24
5205
5405
5206
5406
Required Envelope:
99991 or 99992
Required Envelope:
44441 or 44442
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W-2 PRE-PRINTED FORMS
	Sheets per pack
	 25	
50	
500	
FORM DESCRIPTION
	 520525	
520550 	 5205B 	
W-2 4-Up Box Employee’s Copies B, C, 2 & 2 Combined – 1 Sheet Equals 1 Form
	 540525	
540550	
5405B 	
W-2 4-Up Box Employer’s Copies 1/D, 1/D, 1/D, 1/D – 1 Sheet Equals 1 Form
 N/A 
N/A  
5917B  
W-2 4-Up Box Employee’s Copies B, C, 2 & 2 Combined (24# paper version of 5205B) – 1 Sheet Equals 1 Form
	 520625	
520650	
5206B 	
W-2 4-Up Horizontal Employee’s Copies B, C, 2 & 2 Combined – 1 Sheet Equals 1 Form
	 540625	
540650	
5406B 	
W-2 4-Up Horizontal Employer’s Copies 1/D, 1/D, 1/D, 1/D Combined – 1 Sheet Equals 1 Form
 N/A 
N/A  
5916B  
W-2 4-Up Box Employee’s Copies B, C, 2 & 2 Combined (24# paper version of 5206B) – 1 Sheet Equals 1 Form
OMB No. 1545-0029
 Visit the IRS Web Site at 
Copy B To Be Filed With Employee’s FEDERAL Tax Return
This information is being furnished to the Internal Revenue Service.
Dept. of the Treasury - IRS
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
11  
 plans
12a
12b
12c
12d  
c
e
OMB No. 1545-0029
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
    15  State
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name    
  Copy C For EMPLOYEE'S RECORDS 
Dept. of the Treasury - IRS
 Code
 Code
 Code
 Code
This information is being furnished to the Internal Revenue Service.
 negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.
OMB No. 1545-0029
   Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return
Dept. of the Treasury - IRS
OMB No. 1545-0029
   Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return
Dept. of the Treasury - IRS
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
Statutory
Retirement 
 Third-party
plan
  sick pay
employee
11  
 plans
13
12a
12b
12c
12d  
c
e
W-2 Wage and Tax  Statement
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
       15  State
 Employer’s state ID no.
 Employer’s state ID no.
 Employer’
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
Code
 Code
Form
W-2 Wage and Tax  Statement
Form
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
10
11  
 plans
12a
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
     15  State
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
W-2 Wage and Tax  Statement
Form
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld    
10
11  
 plans
  Employee’s social security no.
12a
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
     15  State
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
W-2 Wage and Tax  Statement
Form
 www.irs.gov/efile
Statutory
em
R
p
e
l
t
o
i
y
r
e
e
e
ment 
 Third-party
13
plan
  sick pay
Statutory
em
R
p
e
l
t
o
i
y
r
e
e
e
ment 
 Third-party
13
plan
  sick pay
Statutory
em
R
p
e
l
t
o
i
y
r
e
e
e
ment 
 Third-party
13
plan
  sick pay
b  Employer 
 number (EIN)
b  Employer 
 number (EIN)
b  Employer 
 number (EIN)
b  Employer 
 number (EIN)
 Suff.
 Suff.
 Suff.
 Suff.
a  Employee’s social security no.
a  Employee’s social security no.
a  Employee’s social security no.
a
2026
2026
2026
2026
5206
 Employer’s state ID no.
s state ID no.
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14b Treasury Tipped Occupation Code(s)
14a
Other
14a
14b Treasury Tipped Occupation Code(s)
Dept. of the Treasury -- IRS
This information is being furnished to the Internal Revenue Service.
penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.
www.irs.gov/efile
Dept. of the Treasury -- IRS
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
9
10
11
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
Code  See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
Other
14a
Other
14a
State income tax
17
State wages, tips, etc.
16
OMB No. 1545-0029
 41-0852411
Suff.
 plans
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
9
10
11
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
1
Local income tax
20 Locality name
Code  See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
OMB No. 1545-0029
 41-0852411
Suff.
 plans
14b Treasury Tipped Occupation Code(s)
14b Treasury Tipped Occupation Code(s)
9
5205
Dept. of the Treasury -- IRS
Dept. of the Treasury -- IRS
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
9
10
11
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
Code
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
OMB No. 1545-0029
 41-0852411
Suff.
 plans
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
9
10
11
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
Code
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
OMB No. 1545-0029
 41-0852411
Suff.
 plans
Other
Other
14a
14a
14b Treasury Tipped Occupation Code(s)
14b Treasury Tipped Occupation Code(s)
Copy B—To Be Filed With Employee's
FEDERAL Tax Return.
Form W-2 Wage and Tax Statement
Copy 2—To Be Filed With Employee's State,
City, or Local Income Tax Return.
Form W-2 Wage and Tax Statement
Copy 2—To Be Filed With Employee's State,
City, or Local Income Tax Return.
Copy C—For EMPLOYEE'S RECORDS 
Form W-2 Wage and Tax Statement
2026
2026
2026
Form W-2 Wage and Tax Statement
2026
OMB No.
1545-0029
Form W-2 Wage and Tax Statement
For Privacy Act and Paperwork Reduction
2026
22222
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8
11
Allocated tips
9
12a
13
10
11
10
11
10
11
10
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax   
 20 Locality name
Dept. of the Treasury -- IRS
Code See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
Suff.
5405
 plans
Act Notice, see separate instructions.
OMB No.
1545-0029
Form W-2 Wage and Tax Statement
For Privacy Act and Paperwork Reduction
2026
22222
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
9
9
9
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax  
 20 Locality name
Dept. of the Treasury -- IRS
Code See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
Suff.
 plans
Act Notice, see separate instructions.
OMB No.
1545-0029
Form W-2 Wage and Tax Statement
For Privacy Act and Paperwork Reduction
2026
22222
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax   
 20 Locality name
Dept. of the Treasury -- IRS
Code See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
Suff.
 plans
Act Notice, see separate instructions.
OMB No.
1545-0029
Form W-2 Wage and Tax Statement
For Privacy Act and Paperwork Reduction
2026
22222
a Employee's soc. sec. no.
1 Wages, tips, other comp.
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
b Employer ID number (EIN)
5 Medicare wages and tips
6 Medicare tax withheld
c Employer's name, address, and ZIP code
d Control number
e Employee's name, address, and ZIP code
7 Social security tips
8 Allocated tips
12a
13
12b
12c
12d
15 State Employer's state ID number
18 Local wages, tips, etc.
19 Local income tax  
 20 Locality name
Dept. of the Treasury -- IRS
Code See inst. for box 12
Statutory employee
Retirement plan
Third-party sick pay
Code
Code
Code
State income tax
17
State wages, tips, etc.
16
Suff.
 plans
Act Notice, see separate instructions.
14b Treasury Tipped Occupation Code(s)
14b Treasury Tipped Occupation Code(s)
14b Treasury Tipped Occupation Code(s)
14b Treasury Tipped Occupation Code(s)
Other
14a
Other
14a
Other
14a
Other
14a
Copy 1 – For State, City, or Local Tax Department
Copy D – For Employer
Copy 1 – For State, City, or Local Tax Department
Copy D – For Employer
Copy 1 – For State, City, or Local Tax Department
Copy D – For Employer
Copy 1 – For State, City, or Local Tax Department
Copy D – For Employer
 
 
 
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
11  
 plans
12a     
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
       15
Employer’s state
.
o
n
 
D
I
16  State wages, tips, etc.
  State
  State
  State
  State
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
 W-2 Wage and  Tax  Statement
Form
22222
Void   
Statutory
  Retirement 
 Third-party
 Plan
  Sick pay
employee
13
  Employee’s social security no.
b  
Suff.
a
2026
  OMB No. 1545-0029 
         Copy 1 – For State, City, or Local Tax Department
         Copy D – For Employer
         Copy 1 – For State, City, or Local Tax Department
         Copy D – For Employer
                        Dept. of the Treasury - IRS
 For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
11  
 plans
14
12a     
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
       15
Employer’s state
.
o
n
 
D
I
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
 W-2 Wage and  Tax  Statement
Form
22222
Void   
Statutory
  Retirement 
 Third-party
 Plan
  Sick pay
employee
13
  Employee’s social security no.
b  
Suff.
a
2026
  OMB No. 1545-0029 
                        Dept. of the Treasury - IRS
 For Privacy Act and Paperwork Reduction  Act Notice, see separate instructions.
 For Privacy Act and Paperwork Reduction  Act Notice, see separate instructions.
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
11  
 plans
12a     
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
       15
Employer’s state
.
o
n
 
D
I
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
 W-2 Wage and  Tax  Statement
Form
22222
Void   
Statutory
  Retirement 
 Third-party
 Plan
  Sick pay
employee
13
  Employee’s social security no.
b  
Suff.
a
2026
  OMB No. 1545-0029 
                        Dept. of the Treasury - IRS
 For Privacy Act and Paperwork Reduction  Act Notice, see separate instructions.
Employer’s name, address, and ZIP code
Employee’s name, address, and ZIP code
8  Allocated tips
3  Social security wages
4  Social security tax withheld
9
5  Medicare wages and tips
6  Medicare tax withheld  
 See instructions for box 12 
10
11  
 plans
12a     
12b
12c
12d  
c
e
7  Social security tips
1  Wages, tips, other comp.
2  Federal income tax withheld
       15
Employer’s state
.
o
n
 
D
I
16  State wages, tips, etc.
17  State income tax
18  Local wages, tips, etc.
19  Local income tax
20  Locality name
 Code
 Code
 Code
 Code
 W-2 Wage and  Tax  Statement
Form
22222
Void   
Statutory
  Retirement 
 Third-party
 Plan
  Sick pay
employee
13
  Employee’s social security no.
b  
Suff.
a
2026
OMB No. 1545-0029
Dept. of the Treasury - IRS
5406
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
         Copy 1 – For State, City, or Local Tax Department
         Copy D – For Employer
         Copy 1 – For State, City, or Local Tax Department
         Copy D – For Employer
Combined 4-Up Laser

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