b'W-2 PRE-PRINTED & BLANK FORMSIndividual 2-Up Laser Packs5201 522222222 VOID aEmployees social security number For Ofcial Use OnlyOMB No. 1545-0029 b 1 Wages, tips, other compensation 2 Federal income tax withheldcEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld5 Medicare wages and tips 6 Medicare tax withheld7 Social security tips 8 Allocated tips Front BlankdControl number 910 e Last name Suff.11RetirementThird-party12a C C ddooe e See instructions for box 12 with W-2 Instructions 13Statutoryplan sick pay 12bemployee 12c C C ddoe e Safe, accurate,Visit the IRS website at5202 on back side.14OtheraEmployees social security number 12d o FAST! Use www.irs.gov/ele fEmployees address and ZIP code b 16State wages, tips, etc.17State income tax OMB No. 1545-0029 Local income tax 20Locality name2 Federal income tax withheld 520715State 18Local wages, tips, etc. 1 Wages, tips, other compensationEmployers state ID numbercEmployers name, address, and ZIP code 19Social security wages 4 Social security tax withheld3 Form W-2 Wage and Tax Statement 2025 Department of the TreasuryInternal Revenue ServiceThis information is being furnished to the Internal Revenue Service. If you52035 Medicare wages and tips 6 Medicare tax withheldFor Privacy Act and Paperwork Reduction 7 Social security tips 8 Allocated tips Act Notice, see the separate instructions. Copy AFor Social Security Administration. Send this entire page with not acceptable. 9Form W-3 to the Social Security Administration; photocopies are41-0852411aEmployees social security numberdControl number Suff.11OMB No. 1545-002910 may be imposed on you if this income is taxable and you fail to report it. C doeDo Not Cut, Fold, or Staple Forms on This PageeEmployees name, address, and ZIP codeb 1 Wages, tips, other compensation 2 Federal income tax withheld12aSee instructions for box 12cEmployers name, address, and ZIP code 13StatutoryRetirementThird-party 3 Social security wages C doe 4 Social security tax withheldemployee plan sick pay 12b22222 VOID aEmployees social security number For Ofcial Use Only doe 6 Medicare tax withheldOMB No. 1545-0008Cb 1 Wages, tips, other compensation 14Other2 Federal income tax withheld5 Medicare wages and tips12c7 Social security tips C 8 Allocated tips12dcEmployers name, address, and ZIP code dControl number 3 Social security wages 4 Social security tax withheld919Local income tax doe 10 15StateEmployers state ID number 16State wages, tips, etc. 6 Medicare tax withheld 11StatutoryRetirement20Locality name C C ddooe e See instructions for box 12 5204 33333 a Control number DO NOT STAPLE 52005 Medicare wages and tips17State income taxeEmployees name, address, and ZIP code7 Social security tips 18Local wages, tips, etc.Suff. 12a8 Allocated tipsThird-party dControl number 922222 VOID10aEmployees social security number13 employee plan sick pay 12b For Ofcial Use Only:e Form W-2 Wage and Tax Statement b plan 2025 C C ddooe e Department of the TreasuryInternal Revenue Service C C ddooe e 2 Federal income tax withheld b Kind of Payer941 Military 943 OMB No. 1545-0008 None apply501c non-govt. Federal govt. Third-party Last name Suff.1114Other OMB No. 1545-0029 12c CT-1 Hshld.Medicare944 Kind of EmployerState/localState/local 501c sick pay Copy BTo Be Filed With Employees FEDERAL Tax Return.12aSee instructions for box 12 1 Wages, tips, other compensation emp. govt. emp. non-501c (Check if This information is being furnished to the Internal Revenue Service. RetirementThird-party12b 3 12d 4 Social security tax withheld (Check one) (Check one) applicable) 13StatutorycEmployers name, address, and ZIP code Social security wagesemployee sick pay15State 14Other 16State wages, tips, etc.12c C C doe e FAST! Use 17State income tax 18Local wages, tips, etc. 5 Medicare wages and tips 6 Medicare tax withheld c Total number of Forms W-2 e d Establishment number 1 Wages, tips, other compensation 2 Federal income tax withheldEmployers state ID number 19Local income tax 20Locality nameaEmployees social security number 12d doSafe, accurate,www.irs.gov/ele7 Social security tips 8 Allocated tips fEmployers name 3 Social security wages 4 Social security tax withheldVisit the IRS website at OMB No. 1545-0008fEmployees address and ZIP code 16State wages, tips, etc.17State income tax Control number 1 Wages, tips, other compensation 9 10See instructions for box 12 5 Medicare wages and tips 6 Medicare tax withheld18dLocal wages, tips, etc. 12a15StateEmployers state ID numberb Form W-2 Wage and Tax Statement19Local income tax 20Locality name2 Federal income tax withheldDepartment of the TreasuryInternal Revenue Service C doe 7 Social security tips 8 Allocated tipscEmployers name, address, and ZIP code eEmployees name, address, and ZIP code 2025 Suff.FAST!UseCopy CFor EMPLOYEES RECORDS (See Notice to4 Social security tax withheldSafe, accurate, 11 3 Social security wagesEmployee on the back of Copy B.)Department of the TreasuryInternal Revenue Service13StatutoryRetirementThird-party12b C C dooe e g 119 10 Employees State, City or Local Incomeor Cop Taxy 2 to be F Returniled With 6 Medicare tax withheld employee plan sick pay5 Medicare wages and tipsForm W-2 Wage and Tax Statement 2025Act Notice, see the separate instructions.14Other 12c ddoe h Employers address and ZIP code 13 For third-party sick pay use only 12a Deferred compensationFor Privacy Act and Paperwork Reduction 7 Social security tips 8 Allocated tipsCopy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411aEmployees social security number9 5201 C 5222Other EIN used this year 12bForm W-3 to the Social Security Administration; photocopies are10 This information is being furnished to the Internal Revenue Service. If you 12ddControl numberOMB No. 1545-0008 may be imposed on you if this income is taxable and you fail to report it. 15 State Employers state ID number 14 Income tax withheld by payer of third-party sick payeEmployees name, address, and ZIP codeb 15State Suff.11RetirementThird-party1 Wages, tips, other compensation C C dooe e 2 Federal income tax withheld 19Local income tax 20Locality name 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income taxEmployers state ID number 16State wages, tips, etc.12aSee instructions for box 12 18Local wages, tips, etc.17State income taxcEmployers name, address, and ZIP code 13Statutoryplan sick pay 3 Social security wages d4 Social security tax withheld Employers contact person Employers telephone numberemployee 12b14Other 5 Medicare wages and tips 6 Medicare tax withheldDepartment of the TreasuryInternal Revenue Service 12cForm W-2 Wage and Tax Statement 7 Social security tips C C ddooe e 8 Allocated tips For Privacy Act and Paperwork ReductionEmployers fax number Employers email addressCopy1ForState, orLocalTaxDepartment 12d 2025 Act Notice, see separate instructions.dControl number CopyDForEmployer.City, 9 10Under 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.15StateEmployers state ID numbereEmployees name, address, and ZIP code16State wages, tips, etc.17State income tax 18Local wages, tips, etc.Suff. 19Local income tax 20Locality name C doe Signature: Title: Date: Department of the Treasury 1112aSee instructions for box 12VOID aEmployees social security number13StatutoryRetirementThird-party12b C doe Form W-3 Transmittal of Wage and Tax Statements 2025 Internal Revenue Service22222 employee plan sick pay Send this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).Form W-2 Wage and Tax Statement b 2025 Department of the TreasuryInternal Revenue ServiceOMB No. 1545-0008C doe 2 Federal income tax withheld Photocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA. 14Other 12c Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.1 Wages, tips, other compensationThis information is being furnished to the Internal Revenue Service. 312d C doe 4 Social security tax withheld Reminder See the 2025 General Instructions for Forms Copy BTo Be Filed With Employees FEDERAL Tax Return.5202 Separate instructions. cEmployers name, address, and ZIP code Social security wagesW-25Local income tax 20Locality name6 Medicare tax withheld W-3 for Form(s) W-2 that were submitted electronically to the SSA.15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Medicare wages and tips 8 Allocated tips LW2NB 5207 Purpose of Form7 Social security tipsdControl number 9 10paper forms must notcomply with IRS standards and be machine readable. Photocopies are acceptable. Use a Form W-3 even if only one Form W-2 Wage and Tax Statement 2025 Department of the TreasuryInternal Revenue Service C doe number (EIN). Make a copy of this form and keep it with Copy D (For Copy CFor EMPLOYEES RECORDS (See Notice toSuff.Safe, accurate,RetirementThird-party12aSee instructions for box 12 C doe Employer) of Form(s) W-2 for your records. The IRS recommendsWhen To File Paper FormseEmployees name, address, and ZIP code 11 FAST!UseEmployee on the back of Copy B.)13Statutoryplan sick pay 5203 retaining copies of these forms for at least 4 years. Mail Form W-3 with Copy A of Form(s) W-2 by February 02, 2026.Employees State, City or Local Incomeor Cop Taxy 2tReturno be Filed With employee 12b14Other 12c C oe E-Filing Where To File Paper FormsThe SSA strongly suggests employers report Form W-3 and Forms W-2 C dCopy A electronically instead of on paper. The SSA provides two free Send this entire page with the entire Copy A page of Form(s) W-2 to:12d doe 50 Forms W-2 at a time to the SSA.toSocial Security AdministrationW-2 Online. Direct Operations Center15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name File Upload.usingNote:Wilkes-Barre, PA 18769-0001Specications for Filing Forms W-2 Electronically (EFW2) .the SSAs18769-0002. If you use an IRS-approved private delivery service, addFebruary 02, 2026. For more information, go to www.SSA.gov/bso. ATTN: W-2 Process, 1150 E. Mountain Dr. to the address and changethe ZIP code to 18702-7997. Go to www.irs.gov/PDS for a list of IRS-approved private delivery services.Form W-2 Wage and Tax Statement 2025 Department of the TreasuryInternal Revenue ServiceFor Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.For Privacy Act and Paperwork Reduction Copy1ForState, orLocalTaxDepartment Act Notice, see separate instructions.5204 41-0852411 5200CopyDForEmployer.City,Required Envelope:66661 or 66662(5) W-3 Transmittal forms are included with each Federal Copy A (Red) Form orderSheets per pack2550500FORM DESCRIPTION5200255200505200B W-3 Transmittal Of Income And Tax Statement1 Sheet Equals 1 Form520125520150 5201B W-2 IRS Federal Copy A1 Sheet Equals 2 Forms5202255202505202B W-2 Employees IRS Federal Copy B1 Sheet Equals 2 Forms5203255203505203B W-2 Employees Copy C and/or State, City Or Local Copy 21 Sheet Equals 2 Forms5204255204505204B W-2 Employers Copy D and/or State, City Or Local Copy 21 Sheet Equals 2 Forms5222255222505222B W-2 Blank Face, With W-2 Backer Instructions1 Sheet Equals 2 Forms5207255207505207B W-2 Blank Face, No Backer1 Sheet Equals 2 Forms530925N/AN/AW-3C Transmittal of Corrected Income and Tax Statement1 Sheet Equals 1 FormN/A531350N/A W-2C Corrected Income Fed Copy A1 Sheet Equals 1 FormN/A531450N/A W-2C Corrected Income Employees Fed Copy B1 Sheet Equals 1 FormN/A531650N/A W-2C Corrected Income Employees Copy C and/or State, City, Local Copy 21 Sheet Equals 1 FormN/A531550N/A W-2C Corrected Income Employers Copy D and/or State, City, local Copy 11 Sheet Equals 1 Form24'