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  1. FORM 1040                WAGES, SALARIES, TIPS
  2.  
  3. !C1                                                     SSN: !C2 !
  4.  
  5.        EMPLOYER:  #01
  6.  
  7.        WAGES.........  #02
  8.        OTHER INCOME..  #03
  9.        FEDERAL W/H...  #04
  10.        FICA W/H......  #05
  11.        STATE1 TAX....  #06
  12.        STATE2 TAX....  #07
  13.        LOCAL TAXES...  #08
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