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Get RRB OE-1a 2014-2024

On should NOT be reported in excess of applicable yearly maximums 7. Month of Quarter 6. Employee Identification Name 8. 9. Gross Earnings and Employee Medicare Tier I Medicare Tax Withheld Earnings 2. Page ___ of ___ Page(s) 5. For Month or Quarter Ending 20_____ Tier I Maximum $ 10. Tier I Earnings See Form OE-1a INST for Complete Instructions Tier II Maximum $ 11. Tier I Employee Tax Withheld 12. Tier II Earnings 13. Tier II Employee Tax Withheld 1 2 SSA Number 3 Name 1 2 SSA N.

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