---
type: tax-form
category: tax
person: xuewei-jiang
date: 2021-01-01
source: "[[jiang_w2_usc_2021.pdf]]"
---

# W-2 Wage and Tax Statement 2021 — Xuewei Jiang / University of Southern California

## Employee Information

- **Employee name:** XUEWEI JIANG
- **Employee SSN:** XXX-XX-3215
- **Employee address:** 11950 IDAHO AVE., APT. 113, LOS ANGELES, CA 90025

## Employer Information

- **Employer name:** UNIVERSITY OF SOUTHERN CALIFORNIA
- **Employer EIN:** 95-1642394
- **Employer address:** UNIVERSITY PARK, LOS ANGELES, CA 90089-0001
- **Control number:** 0000088315 TYI
- **Department:** WSJ7
- **Employer use:** 17337

## Wage and Tax Data

| Box | Description | Amount |
|-----|-------------|--------|
| 1 | Wages, tips, other compensation | $269,733.09 |
| 2 | Federal income tax withheld | $65,396.81 |
| 3 | Social security wages | $142,800.00 |
| 4 | Social security tax withheld | $8,853.60 |
| 5 | Medicare wages and tips | $276,141.46 |
| 6 | Medicare tax withheld | $4,689.32 |
| 7 | Social security tips | (blank) |
| 8 | Allocated tips | (blank) |
| 9 | (blank) | (blank) |
| 10 | Dependent care benefits | (blank) |
| 11 | Nonqualified plans | (blank) |

## Box 12 — Codes

| Code | Description | Amount |
|------|-------------|--------|
| E | Elective deferrals to 403(b) | $6,408.37 |
| DD | Cost of employer-sponsored health coverage | $9,068.64 |

## Box 13 — Checkboxes

- **Statutory employee:** Not checked
- **Retirement plan:** Checked
- **Third-party sick pay:** Not checked

## Box 14 — Other

| Description | Amount |
|-------------|--------|
| VDICA | $1,539.58 |

## State and Local Tax Information

| Box | Description | Value |
|-----|-------------|-------|
| 15 | State | CA |
| 15 | Employer's state ID number | 910-0606 4 |
| 16 | State wages, tips, etc. | $269,733.09 |
| 17 | State income tax | $23,964.49 |
| 18 | Local wages, tips, etc. | (blank) |
| 19 | Local income tax | (blank) |
| 20 | Locality name | (blank) |