b"W-2 PRE-PRINTED & BLANK FORMSW-2 PRE-PRINTED FORMS Individual 2-Up Laser Packs Combined 3-Up & 4-Up Laser22222 VOID aEmployees social security number For Ofcial Use Only LW2ALW2BL b OMB No. 1545-00082 Federal income tax withheld a Copy BTo Be Filed With Employee's 1 241-0852411 a Copy 2To Be Filed With Employee's State, 1 241-0852411 L4UP Form c W-2 Wage and Tax Statement 2023 7Social security tips 1 Wages, tips, other comp. 2Federal income tax withheld L87cEmployers name, address, and ZIP code 1 Wages, tips, other compensation 4 Social security tax withheld 5201 5222 FEDERAL Tax Return. Wages, tips, other comp. OMB No. 1545-0008 City, or Local Income Tax Return. 3 4 Federal income tax withheld Employers name, address, and ZIP code 8Allocated tips 9 3Social security wages 4Social security tax withheld3 Social security wages Employee's soc. sec. no. Federal income tax withheld Employee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-00085 Medicare wages and tips 6 Medicare tax withheld b c Employer ID number (EIN) 5 3Social security wages 6 4Social security tax withheld b c Employer ID number (EIN) 5 Social security wages 6 Social security tax withheld 5205 eEmployees name, address, and ZIP codeSuff. 10 emtaptulotoy S eye r RetirementThird-party 5Medicare wages and tipsC C e d d o o 6Medicare tax withheld 52067 Social security tips 8 Allocated tips Medicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 11 plans 12a See instructions for box 12 dControl number 910C See instructions for box 12 Front Blank Employer's name, address, and ZIP code Employer's name, address, and ZIP code 13 Employerplansickpay 14OtherCC e e e d d o o 12be Last name Suff.11StatutoryRetirementThird-party12a C ddooe e Safe, accurate,Visit the IRS website atLW2Bwith W2 InstructionsdControl number dControl number15StateEmployers state ID no. 16State wages, tips, etc. b number (EIN) 12c 20Locality nameaEmployees social security no.aEmployees social security number13 employee plan sick pay 12b FAST! Use www.irs.gov/ele17State income tax 18Local wages, tips, etc. 12d b 14Other OMB No. 1545-000812c C doe 2 Federal income tax withheld eEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff. 19Local income tax3 12d on back side. OMB No.1545-008Visit the IRS Web Site atwww.irs.gov/elefEmployees address and ZIP code cEmployers name, address, and ZIP code 1 Wages, tips, other compensation C doe 4 Social security tax withheld 5202 Copy B To Be Filed With Employees FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. Dept. of the Treasury - IRSSocial security wages15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 5Local income tax 20Locality name6 Medicare tax withheld LW2NB10 7Social security tips 11 8Allocated tipsplans 12a 9 CodeSee inst. for box 12 10 7Social security tips 11 8Allocated tipsplans 12a 9 Code Form c W-2 Wage and Tax Statement 2023 7Social security tips 1 negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.19Medicare wages and tips This information is being furnished to the Internal Revenue Service.7 Social security tips 8 Allocated tips Employers name, address, and ZIP code 8Allocated tips Wages, tips, other comp. 2Federal income tax withheld3Social security wages 4Social security tax withheldForm W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue ServiceSt C C C C ddooooe e e e This information is being furnished to the Internal Revenue Service. If you5207 1 13Statutory employee 14Other Local income tax 12b 7 Code 1 13Statutory employee 14Other Local income tax 12b 7 Code eEmployees name, address, and ZIP code 16State wages, tips, etc.Suff. 10 9 e Smtaptulotoyeye r RetirementThird-party5Medicare wages and tipsCCCC e e e e d d d d o o o o 6Medicare tax withheld dControl number 9 10 eEmployees name, address, and ZIP code Suff.For Privacy Act and Paperwork Reductionmay be imposed on you if this income is taxable and you fail to report it. LW2CLW22Retirement plan 12cCode Retirement plan 12cCode 13 Employerplansick pay 11 plans 12a See instructions for box 12 1112aSee instructions for box 12Copy AFor Social Security Administration. Send this entire page with Act Notice, see the separate instructions.Third-party sick pay 12dCode Third-party sick pay 12dCode 14Other 12bForm W-3 to the Social Security Administration; photocopies are not acceptable. 41-0852411aEmployees social security number13 emaptutloyeeoryRementThir 12bDo Not Cut, Fold, or Staple Forms on This Page platnire sickd p-party ay b number (EIN) 12cOMB No. 1545-0008b 14Other 1 Wages, tips, other compensation 2 Federal income tax withheld12c22222 VOID aEmployees social security numbercEmployers name, address, and ZIP codeFor Ofcial Use OnlyOMB No. 1545-00083 12d dd4 Social security tax withheld 5203 158 State Employer's state ID number 19 16State wages, tips, etc. 20 1Locality name 158 State Employer's state ID number 19 16State wages, tips, etc. 20 1Locality name 15StateEmployers state ID no. aEmployees social security no. 18Local wages, tips, etc. 12d20Locality nameSocial security wages Local wages, tips, etc. State income tax Local wages, tips, etc. State income tax17State income tax 19Local income taxb 15StateEmployers state ID number 16State wages, tips, etc. 2 Federal income tax withheld5 Medicare wages and tips 6 Medicare tax withheld Form W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Form W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRScEmployers name, address, and ZIP code dControl number 1 Wages, tips, other compensation17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 8 Allocated tips This information is being furnished to the Internal Revenue Service. a Local,or File 1 www.irs.gov/ele 2 2023OMB No. a EmployersState,Local,or File 1 Copy22222 2 2023OMB No. L4UPR Copy C For EMPLOYEE'S RECORDS (See Notice to Employee on back of Copy B.)c 22222Void OMB No.1545-008 Dept. of the Treasury - IRS 2Federal income tax withheld L87RL3UP3 Social security wages 4 Social security tax withheld 7 Social security tips 10EmployersState, Copy22222 1545-0008 Employee's soc. sec. no. Wages, tips, other comp. 1545-0008 2023 FormW-2 Wage and Tax Statement 7Social security tips 1 Wages, tips, other comp. 4Social security tax withheld9 Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Federal income tax withheld Employers name, address, and ZIP code 8Allocated tips 3Social security wagesLast name Wage and Tax Statement 7 Social security tips sick pay C C ddooe e 6 Medicare tax withheldDepartment of the TreasuryInternal Revenue Service si C C C C ddddooooe e e e See instructions for box 12 2 Federal income tax withheld b OMB No. 1545-0008 FAST! Use www.irs.gov/eleb c a Copy CFor EMPLOYEE'S RECORDS (See 5 3 1 d b c 6 2 5 3Social41-0852411 6 4 b c a Copy 2To Be Filed With Employee's State, 5 d 6 2341-0852411 6 4Social security tax withheld Form c e W-2 Wage and Taxe Statement 2023 ID no.Suff. 7Social security tips 9 Ssick paySuff. 1 9 13 Wages, tips, other comp.eP ReThird-partyCCC e e e d d d o o o 5Medicare wages and tipsCCCC e e e e d d d d o o o o 6 Medicare tax withheld Se instructions for box 12eEmployees name, address, and ZIP code5 Medicare wages and tipsForm W-2 2023 Suff.11employee plan k ppaay 12a Notice to Employee on the back of Copy B.) OMB No. 1545-0008 Social security tax withheld 1b Wages, tips, other comp. SocialOMB No. 1545-0008 Medicare tax withheld Employers name, address, and ZIP code 8Allocated tips 10 2Federal income tax withheld 12aSe e instructions for box 12 dControl number Copy BTo Be Filed With Employees FEDERAL Tax Return.22222 VOID 8 Allocated tips StatutoryRetirementThicrd-rty12b LW2D1aEmployees social security number Safe, accurate,Visit the IRS website atLW2BC Employee's soc. sec. no. Wages, tips, other comp. security wages City, or Local Income Tax Return.security wages 5405 Employees name, address, and ZIP code 3Social security wagesSick pay 11 plans 12b 5406 5210Employer ID number (EIN) Medicare wages and tips Medicare tax withheld Employer ID number (EIN) Medicare wages and tipsThis information is being furnished to the Internal Revenue Service. 10aEmployees social security number13 OMB No. 1545-00081 Wages, tips, other compensation 2 Federal income tax withheld Social security wages Federal income tax withheld Employee's soc. sec. no. 3c Social security wages Federal income tax withheld 5Medicare wages and tips 4Social security tax withheld 12ce Suff. 9b 12aSee instructions for box 12 14Other 1 Wages, tips, other compensation Employer's name, address, and ZIP code4Social security tax withheld Employer ID number (EIN) Employer's name, address, and ZIP code45 Social security tax withheld 10 b Smtaptluotoyeryelatnirement14Other6Medicare tax withheld1112c Employer ID number (EIN) Medicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 11 plans 12ab aEmployees social security number13StatutorycEmployers name, address, and ZIP code C doe e 17State income tax www.irs.gov/ele3 Social security wages 20Locality name 4 Social security tax withheld 5204 cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld 5212 Employer's name, address, and ZIP code e Employer's name, address, and ZIP code e Suff. Employees name, address, and ZIP code State Employersstate 13emtaptulotyoreye Retirement Third-party aEmployees social security no.C e d o 12b separateinstructions. 12d0820Locality name12demployee RetirementThird-party12bSafe, accurate,Visit the IRS website atplan 14Other14Other plan 12c FAST! Use 2 Federal income tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld Control number Control number15 b Employer17State income tax 18Local wages, tips, etc. 19Local income taxOMB No. 1545-0008 12c15StateEmployers state ID number 16State wages, tips, etc. 18Local wages, tips, etc.19Local income tax 16State wages, tips, etc. number (EIN)1 Wages, tips, other compensation7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips Employee's name, address, and ZIP code Suff. Employee's name, address, and ZIP code aEmployees social security no. 12d cEmployers name, address, and ZIP code dControl number 3 12d C do4 Social security tax withheld 9 10dControl number 9 10d e Control number Suff. d e Control number Suff.15StateCOPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionActNotice,seeOMB No. 1545-0Social security wages Dept. of the Treasury - IRS Employers state ID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality namefEmployees address and ZIP code 16State wages, tips, etc.Form W-2 Wage and Tax Statement 5emaptutloyeeory St Re 2023 C C ddooe e 6 Medicare tax withheldDepartment of the TreasuryInternal Revenue Service 12aSee instructions for box 12 C C C ddddooooe e e e eEmployees name, address, and ZIP code Suff.11emptutloyeeoryplanrementThird-party12a C C C ddddoooe e e e See instructions for box 12 10 Employee's name, address, and ZIP code 7 12a 11 8Allocated tipsplans 12a 9 13 Employee's name, address, and ZIP code e 7 14 9 11 8Allocated tipsplans 12a 9 Code See inst. for box 12Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return c c e Statement 9 22222Void OMB No. 9 1545-0S 08R Pleatnirement Sick pay Dept. of the Treasury - IRSCC e e d d o o 2Federal income tax withheld 2023eEmployees name, address, and ZIP code19Medicare wages and tipsLocal income tax Suff.Safe, accurate, 15StateEmployers state ID number 17State income tax 18Local wages, tips, etc. 7 Social security tips 20Locality name 8 Allocated tips 11StatutoryRetirementThird-party12b 13Sta Reti sick pay 12b 10 Social security tips Code See inst. for box 12 10 Social security tips 2023 FormW-2 Wage and Tax7Social security tips 1 Wages, tips, other comp. 4Social security tax withheldCopy CFor EMPLOYEES RECORDS (See Notice toFAST!UseEmployee on the back of Copy B.)Filed With 13 employee plan sick pay Employers name, address, and ZIP code 8Allocated tips 3Social security wagesdControl number Employees State, City or Local Incomeor Cop Taxy 2tReturno be9 10 Form W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service14Other 12c C 14Other 12c C o7Social security tips 11 813Allocated tips 14Other 9 CodeSee inst. for box 12 12b 7Social security tips 13 8Allocated tips Ot1h2ear Code 12bCode Form W-2 Wage and Tax Statement 2023 7Social security tips 1 Wages, tips, other comp. 5Medicare wages and tips 6 Medicare tax withheldeEmployees name, address, and ZIP code Suff.For Privacy Act and Paperwork ReductionThis information is being furnished to the Internal Revenue Service. If you13Statutory employee 14Other Statutory employee 12bCode 12d Code 14Other 11 Statutory employee 12bCode 12cCode Employers name, address, and ZIP code Employees name, address, and ZIP code 8Allocated tips Suff. 3Social security wagesThird-party 2Federal income tax withheld 12aSe e instructions for box 12 1112aSee instructions for box 12Copy AFor Social Security Administration. Send this entire page withLW2AAct Notice, see the separate instructions.12d 12d Retiremen tplans plan 12c1C0ode Retirementpplanslan 10 emtaptulotyoerye1112bForm W-3 to the Social Security Administration; photocopies are not acceptable. 41-0852411aEmployees social security number13 platnirementsickd p-party ay 5201 5Medicare wages and tips 4Social security tax withheld plansThir 12bb 15StateEmployers state ID number14Other OMB No. 1545-0008 12c C doe may be imposed on you if this income is taxable and you fail to report it. 19Local income tax 20Locality name 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name Retirement plan Third-party sick pay 12cCode CodStatutory employee Third-party sick pay 12cCode . 12dCode 10 13plansCC e e d d o o 14OtherCC e e d d o o 12c6Medicare tax withheld16State wages, tips, etc.17State income tax2 Federal income tax withheld Retirement plan b 12a1 Wages, tips, other compensation 18Local wages, tips, etc. 11 15State cEmployers name, address, and ZIP code State, Wage and Tax Statement 3 12d C doe 20Locality name 4 Social security tax withheld Act Notice, see separate instructions. b 33333 a Control number 943 944 DO NOT STAPLE None apply501c non-govt. Third-partyLW3 Form Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 18 Third-party sick pay 19 15 Local wages, tips, etc. 121d9 Code State wages, tips ,etc.15 7 Third-party sick pay 1 158 State Employer's state ID number 1 Code State wage s ,tips ,etc 20 1Locality name 7 eEmployees name, address, and ZIP code State EmployersstateID no.Suff.13e Smtaptulotoyeye r Retirement Third-party aEmployees social security no. Notice,CC e e d d o o 12b separateinstructions. 12d0820Locality nameSocial security wages 15State Employer's state ID number 18 State Employer's state ID number 16 State income tax Local wages, tips, etc. 129dLocal income tax State income tax bEmployerplansick pay14Other 12c 19Local income taxdControl number Copy1ForrEmployer.City,orLocalTaxDepartment 5 Medicare wages and tips rtyC C ddooe e 6 Medicare tax withheld e Kind of Payer941 Military MedicareKind of EmployerState/localState/local 501cFederal govt. sick payThis information is being furnished to the Internal Revenue Service. OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If youForm W-2 Wage and Tax Statement a 16State wages, tips, etc. 1 Local income tax 22222 20 1Locality name 2 OMB No. 19Form W-2 Wage and Tax Statement a 1 16 Copy5205 2 Dept. of the Treasury IRS15StateCOPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPY cnumber (EIN) 17State income tax Act 18Local wages, tips, etc. the 20Locality name - Dept. of the Treasury - IRSEmployers state ID number 16State wages, tips, etc.Form W-2 18Local wages, tips, etc.19Local income tax 2023 Department of the TreasuryInternal Revenue ServiceFor Ofcial Use Only: W-2 Local wages, tips, etc. Form W-2 Wage and Tax Statement State income tax 18DeptLocal wages, tips, etc. Local income tax 20 17Locality name15 16State wages, tips, etc. 12d 17State income tax For Privacy Act and Paperwork Reduction State Employer's state ID number 16State wages, tips, etc. State income tax aEmployees social security no.OMB No. 1545-07 Social security tips 8 Allocated tips For Privacy Act and Paperwork ReductionOMB No. 1545-0008 Copy BTo Be Filed With Employees FEDERAL Tax Return.Local income tax 20 17Locality name . of the Treasury IRS For Privacy Act and Paperwork ReductionForm W-2 Wage and Tax Statement CopyDFo Suff. 9 em plan sik paapy 10(Check one) CT-1 Hshld.govt. emp. (Check one) non-501c 2 Federal income tax withheld (Check if520010aEmployees social security number Act Notice, see separate instructions. Dept. of the Treasury IRS Form W-2 Wage and Tax Statement Act Notice, see separate instructions. Dept. of the Treasury IRS 2023OMB No.Employers state ID no. Form 16State wages, tips, etc. 17State income taxFor Privacy Act and Paperwork Reduction 5206 see Wages, tips, other comp. IRS 2Federal income tax withheld18Local wages, tips, etc. 19Local income tax1112aSee instructions for box 12 d Establishment number 3 Social security wages Employers 2023 Local,or FileCopy2023 2023 Wages, tips, other comp. Federal income tax withheldW-2 Wage and Tax7Social security tips 3Social security wageseEmployees name, address, and ZIP code 2023 Department of the TreasuryInternal Revenue Service c Total number of Forms W-2 emp. 1 Wages, tips, other compensation 4 Social security tax withheld applicable)may be imposed on you if this income is taxable and you fail to report it. penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. L4UP 1545-0008 EmployersState,Local,or File 22222 1545-0008Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return Statement L87 22222Void OMB No.1545-008 1Dept.of Treasury 4Social security tax withheldCopy BTo Be Filed With Employees FEDERAL Tax Return.22222 VOID aEmployees social security number RetirementThicrd- 520212b C C doe e 2 Federal income tax withheld fEmployers name 9 5 Medicare wages and tips 106 Medicare tax withheld orb 1 Wages, tips, other compensation 2 Federal income tax withheld b c State, 3 5 Wages, tips, other comp. 6 4 Federal income tax withheld b c Employee's soc. sec. no. 5 3Social security wages 6 4Social security tax withheld e 2023 Suff. 9 8Allocated tipseRPelatnirement Third-party 5Medicare wages and tipsCCC e e e d d d o o o 6 Medicare tax withheld 2023This information is being furnished to the Internal Revenue Service. LW2B 13StaptutloyeeoryEmployee's soc. sec. no. Employers name, address, and ZIP codeb 14Other OMB No. 1545-0008 12c do4 Social security tax withheld 7 Social security tips 8 Allocated tips 520025 cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Employer ID number (EIN) Social security wages Social security tax withheld Employer ID number (EIN) Medicare wages and tips Medicare tax withheld Employees name, address, and ZIP code 10 Smtaptulotoyerye Sick pay 11 plans 12aSe e instructions for box 12 1 Wages, tips, other compensationcEmployers name, address, and ZIP code 12d 5 Medicare wages and tips 6 Medicare tax withheld Medicare wages and tips Medicare tax withheld 13 14Other 12b3 Social security wagesEmployer's name, address, and ZIP code Employer's name, address, and ZIP code5 Medicare wages and tips2015StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax Locality name6 Medicare tax withheld b 12c7 Social security tips 8 Allocated tips g Employers address and ZIP code 1112a Deferred compensation dControl number 7 Social security tips 8 Allocated tips dControl number dControl number15State EmployersstateID no. 16State wages, tips, etc. aEmployees social security no. 18Local wages, tips, etc.C e d o 12d20Locality namedControl number 9 9 10 Form W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 10C doe h Other EIN used this year 13 For third-party sick pay use only 12b eEmployees name, address, and ZIP code Suff.11Sta RetirementThird-party12aSee instructions for box 12 C C ddooe e eEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff. COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPY 17State income taxActNotice,seeseparateinstructions. 19Local income taxCopy CFor EMPLOYEES RECORDS (See Notice toSuff. Safe, accurate,RetirementThird-party5203 12aSee instructions for box 12 C C ddooe e e 15 State Employers state ID number 14 Income tax withheld by payer of third-party sick pay 15StateEmployers state ID number 16State wages, tips, etc.17State income tax emptutloyeeoryplan sick pay 12c C C ddooe e 20Locality name 10 7Social security tips 14 11 8Allocated tipsplans 12a 9 Code See inst. for box 12 10 7Social security tips 14 11 8Allocated tipsplans 12a 9 Code See inst. for box 12 c 2023 FormW-2 Wage and Tax StatementFor Privacy Act and Paperwork Reduction 9 1 Wages, tips, other comp. Dept. of the Treasury - IRS Se instructions for box 12eEmployees name, address, and ZIP code FAST!Use11 Employee on the back of Copy B.)y 2 tReturn LW2C/LW22 13Statutoryplan sick pay 12b 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 13 12bOMB No. 1545-008 Employees State, City or Local Incomeor Cop Taxo be Filed With employee14Other14Other 12c C doEmployers contact person Employers telephone number 12d 22222Void 7Social security tips 2Federal income tax withheld12d Employers fax number Employers email address Employers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheldUnder penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, and18Local wages, tips, etc.19Local income tax 13Statutory employee Other 12bCode 13Statutory employee Other 12bCode 5Medicare wages and tips 6 Medicare tax withheld15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name complete. Copy CFor EMPLOYEES RECORDS (See Notice toDepartment of the TreasuryInternal Revenue Service 15 Retirement plan 16State wages, tips, etc.12c 17 Code 15 Retirement plan 19 16State wages, tips, etc.12c 17 Code 10eThird-party 11 plansCCCC e e e e d d d d o o o o 12aSe e instructions for box 12 Signature: Title: Date: eEmployees name, address, and ZIP code Suff.13Smtaptluotyoerye PRelatnirement Sick pay 14Other 12b12d 12dForm W-3 Transmittal of Wage and Tax Statements 2023 Department of the TreasuryForm Wage and Tax Statement Safe, accurate,Third-party sick pay Code Third-party sick pay Code b 12cForm Wage and Tax Statement Department of the TreasuryInternal Revenue ServiceSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA). Internal Revenue Service W-2 2023 FAST!Use State income tax 18 State Employer's state ID number Local income tax 20 Locality name aEmployees social security no. 12d Copy W-2 orLocalTaxDepartment 2023 LW2D1For Privacy Act and Paperwork ReductionPhotocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA.Employee on the back of Copy B.)LW2BC 5212 18 State Employer's state ID number19Local income tax 20 Locality name Local wages, tips, etc. State income taxCopy 1Forr State, Act Notice, see separate instructions.5204 Reminder Employees State, City or Local Incomeor Cop yTax 2 to Return be Filed With Local wages, tips, etc.15State EmployersstateID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality nameDFoEmployer.City, Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.Separate instructions. See the 2023 General Instructions for FormsForm W-2 Wage and Tax Statement Dept. of the Treasury IRS For Privacy Act and Paperwork Reduction L4UPR Dept. of the Treasury IR5405S COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionAct Notice,seseparateinstructions.L87R 5406 OMB No. 1545-0Dept. of the Treasury - IRS08 2023W-2Act Notice, see separate instructions. Form W-2 Wage and Tax StatementW-3 for Form(s) W-2 that were submitted electronically to the SSA. For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.Purpose of FormDWCL or DWCLS paper forms must notcomply with IRS standards and be machine readable. Photocopies are acceptable. Use a Form W-3 even if only oneDW4S or DW4SS DW3 or DW3S66661 or 66662 required envelope number (EIN). Make a copy of this form and keep it with Copy D (ForWhen To File Paper FormsEmployer) of Form(s) W-2 for your records. The IRS recommends retaining copies of these forms for 4 years. Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2024. 99991 or 99992 required envelope 33331 or 33332 required envelopeE-FilingThe SSA strongly suggests employers report Form W-3 and Forms W-2Where To File Paper FormsCopy A electronically instead of on paper. The SSA provides two freeSend 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.Direct Operations Center File Upload. usingWilkes-Barre, PA 18769-0001Specications for Filing Forms W-2 Electronically (EFW2). the SSAs18769-0002. If you use an IRS-approved private delivery service, addNote: January 31, 2024. For more information, go to www.SSA.gov/bso. First- ATTN: W-2 Process, 1150 E. Mountain Dr. to the address and change Register Log In. the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers Tax Guide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. MFG SKU Sheets PER packMFG ID Forms PER pack LW3 41-0852411 52005 Transmittal W-3 forms are included with each Red Federal Copy A form order 50s500s100s500sFORM DESCRIPTION(see page 12 for required envelope)L4UPAL4UPA5005205A5205ABW-2 4-Up Box Employee Copy B, C and 2 or Extra Copy (P Style) MFG SKU Sheets PER packMFG ID Forms PER packL4UPL4UP50052055205BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy 50s500s100s1000sFORM DESCRIPTION(see page 12 for required envelope) L87L8750052065206BW-2 4-Up Horizontal Employee Copy B,C, 2 and 2 or Extra Copy (5 00 formsLW3LW3500520010 or 5200255200BPER package) Laser W-3 Transmittal of Income And Tax StatementL87BL87B50052085208BW-2 4-Up Horizontal Blank w/ Printed Backer Employee Copy B,C, 2 and 2 or Extra CopyLW2ALW2A50052015201BW-2 Federal IRS Copy A L4BLL4BL50052095209BW-2 4-Up Box Blank w/ Printed BackerLW2BLW2B50052025202BW-2 Federal Employee Copy BL3UPL3UP50052105210BW-2 3-Up Horizontal Employee Copy B, C and 2 LW2CLW22LW2CW2250052035203BW-2 Employee Copy C and/or State, City, Or Local Copy 2 L3BLL3BL50052115211BW-2 3-Up Horizontal Blank w/ Printed Backer Information (w/ Stub)LW2D1LW2D150052045204BW-2 Employer Copy D and/or State, City Or Local Copy 1#N/A#N/A5213#N/AW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (T Style) LW2NBLW2NB50052075207BW-2 Blank w/o Printed Backer L275L27550052145214BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (M Style) LW2BCLW2BC50052125212BW-2 Employee Copy B and Copy C Combined L4UPWL4UPW50052165216BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (W Style) LW2BLLW2BL50052225222BW-2 Blank w/ Printed BackerL4DNL4DN50052185218BW-2 4-Up Horizontal Employee Copy B, C, 2 and 2 or Extra Copy (N Style)OUR BASIC W-2 FORM L4BLNBL4BLNB50052215221BW-2 4-Up Box Blank w/o Printer BackerW-2 COPY OPTIONS L4UPARL4UPAR5005405A5405ABW-2 4-Up Box Employer Copy D and/or State, City, Local Copy 1 (P-Style Four Employees PER page)Each sheet contains information for two employees. All copies are printed separately and theSimplify your Employee Copies with our Form LW2BC/5212. This form provides Employee CopyL4UPRL4UPR50054055405BW-2 4-Up Box Employer Copy D and/or State, City, Local Copy 1 (Four employees PER page)employee copies must be collated for envelope insertion. Forms are sold in packages of 50B and Employee Copy C on a single sheet. One employee PER page.8-1/2 x 11 sheets yielding 100 individual W-2 forms. Bulk packages of 500 sheets yielding 1,000L87RL87R50054065406BW-2 4-UP HORIZONTAL Employer Copy d and/or State, city, Local Copy 1 (four employees PER page)forms are available.W-3 TRANSMITTAL FORMHOW MANY COPIES DO I NEED? Form LW3/520010 or 520025 Transmittal of Income and Tax Statement forms are included with For states with no state or local tax youll use a 4-part form. the purchase of the Red Federal IRS Copy A orders at no charge. Additional copies may be4-UP BOX 3-UP HORIZONTALFor states with State Income Tax youll use a 6-part form. ordered separately. These pre-printed and blank combined formats are designed to print all employees copies onAvailable as a pre-printed form or as a blank form with Perforations and Backer copy. Provides For states with local or city tax youll use an 8-part form. W-2 BLANK FORMS FOR YOUR SOFTWARE one sheet. These pre-printed and blank combined formats eliminate collating and are availableEmployee Copy B, C, and 2 with one employee PER page. These pre-printed and blank combined Blank forms are available for use with your software and feature a center perforation. Blank formsfor Employee Copies (one employee PER page) and Employer Copies (four employees PERforms are ideal for electronic filing (if filing Copy A to the Social Security Administration, you must OK, SO HOW MANY DO I ORDER OF EACH FORM?are available with and without Copy B, Copy C and Copy 2 backer information. Two employeespage). For example, the L4UP/5205 contains employees Copies B, C, 2 and 2 pre-printed on oneuse the official format Federal Copy A). Refer to page 12 for required envelope. Note: blank If you need to order all parts for 100 Employees for a 4-part form youll order 100 forms each ofPER page. Order 100 forms for 100 employees sheet. Just fold and put in a matching window envelope. formats may not work with our stock envelopes, please request samples for testing.the Copy A, Copy B, Copy C and Copy D. For a 6-part form youll order 100 forms each of the4-UP HORIZONTALCopy A and Copy B and 200 each of the Copy C and/or Copy 2 and D and/or Copy 1 for 100Available as pre-printed forms or as a blank form with Perforations and Backer copy. For employees. Finally, for an 8-part form, youll order 100 forms each of the Copy A and B and 300example, the L87R/5406 contains employees Copies D, D, 1 and 1 pre-printed on one sheet. forms each of the Copy C and/or Copy 2 and D and/or Copy 2 for 100 employees. Available in regular and bulk packages.4 5"