b"MISCELLANEOUS FORMS1042-S, W-2G & I-91042-S LASER 1042-S532025 532125 532225 532325FormForeign Persons U.S. Source Income Subject to Withholding OMB No. 1545-0096 2025 Form1042-S 2025 OMB No. 1545-0096 2025 OMB No. 1545-0096 Used to report all income and/or tax with held for non-resident aliens and Department of the TreasuryUNIQUE FORM IDENTIFIER AMENDED 2025 Form1042-S AMENDED AMENDMENT NO. OMB No. 1545-0096 Go to www.irs.gov/Form1042S for instructions and the latest information.1042-S Form1042-S Foreign Persons U.S. Source Income Subject to WithholdingForeign Persons U.S. Source Income Subject to WithholdingForeign Persons U.S. Source Income Subject to Withholding AMENDMENT NO. Copy Dfor RecipientInternal Revenue Service 3 Chapter indicator.Enter 3 or 4 Department of the TreasuryAMENDMENT NO. Copy Afor Go to www.irs.gov/Form1042S for instructions and the latest information. AMENDMENT NO. Copy Cfor Recipient foreign corporations with United States income. (However, resident aliens Go to www.irs.gov/Form1042S for instructions and the latest information.Go to www.irs.gov/Form1042S for instructions and the latest information. Copy BAMENDED UNIQUE FORM IDENTIFIER AMENDEDDepartment of the TreasuryDepartment of the Treasury code 2Gross income3a Internal Revenue Service 3 Chapter indicator.Enter 3 or 4Internal Revenue Service 3Exemption code 4aUNIQUE FORM IDENTIFIER 3Exemption code 4a Exemption code 13dCity or town, state or province, country, ZIP or foreign postal codeInternal Revenue Service for Recipient1 Income1 Income 213d UNIQUE FORM IDENTIFIER Internal Revenue ServiceCity or town, state or province, country, ZIP or foreign postal code code 13dCity or town, state or province, country, ZIP or foreign postal codeExemption code code 13dCity or town, state or province, country, ZIP or foreign postal codecode Gross income1 Income 2Gross income3a Chapter indicator.Enter 3 or 41 Income 2Gross income3a Chapter indicator.Enter 3 or 45Withholding allowance 3b Exemption code . 4a Tax rate . 13eRecipients U.S. TIN, if any3b3a Exemption code Tax rate 13iRecipient . 4a Tax rate 13eRecipients U.S. TIN, if any Recipient . s 4b Exemption code . 13eRecipients U.S. TIN, if any Recipient . s 13fCh. 3 status code. 13eRecipients U.S. TIN, if any Recipients 13fCh. 3 status code 13jLOB codeare treated the same as U.S. citizens; thus a regular W-2 Form may be usedTax rate 4b 13f Exemption code 3b Tax rate 13fCh. 3 status code 3b Tax rate 4b Tax rate4b Ch. 3 status code6Net income 5Withholding allowance s13g Ch. 4 status code. LOB code13i 13gTax rate 5Withholding allowance 13i 13g Ch. 4 status code 13hLOB code13i 13g Ch. 4 status code5Withholding allowance Ch. 4 status code7aFederal tax withheld . . . . 6Net income13hRecipients GIIN. . number, if any. . . . 6Net income13h13j . Recipients GIINnumber, if any. . . . 6Net income . 13hLOB codenumber, if any. . . . . . 13jRecipients GIINnumber, if any for reporting. If in doubt whether employee qualifies as a resident or non-13jRecipients GIIN 7aFederal tax withheld 7aFederal tax withheld 7aFederal tax withheld7b Check if federal tax withheld was not deposited with the IRS becauseCheck if federal tax withheld was not deposited with the IRS becauseescrow procedures were applied (see instructions) 7b. Check if federal tax withheld was not deposited with the IRS because13kRecipients account numberescrow procedures were applied (see instructions)7b escrow procedures were applied (see instructions) 7b. Check if federal tax withheld was not deposited with the IRS becauseescrow procedures were applied (see instructions)13kRecipients account number 13kRecipients account number 13kRecipients account number7c Check if withholding occurred in subsequent year with respect to a. . . . . . . . . . . . 7c.Check if withholding occurred in subsequent year with respect to a . . . . . . . . . . . partnership interest . . . . . . . . . . . 7c. Check if withholding occurred in subsequent year with respect to a . . . . . . . . . . . . . 13lRecipients date of birth (YYYYMMDD) resident, check with local IRS offices.)partnership interestpartnership interest 7c. Check if withholding occurred in subsequent year with respect to apartnership interest13lRecipients date of birth (YYYYMMDD) 13lRecipients date of birth (YYYYMMDD) 13lRecipients date of birth (YYYYMMDD)7d 7d 7d 7d partnership, or withholding foreign trust revising its reporting on Form14aPrimary withholding agents name (if applicable)partnership, or withholding foreign trust revising its reporting on Form partnership, or withholding foreign trust revising its reporting on Form 14aPrimary withholding agents name (if applicable). . . . . . . . partnership, or withholding foreign trust revising its reporting on Form. 14aPrimary withholding agents name (if applicable)8Tax withheld by other agents8Tax withheld by other agents15b Ch. 3 status code 814aPrimary withholding agents name (if applicable) 9Tax withheld by other agents 815b Ch. 3 status code 14bPrimary withholding agents EIN 15Check if pro-rata basis reportingOnly available in Laser format. 9Tax withheld by other agents14bPrimary withholding agents EIN9Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)14bPrimary withholding agents EIN 15Check if pro-rata basis reporting15Check if pro-rata basis reporting15Check if pro-rata basis reporting 14bPrimary withholding agents EIN9Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)Overwithheld tax repaid to recipient pursuant to adjustment procedures (see instructions)()()() 15c15a15c15a15b Ch. 3 status code15c Ch. 4 status code10Total withholding credit (combine boxes 7a, 8, and 9) 10Total withholding credit (combine boxes 7a, 8, and 9) 10Total withholding credit (combine boxes 7a, 8, and 9) 15b()Ch. 4 status code15a15c15aCh. 3 status codeCh. 4 status code Ch. 4 status code 10Total withholding credit (combine boxes 7a, 8, and 9)11Tax paid by withholding agent (amounts not withheld) (see instructions)11Tax paid by withholding agent (amounts not withheld) (see instructions)15d 12bCh. 3 status code12c11Tax paid by withholding agent (amounts not withheld) (see instructions) 15d 12bCh. 3 status code12cCh. 4 status code 15d Required Envelope:2121115d 11Tax paid by withholding agent (amounts not withheld) (see instructions)12aWithholding agents EIN 12bCh. 3 status code12cCh. 4 status codeCh. 4 status code 12bCh. 3 status code12cCh. 4 status code12aWithholding agents EIN 12aWithholding agents EIN 12aWithholding agents EIN15e Country code 15g 15e Country code 15g 15e Country code 15g 15e Country code 15g12dWithholding agents name 12e 15f 12e 15f 12e 15f 15f Order by year:2025 = 252026 = 2612dWithholding agents name 12dWithholding agents name 12dWithholding agents name15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street) 15hAddress (number and street)12e15iCity or town, state or province, country, ZIP or foreign postal code15iCity or town, state or province, country, ZIP or foreign postal code15iCity or town, state or province, country, ZIP or foreign postal code15iCity or town, state or province, country, ZIP or foreign postal code12fCountry code 12g 12fCountry code16aPayers name 12g 16d12fCountry code 12g 16d12fCountry code 12g 16d16bPayers TIN16aPayers name16d16bPayers TIN To IRS/SSA and to Recipient Paper Filing due date: March 1516bPayers TIN16aPayers name16bPayers TIN16aPayers name 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street) 12hAddress (number and street)16cPayers GIIN Ch. 3 status code16e 16cPayers GIIN Ch. 3 status code16e 16cPayers GIIN Ch. 3 status code16e 16cPayers GIIN Ch. 3 status code16e Ch. 4 status codeCh. 4 status code Ch. 4 status code Ch. 4 status code12iCity or town, state or province, country, ZIP or foreign postal code12iCity or town, state or province, country, ZIP or foreign postal code12iCity or town, state or province, country, ZIP or foreign postal code12iCity or town, state or province, country, ZIP or foreign postal code17cName of state17aState income tax withheld s state tax no.17cName of state 17bPayers state tax no.17cName of state13aRecipients name 13bRecipients country code13a,c 17aState income tax withheld 17bPayer13b s state tax no.13a,c 17cName of state 17bPayer13b s state tax no.13a,c 17bPayer13b Recipients country code 17aState income tax withheld17aState income tax withheldRecipients name, address (number and street)Recipients country codeRecipients name, address (number and street)Recipients country codeRecipients name, address (number and street)13cAddress (number and street) 5320 Form1042-S(2025) 5321 Form1042-S(2025) 5322 Form1042-S(2025) 5323 Form1042-S(2025) 1042-S FOREIGN PERSONS U.S. SOURCE INCOME For Privacy Act and Paperwork Reduction Act Notice, see instructions.(keep for your records)SUBJECT TO WITHHOLDINGLASER FORMS20252026FORM FORMDESCRIPTION5320255053202650Laser 1042-S Copy A5321255053212650Laser 1042-S Copy B5322255053222650Laser 1042-S Copy CW-2G LASER 5323255053232650Laser 1042-S Copy D5230 5231 5232 52333232 VOIDCORRECTED 2Date won CORRECTED (if checked) 2Date won CORRECTED (if checked) VOIDCORRECTED 2Date won OMB No. 1545-0238 W-2GPAYERS name, street address, city or town, state or province, country, 1Reportable winnings OMB No. 1545-0238 PAYERS name, street address, city or town, state or province, country, OMB No. 1545-0238 DETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGDETACH BEFORE MAILINGand ZIP or foreign postal code PAYERS name, street address, city or town, state or province, country, OMB No. 1545-0238 2Date won 1Reportable winnings MANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKSMANUFACTURED ON OCR LASER BOND PAPER USING HEAT RESISTANT INKS1Reportable winnings 1Reportable winningsand ZIP or foreign postal code PAYERS name, street address, city or town, state or province, country, $ Form W-2G $ and ZIP or foreign postal code $ Form W-2G $ Form W-2Gand ZIP or foreign postal code Form W-2G3Type of wager 4Federal income tax withheld Certain4Federal income tax withheld Certain4Federal income tax withheld Certain4Federal income tax withheld Certain GamblingGamblingGambling $ 3Type of wager $ 3Type of wager $ 3Type of wager $ Gambling 5Transaction 7 6Race 7 Winnings 6Race 7 Winnings 6Race 7 Winnings 6Race Winnings Used to report gambling winnings and any Federal income tax withheldWinnings from identical wagers8Cashier (Rev. December 2023) 8Cashier (Rev. December 2023) 8Cashier 5For calendar year 8Cashier (Rev. December 2023)5Transaction 5For calendar year Transaction For calendar yearTransaction (Rev. December 2023)For calendar year20 20 20PAYERS TIN PAYERS telephone no. PAYERS TIN$ 9PAYERS telephone no. $ 9Winnings from identical wagers PAYERS telephone no. $ 9Winnings from identical wagers PAYERS telephone no. $ 9Winnings from identical wagers 10Window on those winnings. The requirements for reporting and withholding PAYERS TIN PAYERS TINWINNERS TIN 10Window For Privacy Act10Window WINNERS TIN 10Window This is important tax WINNERS TIN WINNERS TINand PaperworkThis informationinformation and isFor Privacy Act WINNERS name 11 12 WINNERS name11 Reduction Actis being furnished12 the Internal Revenue12 and Paperworkdepend on the type of gambling, the amount of the gambling winnings being furnished to , street address (including apt. no.), city or town,12 11to the Internal state or province, country, and ZIP or foreign postal code state or province, country, and ZIP or foreign postal code state or province, country, and ZIP or foreign postal code Service. If you areReduction Act WINNERS name, street address (including apt. no.), city or town, Notice, see theWINNERS name, street address (including apt. no.), city or town, 11current GeneralRevenue Service. return, a negligenceNotice, see the Street address (including apt. no.) 1314State winnings Instructions for14State winnings 1314State winnings 13 penalty or other14State winnings Instructions forCity or town,state or province, country, and ZIP or foreign postal code 15State income tax withheld $ 16Local winnings Certain Information$ 16Local winnings Copy B$ 16Local winnings imposed on you if$ 16Local winnings current General and the ratio of the winnings to the wager. The types of gambling are 13 Returns. sanction may beCertain Information this income isReturns.15State income tax withheld Report this incometaxable and the $ 17Local income tax withheld $ 18Name of locality File with Form 1096 $ $ 18Name of locality on your federal tax$ $ 18Name of locality Copy $ 152 IRS determines$ 18Name of locality ForState, Copy1 grouped as follows: 1. Horse racing, dog racing, jai alai and Other 15State income tax withheld State income tax withheldreturn. If this formthat it has not been reported.shows federal 17Local income tax withheld income taxyour Attach tacopy to ifLocalCityTaxorCopy Awithheld in box 4,17 state, city, thisreturn, or local Department17Local income tax withheld Local income tax withheldcorrectly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is enti I$ Imy knowledgeFor Internal Revenue$ I address, that, taxpayer bestmy knowledge$ attach this copyI address, that, taxpayer bestmy knowledge$ For income or x Records. address, and taxpayernumberor Copy D For Payer. IWagering Transactions, 2. Sweepstakes, Wagering Pools and Lotteries, Service Center to your return. required Copy CWinners Under and penalties belief, the perjury, address,the best of tled to any part of these payments. declare and to theof tled to any part of these payments. number and that belief, I have the furnished name,that have furnished of name, declare and that, taxpayer tonumberhave of the furnished perjury, name,correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entiUnder that and penalties belief, IUnder and that penalties belief, I Under penalties of perjury, declare that, to the best of my knowledge correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is enti numberhave of the furnished perjury, name, declare and to theof tled to any part of these payments. tled to any part of these payments.Signature: (Rev. 12-2023) Signature:(Rev. 12-2023) Date:correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is enti www.irs.gov/FormW2G Date:3. Bingo, keno and slot machines. Due to recent IRS changes, we only Signature:Date:Signature:Date: FormW-2G 41-0852411FormW-2G Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue ServiceFormW-2G FormW-2Gwww.irs.gov/FormW2G www.irs.gov/FormW2G (Rev. 12-2023) www.irs.gov/FormW2G (Rev. 12-2023)Do Not Cut or Separate Forms on This PageDo Not Cut or Separate Forms on This Page3232 VOIDCORRECTED CORRECTED (if checked) CORRECTED (if checked) VOIDCORRECTED 2Date won OMB No. 1545-0238 offer dateless forms, available in both laser and continuous formats. PAYERS name, street address, city or town, state or province, country,PAYERS name, street address, city or town, state or province, country,1Reportable winnings $ 2Date won PAYERS name, street address, city or town, state or province, country, $ 4 OMB No. 1545-0238 $ 4 2Date won OMB No. 1545-0238 $ 4Federal income tax withheld Form W-2G Required Envelope: 77771OMB No. 1545-0238 2Date won PAYERS name, street address, city or town, state or province, country, 1Reportable winnings1Reportable winnings 1Reportable winningsand ZIP or foreign postal code and ZIP or foreign postal code and ZIP or foreign postal code and ZIP or foreign postal code Form W-2GForm W-2G Form W-2G3Type of wager 4Federal income tax withheld CertainFederal income tax withheld CertainFederal income tax withheld CertainCertain GamblingGambling$ 6Race Gambling$ 6Race Winnings3Type of wager 3Type of wager 3Type of wager Gambling 5Transaction $ 6Race Winnings $ 6Race Winnings Winnings (Rev. December 2023)5Transaction 5For calendar year 5For calendar year For calendar yearTransaction Transaction(Rev. December 2023) (Rev. December 2023) (Rev. December 2023)For calendar year 7 Winnings from identical wagers8Cashier 7 Winnings from identical wagers8Cashier7 Winnings from identical wagers8Cashier 7 Winnings from identical wagers8Cashier 20 2020PAYERS TIN PAYERS telephone no. PAYERS TIN$ PAYERS telephone no. PAYERS TIN$ WINNERS TIN PAYERS telephone no. PAYERS TIN$ 9WINNERS TIN PAYERS telephone no. $ 9WINNERS TIN 10WindowWINNERS name 11 9 WINNERS TIN 10Window 9 For Privacy Act10Window This information10Window information and is12 For Privacy ActW-2G CERTAIN GAMBLING WINNINGSThis is important tax and Paperworkis being furnished12 being furnished toand Paperwork , street address (including apt. no.), city or town,12 Revenue Service. the Internal Revenue 12 WINNERS name11 Reduction ActWINNERS name11to the Internal11WINNERS name, street address (including apt. no.), city or town, state or province, country, and ZIP or foreign postal code state or province, country, and ZIP or foreign postal code Service. If you areReduction Act state or province, country, and ZIP or foreign postal code Notice, see the, street address (including apt. no.), city or town, return, a negligenceNotice, see the current General Instructions forpenalty or other Street address (including apt. no.) 13$ 14State winnings Certain Information$ 14State winnings 13Copy B$ 14State winnings 13 sanction may be$ 14State winnings Instructions for FORMDESCRIPTION13 Returns. imposed on you ifcurrent Generalthis income isCertain Information Report this income16Local winnings taxable and the16Local winnings Returns.City or town,state or province, country, and ZIP or foreign postal code 15State income tax withheld16Local winnings 15State income tax withheld16Local winnings on your federal tax15 IRS determines 15State income tax withheld State income tax withheldreturn. If this formthat it has not $ 17Local income tax withheld $ 18Name of locality File with Form 1096 $ $ 18Name of locality $shows federal$ 18Name of locality Copy $ 17 2 been reported. if$ 18Name of locality ForState,Local 1 523025Laser W2-G Copy Aincome taxLocal income tax withheldCopy A17Local income tax withheldAttachlocal to Copy17Local income tax withheld withheld in box 4,your incometa copy CityTaxorFor Internal Revenue$ $ attach this copy$ For state, city, thisreturn,or or Copy D For Payer.$ of perjury, address, Ithe bestmy knowledgeService Center I address, that, taxpayer bestmy knowledgeto your return. I address, that, taxpayer bestmy knowledgeWinners or x Records. address, and taxpayernumber that I haveDepartmentrequired Copy CUnder penalties of perjury, I declare that, to the best of my knowledge correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is enti numberW-2G have of the furnished perjury, name, declare and to theof tled to any part of these payments. Date:tled to any part of these payments. 523125Laser W2-G Copy BUnder that and penalties belief, IUnder and that penalties belief, I correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is enti numberhave of the furnished perjury, name, declareto thecorrectly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entiUnder and penalties belief, the name, declare and that, taxpayer toof tled to any part of these payments. andof tled to any part of these payments. number and that belief, I have the furnished name,furnished correctly identify me as the recipient of this payment and any payments from identical wagers, and that no other person is entiSignature:Signature: Date:Signature:Date:Signature:Date: FormW-2G Form523225Laser W2-G Copy 2 and/or CFormW-2G(Rev. 12-2023) 5230 LW2GA 41-0852411FormW-2G(Rev. 12-2023) 5231 LW2GB www.irs.gov/FormW2G (Rev. 12-2023) 5232 Department of the Treasury - Internal Revenue Service5233 Department of the Treasury - Internal Revenue Service Department of the Treasury - Internal Revenue Servicewww.irs.gov/FormW2G Department of the Treasury - Internal Revenue Service LW2GC2www.irs.gov/FormW2G (Rev. 12-2023) LW2GD1www.irs.gov/FormW2G523325Laser W2-G Copy D and/or 1I-910251Supplement B,USCIS Reverification and Rehire (formerly Section 3)Form I-9Department of Homeland SecuritySupplement BExpires 05/31/2027Last Name (Family Name) from Section 1.First Name (Given Name) from Section 1.Middle initial (if any) from Section 1. Instructions: This supplement replaces Section 3 on the previous version of Form I-9. Only use this page if your employee reme change.Enter quires reverification, is rehired within three years of the date the original Form I-9 was completed, or provides proof of a legal na Review the Form I-9 instructions before the employee's name in the fields above. Use a new section for each reverification or rehire. Additional guidance can be found in the completing this page. Keep this page as part of the employee's Form I-9 record.Handbook for Employers: Guidance for Completing Form I-9 (M-274) Date of RehireNew Name (if applicable)Date (mm/dd/yyyy(if applicable) )Last Name (Family Name)First Name (Given Name)Middle Initial Reverification: If the employee requires reverification, your employee can ch documentation to show continued employment authorization. Enter the document information in the oose to present any acceptable List A or List C spaces below. Document TitleDocument Number (if any)Expiration Date (if any) (mm/dd/yyyy) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if thented it. employee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who preseName of Employer or Authorized RepresentativeSignature of Employer or Authorized RepresentativeToday's Date (mm/dd/yyyy) Additional Information (Initial and date each notation.)Check here if you used an alternative procedure authorized by DHS to examine documents. Date of RehireNew Name (if applicable)First Name (Given Name)Middle InitialI-9 EMPLOYMENT ELIGIBILITY VERIFICATIONDate (mm/dd/yyyy(if applicable) )Last Name (Family Name) Reverification: If the employee requires reverification, your employee can ch documentation to show continued employment authorization. Enter the document information in the oose to present any acceptable List A or List C Document Titlespaces below.Expiration Date (if any) (mm/dd/yyyy)The Department of Homeland Security requires employers to use this form Document Number (if any) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if thented it.to verify that every new employee (both citizens and non-citizens) hired after employee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who preseName of Employer or Authorized RepresentativeSignature of Employer or Authorized RepresentativeToday's Date (mm/dd/yyyy) Additional Information (Initial and date each notation.)alternative procedure authorizedNovember 6, 1986, is authorized to work in the United States. The form must be Check here if you used an Date of RehireNew Name (if applicable)First Name (Given Name)by DHS to examine documents.completed by both the employer and the employee at the time of hire, which is Date (mm/dd/yyyy(if applicable) )Last Name (Family Name)Middle Initial Reverification: If the employee requires reverification, your employee can ch spaces below.documentation to showthe actual start of employment.continued employment authorization. Enter the document information in the oose to present any acceptable List A or List C Document TitleDocument Number (if any)Expiration Date (if any) (mm/dd/yyyy) I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States FORMDESCRIPTIONemployee presented documentation, the documentation I examined appears to be genuine and to relate to the individual who prese, and if thented it. Name of Employer or Authorized RepresentativeSignature of Employer or Authorized RepresentativeToday's Date (mm/dd/yyyy) Additional Information (Initial and date each notation.)alternative procedure authorized10251I-950 FORMSPER PACK - Instruction booklet is included with each form.Check here if you used an by DHS to examine documents. 0801 Form I-9 Supplement B 08/01/202336"