Name and surname
E-mail
Year: —Proszę wybrać opcję—20172016201520142013
Wiza type: —Proszę wybrać opcję—J1H2B
State: —Proszę wybrać opcję—AlabamaAlaskaArizonaArkansasConnecticutSouth DakotaNorth DakotaDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaCaliforniaKansasSouth CarolinaNorth CarolinaKentuckyColoradoLouisianaMaineMarylandMassachusettsMichiganMinnesotaMissisipiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew YorkNew MexicoOhioOklahomaOregonPennsylvaniaRhode IslandTexasTennesseeUtahVermontWashingtonVirginiaWest VirginiaWisconsinWyoming
Total earnings $:
Sum of federal tax $:
Sum of state tax $:
First name
Second name - - Only if included on your Social Seurity Card
Surname
Your SSN - - type from Social Seurity Number Card
Date of birth
Phone number
State/Region
City
Street name
Building number/Flat number
Post Code
Rabate Code
Add first employer [group pracodawca1] Your possition
Your wages - Box 1 in W2 or Box 7 in 1099-MISC
Federal tax deducted - Box 2 in W2
State tax deducted - Box 17 in W2
State you worked —Proszę wybrać opcję—AlabamaAlaskaArizonaArkansasConnecticutSouth DakotaNorth DakotaDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaCaliforniaKansasSouth CarolinaNorth CarolinaKentuckyColoradoLouisianaMaineMarylandMassachusettsMichiganMinnesotaMissisipiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew YorkNew MexicoOhioOklahomaOregonPennsylvaniaRhode IslandTexasTennesseeUtahVermontWashingtonVirginiaWest VirginiaWisconsinWyoming [/group]
Add next employer
[group pracodawca2] Your possition
[group pracodawca3] Your possition
[group pracodawca4] Your possition
Date you entered USA
Date you departured USA
Wiza type —Proszę wybrać opcję—J1H2B
Have you worked in USA before 2023? —Proszę wybrać opcję—NieTak
If yes, provide the year
How many days you were working In USA In 2022
How many days you were working In USA In 2021
Who organized your work In USA?
Way return —Proszę wybrać opcję—CheckDirect deposit to account in USA
[group zwrot-opcje]Routing number
Account number [/group]
Additional informations
