTEIN
C/O AMERICAN YACHT HARBOR
6100 RED HOOK, SUITE 2
ST. THOMAS, VI, 00802
11 Nonqualified plans12a Snee Form W-3SS instructions
C 1021.28
13 Subsidy employee
intiminal pay
third-party risk pay
12b
14 Other12c
12d
f Employee's address and ZIP code.
2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. FTC0012 EFTA00176023
a Control number22222VoidOMB No. 1546-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
650.00
2 VI Income tax withheld
68.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
650.00
4 Social security tax withhold
40.30
5 Medicare wages and tips
650.00
6 Medicare tax withhold
9.43
7 Social security tips8
d Employee's social security number
580-23-1452
9 Advance EIO payment10
e Employee's first name and initial
TEQUASI O HENDRICKS
PO BOX 672
ST. JOHN, USVI, 00831
11 Nonqualified plans12n See Form W-38B instructions
13 Business employment plan14 National plan12b
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-355.
a Control number22222VoidOMB No. 1845-0008
b Employer Identification number (EIN)
66-0567418
1 Wages, tips, other compensation
21670.14
2 VI Income tax withheld
1815.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
22396.74
4 Social security tax withheld
1388.60
5 Medicare wages and tips
22396.74
6 Medicare tax withhold
324.75
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-29-3823
e Employee's first name and initial
LORETTA MCDONALD MORRELL
PO BOX 306077
ST. THOMAS, VI, 00803
11 Nonqualified plans12a See Form W-355 instructions
126.60
13 Sick pay employee
29
12b
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS. ```markdown FTC0013 ``` EFTA00176024
a Control number22222VoidOMB No. 1546-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
41893.44
2 VI income tax withhold
1052.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
43126.06
4 Social security tax withhold
2673.82
5 Medicare wages and tips
43126.06
6 Medicare tax withhold
625.33
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-11-2937
e Employee's first name and initial
UNA R PASCAL
HIDDEN VALLEY BLDG. 13 APT. 239
CHARLOTTE AMALIE, VI, 00802
11 Nonqualified plans12a See Form W-388 Instructions
S 1232.62
13 Highway segment
Adjustment plan
Traffic safety play
12b C 37.32
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS.
a Control number22222VoidOMB No. 1545-000B
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
29819.87
2 VI Income tax withheld
4.00
e Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
9 Social security wages
30695.54
4 Social security tax withheld
1903.12
8 ModiCare wages and tips
30695.54
6 ModiCare tax withhold
445.09
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
066-64-1041
11 * Nonqualified plans12a See Form W-365 Instructions
875.67
e Employee's first name and initial
ANN M RODRIGUEZ
6014 ESTATE SMITHBAY
ST. THOMAS, VI 00802
12b See Form W-365 Instructions
5.03
14 Other12a
12d
f Employee's address and ZIP code
Form W-2U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-BSS. FTCO014 EFTA00176025
a Control number22222VoidOMB No. 1545-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
38196.15
2 VI income tax withheld
3250.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS I, 00802
3 Social security wages
41069.29
4 Social security tax withhold
2546.30
5 Medicare wages and tips
41069.29
6 Medicare tax withhold
595.50
7 Social security tips8
d Employee's social security number
580-15-5038
9 Advance EIO payment10
e Employee's first name and initial Last name
JERMAINE A RUAN
UVI FAC. E. APT.1 BLDG. 3.
ST. THOMAS, VI, 00804
11 Nonqualified plans12a See Form W-3SS Instructions
2873.14
18 Banked employee19 Trustee use only
14 Other18b C 24.03
12c
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-SSS.
a Control number22222VoidOMB No. 1645-0008
b Employer identification number (EIN)
66-0567418
1 Wages, tips, other compensation
38744.92
2 VI Income tax withheld
3757.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS, 00802
3 Social security wages
43097.29
4 Social security tax withheld
2672.03
6 Medicare wages and tips
43097.29
6 Medicare tax withhold
624.91
7 Social security tips8
9 Advance EIO payment10
e Employee's first name and initial
DAPHNE L WALLACE
P.O. BOX 11184
ST. THOMAS, USVI, 00801
11 Nonqualified plans12a See Form W-38S Instructions
S 4352.37
13 Banking employees12b C 30.29
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Copy 1-For VI Bureau of Internal Revenue or Copy D-For Employer 2005 Department of the Treasury—Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-0SS. FTC0015 EFTA00176026 ```markdown DG-NOT STAPLE OR FOLD ```
a Control number33333For Official Use Only
OMB No. 1545-0008
b Kind of Payer941-8B Military 94B Helid, emp. Medicare gov. emp. Third-party sick pay1 Wages, tips, other compensation2 Income tax withheld
732788.09113360.00
c Total number of Forms W-2 12d Establishment number3 Social security wages4 Social security tax withhold
600413.9637225.68
e Employer identification number5 Medicare wages and tips6 Medicare tax withhold
66-05674187 Social security tips8
f Employer's name FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QUARTER B-3 ST. THOMAS, USVI 008029 Advance ID payments10
11 Nonqualified plans12 Deferred compensation
13 For third-party sick pay use only35019.95
14 Income tax withhold by payer of third-party sick pay
h Other EIN used this year16 Check the appropriate box
Type of Form W-2AG W-2OM W-2GU W-2VI
i Employer's territorial ID number
Contact person Jeanne Brennan
E-mail address
Telephone number
(340) 775-2525
Fax number
(340) 775-2528
For Official Use Only
Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. ```markdown Title ▶ Controller ``` ```markdown Date ▶ x / 15 / 0₅ ``` 2004 Department of the Treasury Internal Revenue Service ```markdown end this entire page with the entire Copy A page of Forms W-2AS, W-2GU, W-2CM, or W-2VI > the Social Security Administration (SSA). Photocopies are not acceptable. > not send any remittance (cash, checks, money orders, etc.) with Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS. ``` Instructions for Forms W-2AS, W-2GU, W-2VK and W-3SS Notice references are to the Internal Revenue Code unless otherwise noted. ems To Note new size for 2004 Forms W-2AS, W-2GU, W-2VI, and W-3SS were reformatted to conform with the guidelines used in the substitute black and white laser Forms W-2 and W-3HDMIS shown in Exhibits E and F of the May 2008 revision of Pub. 1141, General Rules and Specifications for Substitute Forms W-2 and W-3. This change allows programmers to write universal code for data entry on both the official and the laser-printed versions of the forms. Make certain that Copy A of your paper forms W-2AS, W-GU, W-2VI, and W-3SS reflects these changes. amoval of dollar signs and shading. The dollar sign and shading have been moved from Copy A of Forms W-2AS, W-2GU, W-2VI, and W-39S to provide pro space. Do not show dollar signs ("$") when reporting money amounts. e Copy.A of Form W-3SS with Copy A of Form W-2AS, W-2GU, W-2CM, or 2VI (including reports filed on magnetic media) by February 28, 2005. However, if you file electronically, you may file by March 31, 2005. See the SSA webalto at www.socialsecurity.gov/employer/ for electronic filing options. sw reporting code for box 12. A new code (Code W—Employer’s contribution on employee’s Health Savings Account) has been added for use in box 12 of arms W-2AS, W-2GU, and W-2VI. See page 5 for details. ## ```markdown 'hen To File ``` Extension to file. You may request an extension of time to file Form W-2AS, W-2GU, W-2CM, or W-2VI by sending Form 8609, Application for Extension of Time To File Information Returns, to the address shown on that form. You must request the extension by the due date of the forms for your request to be considered. You will have an additional 30 days to file. See Form 8609 for details. Caution: Even if you receive an extension of time to file Forms W-2AS, W-2GU, W-2CM, or W-2VI, you must still furnish the forms to your employees by January 31, 2005. But see Extension to furnish Forms W-2 to employees on page 3. ## Where To File Copy A Send the entire first page of this form (Copy A) with the entire Copy A page of Form W-2AS, W-2GU, W-2CM, or W-2VI to: ## Social Security Administration Data Operations Center Wilkes-Barre, PA 18769-0001 Note: If you use "Certified Mail" to file, change the ZIP code to "18769-0002." If you use an IRS-approved private delivery service, add "ATTN: W-2 Process, 1150 E. Mountain Dr." to the address and change the ZIP code to "18702-7997." See Circular E (Pub. 15), Employer’s Tax Guide, for a list of IRS-approved private delivery services. Also see Where to file Copy 1 and Shipping and mailing on page 2. FTCO016 Cnt. No. 101178 ```markdown EFTA00176027 ```
a Control numberVoidOMB No. 1545-0008
b Employer identification number
66-0567418
1 Wages, tips, other compensation
59341.18
2 VI income tax withheld
6418.00
a Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
65841.18
4 Social security tax withheld
4082.15
5 Medicare wages and tips
65841.18
6 Medicare tax withheld
954.70
7 Social security tips8
8 Advance EIC payment10
d Employee's social security number
580-06-2353
11 Nonqualified plans12a See Form W-3SS instructions
S 6500.00
e Employee's first name and initial
DALE BASTIAN GORDON
P.O. BOX 115
ST. THOMAS, VI, 00804
13 Retirement plan12b C 91.22
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Department of the Treasury - Internal Revenue Service 2004 ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3S!
b Employer identification number
66-0567418
1 Wages, tips, other compensation
81917.11
2 VI Income tax withheld
8022.00
c Employer's name, address, and ZIP code:
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
87137.22
4 Social security tax withhold
5402.51
5 Medicare wages and tips
87137.22
6 Medicare tax withhold
1263.49
7 Social security tips8
d Employee's social security number
150-46-4746
9 Advance EIC payment10
c Employee's first name and initial Last name
JEANNE
6501 RED HOOK PLAZA STE.
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a San Form W-SSS Instructions
S | 5220.11
13 Retirement employee Retirement plan Third-party stock pay12b C | 137.25
14 Other12c
12d
f Employee's address and ZIP code
U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Servi For Privacy Act and Paperwork Reduction Act Notices and Instructions, see Form W-35 ```markdown Copy D - For Employer FTC0017 ``` EFTA00176028
a Control numberVoidOMB No. 1545-0009
b Employer identification number
66-0567418
1 Wages, tips, other compensation
42312.73
2 VI income tax withheld
4328.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
46990.63
4 Social security tax withhold
2913.42
5 Medicare wages and taxes
46990.63
6 Medicare tax withhold
681.36
7 Social security tips8
9 Advance EIC payment10
e Employee's first name and initial
LEON A
CASEY, SR.
P.O. BOX 503032
ST. THOMAS, VI, 00805
11 Nonqualified plane12a See Form VLASS instructions
S 4677.90
13 Birthday employee
Relationment plan
Think party and play
12b C 211.63
14 Other12o
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Serv ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-35
a Control numberVoldOMB No. 1545-000B
b Employer identification number
66-0567418
1 Wages, tips, other compensation
47313.38
2 VI Income tax withheld
6911.00
c Employer's name, address, and ZIP code.
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
51249.78
4 Social security tax withheld
3177.49
5 Medicare wagues end tips
51249.78
6 Medicare tax withheld
743.12
7 Social security tips8
d Employee's social security number
580-13-4697
9 Advance EIC payment10
e Employee's first name and initial Last name
JAMIE I CORNELIUS
6501 RED HOOK PLAZA
PMB 201
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-3SS Instructions
S | 3936.40
13 Retirement employee Retirement plan Third party mask pay12b C | 44.78
14 Other12c
12d
f Employee's address and ZIP code
U.S. Virgin Islands Wage and Tax Statement 2004 ```markdown Copy D • For Employer ``` Department of the Treasury - Internal Revenue Service For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS FTC0018 EFTA00176029
a Control numberVoidOMB No. 1548-0008
b Employer Identification number
66-0567418
1 Wages, tips, other compensation
97072.89
2 VI Income tax withheld
13099.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
87900.00
4 Social security tax withhold
5449.80
5 Medicare wages and tips
102172.80
6 Medicare tax withhold
1481.51
7 Social security tips8
8 Advance EIC payment10
d Employee's social security number
580-06-1538
e Employee's first name and initial
CECILE R
P.O. BOX 8361
ST. THOMAS, VI, 00801
11 Nonqualified plans12a See Form W-335 Instructions
S 5099.91
13 Military employee
Retirement plan
Third-party aid pay
12b C 172.78
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Service ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-39
a Control numberVoidOMB No. 1545-0008
b Employer Identification number
66-0567418
1 Wages, tips, other compensation
241021.28
2 Income tax withheld
65884.00
c Employer's name, address, and ZIP code;
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B--3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
87900.00
4 Social security tax withhold
5449.80
5 Medicare wages and tips
241021.28
6 Medicare tax withhold
3494.81
7 Social security tips8
d Employee's social security number
090-44-3348
9 Advance EIC payment10
e Employee's first name and initial
JEFFREY E EPSTEIN
C/O AMERICAN YACHT HARBOR
6100 RED HOOK, SUITE 2
ST. THOMAS, VI, 00802
11 Nonqualified plans12a See Form W-388 Instructions
C | 1021.26
13 Statutory employee
Bounty/mortgage
Their own pay
12b
14 Other12a
12d
employee's address and ZIP code
```markdown W-2WI ``` U.S. Virgin Islands Wage and Tax Statement ```markdown Copy D - For Employer ``` 2004 Department of the Treasury - Internal Revenue Serv For Privacy Act and Paperwork Reduction Act Noti and Instructions, see Form W-3¢ FTC0019 EFTA00176030
aControl numberVoidOMB No. 1548-0008
b Employee identification number
66-0567418
1 Wages, tips, other compensation
2074.00
2 VI income tax withheld
175.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
2074.00
4 Social security tax withhold
128.59
5 Medicare wages and tips
2074.00
6 Medicare tax withhold
30.07
7 Social security tips8
d Employee's social security number
580-23-1452
9 Advance EIC payment10
e Employee's first name and initial
TEQUASI O HENDRICKS
PO BOX 672
ST. JOHN, USVI, 00831
11 Nonqualified plans12a See Form W-3SS instructions
13 Subsidy employeeRetirement planThird-party employer
14 Other12b
12c
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Department of the Treasury - Internal Revenue Service 2004 ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3S
a Control numberVoidOMB No. 1040-0009
b Employer Identification number
66-0567418
1 Wages, tips, other compensation
21460.81
2 VI Income tax withheld
1005.00
c Employee's name, address, and ZIP code,
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
22108.99
4 Social security tax withheld
1370.76
5 Medicare wages and tips
22108.99
6 Medicare tax withheld
320.58
7 Social security tips8
d Employee's social security number
580-29-3823
9 Advance EIC payment10
e Employee's first name and initial Last name
LORETTA MCDONALD MORRELL
PO BOX 306077
ST. THOMAS, VI, 00803
11 Nonqualified plans12a Sea Form W-3SS Instructions
S | 648.18
13 Childcare employee Retirement plan Third-party care pay12b
14 Other12c
12d
f Employee's address and ZIP code
U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Servi ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form 1W-35 FTC0020 EFTA00176031
aControl numberVoidOMB No. 1545-0006
b Employer identification number
66-0567418
1 Wages, tips, other compensation
40047.86
2 VI income tax withhold
1586.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
41285.35
4 Social security tax withhold
2559.69
5 Medicare wages and tips
41285.35
6 Medicare tax withhold
598.64
7 Social security tips8
9 Advance BIC payment10
e Employee's first name and initial
UNA R PASCAL
HIDDEN VALLEY BLDG. 13 APT. 239
CHARLOTTE AMALIE, VI, 00802
11 Nonqualified plans12a See Form W-3BS Instructions
S | 1237.49
13 Secretary employee
K
12b C | 35.38
14 Other12c
12d
f Employee's address and ZIP code
Form W-2VI U.S. Virgin Islands Wage and Tax Statement Department of the Treasury - Internal Revenue Service 2004 ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-38
a Control numberVoidOMB No. 1845-0008
b Employer identification number
66-0567418
1 Wages, tips, other compensation
27935.72
2 VI income tax withheld
9.00
c Employer's name, address, and ZIP code;
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
28753.16
4 Social security tax withhold
1782.70
5 Medicare wages and tips
28753.16
6 Medicare tax withhold
416.92
7 Social security tips8
d Employee's social security number
066-64-1041
9 Advance EIC payment10
e Employee's first name and initial Last name
ANN M RODRIGUEZ
6014 ESTATE SMITHBAY
ST. THOMAS, VI 00802
11 Nonqualified plane12a Bee Form W-3SS instructions
S | 817.44
13 Secretary employee
Retirement plan
Third-party pay
12b C | 3.21
14 Other12c
12d
```markdown f Employee's address and ZIP code ``` U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Servi ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Noti and Instructions, see Form W-35 FTC0021 EFTA00176032
aControl numberVoidOMB No. 1648-0008
b Employee identification number
66-0567418
1 Wages, tips, other compensation
35326.30
2 VI income tax withhold
2832.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
37983.56
4 Social security tax withhold
2354.98
5 Medicare wages and tips
37983.56
6 Medicare tax withhold
550.76
7 Social security tips8
9 Advance EIC payment10
d Employee's social security number
580-15-5038
11 Nonqualified plans12a See Form W-385 Instructions
S | 2657.26
e Employee's first name and initial
JERMAINE A RUAN
UVI FAC. E. APT.1 BLDG. 3.
ST. THOMAS, VI, 00804
13 Simultary employment Retirement plan Third-party aid pay12b C | 23.00
14 Other12o
12d
f Employee's address and ZIP code
Form W=2VI U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Service ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and Instructions, see Form W-3SS
a Control numberVoidOMB No. 1545-0088
b Employer identification number
66-0567418
1 Wages, tips, other compensation
36964.83
2 VI income tax withheld
3091.00
c Employee's name, address, and ZIP code;
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
41190.09
4 Social security tax withheld
2553.79
5 Medicare wages and tips
41190.09
6 Medicare tax withhold
597.26
7 Social security tips8
d Employee's social security number
580-17-3729
9 Advance EIO payment10
e Employee's first name and initial Last name
DAPHNE L WALLACE
P.O. BOX 11184
ST. THOMAS, USVI, 00801
11 Nonqualified plans12a Saa Form W-3SS Instructions
S | 4225.26
13 Biological employee Retirement plan Third-party risk pay12b C | 29.12
14 Other12c
12d
```markdown f Employee's address and ZIP code ``` U.S. Virgin Islands Wage and Tax Statement 2004 Department of the Treasury - Internal Revenue Service ```markdown Copy D - For Employer ``` For Privacy Act and Paperwork Reduction Act Notice and instructions, see Form W-3ST FTC0022 EFTA00176033 ```markdown DO NOT STAPLE OR FOLD ```
aControl numberfor Official Use Only
b941-89 Military 845 Kind of Payer Holding emp Medicare gov. emp. Third party slot pay1 Wages, tips, other compensation
$ 710836.58
2 Income tax withheld
$ 116848.00
c3 Social security wages
$ 574878.61
4 Social security tax withhold
$ 35642.47
eTotal number of Forms W-2 148 Medicare wages and tips
$ 743059.78
9 Medicare tax withhold
$ 10774.36
fEmployer identification number 66-05674187 Social security tips
$
gFINANCIAL TRUST COMPANY, INC.9 Advance EIO payments
$
11 Nonqualified plans
$
12 Obtained compensation
$ 32223.20
13 For third-party slot pay use only
hOther EIN used this year14 Income tax withheld by payer of third-party slot pay
iEmployer's territorial ID number15 Check the appropriate box
Type of Form W-2AS W-2OM W-2GU W-2VI
Contact person Jeanne BrennanTelephone number (340) 775-2525For Official Use Only
E-mail addressFax number (340) 775-2528
Form W-3SS Transmittal of Wage and Tax Statements 2003 Send this entire page with the entire Copy A page of Forms W-2AS, W-2GU, W-2CM, or W-2VI to the Social Security Administration (SSA). Photocopies are not acceptable. Do not send any remittance (cash, checks, money orders, etc) with Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS. Instructions for Forms W-2AS, W-2GU, W-2VI, and W-3SS Section references are to the Internal Revenue Code unless otherwise noted. Items to Note Reporting Code Q for box 12. Recent legislation has eliminated the use of Code Q in box 12. When To File File Copy A of Form W-3SS with Copy A of Form W-2AS, W-2GU, W-2CM, or W-2VI by March 1, 2004. However, if you file electronically, you may file by March 31, 2004. See the SSA Web Site at www.ssa.gov/employer/for electronic filing options. Extension to file. You may request an extension of time to file Forms W-2AS, W-2GU, W-2CM, or W-2VI by sending Form 8B09, Request for Extension of Time To File Information Returns, to the address shown on that form. You must request the extension by the due date of the forms for your request to be considered. If approved, you will have an additional 30 days to file. See Form 8B09 for more details. Where To File Copy A Send the entire first page of this form (Copy A) with the entire Copy A page of Form W-2AS, W-2GU, W-2CM, or W-2VI to: Social Security Administration Data Operations Center Wilkes-Barre, PA 19769-0001 Note: If you use "Certified Mall" to file, change the ZIP code to "18769-0002." If you use an IRS approved private delivery service, add "18702-7907." See Circular E. Employer's Tax Guide (Pub. 15) for a list of IRS approved private delivery services. Also see Where to file Copy 1 and Shipping and mailing on page 2. Notice to Employers In the Commonwealth of the Northern Mariana Islands If you are an employer in the Commonwealth of the Northern Mariana Islands; you must contact the Division of Revenue and Taxation, Capitol Hill, Salpani, MP 86950, to get Form W-2CM and the instructions for completing and filing that form. General Instructions for Form W-3SS Purpose of forms. Use Copy A of Form W-3SS to transmit Copy A of Form W-2AS, W-2GU, W-2CM, or W-2VI to the Social Security Administration. File Copy 1 of Form W-3$$ and Copy 1 of Form W-2AS. FTC0023 Cat. No, 10117S EFTA00176034
a Control number22222 JdFor Official Use Only. ORM No. 10614-6088
h Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 59388.04
Ⅵ License fee waived
o Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Dental security wages
$ 65471.10
Ⅳ Social security tax waived
4 Medicare wages and lines
$ 65471.10
Ⅴ Medicare tax waived
7 Social security tips
$
8 Adverse EIC payment
$
d Employee's social security number
580-06-2353
9 Adverse EIC payment
$
10
e Employee's first name and initial DALELast name
BASTIAN GORDON
11 Nonqualified plan
$
12a See Plan W-02A instructions
S $ 6083.06
P.O. BOX 115
ST. THOMAS, VI, 00804
14 Insurance expenses13b C $ 86.00
14 Other14c
f Employee's address and ZIP code
U. S. Virgin Islands Wage and Tax Statement Department of the Treasury - Internal Revenue Ben Copy A For Social Security Administration - Send this entire page with Copy A of Form W-388 to the Social Security Administration; photocopies are not acceptable. [Rev. February 2002] For Privacy Act and Paperwork Reduction Notice and Instructions, and Form W-3 Oat, No. 489770 Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
b Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 8294.75
2 VI income tax withheld
$ 8697.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
8 Social security wages
$ 87000.00
4 Social security tax withholding
$ 5394.00
8 Medicare wages and tips
$ 87582.31
8 Medicare tax withholding
$ 1269.94
7 Social security tip
$
9
d Employee's social security number
150-46-4746
9 Advance EIC payment
$
10
a Employee's first name and initial
JEANNE
Last name
BRENNAN
11 Nonqualified plan
$
12a See Form VI-SRS Institution line
S $4638.56
6501 RED HOOK PLAZA STE.
PMB 201
ST. THOMAS, VI, 00802
13 Obligatory employee
x
13b C $123.50
14 Other
```markdown 70024 ``` (Rev. February 2002) EFTA00176035 # a Control number 22222 Jid For Official Use Only OMR No. 1984-008 b Employee identification number 66-0567418 n Employer’s name, address, and ZIP code FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QUARTER B-3 ST. THOMAS U.S.VIRGIN ; 00802 d Employee’s social associate number 580-03-9952 e Employee’s first name and initial LEON A Last name CASEY, SR. P.O. BOX 503032 ST. THOMAS, VI, 00805 f Employee’s address and ZIP code 1 Wage, tip, other compensation $ 42709.71 2 Social security wages $ 47095.73 3 Medicare wages and tips $ 47095.73 4 Social security tips $ 9 Advance ZIC payment $ 11 Nonqualified plans $ 13 Advisory employee Intermediate level Non-pay 14 Other $ 1 Vehicle tax withholding $ 4488.00 1 Rural activity tax withholding $ 2919.94 1 Mortgage tax withholding $ 682.89 10 12 See Form W-SS2 Instructions S $ 4386.02 13 C $ 197.37 14 $ Wage and Tax Statement Copy A For Social Security Administration - Send this entire page with Copy A of Form W-9SS to the Social Security Administration; photocopies are not acceptable. (Rev. February 2002) Department of the Treasury - Internal Revenue Service For Privacy Act and Paperwork Reduction Notice and Instructions, see Form W-8E ```markdown Ost. No. 4189770 ``` Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoidFor Official Use Only ► OMB No. 1545-0009
b Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 48924.67
2 VI income tax withheld
$ 6819.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 52736.75
4 Social security tax withheld
$ 3269.68
5 Medicare wages and tips
$ 52736.75
6 Medicare tax withhold
$ 764.68
7 Social security tips
$
8
9 Advance EIC payment
$
10
d Employee's social security number
580-13-4697
11 Nonqualified plans
$
12n Gae Form W-BSG instructions
S 3812.08
a Employee's first name and initial
JAMIE I
Last name CORNELIUS18 Social security benefits
X
19 C 43.44
6501 RED HOOK PLAZA
PMB 201
ST. THOMAS, VI, 00802
14 Other15
1 Employer's trade mark
FTC0026 ```markdown ``` EFTA00176036
a Control number22222idPor Official Use Only > OMB No. 1648-7100
h Employer identification number
66-0567418
1 Wages, tips, other compensation$ 5067.30$ 391.00
u Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
2 Social security wages$ 5307.70$ 329.08
3 Machinery wages and tips$ 5307.70$ 76.96
4 Social security tips
5
d Employer's social security number
580-15-0869
6 Advance EIC payment
eEmployee's first name and initial
KHANIA M
Last name DAWSON7 Nonqualified plansS 240.40
8
f Employee's address and ZIP code9 Security guardsMilitary personnel
10 OtherNonqualified plans
Copy A For Social Security Administration - Send this entire page with Copy A of Form W-SSS to the Social Security Administration; photocopies are not acceptable. Department of the Treasury - Internal Revenue Service For Privacy Act and Paperwork Reduction A Notice and Instructions, see Form W-9-E Cat. No. 48977C Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoidFor Official Use Only
OMD No. 1645-0088
b Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 96070.04
2 VI income tax withheld
$ 12741.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 87000.00
4 Social security tax withheld
$ 5394.00
5 Medicare wages and tips
$ 100577.64
6 Medicare tax withhold
$ 1458.38
7 Social security tips
$
8
9 Advance EIC payment
$
10
d Employee's social security number
580-06-1538
11 Nonqualified plans
$
12 Use Form W-980 instructions
S 4507.60
e Employee's first name and initial
CECILE R
Last name
DE JONGH
13 Military service plan
X
14 Other
C 151.80
P.O. BOX 8361
ST. THOMAS, VI, 00801
{Rev. February 2002} ```markdown ``` EFTA00176037
aControl number22222 3rdFor Official Use Only
CMB No. 1546-0300
bEmployer identification number
66-0567418
4Wagon lips, other components
$ 241021.22
9Hawker lips with lid
$ 67996.00
cEmployee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
5Social security wages
$ 87000.00
6social security tax withholding
$ 5394.00
6Medicare wages and lips
$ 241021.22
7Medicare lips with lid
$ 3494.81
dEmployee's social security number
090-44-3348
7Social security lips
$
8
eEmployee's first name and initial
JEFFREY E
Last name
EPSTEIN
8Advance FIO payment
$
10
C/O AMERICAN YACHT HARBOR
6100 RED HOOK, SUITE 2
ST. THOMAS, VI, 00802
11Nonqualified plane
$
12See Form W-4488 Instructions
C $ 1021.20
1 Employee's address and ZIP code13Other13b
13n
13t
W-2U U.S. Virgin Islands Wage and Tax Statement Copy A For Social Security Administration - Send this entire page with Copy A of Form W-SSS to the Social Security Administration; photocopies are not acceptable. Department of the Treasury - Internal Revenue Service (Rev. February 2002) For Privacy Act and Paperwork Reduction A Notice and Instructions, see John W. Wade Cet. No. 49077C Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoidFor Official Use Only ► OMB No. 1545-0000
b Employer Identification number
66-0567418
1 Wages, tips, other compensation
$ 1458.92
2 VI Income tax withhold
$ 133.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 1458.92
4 Social security tax withhold
$ 90.45
5 Modiarnare wages and tips
$ 1458.92
6 Medicare tax withhold
$ 21.15
7 Social security tips
$
8
9 Advance EIO payment
$
10
d Employee's social security number
580-23-1452
11 Non-prefilled plane
$
12n Goo Form W-3RS Instructions
$
e Employee's first name and initial TEQUASI OLast name HENDRICKS13 Retirement plan
Retirement plan
14 Other
PO BOX 672
ST. JOHN, USVI, 00831
f Employee's social security ID code
FTC025 {Rev, February 2002} EFTA00176038 # a Control number 22222 For Official Use Only 018B No. 1074-0038 b Employee identification number 66-0567418 c Employer’s name, address, and ZIP code FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QUARTER B-3 ST. THOMAS U.S.VIRGIN , 00802 d Employee’s modal security number 580-29-3823 e Employee’s first name and initial LORETTA f Employee’s address and ZIP code 4 Wages, tips, other compensation $ 21277.44 5 Social security wages $ 21903.98 6 Medicare wages and tips $ 21903.98 7 Social security tips $ 8 Advance GIC payment $ 11 Nonqualified plans 12 Security embezzlement X 13 Taxable income X 14 Other 942.00 1358.05 317.61 10 13a See Form VI-103 Instructions S $ 626.54 11 12 13 14 U. S. Virgin Islands Wage and Tax Statement Copy A For Social Security Administration - Send this entire page with Copy A of Form W-393 to the Social Security (Rev. February 2002) Department of the Treasury - Internal Revenue Service For Privacy Act and Paperwork Reduction Motto and Instructions, see Form W-8 Administration; photocopies are not acceptable. Cat. No. 49977C Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoklPor Official Use Only © OMB No. 1645-0008
b Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 6070.00
2 VI income tax withheld
$ 292.01
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 6250.00
4 Social security tax withholding
$ 387.51
5 Medicare wages and tips
$ 6250.00
6 Medicare tax withholding
$ 90.61
7 Social security tips
$
8
d Employee's social security number
580-11-2937
8 Advance EIC payment
$
10
a Employee's first name and initial
UNA R
Last name
PASCAL
11 Nonqualified place
$
12 a See Form W-10 Interactions b S $180.00
HIDDEN VALLEY BLDG. 13 APT. 239
CHARLOTTE AMALIE, VI, 00802
12 Identified employee
x
13 Identified employee
x
i Employee's telephone number14 Other15 Other
```markdown ``` {Rev. February 2002} EFTA00176039
a Control number22222 badFor Official Use Only
OMB No. 1845-0008
b Employee identification number
66-0567418
1 Wage, tips, other compensation
$ 15065.60
1 Wage, tips, other compensation
$ 181.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
2 Social security wages
$ 15500.60
2 Social security wages without
$ 961.04
3 Medicare wages and tips
$ 15500.60
3 Medicare wages without
$ 224.76
7 Social security tips
$
9 Advance EIO payment
$
d Employee's social security number
066-64-1041
e Employee's first name and initial
ANN M
Last name
RODRIGUEZ
10 Nonqualified plans
$
10 Nonqualified plans
S | $435.00
6014 ESTATE SMITHBAY
ST. THOMAS, VI 00802
11 Safety analysis
[ ] [X]
11 Safety analysis
C | $0.60
14 Other14 Other
f Employee's address and ZIP code
Copy A For Social Security Administration • Send this entire page with Copy A of Form W-399 to the Social Security Administration; photocopies are not acceptable. Department of the Treasury - Internal Revenue Serv: (Rev. February 2002) For Privacy Act and Paperwork Reduction J Notices and Instructions, see Perm W-81 Cat. No. 490770 Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoidFor Official Use Only © OMB No. 15418-0008
b Employer identification number
66-0567418
1 Wages, tips, other compensation
$ 38393.23
2 VI income tax withhold
$ 2889.00
c Employee's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 40902.75
4 Social security tax withhold
$ 2535.97
5 Medicare wages and tips
$ 40902.75
6 Medicaid tax withhold
$ 593.05
7 Social security tips
$
8
9 Advance BIC payment
$
10
d Employee's social security number
580-15-5038
11 Nonqualified plans
$
13a Sea Form W-998 instructions
S 2509.52
e Employee's first name and initial
JERMAINE A
Last name
RUAN
12 Savings employee
X
13b Savings employee
X
UVI FAC. E. APT.1 BLDG. 3.
ST. THOMAS, VI, 00804
14 Other14 Other
f Employee's address and ZIP code
```markdown ``` EFTA00176040
a Control number22222idFor Official Use Only
OMB No. 1840-0008
b Employee identification number
66-0567418
4 Wagon lips, other compartment
$1451.86
1 Vehicle lips, other compartment
$1451.00
c Employee's main address and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
5 Social security wages
$15212.34
4 Social security wages
943.15
6 Medicare wages and tips
$15212.34
6 Medicare wages and tips
220.57
7 Social security tips
d Employee's social security number
580-13-7556
8 Advance ZIP payment
n Employee's first name and initial KIMLast name
VAN HOLTEN
11 Nonqualified plans12 New Form VI-10 instructions
C $2.88
PO BOX 9583
ST. THOMAS, VI, 00801
18 Stairway access
X
19 Stairway access
S $660.48
14 Other
f Employee's address and ZIP code
(Rev. February 2002) For Privacy Act and Paperwork Reduction. Noting and Instructions, www.FarmW-3 Oat. No. 499770 Do Not Cut, Fold, or Staple Forms on This Page - Do Not Cut, Fold, or Staple Forms on This Page
a Control number22222VoidFor Official Use Only © OMB No. 1845-0008
b Employer Identification number
66-0567418
1 Wages, tips, other compensation
$ 37894.80
2 VI Income tax withholding
$ 3318.00
c Employer's name, address, and ZIP code
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QUARTER B-3
ST. THOMAS U.S.VIRGIN , 00802
3 Social security wages
$ 42038.74
4 Social security tax withholding
$ 2606.4
5 Medicare wages and tips
$ 42038.74
6 Medicare tax withholding
$ 609.5
7 Social security tips
$
8
9 Advance EIC payment
$
10
d Employee's social security number
580-17-3729
11 Nonqualified plans
$
12 See Form W-SSD instructions
S $ 4143.94
e Employee's final name and initial DAPHNE LLast name WALLACE13 Business employees
X X
14 C 26.82
P.O. BOX 11184
ST. THOMAS, USVI, 00801
15 Other16
(Rev. February 2002) FTCO030 ```markdown ``` EFTA00176041 ```markdown ``` Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. FILE COPY Signature ▶ Title ▶ PRESIDENT Date ▶ 2/23/07 ## Instructions Purpose of form. Use this form to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. Do not use Form 1096 to transmit electronically or magnetically. For magnetic media, see Form 4804, Transmittal of Information Returns Reported Magnetically; for electronic submissions, see Pub. 1220, Specifications for Filing Forms 1098, 1099, 5498, and W-2G Electronically or Magnetically. Who must file. The name, address, and TIN of the filer on this form must be the same as those you enter in the upper left area of Forms 1099, 1098, 5498, or W-2G. A filer includes a payer; a recipient of mortgage interest payments (including points) or student loan Interest; an educational Institution; a broker; a barter exchange; a creditor; a person reporting real estate transactions; a trustee or issuer of any individual retirement arrangement, a Coverdell ESA, an HSA, an Archer MSA (including a Medicare Advantage MSA); certain corporations; certain donees of motor vehicles, boats, and airplanes; and lender who acquires an interest in secured property or who reason to know that the property has been abandoned. Preaddressed Form 1098. If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. If any of the preprinted information is incorrect, make corrections on the form. If you are not using a preaddressed form, enter the filer's name, address (including room, suite, or other unit number), and TIN In the spaces provided on the form. When to file. File Form 1096 as follows, ## Where To File For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2006 General Instructions for Forms 1099, 1098, 5498, and W-2G. FTC0031 EFTA00176042
PAYER's name, street address, city, state, ZIP code, and telephone no.1 RentaOhio No. 1545-0115
2006
Form 1099-MISC
Miscellaneous Income
$
2 Royalties$
3 Other income$
PAYER's federal identification numberRECIPIENT's identification number5 Fishing boat proceeds4 Federal income tax withheldState Copy or Extra File Copy
66-056741866-0473483$6 Medical and health care payments
RECIPIENT's name, address, and ZIP code7 Nonemployee compensation$ 796.648 Subsidize payments in lieu of dividends or interest
9 Payer made direct sales of $5,000 or more consumer products to a buyer (recipient) for reads □10 Crop insurance proceeds
1112
Account number (see instructions)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
15a Section 409A deferrals15b Section 409A Income16 State tax withheld17 State/Payer's state no.18 State Income
Department of the Treasury - Internal Revenue Service
PAYER's name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2006
Form 1099-MISC
Miscellaneous Income
$
$
2 Royalties
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
$6 Medical and health care payments
PAYER's federal identification number
66-0567418
RECIPIENT's identification number
66-0578959
8 Fishing boat proceeds
RECIPIENT's name, address, and ZIP code
MARJORIE RAWLS ROBERTS
DO BOX 6047
ST. THOMAS, VI 00804-6247
7 Nonemployee compensation
$22,373.16
8 Substitute payments to lieu of dividends or interest
8 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for, retail ▷10 Crop insurance proceeds
11 Excess golden parachute payments12 Groca proceeds paid to an attorney
Account number (see instructions)13 Excess golden parachute payments14 Groca proceeds paid to an attorney
15a Section 409A deferrals15b Section 409A Income18 State tax withhold17 State/Payer's state no.18 State income
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0032 EFTA00176043
PAYER's name, street address, city, state, ZIP code, and telephone no.1 RunteOMB No. 1545-0115
2006
Form 1099-MISC
Miscellaneous Income
$
2 Royalties$
3 Other income$
PAYER's federal identification numberRECIPIENT's identification number5 Fishing boat proceeds4 Federal income tax withholdState Copy or Extra File Copy
66-056741852-0749196$6 Medical and begin care payments
RECIPIENT's name, address, and ZIP code7 Nonamptoyes compensation$ 7,150.008 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (noliplant) for resale ▷$10 Crop insurance proceeds
1112
Account number (see instructions)13 Expense golden parachute payments14 Grose proceeds paid to an attorney
15a Section 409A deferrals16b Section 409A Income16 State tax withhold17 State/Payer's state no.18 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2006
Form 1099-MISC
Miscellaneous Income
$
2 Royalties$
$$
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
$$
5 Fishing-bont prooceds6 Medical and health care payments
$$
7 Nonemployee compensation8 Subsidize payments in lieu of dividends or interest
$$
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (repliant) for resale10 Crop insurance proceeds
$$
1112
Account number (see instructions)18 Excess golden parachute payments14 Gross proceeds paid to an attorney
$
15a Section 409A deferrals15b Section 409A Income17 State/Payer's state no.18 State Income
$
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0033 EFTA00176044 Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. ```markdown Title ▶ \textcircled{1}$$\textcircled{2}$\textcircled{3}$\textcircled{4}$\textcircled{5}$\textcircled{6}$\textcircled{7}$\textcircled{8}$\textcircled{9}$\textcircled{10}$\textcircled{11}$\textcircled{12}$\textcircled{13}$\textcircled{14}$\textcircled{15}$\textcircled{16}$\textcircled{17}$\textcircled{18}$\textcircled{19}$\textcircled{20}$\textcircled{21}$\textcircled{22}$\textcircled{23}$\textcircled{24}$\textcircled{25}$\textcircled{26}$\textcircled{27}$\textcircled{28}$\textcircled{29}$\textcircled{30}$\textcircled{31}$\textcircled{32}$\textcircled{33}$\textcircled{34}$\textcircled{35}$\textcircled{36}$\textcircled{37}$\textcircled{38}$\textcircled{39}$\textcircled{40}$\textcircled{41}$\textcircled{42}$\textcircled{43}$\textcircled{44}$\textcircled{45}$\textcircled{46}$\textcircled{47}$\textcircled{48}$\textcircled{49}$\textcircled{50}$\textcircled{51}$\textcircled{52}$\textcircled{53}$\textcircled{54}$\textcircled{55}$\textcircled{56}$\textcircled{57}$\textcircled{58}$\textcircled{59}$\textcircled{60}$\textcircled{61}$\textcircled{62}$\textcircled{63}$\textcircled{64}$\textcircled{65}$\textcircled{66}$\textcircled{67}$\textcircled{68}$\textcircled{69}$\textcircled{70}$\textcircled{71}$\textcircled{72}$\textcircled{73}$\textcircled{74}$\textcircled{75}$\textcircled{76}$\textcircled{77}$\textcircled{78}$\textcircled{79}$\textcircled{80}$\textcircled{81}$\textcircled{82}$\textcircled{83}$\textcircled{84}$\textcircled{85}$\textcircled{86}$\textcircled{87}$\textcircled{88}$\textcircled{89}$\textcircled{90}$\textcircled{91}$\textcircled{92}$\textcircled{93}$\textcircled{94}$\textcircled{95}$\textcircled{96}$\textcircled{97}$\textcircled{98}$\textcircled{99}$\textcircled{100}$\textcircled{101}$\textcircled{102}$\textcircled{103}$\textcircled{104}$\textcircled{105}$\textcircled{106}$\textcircled{107}$\textcircled{108}$\textcircled{109}$\textcircled{110}$\textcircled{111}$\textcircled{112}$\textcircled{113}$\textcircled{114}$\textcircled{115}$\textcircled{116}$\textcircled{117}$\textcircled{118}$\textcircled{119}$\textcircled{120}$\textcircled{121}$\textcircled{122}$\textcircled{123}$\textcircled{124}$\textcircled{125}$\textcircled{126}$\textcircled{127}$\textcircled{128}$\textcircled{129}$\textcircled{130}$\textcircled{131}$\textcircled{132}$\textcircled{133}$\textcircled{134}$\textcircled{135}$\textcircled{136}$\textcircled{137}$\textcircled{138}$\textcircled{139}$\textcircled{140}$\textcircled{141}$\textcircled{142}$\textcircled{143}$\textcircled{144}$\textcircled{145}$\textcircled{146}$\textcircled{147}$\textcircled{148}$\textcircled{149}$\textcircled{150}$\textcircled{151}$\textcircled{152}$\textcircled{153}$\textcircled{154}$\textcircled{155}$\textcircled{156}$\textcircled{157}$\textcircled{158}$\textcircled{159}$\textcircled{160}$\textcircled{161}$\textcircled{162}$\textcircled{163}$\textcircled{164}$\textcircled{165}$\textcircled{166}$\textcircled{167}$\textcircled{168}$\textcircled{169}$\textcircled{170}$\textcircled{171}$\textcircled{172}$\textcircled{173}$\textcircled{174}$\textcircled{175}$\textcircled{176}$\textcircled{177}$\textcircled{178}$\textcircled{179}$\textcircled{180}$\textcircled{181}$\textcircled{182}$\textcircled{183}$\textcircled{184}$\textcircled{185}$\textcircled{186}$\textcircled{187}$\textcircled{188}$\textcircled{189}$\textcircled{190}$\textcircled{191}$\textcircled{192}$\textcircled{193}$\textcircled{194}$\textcircled{195}$\textcircled{196}$\textcircled{197}$\textcircled{198}$\textcircled{199}$\textcircled{200}$\textcircled{201}$\textcircled{202}$\textcircled{203}$\textcircled{204}$\textcircled{205}$\textcircled{206}$\textcircled{207}$\textcircled{208}$\textcircled{209}$\textcircled{210}$\textcircled{211}$\textcircled{212}$\textcircled{213}$\textcircled{214}$\textcircled{215}$\textcircled{216}$\textcircled{217}$\textcircled{218}$\textcircled{219}$\textcircled{220}$\textcircled{221}$\textcircled{222}$\textcircled{223}$\textcircled{224}$\textcircled{225}$\textcircled{226}$\textcircled{227}$\textcircled{228}$\textcircled{229}$\textcircled{230}$\textcircled{231}$\textcircled{232}$\textcircled{233}$\textcircled{234}$\textcircled{235}$\textcircled{236}$\textcircled{237}$\textcircled{238}$\textcircled{239}$\textcircled{240}$\textcircled{241}$\textcircled{242}$\textcircled{243}$\textcircled{244}$\textcircled{245}$\textcircled{246}$\textcircled{247}$\textcircled{248}$\textcircled{249}$\textcircled{250}$\textcircled{251}$\textcircled{252}$\textcircled{253}$\textcircled{254}$\textcircled{255}$\textcircled{256}$\textcircled{257}$\textcircled{258}$\textcircled{259}$\textcircled{260}$\textcircled{261}$\textcircled{262}$\textcircled{263}$\textcircled{264}$\textcircled{265}$\textcircled{266}$\textcircled{267}$\textcircled{268}$\textcircled{269}$\textcircled{270}$\textcircled{271}$\textcircled{272}$\textcircled{273}$\textcircled{274}$\textcircled{275}$\textcircled{276}$\textcircled{277}$\textcircled{278}$\textcircled{279}$\textcircled{280}$\textcircled{281}$\textcircled{282}$\textcircled{283}$\textcircled{284}$\textcircled{285}$\textcircled{286}$\textcircled{287}$\textcircled{288}$\textcircled{289}$\textcircled{290}$\textcircled{291}$\textcircled{292}$\textcircled{293}$\textcircled{294}$\textcircled{295}$\textcircled{296}$\textcircled{297}$\textcircled{298}$\textcircled{299}$\textcircled{300}$\textcircled{301}$\textcircled{302}$\textcircled{303}$\textcircled{304}$\textcircled{305}$\textcircled{306}$\textcircled{307}$\textcircled{308}$\textcircled{309}$\textcircled{310}$\textcircled{311}$\textcircled{312}$\textcircled{313}$\textcircled{314}$\textcircled{315}$\textcircled{316}$\textcircled{317}$\textcircled{318}$\textcircled{319}$\textcircled{320}$\textcircled{321}$\textcircled{322}$\textcircled{323}$\textcircled{324}$\textcircled{325}$\textcircled{326}$\textcircled{327}$\textcircled{328}$\textcircled{329}$\textcircled{330}$\textcircled{331}$\textcircled{332}$\textcircled{333}$\textcircled{334}$\textcircled{335}$\textcircled{336}$\textcircled{337}$\textcircled{338}$\textcircled{339}$\textcircled{340}$\textcircled{341}$\textcircled{342}$\textcircled{343}$\textcircled{344}$\textcircled{345}$\textcircled{346}$\textcircled{347}$\textcircled{348}$\textcircled{349}$\textcircled{350}$\textcircled{351}$\textcircled{352}$\textcircled{353}$\textcircled{354}$\textcircled{355}$\textcircled{356}$\textcircled{357}$\textcircled{358}$\textcircled{359}$\textcircled{360}$\textcircled{361}$\textcircled{362}$\textcircled{363}$\textcircled{364}$\textcircled{365}$\textcircled{366}$\textcircled{367}$\textcircled{368}$\textcircled{369}$\textcircled{370}$\textcircled{371}$\textcircled{372}$\textcircled{373}$\textcircled{374}$\textcircled{375}$\textcircled{376}$\textcircled{377}$\textcircled{378}$\textcircled{379}$\textcircled{380}$\textcircled{381}$\textcircled{382}$\textcircled{383}$\textcircled{384}$\textcircled{385}$\textcircled{386}$\textcircled{387}$\textcircled{388}$\textcircled{389}$\textcircled{390}$\textcircled{391}$\textcircled{392}$\textcircled{393}$\textcircled{394}$\textcircled{395}$\textcircled{396}$\textcircled{397}$\textcircled{398}$\textcircled{399}$\textcircled{400}$\textcircled{401}$\textcircled{402}$\textcircled{403}$\textcircled{404}$\textcircled{405}$\textcircled{406}$\textcircled{407}$\textcircled{408}$\textcircled{409}$\textcircled{410}$\textcircled{411}$\textcircled{412}$\textcircled{413}$\textcircled{414}$\textcircled{415}$\textcircled{416}$\textcircled{417}$\textcircled{418}$\textcircled{419}$\textcircled{420}$\textcircled{421}$\textcircled{422}$\textcircled{423}$\textcircled{424}$\textcircled{425}$\textcircled{426}$\textcircled{427}$\textcircled{428}$\textcircled{429}$\textcircled{430}$\textcircled{431}$\textcircled{432}$\textcircled{433}$\textcircled{434}$\textcircled{435}$\textcircled{436}$\textcircled{437}$\textcircled{438}$\textcircled{439}$\textcircled{440}$\textcircled{441}$\textcircled{442}$\textcircled{443}$\textcircled{444}$\textcircled{445}$\textcircled{446}$\textcircled{447}$\textcircled{448}$\textcircled{449}$\textcircled{450}$\textcircled{451}$\textcircled{452}$\textcircled{453}$\textcircled{454}$\textcircled{455}$\textcircled{456}$\textcircled{457}$\textcircled{458}$\textcircled{459}$\textcircled{460}$\textcircled{461}$\textcircled{462}$\textcircled{463}$\textcircled{464}$\textcircled{465}$\textcircled{466}$\textcircled{467}$\textcircled{468}$\textcircled{469}$\textcircled{470}$\textcircled{471}$\textcircled{472}$\textcircled{473}$\textcircled{474}$\textcircled{475}$\textcircled{476}$\textcircled{477}$\textcircled{478}$\textcircled{479}$\textcircled{480}$\textcircled{481}$\textcircled{482}$\textcircled{483}$\textcircled{484}$\textcircled{485}$\textcircled{486}$\textcircled{487}$\textcircled{488}$\textcircled{489}$\textcircled{490}$\textcircled{491}$\textcircled{492}$\textcircled{493}$\textcircled{494}$\textcircled{495}$\textcircled{496}$\textcircled{497}$\textcircled{498}$\textcircled{499}$\textcircled{500}$\textcircled{501}$\textcircled{502}$\textcircled{503}$\textcircled{504}$\textcircled{505}$\textcircled{506}$\textcircled{507}$\textcircled{508}$\textcircled{509}$\textcircled{510}$\textcircled{511}$\textcircled{512}$\textcircled{513}$\textcircled{514}$\textcircled{515}$\textcircled{516}$\textcircled{517}$\textcircled{518}$\textcircled{519}$\textcircled{520}$\textcircled{521}$\textcircled{522}$\textcircled{523}$\textcircled{524}$\textcircled{525}$\textcircled{526}$\textcircled{527}$\textcircled{528}$\textcircled{529}$\textcircled{530}$\textcircled{531}$\textcircled{532}$\textcircled{533}$\textcircled{534}$\textcircled{535}$\textcircled{536}$\textcircled{537}$\textcircled{538}$\textcircled{539}$\textcircled{540}$\textcircled{541}$\textcircled{542}$\textcircled{543}$\textcircled{544}$\textcircled{545}$\textcircled{546}$\textcircled{547}$\textcircled{548}$\textcircled{549}$\textcircled{550}$\textcircled{551}$\textcircled{552}$\textcircled{553}$\textcircled{554}$\textcircled{555}$\textcircled{556}$\textcircled{557}$\textcircled{558}$\textcircled{559}$\textcircled{560}$\textcircled{561}$\textcircled{562}$\textcircled{563}$\textcircled{564}$\textcircled{565}$\textcircled{566}$\textcircled{567}$\textcircled{568}$\textcircled{569}$\textcircled{570}$\textcircled{571}$\textcircled{572}$\textcircled{573}$\textcircled{574}$\textcircled{575}$\textcircled{576}$\textcircled{577}$\textcircled{578}$\textcircled{579}$\textcircled{580}$\textcircled{581}$\textcircled{582}$\textcircled{583}$\textcircled{584}$\textcircled{585}$\textcircled{586}$\textcircled{587}$\textcircled{588}$\textcircled{589}$\textcircled{590}$\textcircled{591}$\textcircled{592}$\textcircled{593}$\textcircled{594}$\textcircled{595}$\textcircled{596}$\textcircled{597}$\textcircled{598}$\textcircled{599}$\textcircled{600}$\textcircled{601}$\textcircled{602}$\textcircled{603}$\textcircled{604}$\textcircled{605}$\textcircled{606}$\textcircled{607}$\textcircled{608}$\textcircled{609}$\textcircled{610}$\textcircled{611}$\textcircled{612}$\textcircled{613}$\textcircled{614}$\textcircled{615}$\textcircled{616}$\textcircled{617}$\textcircled{618}$\textcircled{619}$\textcircled{620}$\textcircled{621}$\textcircled{622}$\textcircled{623}$\textcircled{624}$\textcircled{625}$\textcircled{626}$\textcircled{627}$\textcircled{628}$\textcircled{629}$\textcircled{630}$\textcircled{631}$\textcircled{632}$\textcircled{633}$\textcircled{634}$\textcircled{635}$\textcircled{636}$\textcircled{637}$\textcircled{638}$\textcircled{639}$\textcircled{640}$\textcircled{641}$\textcircled{642}$\textcircled{643}$\textcircled{644}$\textcircled{645}$\textcircled{646}$\textcircled{647}$\textcircled{648}$\textcircled{649}$\textcircled{650}$\textcircled{651}$\textcircled{652}$\textcircled{653}$\textcircled{654}$\textcircled{655}$\textcircled{656}$\textcircled{657}$\textcircled{658}$\textcircled{659}$\textcircled{660}$\textcircled{661}$\textcircled{662}$\textcircled{663}$\textcircled{664}$\textcircled{665}$\textcircled{666}$\textcircled{667}$\textcircled{668}$\textcircled{669}$\textcircled{670}$\textcircled{671}$\textcircled{672}$\textcircled{673}$\textcircled{674}$\textcircled{675}$\textcircled{676}$\textcircled{677}$\textcircled{678}$\textcircled{679}$\textcircled{680}$\textcircled{681}$\textcircled{682}$\textcircled{683}$\textcircled{684}$\textcircled{685}$\textcircled{686}$\textcircled{687}$\textcircled{688}$\textcircled{689}$\textcircled{690}$\textcircled{691}$\textcircled{692}$\textcircled{693}$\textcircled{694}$\textcircled{695}$\textcircled{696}$\textcircled{697}$\textcircled{698}$\textcircled{699}$\textcircled{700}$\textcircled{701}$\textcircled{702}$\textcircled{703}$\textcircled{704}$\textcircled{705}$\textcircled{706}$\textcircled{707}$\textcircled{708}$\textcircled{709}$\textcircled{710}$\textcircled{711}$\textcircled{712}$\textcircled{713}$\textcircled{714}$\textcircled{715}$\textcircled{716}$\textcircled{717}$\textcircled{718}$\textcircled{719}$\textcircled{720}$\textcircled{721}$\textcircled{722}$\textcircled{723}$\textcircled{724}$\textcircled{725}$\textcircled{726}$\textcircled{727}$\textcircled{728}$\textcircled{729}$\textcircled{730}$\textcircled{731}$\textcircled{732}$\textcircled{733}$\textcircled{734}$\textcircled{735}$\textcircled{736}$\textcircled{737}$\textcircled{738}$\textcircled{739}$\textcircled{740}$\textcircled{741}$\textcircled{742}$\textcircled{743}$\textcircled{744}$\textcircled{745}$\textcircled{746}$\textcircled{747}$\textcircled{748}$\textcircled{749}$\textcircled{750}$\textcircled{751}$\textcircled{752}$\textcircled{753}$\textcircled{754}$\textcircled{755}$\textcircled{756}$\textcircled{757}$\textcircled{758}$\textcircled{759}$\textcircled{760}$\textcircled{761}$\textcircled{762}$\textcircled{763}$\textcircled{764}$\textcircled{765}$\textcircled{766}$\textcircled{767}$\textcircled{768}$\textcircled{769}$\textcircled{770}$\textcircled{771}$\textcircled{772}$\textcircled{773}$\textcircled{774}$\textcircled{775}$\textcircled{776}$\textcircled{777}$\textcircled{778}$\textcircled{779}$\textcircled{780}$\textcircled{781}$\textcircled{782}$\textcircled{783}$\textcircled{784}$\textcircled{785}$\textcircled{786}$\textcircled{787}$\textcircled{788}$\textcircled{789}$\textcircled{790}$\textcircled{791}$\textcircled{792}$\textcircled{793}$\textcircled{794}$\textcircled{795}$\textcircled{796}$\textcircled{797}$\textcircled{798}$\textcircled{799}$\textcircled{800}$\textcircled{801}$\textcircled{802}$\textcircled{803}$\textcircled{804}$\textcircled{805}$\textcircled{806}$\textcircled{807}$\textcircled{808}$\textcircled{809}$\textcircled{810}$\textcircled{811}$\textcircled{812}$\textcircled{813}$\textcircled{814}$\textcircled{815}$\textcircled{816}$\textcircled{817}$\textcircled{818}$\textcircled{819}$\textcircled{820}$\textcircled{821}$\textcircled{822}$\textcircled{823}$\textcircled{824}$\textcircled{825}$\textcircled{826}$\textcircled{827}$\textcircled{828}$\textcircled{829}$\textcir ## Instructions Purpose of form. Use this form to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. Do not use Form 1096 to transmit electronically or magnetically. For magnetic media, see.Form 4804, Transmission of Information Returns Reported Magnetically; for electronic submissions, see Pub.-1220, Specifications for Filing Forms 1098, 1099, 5498, and W-2G Electronically or Magnetically. ```markdown Date ▶ $c = -7, 06$ ``` Who must file. The name, address, and TIN of the filer on this form must be the same as those you enter in the upper left area of Forms 1099, 1098, 5498, or W-2G. A filer includes a payer; a recipient of mortgage Interest payments (including points) or student loan Interest; an educational institution; a broker; a barter exchange; a creditor; a person reporting real estate transactions; a trustee or issuer of any Individual retirement arrangement; a Coverdell ESA, an HSA, an Archer MSA (including a Medicare Advantage MSA); certain corporations; certain donees of motor vehicles, boats, and airplanes; and a lender who acquires an interest in secured property or who has reason to know that the property has been abandoned. Preaddressed Form 1096. If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. If any of the preprinted Information is Incorrect, make corrections on the form. If you are not using a preaddressed form, enter the filer's name, address (including room, suite, or other unit number), and TIN in the spaces provided on the form. When to file. File Form 1096 with Forms 1099, 1098, or W-2G by February 28, 2006. File Form 1096 with Forms 5498, 5498-ESA, and 5498-SA by May 31, 2006. Where To File Send all information returns file with Form 1096 to the following: COLLECTIONS & DEPOSIT NO. 3 If your principal business, office or agency, or legal residence in the case of an individual, is located in VIRGIN ISLANDS BUREAU OF INTERNAL REVENUE, ST. THOMAS, VI Use the following Internal Revenue Service Center address: Alabama, Arizona, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Texas, Austin, TX 73301 Arkansas, Connecticut, Delaware, Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, West Cincinnati, OH 45999 Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Wisconsin For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2005 General Instructions for Forms 1099, 1098, 5498, and W-2G. Kansas City, MO 64999 FTC0034 EFTA00176045
PAYER's name, street address, city, state, ZIP code, and telephone no. FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QTRS, B3 ST. THOMAS, VI 008021 RantaOMB No. 1545-0115 Form 1099-MISCMiscellaneous Income
2 Royalties
3 Other income
4 Federal income tax withheld
PAYER's Federal Identification number 66-0567418RECIPIENT's identification number 13-30851145 Fishing boat proceeds6 Medical health care paymentsCopy for Payer or State Copy
RECIPIENT's name, address, and ZIP code GERALD B. LEFCOURT, P.C. 148 EAST 78TH STREET NEW YORK, NY 100217 Nonemployees compensation 15070.078 Subsidies payments in lieu of dividends or interestFor Privacy A and Paperw/o Reduction A Notice, see the 2005 General Instructions for Forms 1098, 548 and W-2
8 Power made direct sales of 85,000 or more consumer products to a buyer (recipient) for resale10 Crop insurance proceeds
1113
10 Excess golden parachute payments14 Gross proceeds paid to an attorney
Account number (see instructions)2nd TIN not.10 Excess golden parachute payments14 Gross proceeds paid to an attorney
19a Section 409A deferrals19b Section 409A Income10 State tax withheld17 State/Payer's state no.18 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service
PAYER's name, street address, city, state, ZIP code, and telephone no. FINANCIAL TRUST COMPANY, INC. 6100 RED HOOK QTRS, B3 ST. THOMAS, VI 008021 RintaOMB No. 1545-0115 Form 1099-MISCMiscellaneous Income
2 Royalties
3 Other income
4 Federal income tax withheld
PAYER's Federal Identification number 66-0567418RECIPIENT's identification number 66-04734836 Fishing boat proceeds8 Medical and health care paymentsCopy for Payer or State Co
RECIPIENT's name, address, and ZIP code HODGE & FRANCOSIS 1340 TAARENBERG GADS CHARLOTTE AMALIE, VI 008027 Nonemployees compensation 5949.498 Schedule payments in lieu of dividends or interestFor Privacy A and Paperw/o Reduction A Notice, see the 2005 Gene Instructions for Forms 1098, 548 and W-2
8 Power made direct sales of 45,000 or more consumer products to a buyer (recipient) for resale10 Crop insurance proceeds
1112
10 Excess golden parachute payments14 Gross proceeds paid to an attorney
Account number (see instructions)2nd TIN not.10 Excess golden parachute payments14 Gross proceeds paid to an attorney
16a Section 409A deferrals10b Section 409A Income10 State tax withheld17 State/Payer's state no.18 State Income
Form 1099-MISC FTCD035 Department of the Treasury - Internal Revenue Service EFTA00176046 ```markdown □ VOID □ CORRECTED ```
PAYER's name, street address, city, state, ZIP code, and telephone no.1 RentleOMB No. 1548-0115
2005
Form 1099-MISC
Miscellaneous Income
2 Royalities
3 Other Income4 Federal income tax withhold
$$
PAYER'S Federal Identification number
66-0567418
RECIPIENT'S Identification number
66-0578959
6 Fishing boat proceeds6 Medical and health care paymentsFor Privacy and Paperwork Reduction Notice, see the 2005 General Instructions for Forms 1099, 1098, 5499 and W-2
RECIPIENT'S name, address, and ZIP code
MAJORIE RAWLS ROBERTS
PO BOX 6347
THOMAS, VI 00804-6347
7 Nonemployee compensation
$ 13328.69
8 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of $5,000 or more of consumer product to a buyer (recipient) for resale10 Crop insurance proceeds
11 Excess golden parachute payments12 Gross proceeds paid to an attorney
Account number (see instructions)2nd TIN not.13 Excess golden parachute payments14 Gross proceeds paid to an attorney
18a Section 409A deferrals15b Section 409A Income16 State tax withheld17 State/Payer's state no.
$$$$
Form 1099-MISC Department of the Treasury - Internal Revenue Serv ```markdown 1099-MISC / COPY C ``` 31, 2006. electronically, the due date is March by February 28, 2006. If you file File Copy A of this form with the IRS 2006, IRS website. form to the recolpient by January 31, Due dates. Furnish Copy B of this Caution: Because paper forms are scanned during processing, you cannot file with the IRS Forms 1096, 1098, 1099, or 5498 that you print from the (1-800-829-3676). General and specific form Instructions are provided as separate products. The products you should use to complete Form 1099-MISC are the 2005 General Instructions for Forms 1099, 1098, 5498, and W-2G and the 2005 Instructions for Form 1099-MISC. A chart in the general instructions gives a quick guide to which form must be filed to report a particular payment. To order these instructions and additional forms, call 1-800-TAX-FORM (1-800-829-3676). Instructions for Payers FTCD036 EFTA00176047 For more Information and the Privacy Act and Paperwork Reduction Act Notice, see the 2004 General Instructions for Forms 1099, 1098, 5498, and W-2G. FTC0037 EFTA00176048 ```markdown ID CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.
FINANCIAL TRUST COMPANY, INC.
6100 RAD BOOK QTRS, IA
30, THOMAS, USVI 00802-1748
1 RentsOMB No. 1545-0115
2004
Form 1090-MISC
Miscellaneous Income
2 Royalties
3 Other Income
PAYER'S Federal Identification numberRECIPIENT'S Identification number5 Fishing boat proceeds6 Medical and health care payments
66-056741809-05405967 Nonemployee compensation8 Substitute payments in lieu of dividends or interest
RECIPIENT'S name, address, and ZIP code
PARNEN K. LINDYKE, ESQ.
2 KEAN COURT
LUTKINGSTON, MT. 07039
9 Payee made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale10 Crop insurance proceeds
1112
13 Excess golden perchute payments14 Gross proceeds paid to an attorney
Account number (optional)16 State tax withhold17 State/Payer's state no.18 State income
15$...$...$...
Form 1099-MISC ```markdown □ VOID □ CORRECTED ``` Department of the Treasury - Internal Revenue Service
PAYER'S name, street address, city, state, ZIP code, and telephone no.
FINANCIAL TRUST COMPANY, XRC.
6100 RED HOOK QTRS, B3
ST. THOMAS, USVI 00802-1348
1 RentsOMB No. 1848-0115
2004
Form 1099-MISC
Inco.
$
$
2 Royalties$4 Federal income tax withholdState Copy
or Extra File Copy
3 Other Income$
5 Fishing boat proceeds$6 Medical and health care payments
7 Nonemployee compensation$25500.458 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of $6,000 or more of consumer products to a buyer (recipient) for resale$10 Crop insurance proceeds
11$12
13 Excess golden parachute payments14 Gross proceeds paid to an attorney
Account number (optional)$
1516 State tax withheld17 State/Payer's state no.18 State Income
$$
Form 1099--MISC Department of the Treasury • Internal Revenue Service FTC0038 EFTA00176049 ```markdown □ ▼ ID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2004
Form 1099-MISC
Miscellaneous Income
$
$
2 Royalties
3 Other Income
4 Federal income tax withholdState Copy or Extra File Copy
$$
PAYER'S Federal Identification numberRECIPIENT'S Identification number6 Fishing boat proceeds8 Medical and health care payments
66-056741066-0473482$$
RECIPIENT'S name, address, and ZIP code7 Nonemployee compensation8 Substitute payments in lieu of dividends or interest
HODGE & FRANCOTS$2670.55$
1340 TAARINBERG GADE9 Payer made direct sales of $8,000 or more of consumer products to a buyer (recipient) for resale10 Crop insurance proceeds
CHARLOTTE AMALTE, V1 008021112
Account number (optional)13 Excess golden perchute payments14 Gross proceeds paid to an attorney
1516 State tax withhold.17 State/Payer's state no.18 State Income
$$$
Form 1099-MISC Department of the Treasury • Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER's name, street address, city, state, ZIP code, and telephone no.
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QURS, B3
ST. THOMAS, USVI 00802-1348
1 RentsOMB No. 1545-0115
2004
Form 1099-MISC
Miscellaneous Income
$
$
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
$$
PAYER's Federal Identification number
65-0567418
RECIPIENT's Identification number
65-0578959
5 Flaming boat proceeds6 Medical and health care payments
RECIPIENT's name, address, and ZIP code
MARJORIE CAVALLE ROBERTS
PO BOX 6347
ST. THOMAS, VT 00804-6247
7 Nonemployee compensation8 Subsidize payments in lieu of dividends or interest
9 Payer made direct sales of 35,000 or more of consumer products to a buyer (recipient) for retail10 Crop insurance proceeds
1112
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1518 State tax withheld17 State/Payor's stato no.
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0039 EFTA00176050
PAYER'S name, street address, city, state, ZIP code, and telephone no.
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QRS, D3
GE. THOMAS, USV 20802-1348
1 RentsDMB No. 1545-0115
2004
Form 1099-MISC
Miscellaneous Income
$
$
PAYER'S Federal Identification number
65-0567418
RECIPIENT'S Identification number
66-0436649
3 Other income4 Federal Income tax withheldState Copy or Extra File Copy
RECIPIENT'S name, address, and ZIP code
PAUL HOFFMAN, PC
PO BOX 870
CHARLOTTE AMALIE, VT 00504-0870
5 Fishing boat proceeds9 Medical and health care payments
7 Nonemployee compensation
$ 24000.00
8 Substitute payments in lieu of dividends or internal
9 Payer made direct sales of $8,000 or more of consumer products to a buyer (recipient) for resale10 Crop insurance proceeds
11 Excess golden parachute payments12 Gross proceeds paid to an attorney
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1516 State tax withheld17 State/Payer's state no.19 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.
FINANCIAL TRUST COMPANY, INC.
6100 RED HOOK QTRS, B3
ST. THOMAS, UBVI 00802-1348
1 RentsOMB No. 1546-0116
2004
Form 1099-MISC
Incon
2 Royalties
3 Other Income
PAYER'S Federal Identification number
66-0567410
RECIPIENT'S Identification number
13-3117822
5 Fishing boat proceeds6 Medical and health care paymentsState Copy or Extra File Copy
RECIPIENT'S name, address, and ZIP code
ROBERT YOUDELMAN, P.C.
19 WEST 44TH STREET SUCK 711
NEW YORK, NY 10036
7 Nonemployee compensation
$8180.00
8 Substitute payments in lieu of dividends or interest
8 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▶10 Crop insurance proceeds
1112
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1816 State tax withhold17 State/Payer's state no.
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0040 EFTA00176051
PAYER's name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1545-0115
2004
Form 1099-MISC
Miscellaneous income
$
$
2 Royalties
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
$$
PAYER's Federal Identification numberRECIPIENT'S Identification number5 Fishing boat proceeds6 Medical and health care payments
66-056741813-1456110$$
RECIPIENT'S name, address, and ZIP code7 Nonemployee compensation8 Substitute payments in lieu of dividends or interest
$10239.50$
9 Payer made direct sales of $85,000 or more of consumer products to a buyer (repliant) for resale □10 Crop insurance proceeds
767 FIFTH AVENUE NEW YORK, NY 101571112
Account number (optional)13 Excess golden perchute payments14 Gross proceeds paid to an attorney
1818 State tax withhold17 State/Poyer's state no.
Form 1099-MISC Department of the Treasury • Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.1 RentsOMB No. 1845-0118
2004
Form 1009-MISC
Miscellaneous Income
2 Royalties
3 Other income
PAYER'S Federal Identification numberRECIPIENT'S Identification number5 Fishing boat proceeds6 Medical and health care paymentsState Copy or Extra File Copy
RECIPIENT'S name, address, and ZIP code7 Nonemployee compensation8 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▷10 Crop insurance proceeds
11 Excess golden parachute payments12 Gross proceeds paid to an attorney
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1516 State tax withheld17 State/Payer's stato no.18 State Income
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTCO041 EFTA00176052 # Annual Summary and Transmittal of U.S. Information Returns **Form 1096** Department of the Treasury Internal Revenue Service --- ## FILER'S name FINANCIAL TRUST COMPANY, INC. Street address (including room or suite number) 6100 RED HOOK QTRS, B3 City, state, and ZIP code ST. THOMAS, USVI 00802-1348 For Official Use Only Name of person to contact JEANNE BRENNAN E-mail address Fax number (340) 775-2528 1. Employer identification number 66-0567418 2. Social security number 8 Total number of forms 6 4. Federal income tax withheld $ 5. Total amount reported with this Form 1095 $ 303,053.33 Enter an "X" In only one box below to indicate the type of form being filed. If this is your final return, enter an "X" here. | W-2G 92 | 1098-B1 | 1098-E8 | 1098-T6 | 1098-A8 | 1098-B70 | 1098-C85 | 1098-QAP73 | 1098-DIV81 | 1098-G86 | 1000-H71 | 1099-NT92 | 1099-LTC93 | 1099-MIBO95 | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | 1099-MBA94 | 1099-CID89 | 1099-PATR97 | 1099-Q91 | 1099-R98 | 1099-B75 | 549826 | 5498-ESA72 | 5498-MBA27 | | | | | | | Return this entire page to the Internal Revenue Service. Photocopies are not acceptable. Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and complete. COLLECTION & DEPOSIT SECTION - No. 2 ```markdown Signature ➤ ``` FEB 2020 ```markdown Date ▶ 2/11/2024 ``` Instructions VIRGIN ISLANDS BUREAU OF Preaddressed Form 1096. If you received a preaddressed Form 1096 from the IRS with Package 1099, use it to transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. If any of the preprinted Information is Incorrect, make corrections on the form. Purpose of form 1098: Transmit paper Forms 1099, 1098, 5498, and W-2G to the Internal Revenue Service. Do not use Form 1096 to transmit electronically or magnetically. For magnetic media, see Form 4804, Transmission of Information. Returns Reported Magnetically; for electronic submissions, see Pub. 1220, Specifications for Filling Forms 1098, 1099, 5498 and W-2G Electronically or Magnetically. If you are not using a preaddressed form, enter the filer's name, address (including room, suite, or other unit number), and TIN in the spaces provided on the form. Who must file. The name, address, and TIN of the filer on this form must be the same as those you enter in the upper left area of Forms 1099, 1098, 8498, or W-2G. A filer includes a payer; a recipient of mortgage interest payments (including points) or student loan interest; an educational institution; a broker; a barter exchange; a creditor; a person reporting real estate transactions; a trustee or issuer of any individual retirement arrangement, a Coverdoll ESA, an Archer MSA (including a Medicare+Choice MSA); certain corporations; and a lander who acquires an Interest in secured property or who has reason to know that the property has been abandoned. When to file. File Form 1096 with Forms 1099, 1098, or W-2G by March 1, 2004. File Form 1096 with Forms 5498, 5498-ESA, and 5498-MSA by May 31, 2004. ## Where To File Send all information returns filed on paper with Form 1096 to the following: If your principal business, office or agency, or legal residence in the case of an individual, is located in Use the following Internal Revenue Service Center address Alabama, Arizona, Florida, Georgia, Louisiana, Mississippi, New Mexico, North Carolina, Texas, Austin, TX 73801 | Arkansas, Connecticut, Delaware, Kentucky, Maine, Massachusetts, New Hampshire, New Jersey, New York, Ohio, Pennsylvania, Rhode Island, Vermont, West | | :--- | :--- | | Cincinnati, OH 45999 | | Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Oklahoma, South Carolina, South Dakota, Tennessee, Wisconsin Kansas City, MO 64909 For more information and the Privacy Act and Paperwork Reduction Act Notice, see the 2003 General Instructions for Forms 1089, 1098, 5498, and W-2G. Cat. No. 144000 Farm 1096 (2003) FTC0042 EFTA00176053 ```markdown □ VQ' ; □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.
Financial Trust Company, Inc., 6100 NW Hook Quarter E-3
St. Thomas U.S. Virgin Islands
00102
1 RentalsOMB No. 1545-0115
2003
Form 1099-MISC
Miscellaneous Income
2 Royalties
3 Other Income
PAYER'S Federal identification number
66-0567418
RECIPIENT'S Identification number
66-0435649
4 Federal income tax withheldState Copy or Extra File Copy
RECIPIENT'S name, address, (including apt. no.), city, state, and ZIP code
Paul O'Fellman
PO Box 870
Charlotte Amalie, VI 00004-0870
6 Medical and health care payments
Account number (optional)7 Nonemployee compensation
$ 25000.00
8 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of 50,000 or more consumer products to a buyer (recipient) for rentals □10 Crop insurance proceeds
1112
1813 Excess golden parachute payments14 Gross proceeds paid to an attorney
16 State tax withheld17 State/Payer's state no.18 State Income
$\cdot$$\cdot$$\cdot$
Form 1099-MISC Department of the Treasury - Internal Revenue Service ```markdown □ VOID □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.
Financial Trust Company, Inc., 6100 Red Hook Quarter B00
St. Thomas U.S. Virgin Islands 00802
1 RentalsOMB No. 1546-0118
2003
Form 1099-MISC
Miscellaneous Income
2 Royalties
3 Other Income
PAYER'S Federal Identification number
66-0567416
RECIPIENT'S Identification number
13-1456110
5 Fishing boat proceeds6 Medical and health care payments
RECIPIENT'S name, address, (including apt. no.), city, state, and ZIP code
Pell, Gotshal & Manges LLP
767 Fifty Avenue
New York, NY 10153
7 Nonemployee compensation
$22949.59
8 Substitute payments in lieu of dividends or interest
8 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale ▶10 Crop insurance proceeds
1112
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1816 State tax withheld
$\cdot$
17 State/Payer's state no.
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0043 EFTA00176054 ```markdown □ VOI □ CORRECTED ```
PAYER'S name, street address, city, state, ZIP code, and telephone no.
Financial Trust Company, Inc.
6100 Red Zook Quarter R-3
St. Thomas U.S. Virgin Islands
00602
1 RentsOMB No. 1545-0115
2003
Form 1099-MISC
Miscellaneous Income
$
$
2 Royalties
3 Other income4 Federal income tax withholdState Copy or Extra File Copy
$$
PAYER'S Federal Identification number
65-0567418
RECIPIENT'S Identification number
53-0214920
5 Fishing boat proceeds6 Medical and health care payments
RECIPIENT'S name, address, (including opt. no.), city, state, and ZIP code
Arant Fox Kintner Plotkin & Kahn, F.L.C.
1675 Broadway, 25th Floor
New York, NY 10019-5874
7 Nonemployee compensation8 Substitute payments in lieu of dividends or interest
$ 60298.50$
9 Payer made direct sales of $52,000 or more of consumer products to a layer (recipient) for resale10 Grop insurance proceeds
1112
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1516 State tax withhold17 State/Payer's state no.18 State Income
$$$
Form 1099-MISC ```markdown □ VOID □ CORRECTED ``` Department of the Treasury - Insental Revenue Service
PAYER'S name, street address, city, state, ZIP code, and telephone no.
Financial Trust Company, Inc., 6100 Red Hook Quarter B-3
St. Thomas U.S. Virgin Islands 00802
1 RontaOMB No. 1548-0115
2003
Form 1099-MISC
Miscellaneous Income
2 Royalties
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
5 Fishing boat proceeds6 Medical and health care payments
PAYER'S Federal Identification number
66-050741A
RECIPIENT'S identification number
13-3085114
RECIPIENT'S name, address, including opt. no., city, state, end ZIP code
Garald A. Liefcourt, P.C.
140 East 73th Street
New York, NY 10021
7 Nonemployee compensation
$ 151261.67
8 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for roselo10 Crop insurance proceeds
1112
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to en attorney
1516 State tax withheld
$
17 State/Payer's state no.18 State Income
$
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0044 EFTA00176055 ```markdown □ VC , □ CORRECTED ```
PAYER's name, street address, city, state, ZIP code, and telephone no.1. RentsDMB No. 1545-0115
2003
Form 1069-MISC
Miscellaneous Income
$
2. Royalties$
3. Other Income$
PAYER's Federal Identification numberRECIPIENT's Identification number5. Fishing boat proceeds8. Medical and health care paymentsState Copy or Extra File Copy
66-050741866-0473403$$
RECIPIENT's name, address, (including apt. no.), city, state, and ZIP code
Hodge 3 Francois
1340 Taunenberg Gale
Charlotte Amalie, VI 00602
7. Nonemployee compensation$ 23494.708. Substitute payments in lieu of dividends or interest
9. Payer made direct sales of $5,000 or more of consumer products to a buyer (recipient) for resale$10. Crop insurance proceeds
11.$12.
Account number (optional)13. Excess golden pyrachute payments14. Gross proceeds paid to an attorney
15.16. State tax withhold17. State/Payer's state no,18. State income
Form 1099-MISC ```markdown VOID CORRECTED ``` Department of the Treasury - Internal Revenue Service
PAYER'S name, street address, city, state, ZIP code, and telephone no.
Financial Trust Company, Inc., 6100 Red Book Quarter B-3
St. Thomas U.S. Virgin Islands 00802
1 RentsOMB No. 1545-0115
2003
Form 1099-MISC
Miscellaneous Income
$
$
3 Other Income4 Federal income tax withheldState Copy or Extra File Copy
$$
PAYER'S Federal Identification number
66-0567418
RECIPIENT'S Identification number
66-0578932
5 Fishing boat proceeds6 Medical and health care payments
RECIPIENT'S name, address, (including opt. no.), city, state, and ZIP code
Marjorie Rawle Roberts
PO Box 6347
St. Thomas, VT 00044-6347
7 Nonemployee compensation
$12043.47
8 Substitute payments in lieu of dividends or interest
9 Payer made direct sales of 95,000 or more of consumer products to a buyer (recipient) for resolo ▷10 Crop insurance proceeds
1112
14 Gross proceeds paid to an attorney
Account number (optional)13 Excess golden parachute payments14 Gross proceeds paid to an attorney
1816 Stato tax withheld17 Stato/Payor's state no.
Form 1099-MISC Department of the Treasury - Internal Revenue Service FTC0045 EFTA00176056 U.S. Department of Justice United States Attorney Southern District of Florida ```markdown 500 South Australian Ave., Suite 400 West Palm Beach, FL 33401 (561) 820-8711 Facsimile: (561) 820-8777 ``` June 1, 2007 VIA FACSIMILE Gerald Lefcourt, Esq. Gerald P. Lefcourt, P.C. 148 East 78th Street New York, NY 10021 Re: Subpoenas to J. Epstein Virgin Islands Foundation, Inc., J. Epstein & Company, Inc., Epstein Interests, and Financial Trust Company, Inc. Dear Mr. Lefcourt: It was a pleasure speaking with you and Ms. Sanchez. As we discussed, I have attached hereto the subpoenas to J. Epstein Virgin Islands Foundation, Inc., J. Epstein & Company Inc., Epstein Interests, and Financial Trust Company, Inc. I understand that you are representing these entities for the purpose of accepting service, but the entities may retain different counsel at a later date. None of these entities is a target of the grand jury investigation. The subpoenas call for documentary and electronic information. I have set the date for the return of the items for Tuesday, June 12, 2007. If additional time is needed to complete the document collection, please let me know. If there are any categories for which no documents exist, please ask the Custodian of Records to provide a certificate of nonexistence of records. Thank you again for your assistance. Sincerely, R. Alexander Acosta United States Attorney By: A. Marie Villafaña Assistant United States Attorney cc: E. Nesbitt Kuyrkendall, FBI (with enclosures) | EFTA00176057 | | :--- | :--- ```text 06/01/2007 10:29 FAX 5618021787 ``` ```markdown USAO WPB FL ``` ```markdown ☑ 001 ``` ```markdown ``` TRANSMISSION OK 4794
TX/RX NO
CONNECTION TEL
SUBADDRESS
CONNECTION ID
ST. TIME
USAGE T
PGS. SENT
RESULT
```markdown 12129886192 ``` ```markdown 06/01 10:23 ``` United States Attorney's Office Southern District of Florida 500 Australian Ave., Suite 400 West Palm Beach, FL 33401 TO: Mr. Gerald Lefcourt, Esq. ```markdown Fax #: ``` ORGANIZATION: SUBJECT: DATE: June 1, 2007 FROM: A. Marie Villafaña Assistant United States Attorney (561) 820-8711, Extension 3047 (561) 802-1787 (Fax) NUMBER OF PAGES, INCLUDING THIS PAGE: 22 EFTA00176058 ## Villafana, Ann Marie C. (USAFLS)
From:Villafana, Ann Marie C.(USAFLS)
Sent:Tuesday, May 22, 2007 7:12 PM
To:GBL@lefcourtlaw.com
Subject:Representation of Financial Trust Company, Inc., J. Epstein & Company, Inc., and other corporate entities
Dear Gerry: I noticed that, at least as of July 2005, you have served as counsel to Financial Trust Company, Inc. in connection with litigation. Can you let me know if you still represent Financial Trust Company, Inc., and if you represent J. Epstein & Company, Inc., J. Epstein Virgin Islands Foundation, Inc., and/or Epstein Interests? If you represent any or all of those entities, are you willing to accept service of subpoenas via fax? Thank you for your assistance. Marie A. Marie Villafaña Assistant U.S. Attorney 500 S. Australian Ave, Suite 400 West Palm Beach, FL 33401 Phone 561 209-1047 Fax 561 820-8777 Tracking: 1 EFTA00176059 ```markdown Recipient ``` ```markdown GBL@lefcourtlaw.com ``` Lourie, Andrew (USAFLS) Read Atkinson, Karen (USAFLS) Read: 5/22/2007 7:28 PM Read: 5/23/2007 9:01 AM 2 EFTA00176060 U.S. Department of Justice United States Attorney Southern District of Florida | Information | Value | | :--- | :--- | | 500 South Australian Ave., Suite 400 | | | West Palm Beach, FL 33401 | | | (561) 820-8711 | | | Facsimile: (561) 820-8777 | | May 24, 2007 VIA FACSIMILE Gerald Lefcourt, Esq. Gerald P. Lefcourt, P.C. 148 East 78th Street New York, NY 10021 Re: Subpoenas to J. Epstein Virgin Islands Foundation, Inc., J. Epstein & Company, Inc., Epstein Interests, and Financial Trust Company, Inc. Dear Mr. Lefcourt: It was a pleasure speaking with you and Ms. Sanchez today. As we discussed, I have attached hereto the subpoenas to J. Epstein Virgin Islands Foundation, Inc., J. Epstein & Company Inc., Epstein Interests, and Financial Trust Company, Inc. I understand that you are representing these entities for the purpose of accepting service, but the entities may retain different counsel at a later date. None of these entities is a target of the grand jury investigation. The subpoenas call for documentary and electronic information. I have set the date for the return of the items for Tuesday, June 19, 2007. If additional time is needed to complete the document collection, please let me know. If there are any categories for which no documents exist, please ask the Custodian of Records to provide a certificate of nonexistence of records. Thank you again for your assistance. Sincerely, R. Alexander Acosta United States Attorney By: A. Marie Villafaña Assistant United States Attorney cc: E. Nesbitt Kuyrkendall, FBI (with enclosures) EFTA00176061 ```markdown ``` Page 3 of 4 Westlaw. 22279979393 Page 1 ```markdown 22279979393-LIT ``` ## LITIGATION PREPARATION RECORDS ```text Information Current Through:05-01-2007 Database Last Updated:05-14-2007 Update Frequency:MONTHLY Current Date:05/14/2007 Source:AS REPORTED BY THE SECRETARY OF STATE OR OTHER OFFICIAL SOURCE ``` ## COMPANY INFORMATION Name: ZORRO DEVELOPMENT CORP. ```markdown Address:110 E 59TH ST- G ASSOC NEW YORK, NY 10022 ``` ## FILING INFORMATION
Filing Date:05/21/1993
State of Incorporation:DELAWARE
Date Incorporated:05/21/1993
Duration:PERPETUAL
Status:ACTIVE
Corporation Type:PROFIT
Business Type:CORPORATION
Address Type:MAILING
Registration ID #:1615137
Where Filed:NEW MEXICO PUBLIC REGULATION COMMISSION
1 STATE CAPITAL BUILDING
SANTA FE, NM 87503
## REGISTERED AGENT INFORMATION Agent Name:PRENTICE- CORPORATION SYSTEM Address:125 LINCOLN AVE STE 223 SANTA FE, NM 87501 ## PRINCIPAL INFORMATION
Name:EPSTEIN, JEFFREY
Title:PRESIDENT
Name:INDYKE, DARREN
Title:SECRETARY
© 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176062 Page 4 of 4 22279979393 Page 2 ```markdown Name:JEFFREY EPSTEIN Title:DIRECTOR ``` ## ADDITIONAL DETAIL INFORMATION Filing Office Details:REPORT CODE:REG RPT/CLEARANCE BUSINESS PURPOSE: DEVELOPMENT Call Westlaw CourtExpress at 1-877-DOC-RETR (1-877-362-7387) to order copies of documents related to this or other matters. Additional charges apply. THE PRECEDING PUBLIC RECORD DATA IS FOR INFORMATION PURPOSES ONLY AND IS NOT THE OFFICIAL RECORD. CERTIFIED COPIES CAN ONLY BE OBTAINED FROM THE OFFICIAL SOURCE. END OF DOCUMENT © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176063 Page 1 of 14 Westlaw. Information Current Through: 05-11-2007 Database Last Updated: 05-14-2007 | Update Frequency: | DAILY | | :--- | :--- | Current Date: 05/14/2007 Source: NEW YORK CITY REGISTER FILING/LIEN INFORMATION ```markdown Document Type: INITIAL UCC1 ``` Document ID: ```markdown FT_1970006745397 ``` Filing Date: 08/12/1999 Filing Borough: MANHATTAN ## DEBTOR INFORMATION Debtor: FINANCIAL TRUST COMPANY, INC. J. EPSTEIN & COMPANY, INC. 457 MADISON AVENUE NEW YORK, NEW YORK 10022 UNITED STATES SECURED PARTY INFORMATION Secured Party: CITIBANK, N.A. ST. JOHN & WAYNE, L.L.C. © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176064 Page 2 of 14 ```markdown 70 EAST 55TH STREET ``` NEW YORK, NEW YORK 10022 UNITED STATES ## CROSS REFERENCES ```markdown Document ID: FT_1900008826990 ``` | Document ID: | FT_1970006745397 | | :--- | :--- | Call Westlaw CourtExpress at 1-877-DOC-RETR (1-877-362-7387) to order copies of documents related to this or other matters. Additional charges apply. ```markdown END OF DOCUMENT ``` © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176065 Page 3 of 4 Westlaw. 1307306 Page 1 1307306 ## CORPORATE RECORDS & BUSINESS REGISTRATIONS
This Record Last Updated:04/04/2001
Database Last Updated:05-14-2007
Update Frequency:WEEKLY
Current Date:05/14/2007
Source:AS REPORTED BY THE SECRETARY OF STATE OR OTHER OFFICIAL SOURCE
THE FOLLOWING DATA IS NOT AN OFFICIAL RECORD OF THE DEPARTMENT OF STATE OR THE STATE OF NEW YORK AND WEST, A THOMSON BUSINESS IS NOT AN EMPLOYEE OR AGENT THEREOF. ALL WARRANTIES, EXPRESS OR IMPLIED, REGARDING THE INFORMATION PROVIDED HEREIN, ARE DISCLAIMED BY THE DEPARTMENT OF STATE. ## COMPANY INFORMATION ```markdown Company Name: Process Name: Process Address: J. EPSTEIN & COMPANY, INC. GOLD & WACHTEL, ESQS 10 EAST 53RD STREET NEW YORK, NY 10022 NEW YORK County: ## FILING INFORMATION
Identification Number:1307306
Filing Date:11/18/1988
State of Incorporation:NEW YORK
Duration:PERPETUAL
Status:INACTIVE
Status Attained Date:04/04/2001
Corporation Type:PROFIT
Business Type:DOMESTIC BUSINESS CORPORATION
Where Filed:DEPARTMENT OF STATE/DIVISION OF CORPORATIONS
41 STATE STREET
ALBANY, NY 12231
© 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176066 ```markdown 1307306 ``` Page 4 of 4 Page 2 ## NAME INFORMATION Former Name: JEFFREY E. EPSTEIN, INC. ## AMENDMENT INFORMATION
Amendments:04/04/2001 DISSOLUTIONREFER TO MICROFILM NUMBER
010404000011
10/03/1997 NAME CHANGEREFER TO MICROFILM NUMBER
971003000402
02/22/1993 ERRONEOUS ENTRYREFER TO MICROFILM NUMBER
930222000039
09/23/1992 DISSOLUTION BY PROCLAMATIONREFER TO MICROFILM NUMBER DP-747315
## STOCK INFORMATION ```markdown Stock: Authorized 200 Shares: Call Westlaw CourtExpress at 1-877-DOC-RETR (1-877-362-7387) to order copies of documents related to this or other matters. Additional charges apply. THE PRECEDING PUBLIC RECORD DATA IS FOR INFORMATION PURPOSES ONLY AND IS NOT THE OFFICIAL RECORD. CERTIFIED COPIES CAN ONLY BE OBTAINED FROM THE OFFICIAL SOURCE. ```markdown END OF DOCUMENT ``` © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176067 Page 1 of 2 Westlaw. FEIN RECORD Information Current Through: 03-11-2007
Database Last Updated:03-13-2007
| Update Frequency: | QUARTERLY | | :--- | :--- | Source: Copyright © 2007 by Dun & Bradstreet, Inc. Current Date: BUSINESS INFORMATION Company Name: J EPSTEIN FOUNDATION Address: ```markdown 457 MADISON AVE NEW YORK, NY 10022 ``` FEIN Number: 13-3643429 D&B Source: DEPARTMENT OF TREASURY - TAX EXEMPT D&B Company Name: J EPSTEIN & CO INC DUNS Number: 62-800-9623 SIC: 62829903 INVESTMENT COUNSELORS EXECUTIVE INFORMATION Executive Name: JEFREY E EPSTEIN ```markdown Title: END OF DOCUMENT ``` PRESIDENT © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176068 Page 2 of 2 Westlaw. FEIN RECORD Information Current Through: 03-11-2007
Database Last Updated:03-13-2007
| Update Frequency: | QUARTERLY | | :--- | :--- | Source: Copyright © 2007 by Dun & Bradstreet, Inc. Current Date: BUSINESS INFORMATION Company Name: J EPSTEIN VIRGIN ISLANDS FOUNDATION INC Address: ```markdown 6100 RED HOOK QUARTER STE B-3 ST THOMAS, VI 00802 ``` FEIN Number: 66-0585379 D&B Source: DEPARTMENT OF TREASURY - TAX EXEMPT D&B Company Name: ISLAND RESOURCES FOUNDATION DUNS Number: 09-031-8080 SIC: 87330203 EDUCATIONAL RESEARCH AGENCY EXECUTIVE INFORMATION Executive Name: BRUCE G POTTER ```markdown Title: END OF DOCUMENT ``` PRESIDENT © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?rs=WLW7.04&destination=atp&sv=Full... 5/14/2007 EFTA00176069 Page 1 of 3 Westlaw. ## EXECUTIVE AFFILIATION RECORD
Information Current Through:04-13-2007
Database Last Updated:05-14-2007
Update Frequency:WEEKLY
Current Date:05/14/2007
Source:AS REPORTED BY THE SECRETARY OF STATE OR OTHER OFFICIAL SOURCE
EXECUTIVE INFORMATION Principal Name: Principal Title: ```markdown EPSTEIN, JEFFREY PRESIDENT ``` Principal Name: Principal Title: ```markdown INDYKE, DARREN SECRETARY ``` Principal Name: Principal Title: ```markdown JEFFREY EPSTEIN DIRECTOR ``` ```markdown Registered Agent: Registered Agent Address: ```markdown PRENTICE CORPORATION SYSTEM 125 LINCOLN AVE STE 223 SANTA FE, NM 87501 BUSINESS INFORMATION ``` ```markdown Business Name: Business Address: ```markdown ZORRO DEVELOPMENT CORP. 110 E 59TH ST- G ASSOC NEW YORK, NY 10022 OTHER INFORMATION ```
Filing Date:05/21/1993
Status:ACTIVE
Business/Filing Type:CORPORATION
Identification No.:1615137
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THE PRECEDING PUBLIC RECORD DATA IS FOR INFORMATION PURPOSES ONLY AND IS NOT THE OFFICIAL RECORD. CERTIFIED COPIES CAN ONLY BE OBTAINED FROM THE OFFICIAL SOURCE. © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176070 Page 2 of 3 ```markdown END OF DOCUMENT ``` © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176071 Page 3 of 3 Westlaw. ## EXECUTIVE AFFILIATION RECORD
Information Current Through:04-06-2007
Database Last Updated:05-14-2007
Update Frequency:WEEKLY
Current Date:05/14/2007
Source:AS REPORTED BY THE SECRETARY OF STATE OR OTHER OFFICIAL SOURCE
EXECUTIVE INFORMATION Principal Name: Principal Title: ```markdown JEFFREY EPSTEIN AUTHORIZED REPRESENTATIVE ``` Principal Name: Principal Title: ```markdown LESLIE H. WEXNER AUTHORIZED REPRESENTATIVE ``` ```markdown Registered Agent: Registered Agent Address: ```markdown CT CORPORATION SYSTEM 36 EAST SEVENTH STREET SUITE 2400 CINCINNATI, OH 45202 BUSINESS INFORMATION ``` ```markdown Business Name: Business Address: THE NEW ALBANY COMPANY LLC 5906 E DUBLIN GRANVILLE RD NEW ALBANY, OH 43054 OTHER INFORMATION
Filing Date:09/21/1998
Status:ACTIVE
Business/Filing Type:FOREIGN LIMITED LIABILITY CO
Identification No.:1034132
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THE PRECEDING PUBLIC RECORD DATA IS FOR INFORMATION PURPOSES ONLY AND IS NOT THE OFFICIAL RECORD. CERTIFIED COPIES CAN ONLY BE OBTAINED FROM THE OFFICIAL SOURCE. ```markdown END OF DOCUMENT ``` © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176072 Page 1 of 1 Westlaw. ## EXECUTIVE AFFILIATION RECORD
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```markdown 05-02-2007 05/14/2007 COPYRIGHT © 2007 DUN & BRADSTREET, INC. ``` EXECUTIVE INFORMATION ```markdown Executive Name: Executive Title: ```markdown MR JEFFREY E EPSTEIN PRESIDENT BUSINESS INFORMATION ``` Business Name: Business Address: ```markdown J EPSTEIN & CO INC 457 MADISON AVE NEW YORK, NY 10022-6843 NEW YORK OTHER INFORMATION ``` ```markdown County: Phone: DUNS: 62-800-9623 (Click for List of Available D&B Reports) Call Westlaw CourtExpress at 1-877-DOC-RETR (1-877-362-7387) to order copies of documents related to this or other matters. Additional charges apply. THE PRECEDING PUBLIC RECORD DATA IS FOR INFORMATION PURPOSES ONLY AND IS NOT THE OFFICIAL RECORD. CERTIFIED COPIES CAN ONLY BE OBTAINED FROM THE OFFICIAL SOURCE. ```markdown END OF DOCUMENT ``` © 2007 Thomson/West. No Claim to Orig. U.S. Govt. Works. https://web2.westlaw.com/print/printstream.aspx?prft=HTMLE&destination=atp&sv=Full... 5/14/2007 EFTA00176073