b'W-2 PRE-PRINTED FORMS1099 PRE-PRINTED FORMS Mfg. ID Convenience Package Sets Mfg. ID Convenience Package Sets22222 VOID aEmployees social security number For Ofcial Use Only 52013 Transmittal 1096 forms are included with each set MFG ID 1099-MISC BLANK PACKAGED LASER SET *b OMB No. 1545-00082 Federal income tax withheld PARTScEmployers name, address, and ZIP code 1 Wages, tips, other compensation 4 Social security tax withheld OMB No. 1545-0008 Safe, accurate,Visit the IRS website at5202 * FOR 50 EMPLOYEES3 Social security wages 6 Medicare tax withheld MFG ID 1099-MISC PACKAGED LASER SET5 Medicare wages and tips7 Social security tips 8 Allocated tipsaEmployees social security number FAST! Use www.irs.gov/ele e 11cEmployers name, address, and ZIP code12aSee instructions for box 12 3 Social security wages 4 Social security tax withhelddControl number Last name Suff. 9b 10C doe 1 Wages, tips, other compensation 2 Federal income tax withheld PARTS 61745-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 13StatutoryRetirementThird-party12b C C doe 5 Medicare wages and tips 6 Medicare tax withheld OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If you5203employee plan sick pay 12c doe 7 Social security tipsb aEmployees social security number may be imposed on you if this income is taxable and you fail to report it. 200- 5144, 3 - 5100fEmployees address and ZIP code 14Other dControl number 12d C doe Suff. 9 RetirementThird-partyC C C dddoooe e e 8 Allocated tips 1 Wages, tips, other compensation VOID 2 Federal income tax withheld OMB No. 1545-00082 Federal income tax withheld FOR 50 EMPLOYEESeEmployees name, address, and ZIP code 11cEmployers name, address, and ZIP code10See instructions for box 12 3 Social security wages 4 Social security tax withheld15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 13Statutoryplan sick pay 12a 5 Medicare wages and tips 6 Medicare tax withheld 5204 6102E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,Form W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service17State income tax employee dControl number 12b C doe 20Locality name Suff. 13 7 Social security tips Third-partyC C dooe e 8 Allocated tipsaEmployees social security number 1 Wages, tips, other compensation 4 Social security tax withheld DO NOT STAPLE 50- 5111, 50 - 5112, 3 - 5100 1096, 50 - 77772 Envelopes MFG ID 1099-MISC PACKAGED LASER SET FOR ELECTRONIC FILING *14Other 12c 22222For Privacy Act and Paperwork Reduction12d 9 b 10See instructions for box 12 3 Social security wagesCopy AFor Social Security Administration. Send this entire page with not acceptable. 41-085241115StateAct Notice, see the separate instructions.eEmployees name, address, and ZIP code 11StatutorycEmployers name, address, and ZIP code12a d5 Medicare wages and tips 6 Medicare tax withheld For Ofcial Use Only: 5200Form W-3 to the Social Security Administration; photocopies areEmployers state ID number 16State wages, tips, etc. 18Local wages, tips, etc.19Local income tax employee Retirementsick pay 12b C doe 7 Social security tipsb 33333 a Control number 943 OMB No. 1545-0008 None apply501c non-govt. Third-party61034-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, PARTSDo Not Cut, Fold, or Staple Forms on This Page plan14Other 12c 8 Allocated tipsMilitary 944 sick pay b 22222 VOID aEmployees social security number For Ofcial Use Only Form W-2 Wage and Tax Statement 2023 15State Department of the TreasuryInternal Revenue Service 17State income tax dControl number 12d C doe 20Locality name Suff. 13 9 Statutorye Kind of PayerC C 941 ddooe e Hshld.govt. emp. Kind of EmployerState/localState/local 501cFederal govt. applicable)50- 5111, 100 - 5112, 3 - 5100 1096 FOR 50 EMPLOYEES(Check one) 10emp. Medicare(Check one) non-501c (Check if OMB No. 1545-0008eEmployees name, address, and ZIP code 11CT-1 d Establishment number 1 Wages, tips, other compensation 2 Federal income tax withheld1 Wages, tips, other compensation 2 Federal income tax withheld Employers state ID number 16State wages, tips, etc. 18Local wages, tips, etc.19Local income tax RetirementThird-party12aSee instructions for box 12Copy BTo Be Filed With Employees FEDERAL Tax Return. cEmployers name, address, and ZIP code This information is being furnished to the Internal Revenue Service. employee c Total number of Forms W-212b 3 Social security wages 4 Social security tax withheld3 Social security wages 4 Social security tax withheld OMB No. 1545-0008 FAST! Use W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 14Other plan sick pay 12c C C ddooe e 5 Medicare wages and tips 6 Medicare tax withheld 6103E4-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 61133-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,5 Medicare wages and tips 6 Medicare tax withheld fEmployers namedControl number Last name Suff. 13 7 Social security tips Third-partyC C C C ddddoooe e e e 8 Allocated tipsaEmployees social security number Suff. 9 Safe, accurate,C oe 2Visit the IRS website atOMB No. 1545-0008 15State DFor rState, Safe, accurate,Tax 16State wages, tips, etc.17State income tax 18Local wages, tips, etc. g 12d 20Locality name 117 Social security tips 9 108 Allocated tips 50- 5111, 100 - 5112, 3 - 5100 1096, 50 - 77772 Envelopes 50- 5111, 100 - 5112, 3 - 1096Form www.irs.gov/eleb 10Copy CFor EMPLOYEES RECORDS (See Notice toFAST!Use 19Local income taxEmployee on the back of Copy B.) 91 Wages, tips, other compensation orFederal income tax withheld Employers state ID numberEmployees State, CityLocal Incomeor Cop Taxy 2 to b Returne Filed Withe 11cEmployers name, address, and ZIP code12aSee instructions for box 12 3 Social security wages 4 Social security tax withheld 12a Deferred compensationStatutoryRetirementsick pay 12b 5 Medicare wages and tips 6 Medicare tax withheld Form W-2 Wage and Tax Statement 2023 h Employers address and ZIP code 13 For third-party sick pay use only 12b 61055-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 6113E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,employee plan 7 Social security tips aEmployees social security number This information is being furnished to the Internal Revenue Service. If you Other EIN used this year 14 Income tax withheld by payer of third-party sick payDepartment of the TreasuryInternal Revenue Service 14Other dControl number 12c b 8 Allocated tips may be imposed on you if this income is taxable and you fail to report it. 15 State Employers state ID number 18 Local wages, tips, etc. 19 Local income tax101 Wages, tips, other compensation 2 Federal income tax withheld For Privacy Act and Paperwork Reduction fEmployees address and ZIP code 16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 12d o20Locality name 11StatutorycEmployers name, address, and ZIP code C ddooe e 9 Copy1Fo Employer.City,orLocal Department OMB No. 1545-000816 State wages, tips, etc. 17 State income tax Employers telephone number 50- 5111, 100 - 5112, 3 - 1096, 50 - 77772 Envelopes Act Notice, see separate instructions.15StateEmployers state ID number eEmployees name, address, and ZIP code 13 employee RetirementThird-party12a C dSee instructions for box 12 Copy 22222 VOID 4 Social security tax withheld Employers contact person Employers email address 50- 5111, 150 - 5112, 3 - 5100 10963 Social security wages19Local income tax plan sick pay 12b 5 Medicare wages and tips 6 Medicare tax withheld Employers fax numberForm W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service14Other dControl number 12c C doe Suff. 7 Social security tips C doe 8 Allocated tipsaEmployees social security number 1 Wages, tips, other compensation 4 Social security tax withheld Title: Date: Department of the TreasuryFOR 25 EMPLOYEESCopy AFor Social Security Administration. Send this entire page with not acceptable. 41-085241115State LW2A For Privacy Act and Paperwork Reduction17State income tax 18Local wages, tips, etc. 12d 20Locality name 11Statutoryb RetirementThird-party10C C C ddoooe e e Suff. 9 Under penalties of perjury, I declare 2 Federal income tax withheldthat I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, andC oe 6103254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, MFG ID 1099-INT PACKAGED LASER SET *complete.Signature: Act Notice, see the separate instructions.eEmployees name, address, and ZIP code cEmployers name, address, and ZIP code12aSee instructions for box 12 3 Social security wagesForm W-3 to the Social Security Administration; photocopies areEmployers state ID number 16State wages, tips, etc. 19Local income tax 13 employee plan sick pay 12b Form W-3 Transmittal of Wage and Tax Statements 2023 Internal Revenue Service5201 5 Medicare wages and tips 6 Medicare tax withheldSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).Photocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA. Form W-2 Wage and Tax Statement 2023 15State Department of the TreasuryInternal Revenue Service 14Other dControl number 12c d20Locality name 13 7 Social security tips Third-partyC ddoe 8 Allocated tips 25- 5111, 50 - 5112, 3 - 5100 1096 PARTSDo not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.12d Reminder 10 66661, 66662Copy BTo Be Filed With Employees FEDERAL Tax Return.LW2B 16State wages, tips, etc.17State income tax eEmployees name, address, and ZIP code 11StatutorySeparate instructions. See the 2023 General Instructions for Forms W-212aSee instructions for box 12This information is being furnished to the Internal Revenue Service. Employers state ID number 5202 18Local wages, tips, etc.19Local income tax W-3 for Form(s) W-2 that were submitted electronically to the SSA.Department of the TreasuryInternal Revenue Service employee Purpose of Form C C ddooe e FOR 50 EMPLOYEESForm Wage and Tax Statement Safe, accurate,14Other Retirementsick pay 12b 6103E254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110,plan12cpaper forms must comply with IRS standards and be machine readable. Photocopies are not acceptable. Use a Form W-3 even if only one W-2 2023 FAST!Use 12dCopy CFor EMPLOYEES RECORDS (See Notice to15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18 number (EIN). Make a copy of this form and keep it with Copy D (ForWhen To File Paper Forms 25- 5111, 50 - 5112, 3 - 5100 1096, 25- 77772 envelopes 6104 Employee on the back of Copy B.)LW2C/LW22 5203 Employer) of Form(s) W-2 for your records. The IRS recommendsMail Form W-3 with Copy A of Form(s) W-2 by January 31, 2024. 3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5120,Employees State, City or Local Incomeor Cop Taxy 2tReturno be Filed With retaining copies of these forms for 4 years. 20Locality nameLocal wages, tips, etc.19Local income taxE-FilingForm W-2 Wage and Tax Statement 2023 Copy A electronically instead of on paper. The SSA provides two freeWhere To File Paper Forms 6105255-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, 50- 5121, 100 - 5122, 3 - 5100 1096The SSA strongly suggests employers report Form W-3 and Forms W-2 Send this entire page with the entire Copy A page of Form(s) W-2 to:50 Forms W-2 at a time to the SSA.toSocial Security Administration W-2 Online.For Privacy Act and Paperwork Reduction usingDirect Operations CenterDepartment of the TreasuryInternal Revenue Service CopyDForrEmployer. Specications for Filing Forms W-2 Electronically (EFW2) Note:Wilkes-Barre, PA 18769-0001Copy1FoState,City,orLocalTaxDepartmentFile Upload.Act Notice, see separate instructions.5204 .the SSAs18769-0002. If you use an IRS-approved private delivery service, add 25- 5111, 75- 5112, 3 - 5100 1096 61064-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5120,LW2D1 ATTN: W-2 Process, 1150 E. Mountain Dr. to the address and changeJanuary 31, 2024. For more information, go to www.SSA.gov/bso. First- the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers Tax Register Log In. Guide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. 50- 5121, 100 - 5122, 3 - 5100, 3 - 1096LW3 41-0852411 5200 MFG ID 1099-NEC PACKAGED LASER SET * FOR 25 EMPLOYEES3 Transmittal W-3 forms are included with each set MFG ID W-2 LASER BLANK PACKAGED SETS PARTS 6106254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5120,PARTS FOR 25 EMPLOYEES 25- 5121, 50 - 5122, 3 - 51003-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, NEC6102 MFG ID W-2 PACKAGED LASER SETFOR 50 EMPLOYEES 50- NEC5111, 50 - NEC5112, 3 - 5100 MFG ID 1099-DIV PACKAGED LASER SET *57466-PART PRE-PACKAGED CONVENIENCE SET includes: 50 -NEC6102E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,PARTS PARTS 5201, 100- 5207, 50 - 5209, 3 - 5201 - 99991 Envelopes50- NEC5111, 50 - NEC5112, 3 - 5100, 50 - DW19WS Envelopes FOR 50 EMPLOYEESFOR 50 EMPLOYEES FOR 25 EMPLOYEES NEC61034-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,61074-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5130,56454-PART SET includes: 50 - 5201, 50 - 5202, 50 - 5203,5746256-PART PRE-PACKAGED CONVENIENCE SET includes: 25 -50- NEC5111, 100 - NEC5112, 3 - 5100 50- 5131, 100 - 5132, 3 - 510050 - 5204, 3 - 52005201, 50- 5207, 25 - 5209, 3 - 5200 - 99992 Envelopes NEC6103E4-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,FOR 25 EMPLOYEES 5645E4-PART SET includes: 50-5201, 50-5202, 50-5203, 50-5204, 50- NEC5111, 100 - NEC5112, 3 - 5100, 50 - DW19WS EnvelopesMFG ID W-2C CORRECTED INCOME PACKAGED LASER SETS 6107254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5130,3 - 5200 W-3, 50 - 66662 Envelopes NEC61055-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,25- 5131, 50 - 5132, 3 - 5100PARTS56506-PART SET includes: 50 - 5201, 50 - 5202, 25 - 5203, 50- NEC5111, 150 - NEC5112, 3 - 5100 50 - 5204, 3 - 5200 FOR 50 EMPLOYEES FOR 25 EMPLOYEES MFG ID 1099-R PACKAGED LASER SET NEC6103254-PART PRE-PACKAGED CONVENIENCE SET includes: PARTS5650E6-PART SET includes: 50 - 5201, 50 - 5202, 50 - 5203, 53174-PART PRE-PACKAGED CONVENIENCE SET Includes: 50-5313, 50 - 5204, 3 - 5200, 50 - 66662 Envelopes 50-5314, 50-5315, 50-5316, 3-5309 25 - NEC5110, 25- NEC5111, 50 - NEC5112 FOR 50 EMPLOYEES56558-PART SET includes: 50 - 5201, 50 - 5202, 150 - 5203, 53186-PART PRE-PACKAGED CONVENIENCE SET Includes: 50-5313,NEC6103E254-PART PRE-PACKAGED CONVENIENCE SET includes:56466-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5140,150 - 5204, 3 - 5200 50-5314, 100-5315, 100-5316, 3-5309 25 - NEC5110, 25- NEC5111, 50 - NEC5112,25 - DW19WS Envelopes 50- 5141, 100 - 5142, 100 - 5143, 3 - 51005655E8-PART SET includes: 50 - 5201, 50 - 5202, 150 - 5203,FOR 25 EMPLOYEESFOR 25 EMPLOYEES150 - 5204, 3 - 5200, 50 -66662 Envelopes 531725 4-PART PRE-PACKAGED CONVENIENCE SET Includes: 25-5313,MFG ID 1099-NEC BLANK PACKAGED LASER SET * 5644254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5140, FOR 25 EMPLOYEES 25-5314, 25-5315, 25-5316, 3-5309PARTS 25- 5141, 25 - 5142, 25 - 5143, 3 - 5100 5645254-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, FOR 25 EMPLOYEES5646256-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5140,25 - 5204, 3 - 5200 531825 6-PART PRE-PACKAGED CONVENIENCE SET Includes: 25-5313,NEC61745-PART PRE-PACKAGED CONVENIENCE SET includes: 25- 5141, 50 - 5142, 50 - 5143, 3 - 51005645E254-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, 25-5314, 50-5315, 50-5316, 3-5309 50 - NEC5110, 200- NEC5144, 3 - 5100 25 - 5204, 3 - 5200, 25 - 66662 Envelopes TFP 1099-MISC LASER PACKAGED SET FOR ELECTRONIC FILING5650256-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, TFP W-2 PACKAGED LASER SETS FOR ELECTRONIC FILING MFG ID 1099-NEC PACKAGED LASER SET FOR ELECTRONIC FILING * PARTSPARTS PARTS25 - 5204, 3 - 5200 FOR 50 EMPLOYEES FOR 50 EMPLOYEES5650E256-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, FOR 50 EMPLOYEES 6112E3-Part PRE-PACKAGED CONVENIENCE SET includes: 5144 (150),5205E4-Part SET includes: 5205 (50), Envelopes 99992 (50) NEC61133-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, 25 - 5204, 3 - 5200, 25 - 66662 Envelopes 77772 (50) Envelopes5207E50PRE-PACKAGED CONVENIENCE SET includes: 5207 (100),50- NEC5111, 100 - NEC5112, 3 - 10965655258-PART SET includes: 25 - 5201, 25 - 5202, 75 - 5203, FOR 25 EMPLOYEESEnvelopes 66662 (50) NEC6113E50 - NEC5110, 75 - 5204, 3 - 5200 3-PART PRE-PACKAGED CONVENIENCE SET includes:61133E253-Part PRE-PACKAGED CONVENIENCE SET includes:5111 (25), 5112 5655E258-PART SET includes: 25 - 5201, 25 - 5202, 75 - 5203, 5221EPRE-PACKAGED CONVENIENCE SET includes: 5221 (50), 50- NEC5111, 100 - NEC5112, 3 - 1096, 50 - DW19WS Envelopes(50), 77772 (25) Envelopes Envelopes 99992 (50)75 - 5204, 3 - 5200, 25 - 66662 Envelopes FOR 25 EMPLOYEES *Forms have had significant changes that may require reprogramming TFP 1099-NEC LASER PACKAGED SET FOR ELECTRONIC FILING5647E25 3-Part SET includes: 5202 (25), 5203 (25), 5204 (25), EnvelopesPARTS 66662 (25) FOR 25 EMPLOYEESNEC6113E253-Part PRE-PACKAGED CONVENIENCE SET includes:NEC5111 (25), 5205E25 4-Part SET includes: 5205 (25), Envelopes 99992 (25)10 11 NEC5112 (50), DW19WS (25) Envelopes'