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                                                                                                            Payroll by Tallybook

Crooked Fender Cycles LLC
                                                                                                           Substitute Form W-2
                                                                                                         not an official IRS form



Form W-2 Wage and Tax Statement 2025. Copy C, for employee's records.
SUBSTITUTE FORM
 EMPLOYER AND EMPLOYEE
 A. EMPLOYEE'S SOCIAL SECURITY NUMBER    B. EMPLOYER IDENTIFICATION NUMBER        D. CONTROL NUMBER
 XXX-XX-XXXX                             41-5550167                               CF-0007
 C. EMPLOYER'S NAME AND ADDRESS          E. EMPLOYEE'S NAME                       F. EMPLOYEE'S ADDRESS
 Crooked Fender Cycles                   Theodore K Nakagawa-Reed                 3318 Brackenmere Avenue
 LLC, 2411 E Hollis                                                               S, Apt 3, Minneapolis,
 Street, Minneapolis, MN                                                          MN 55406
 55406

 FEDERAL
 1. WAGES, TIPS, OTHER COMPENSATION      2. FEDERAL INCOME TAX WITHHELD           3. SOCIAL SECURITY WAGES
 $19,841.25                              $1,204.18                                $19,841.25
 4. SOCIAL SECURITY TAX WITHHELD         5. MEDICARE WAGES AND TIPS               6. MEDICARE TAX WITHHELD
 $1,230.16                               $19,841.25                               $287.70
 12. CODES                               13. STATUTORY EMPLOYEE / RETIREMENT      14. OTHER
 None                                    PLAN / THIRD-PARTY SICK PAY              None
                                         None checked

 STATE AND LOCAL
 15. STATE AND EMPLOYER'S STATE ID       16. STATE WAGES, TIPS, ETC.              17. STATE INCOME TAX
 MN 2290417                              $19,841.25                               $612.40
 18. LOCAL WAGES                         19. LOCAL INCOME TAX                     20. LOCALITY NAME
 None                                    None                                     None

 EMPLOYER'S SUMMARY, NOT PART OF FORM W-2
 HOURS PAID IN 2025                      HOURLY RATE                              PAY PERIODS
 1,017.50                                $19.50                                   26

This information is being furnished to the Internal Revenue Service. Substitute statement prepared by the employer's
payroll service. Keep this copy with your tax records.

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W2 2025 Document · saved Jan 28, 2026

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Planted

only_in_file Only inside files. The lease, nine pages: the late fee ($50 after the 5th, section 6), the returned-payment charge ($30), the lockout charge ($75, section 29), the 21-day deposit return (section 8), early termination (60 days' notice to a month end plus one month's rent, section 36) and the year the building was built (Addendum C). The $9,850.00 on the Pilcrow 1099 and the tax withheld on the W-2 ($1,204.18 federal), both boxed substitute forms. The royalty (3% after 4,000 copies) and the print limits in the book contract. The date Miso was spayed and her shelter shots. What Gail wrote by hand on the 2026 renewal. The renters policy number and limits. Also only on a picture: the old address on the Minnesota license. Miso's microchip number is in two files and no note.

attachments.yaml 
record: doc-w2-2025
template: document
style: form
org:
  name: Crooked Fender Cycles LLC
  lines:
  - Payroll by Tallybook
  - Substitute Form W-2
  - not an official IRS form
  color: '#7a2d1c'
title: Form W-2 Wage and Tax Statement 2025. Copy C, for employee's records. SUBSTITUTE FORM
body: '| Employer and employee | |

  |---|---|

  | a. Employee''s social security number | XXX-XX-XXXX |

  | b. Employer identification number | 41-5550167 |

  | d. Control number | CF-0007 |

  | c. Employer''s name and address | Crooked Fender Cycles LLC, 2411 E Hollis Street, Minneapolis, MN
  55406 |

  | e. Employee''s name | Theodore K Nakagawa-Reed |

  | f. Employee''s address | 3318 Brackenmere Avenue S, Apt 3, Minneapolis, MN 55406 |


  | Federal | |

  |---|---|

  | 1. Wages, tips, other compensation | $19,841.25 |

  | 2. Federal income tax withheld | $1,204.18 |

  | 3. Social security wages | $19,841.25 |

  | 4. Social security tax withheld | $1,230.16 |

  | 5. Medicare wages and tips | $19,841.25 |

  | 6. Medicare tax withheld | $287.70 |

  | 12. Codes | None |

  | 13. Statutory employee / Retirement plan / Third-party sick pay | None checked |

  | 14. Other | None |


  | State and local | |

  |---|---|

  | 15. State and employer''s state ID | MN 2290417 |

  | 16. State wages, tips, etc. | $19,841.25 |

  | 17. State income tax | $612.40 |

  | 18. Local wages | None |

  | 19. Local income tax | None |

  | 20. Locality name | None |


  | Employer''s summary, not part of Form W-2 | |

  |---|---|

  | Hours paid in 2025 | 1,017.50 |

  | Hourly rate | $19.50 |

  | Pay periods | 26 |


  This information is being furnished to the Internal Revenue Service. Substitute statement prepared by
  the employer''s payroll service. Keep this copy with your tax records.

  '