This exhibit is a completed Form 885-E, Schedule For FICA Tax Adjustment of Wages Not Previously Reported, for tax year 2000. The exhibit is a two-part form. The top part shows the quarterly break-down of the wages received where no FICA Tax was withheld and the bottom portion is a worksheet entitled, Worksheet for FICA Tax Adjustments.The amounts used to complete the top portion are taken from the worksheet so this explanation will cover the line item descriptions and amounts for the worksheet first. Each line is broken down by a) Social Security and (b) Medicare. Maximum taxable FICA wages by law for this year: a) Social Security = $76,200 and b) Medicare = Unlimited.Total FICA wages shown on all Forms W-2 (include covered wages received as agriculture or household employee and any RRTA wages: a) and b) are blank. Report amount of tips shown on all Forms W-2 (include unreported tips reported on Form 4137) or as corrected on examination reports: a) and b) are blank.Total wages for which FICA tax has been previously paid (Total of 2 and 3): a) and b) are blank.Balance (line 1a. less 4a. for Social Security) = $76,200 and Line 1b. less 4b for Medicare = unlimited.Total wages received for which no FICA tax was withheld by the payer: a) Social Security = 25,000 and b) $25,000Line 6 or line 5, whichever is smaller: a) Social Security = 25,000 and b) Medicare = $25,000.FICA tax adjustment. Multiply the amount on line 7 by the applicable rate: a) Social Security = 1,550 and b) Medicare = $362.50.Total adjustment. Add line 8a. and line 8b. = $1,912.50.The top portion of the exhibit includes the following information: Employer's Name, Address and EIN = Joe's Construction, 00000 Downtown Avenue, Los Angeles, CA 90000; XX-XXXXXXX.Name, Address, Occupation and Social Security of person who received these wages = John Smith, 123 Main Street, Anywhere, USA 00000; Construction; XXX-XX-XXXX.The remainder of the top portion of the form consists of three sections - A, B and C.Section A is a table that reflects the wages received where no FICA Tax was withheld. This amount comes from Line 7 of the worksheet at the bottom of the page and totals $25,000. It is divided into 4 quarters. Each quarter is split between a) Social Security and b) Medicare.In this exhibit each of the four quarters totals $13,000 split equally between Social Security and Medicare ($6,250 each).Line 5 is the Total of Lines 1a through 4a = $25,000 and 1b through 4b = $25,000.