25
5216
5214
Required Envelope:
91911
Required Envelope:
61611 or 61612
W-2 PRE-PRINTED FORMS
	
Sheets per pack
	
 25	
50	
500	
FORM DESCRIPTION
	
 521025	
521050	
5210B 
W-2 W-Style 3-Up Employee’s Copies B, C & 2 Combined – 1 Sheet Equals 1 Form
	
 N/A	
521450	
5214B 
W-2 M-Style Alternate 4-Up Employee’s Copies B, C, 2, 2 – 1 Sheet Equals 1 Form
	
 N/A	
521650	
5216B	
W-2 W-Style Alternate 4-Up Employee’s Copies B, C, 2, 2 – 1 Sheet Equals 1 Form
__
2026
2026
7 Social security tips
1 Wages, tips, other comp.
2 Federal income tax withheld
8 Allocated tips
3 Social security wages
4 Social security tax withheld
9
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
15 State
Employer’s state ID no.
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
7 Social security tips
1 Wages, tips, other comp.
2 Federal income tax withheld
8 Allocated tips
3 Social security wages
4 Social security tax withheld
9
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
15 State
Employer’s state
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
Form
Form
Visit the IRS Web Site
OMB No.1545-0029
OMB No.1545-0029
COPY B To Be filed with employee’s FEDERAL Tax Return
This information is being furnished to the Internal Revenue Service
This information is being furnished to the Internal Revenue Service. If you are
required to
a tax return, a negligence penalty or other sanction may be imposed
on you if this income is taxable and you fail to report it.
COPY C  For EMPLOYEE'S RECORDS
(See Notice to Employee
on back of Copy B.)
at 
W-2 Wage and Tax Statement
W-2 Wage and Tax Statement
   Dept. of the Treasury - IRS
   Dept. of the Treasury - IRS
ID no.
2026
2026
9
7 Social security tips
1 Wages, tips, other comp.
2 Federal income tax withheld
8 Allocated tips
3 Social security wages
4 Social security tax withheld
9
 Medicare wages and tips
6 Medicare tax withheld
5
c Employer’s name, address, and ZIP code
15 State
Employer’s state
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
7 Social security tips
1 Wages, tips, other comp.
2 Federal income tax withheld
8 Allocated tips
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
15 State
Employer’s state ID no.
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
Form
OMB No.1545-0029
Form
OMB No.1545-0029
   Dept. of the Treasury - IRS
   Dept. of the Treasury - IRS
5216
W-2 Wage and Tax Statement
W-2 Wage and Tax Statement
Income Tax Return
Copy 2 For Employee's State, City or Local
Income Tax Return
Copy 2 For Employee's State, City or Local
ID no.
 12a See instructions for box12 
 12a See instructions for box12 
 Employee’s social security number
10 Dependent care
11
plans
13
S t a t u t o r y
e m p l o y e e
Retirement
plan
T h i r d - p a r t y
s i c k p a y
 Code
 12b 
 Code
 12c 
 Code
 12d 
 Code
oy
b Employ
number (EIN)                          
 Empl
ee’s name, address, and ZIP code
e
Suff.
 Empl
ee’s name, address, and ZIP code
e
Suff.
a
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
 Employee’s social security number
10 Dependent care
11
plans
13
S t a t u t o r y
e m p l o y e e
Retirement
plan
T h i r d - p a r t y
s i c k p a y
 Code
 12b 
 Code
 12c 
 Code
 12d 
 Code
oy
b Employ
number (EIN)                          
 Empl
ee’s name, address, and ZIP code
e
Suff.
 Empl
ee’s name, address, and ZIP code
e
Suff.
a
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
 12a See instructions for box12 
 Employee’s social security number
10 Dependent care
11
plans
13
S t a t u t o r y
e m p l o y e e
Retirement
plan
T h i r d - p a r t y
s i c k p a y
 Code
 12b 
 Code
 12c 
 Code
 12d 
 Code
oy
b Employ
number (EIN)                          
 Empl
ee’s name, address, and ZIP code
e
Suff.
 Empl
ee’s name, address, and ZIP code
e
Suff.
a
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
 Employee’s social security number
10 Dependent care
11
plans
13
S t a t u t o r y
e m p l o y e e
Retirement
plan
T h i r d - p a r t y
s i c k p a y
 Code
 12b 
 Code
 12c 
 Code
 12d 
 Code
oy
b Employ
number (EIN)                          
 Empl
ee’s name, address, and ZIP code
e
Suff.
 Empl
ee’s name, address, and ZIP code
e
Suff.
a
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
 12a
2
1
x
o
b
r
o
f
s
n
oit
c
u
rt
s
ni
e
e
S
s state ID number
I
1 Wages, tips, other compensation
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
Department of the Treasury - Internal Revenue Service  
OMB No. 1545-0029
15
e
t
a
t
S
 Employer’
16
 State wages, tips, etc.
17  State income tax
18
Local wages, tips, etc.
19
 Local income tax
20
Locality name
W-2
Wage and Tax
Statement
1 Wages, tips, other compensation
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
Department of the Treasury - Internal Revenue Service
OMB No. 1545-0029
15
e
t
a
t
S
 Employer’
16
 State wages, tips, etc.
17  State income tax
18
Local wages, tips, etc.
19
 Local income tax
20
Locality name
W-2
Wage and Tax
Statement
1 Wages, tips, other compensation
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
Department of the Treasury - Internal Revenue Service 
OMB No. 1545-0029
15
e
t
a
t
S
 Employer’s state ID number
16
 State wages, tips, etc.
17  State income tax
18
Local wages, tips, etc.
19
 Local income tax
20
Locality name
W-2
Wage and Tax
Statement
II
1 Wages, tips, other compensation
2 Federal income tax withheld
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
c Employer’s name, address, and ZIP code
Department of the Treasury - Internal Revenue Service  
OMB No. 1545-0029
15
e
t
a
t
S
 Employer’
16
 State wages, tips, etc.
17  State income tax
Copy B To Be Filed with 
  Employee's FEDERAL Tax Return.
18
Local wages, tips, etc.
19
 Local income tax
20
Locality name
W-2
Wage and Tax
Statement
Copy 2 To Be Filed with Employee's State,
City, or Local Income Tax Return.
Copy 2 To Be Filed with Employee's State,
City, or Local Income Tax Return.
Copy C For EMPLOYEE'S RECORDS.
  (See Notice to Employee on back of Copy B).
This information is
being furnished to
the Internal
Revenue Service.
This information is
being furnished to the
Internal Revenue
Service. If you are
required to
a tax
return, a negligence
penalty or other
sanction may be
imposed on you if this
income is taxable and
you fail to report it.
5214
I
www.irs.gov/efile
2026
2026
2026
2026
s state ID number
s state ID number
 See instructions for box 12 
See instructions for box 12 
7 Social security tips
8 Allocated tips
9
10 Dependent care
11
plans
12b
12c
12d
e Employee’s name, address, and ZIP code
12a
Cod
Code
Code
Code
7 Social security tips
8 Allocated tips
9
10 Dependent care
11
plans
12b
12c
12d
e Employee’s name, address, and ZIP code
12a
Code
Code
Code
Code
e
b Employer’s iden
n number (EIN)                  Employee’s social security number
b Employer’s
n number (EIN)                Employee’s social security number
Suff.
Suff.
a
a
13 S ta t u t o r y
e m p l o y e e
Retirement
plan
Third-party
sick pay
14b Treasury Tipped Occupation Code(s)
Other
14a
14b 
13 S ta t u t o r y
e m p l o y e e
Retirement
plan
Third-party
sick pay
14b Treasury Tipped Occupation Code(s)
Other
14a
14b 
7 Social security tips
8 Allocated tips
9
10 Dependent care
11
plans
12b
12c
12d
e Employee’s name, address, and ZIP code
12a
Cod
Code
Code
Code
7 Social security tips
8 Allocated tips
9
10 Dependent care
11
plans
12b
12c
12d
e Employee’s name, address, and ZIP code
12a
Code
Code
Code
Code
e
b Employer’s iden
n number (EIN)                  Employee’s social security number
b Employer’s
n number (EIN)                Employee’s social security number
Suff.
Suff.
a
a
13 S ta t u t o r y
e m p l o y e e
Retirement
plan
Third-party
sick pay
14b Treasury Tipped Occupation Code(s)
Other
14a
14b 
13 S ta t u t o r y
e m p l o y e e
Retirement
plan
Third-party
sick pay
14b Treasury Tipped Occupation Code(s)
Other
14a
14b 
13 S ta t u t o r y
e m p l o y e e
Retirement
plan
Third-party
sick pay
14b Treasury Tipped Occupation Code(s)
Other
14a
14b 
Required Envelope:
33331 or 33332
5210
2026
2026
2026
See instructions for box 12
See instructions for box 12
0029
0029
0029
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
14b Treasury Tipped Occupation Code(s)
Other
14a
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