Page 27

27
DO NOT STAPLE
a Control number
For Ofﬁcial Use Only:
OMB No. 1545-0029
b
Kind of Payer
(Check one)
941
Military
943
944
CT-1
Hshld.
emp.
Medicare
govt. emp.

Kind of Employer
(Check one)
None apply
501c non-govt.
State/local
non-501c
State/local 501c
Federal govt.
Third-party
sick pay
(Check if
applicable)
c Total number of Forms W-2
d Establishment number
e
f Employer’s name
g Employer’s address and ZIP code
h Other EIN used this year
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
7 Social security tips
8 Allocated tips
9
10
11
12a Deferred compensation
12b
13 For third-party sick pay use only
14 Income tax withheld by payer of third-party sick pay
15 State
Employer’s state ID number
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
Employer’s contact person
Employer’s telephone number
Employer’s fax number
Employer’s email address
Under 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, and
complete.
Signature:
Title:
Date:
Form
Transmittal of Wage and Tax Statements
Department of the Treasury
Internal Revenue Service
5200
41-0852411
2026
W-3
Send 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 ﬁled electronically with the SSA.
Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.
Reminder
Separate instructions. See the 2026 General Instructions for Forms
W-2
W-3 for Form(s) W-2 that were submitted electronically to the SSA.
Purpose of Form
paper forms must comply with IRS standards and be machine readable.
Photocopies are not acceptable. Use a Form W-3 even if only one
number (EIN). Make a copy of this form and keep it with Copy D (For
Employer) of Form(s) W-2 for your records. The IRS recommends
retaining copies of these forms for at least 4 years.
E-Filing
The SSA strongly suggests employers report Form W-3 and Forms W-2
Copy A electronically instead of on paper. The SSA provides two free
• W-2 Online.
to
50 Forms W-2 at a time to the SSA.
• File Upload.
using
the SSA’s
Speciﬁcations for Filing Forms W-2 Electronically (EFW2).
February 01, 2027. For more information, go to www.SSA.gov/bso.
When To File Paper Forms
Mail Form W-3 with Copy A of Form(s) W-2 by February 01, 2027.
Where To File Paper Forms
Send this entire page with the entire Copy A page of Form(s) W-2 to:
Social Security Administration
Direct Operations Center
Wilkes-Barre, PA 18769-0001
Note:

“18769-0002.” If you use an IRS-approved private delivery service, add
“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change
the ZIP code to “18702-7997.” Go to www.irs.gov/PDS for a list of IRS-
approved private delivery services.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Created 6/30/25
33333
5204
e Employee’s name, address, and ZIP code
VOID
a Employee’s social security number
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Copy 1—For State, City, or Local Tax Department
Copy D—For Employer
Form W-2
Wage and Tax Statement
2026
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
e Employee’s name, address, and ZIP code
VOID
a Employee’s social security number
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Copy 1—For State, City, or Local Tax Department
Copy D—For Employer
Form W-2
Wage and Tax Statement
2026
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
22222
22222
5200
5204
5203
5202
5203
Copy C—For EMPLOYEE’S RECORDS (See Notice to
Employee on the back of Copy B.) or Copy 2 to be Filed With
Employee’s State, City or Local Income Tax Return
W-2
Form
Wage and Tax Statement
e Employee’s name, address, and ZIP code
a Employee’s social security number
OMB No. 1545-0029
This information is being furnished to the Internal Revenue Service. If you
may be imposed on you if this income is taxable and you fail to report it.
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
2026
Department of the Treasury—Internal Revenue Service
Safe, accurate,
FAST! Use
Copy C—For EMPLOYEE’S RECORDS (See Notice to
Employee on the back of Copy B.) or Copy 2 to be Filed With
Employee’s State, City or Local Income Tax Return
W-2
Form
Wage and Tax Statement
e Employee’s name, address, and ZIP code
a Employee’s social security number
OMB No. 1545-0029
This information is being furnished to the Internal Revenue Service. If you
may be imposed on you if this income is taxable and you fail to report it.
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
2026
Department of the Treasury—Internal Revenue Service
Safe, accurate,
FAST! Use
5202
e Employee’s name, address, and ZIP code
a Employee’s social security number
OMB No. 1545-0029
Safe, accurate,
FAST! Use
Visit the IRS website at
www.irs.gov/eﬁle.
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
2026
Department of the Treasury—Internal Revenue Service
Form W-2
Wage and Tax Statement
Copy B—To Be Filed With Employee’s FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
e Employee’s name, address, and ZIP code
a Employee’s social security number
OMB No. 1545-0029
Safe, accurate,
FAST! Use
Visit the IRS website at
www.irs.gov/eﬁle.
b
c Employer’s name, address, and ZIP code
d Control number
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
2026
Department of the Treasury—Internal Revenue Service
Form W-2
Wage and Tax Statement
Copy B—To Be Filed With Employee’s FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
22222
22222
2026
2026
5201
41-0852411
VOID
a Employee’s social security number
For Ofﬁcial Use Only
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
e
Last name
Suff.
f Employee’s address and ZIP code
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Form W-2
Wage and Tax Statement
Copy A—For Social Security Administration. Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.
Created 1/7/26
Do Not Cut, Fold, or Staple Forms on This Page
41-0852411
VOID
a Employee’s social security number
For Ofﬁcial Use Only
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
e
Last name
Suff.
f Employee’s address and ZIP code
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Form W-2
Wage and Tax Statement
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Copy A—For Social Security Administration. Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.
Created 1/7/26
5201
W-2 PACKAGED LASER SET
5200
5205
5201
W-2 PACKAGED BLANK LASER SET
W-2 Packaged Laser Sets
FOR 50 EMPLOYEES
5645
4-Part Set Includes: Copy A, B, C, D (25 Sheets each)
3 Transmittals
5645E
4-Part Set Includes: Copy A, B, C, D (25 Sheets each)
3 Transmittals and 50 Self-Seal ENV.
5650
6-Part Set Includes: Copy A, B, C, 2, D, 1 (25 Sheets each)
3 Transmittals
5650E
6-Part Set Includes: Copy A, B, C, 2, D, 1 (25 Sheets each)
3 Transmittals and 50 Self-Seal ENV.)
5655E
8-Part Set Includes: Copy A, B, C, 2, 2, D, 1, 1
(25 Sheets each) 3 Transmittals and 50 Self-Seal ENV.
FOR 25 EMPLOYEES
564525
4-Part Set Includes: Copy A, B, C, D (13 Sheets each)
3 Transmittals
5645E25 4-Part Set Includes: Copy A, B, C, D (13 Sheets each)
3 Transmittals and 25 Self-Seal ENV.)
565025
4-Part Set Includes: Copy A, B, C, D (13 Sheets each)
3 Transmittals and 25 Self-Seal ENV.
5650E25 6-Part Set Includes: Copy A, B, C, 2, D, 1 (13 Sheets each)
3 Transmittals and 25 Self-Seal ENV
565525
8-Part Set includes: Copy A, B, C, 2, 2 D, 1, 1 (13 Sheets each)
3 Transmittals)
5655E25 8-Part Set Includes: Copy A, B, C, 2, 2 D, 1, 1 (13 Sheets each)
3 Transmittals and Self-Seal ENV.
(3) Transmittal W-3 forms are included with each set
W-2 4-Up Packaged Laser Sets
FOR 50 EMPLOYEES
5844
4-Part Set Includes: Copy A, D (25 Sheets each) 4-Up
Copies B, C, 2, 2 (50 Sheets) 3 Transmittals
5846
6-Part Set Includes: Copy A, D, 1 (25 Sheets each) 4-Up
Copies B, C, 2, 2 (50 Sheets) 3 Transmittals
W-2 Packaged Laser Sets for Electronic Filing
FOR 50 EMPLOYEES
5205E
Employee Copies Only Set Includes: 4-Up Box
Copies B, C, 2, 2 (50 Sheets) and 50 Self-Seal ENV.
5221E
Employee Copies Only Set Includes: 4-Up Box
Blank No Backer (50 Sheets) and 50 Self-Seal ENV.
5648
5-Part Set Includes: Copy B, C, 2, D, 1 (25 Sheets each)
3 Transmittals
5648E
5-Part Set Includes: Copy B, C, 2, D, 1 (25 Sheets each)
3 Transmittals and 50 Self-Seal ENV.
FOR 25 EMPLOYEES
5205E25 Employee Copies Only Set Includes: 4-Up Box Copies B, C, 2, 2
(25 Sheets) and 25 Self-Seal ENV.
5648E25 5-Part Set Includes: Copy B, C, 2, D, 1 (13 Sheets each)
25 Self-Seal ENV.
66661 or 66662
Suggested envelopes for use with
LaserLink or TaxRight 20.26 software.
Envelopes ordered separately.
Packaged Laser Sets
W-2 PRE-PRINTED & BLANK FORMS
22222
22222
2026
2026
5201
41-0852411
VOID
a Employee’s social security number
For Ofﬁcial Use Only
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
e
Last name
Suff.
f Employee’s address and ZIP code
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Form W-2
Wage and Tax Statement
Copy A—For Social Security Administration. Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.
Created 1/7/26
Do Not Cut, Fold, or Staple Forms on This Page
41-0852411
VOID
a Employee’s social security number
For Ofﬁcial Use Only
OMB No. 1545-0029
b
c Employer’s name, address, and ZIP code
d Control number
e
Last name
Suff.
f Employee’s address and ZIP code
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
7 Social security tips
8 Allocated tips
9
10
11
12a See instructions for box 12
Co
de
12b
Co
de
12c
Co
de
12d
Co
de
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14a Other
14b Treasury Tipped Occupation Code(s)
15 State
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
Form W-2
Wage and Tax Statement
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see the separate instructions.
Copy A—For Social Security Administration. Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.
Created 1/7/26

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