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•d8U s11l; 33?I S11ir;r*Ea uag; 'sqn;s pna OAOM31 :gado oJO CONTINUED FROM BOTTOM Box 7. Shows nonemployee compensation. If you are in the trade or business of catching fi h, box 7 may show cash you received for the sale of fish. If pa ments that are reported In this box are in ome from Self-employment, report this amount on Schedule C C-EZ, or F (Form 1040), and complete Schedule SE 1GForm 1040!. Because you received this form rather than Form W-2' the payer may have considered you self-employed and did not withhold social securit or Medicare taxes. Contact the payer if �y�o�u believe this form is incorrect or has been i sued in error. If ou are not SalfY employed, report this amount on the "Wages, salaries, tips, etc." line of Form 1040. Call the IRS for i4ormation about how to report. any social security and Medicare taxes. Box transfer Shows UyourUsecuritlesnfornuseU in a dividends lho tnsale Report onntphe l"Other`income' line your broker 1040.your behalf Box S. If marked, salts to you of consumer products on a buy-jell, deposit-commission, or any other basis ,for resale Generally to oany nccome from yourr person these products non ScheduleaC oro C-EZ(Forrm 1dol lar Oa4munt In this box. Box 10. Report on the "Crop insurance proceeds. . ." line on Schedule F (Form 1040). 11 B13. Shows excess golden parachute payments subject to a 20% excise tax. See your Form 1040 instructions for the "!Dotal Tax' line. The amount in box 7 is your total compensation. Box 14. Shows gross proceeds paid to an attorney in connection with legal services. Report only the taxable part as income on your return. Box 15. Other information may be provided to you in box 15. Boxes 16-18. If state or local income tax was withheld from the payment, these boxes may be completed. KAISER PERMANENTE FIRST CLASS MAIL P O BOX 12916 U.S. POSTAGE PAID OAKLAND, CA OAKLAND, CA 94604 PERMIT NO. 1160 FIRST CLASS MAIL COUNTY OF SAN JOAQUIN 7— OFFICE OF EMERGENCY SERVICES � 222 EAST�y(1�.t � STOCKTON,wCAER95202 . 610 � qAN JOAOUIN COUNTY` }ncFlCE OFOF EM�RCE S�' Amounts shown on this form may be subject to self-employment tax.lf your net income from self-employment is $400 or more, you must file a return and compute your self-employment tax on Schedule SE (Form 10401. See Pub. 533, Self-Employment Tax, for more information. If no Income or social security and Medicare taxes were withheld, you may have to make estimated tax payments if you are still receiving these payments. See Form 1040-ES, Estimated Tax for Individuals. fiduciaries aor an partnerships, report the amounts on the prloper line Form yourr 4taax returnPlained below. For corporations, Boxes 1 and 2. Report rents from real estate on Schedule E (Form 1040). If you provided significant services to the tenant sold real estate as a business, or rented personal property as a business, report on Schedule C or C-EZ (Form 10405. For royalties on timber, coal, and iron ore, see Pub. 544, Sales and Other Dispositions of Assets. business incomle, report this amount on on Schedule C�nC EZI or F(Form n1040).OThed amountyshownamaynbelf it payments tradeor received as the beneficiary of a deceased employee, prizes, awards, taxable damages, Indian gaming profits, or other taxable income. Box 4. Shows backup withholding or withholding on Indian gaming profits. Generally, a ager must backup withhold at a 31% rate if you did not furnish your taxpayer identification number to the payer. See Form W-9, Request for Taxpayer Identification Number and Certification, for information on backup withholding. Include this amount on your income tax return as tax withheld. g pp Schedule Camount oroC tEZ (Form box means Pub h1595,Tax Highlights for considers mercialf Fisherlmena Report this amount on Box 6. Report on Schedule C or C-EZ (Form 1040).