b'W-2 PRE-PRINTED FORMS1099 PRE-PRINTED FORMS Mfg. ID Convenience Package Sets Mfg. ID Convenience Package Sets22222 VOID aEmployees social security number For Ofcial Use Only 52013 Transmittal 1096 forms are included with each set MFG ID 1099-MISC BLANK PACKAGED LASER SET *b OMB No. 1545-00082 Federal income tax withheld PARTScEmployers name, address, and ZIP code 1 Wages, tips, other compensation 4 Social security tax withheld OMB No. 1545-0008 Safe, accurate,Visit the IRS website at5202 * FOR 50 EMPLOYEES3 Social security wages 6 Medicare tax withheld MFG ID 1099-MISC PACKAGED LASER SET5 Medicare wages and tips7 Social security tips 8 Allocated tipsaEmployees social security number FAST! Use www.irs.gov/ele e 11cEmployers name, address, and ZIP code12a 3 Social security wages 4 Social security tax withhelddControl number Last name Suff. 9b 10C doe See instructions for box 12 1 Wages, tips, other compensation 2 Federal income tax withheld PARTS 61745-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 13StatutoryRetirementThird-party12b C C ddooe e 5 Medicare wages and tips 6 Medicare tax withheld OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If you5203employee plan sick pay 12c 7 Social security tipsb 8 Allocated tipsaEmployees social security number may be imposed on you if this income is taxable and you fail to report it. 200- 5144, 3 - 510014Other dControl number 12d C oe Suff. 9 RetirementThird-party10C C C ddoooe e e See instructions for box 12 1 Wages, tips, other compensation VOID 2 Federal income tax withheld OMB No. 1545-00082 Federal income tax withheld FOR 50 EMPLOYEESfEmployees address and ZIP code 16State wages, tips, etc.17State income tax eEmployees name, address, and ZIP code 20Locality name 11StatutorycEmployers name, address, and ZIP code12a d3 Social security wages 4 Social security tax withheld 5204 6102E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,15StateEmployers state ID number 2023 18Local wages, tips, etc.19Local income tax d16State wages, tips, etc. 13 employee plan sick pay 12b C doe 20Locality name Suff. 13 5 Medicare wages and tips C C ddooe e 6 Medicare tax withheld 1 Wages, tips, other compensation 4 Social security tax withheld DO NOT STAPLE 50- 5111, 50 - 5112, 3 - 5100 1096, 50 - 77772 Envelopes MFG ID 1099-MISC PACKAGED LASER SET FOR ELECTRONIC FILING *14Other 12c 7 Social security tips 8 Allocated tipsaEmployees social security number22222dControl number 9 b 10 Form W-2 Wage and Tax Statement Department of the TreasuryInternal Revenue ServiceeEmployees name, address, and ZIP code12d 11cEmployers name, address, and ZIP code12aSee instructions for box 12 3 Social security wagesCopy AFor Social Security Administration. Send this entire page with not acceptable. 41-085241115State For Privacy Act and Paperwork Reduction17State income tax 18Local wages, tips, etc.19Local income tax StatutoryRetirementThird-party12b 5 Medicare wages and tips 6 Medicare tax withheld For Ofcial Use Only: 5200Do Not Cut, Fold, or Staple Forms on This PageAct Notice, see the separate instructions.employee plan sick pay 12c C ddooe e Suff. 9 b 33333 a Control number C doe 943 OMB No. 1545-0008 None apply501c non-govt. Federal govt. Third-partyPARTSForm W-3 to the Social Security Administration; photocopies areForm Employers state ID number 14Other dControl number 12d C 7 Social security tips 8 Allocated tipsMilitary govt. emp. 944 Kind of EmployerState/localState/local 501c sick pay61034-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,b 22222 VOID aEmployees social security number For Ofcial Use Only W-2 Wage and Tax Statement 2023 15State Department of the TreasuryInternal Revenue Service 17State income tax eEmployees name, address, and ZIP code19Local income tax 20Locality name 11StatutoryKind of PayerC 941 oe Hshld.Medicare(Check one) non-501c 2 Federal income tax withheld applicable)50- 5111, 100 - 5112, 3 - 5100 1096 FOR 50 EMPLOYEESOMB No. 1545-0008(Check one) 10emp. (Check if CT-11 Wages, tips, other compensation 2 Federal income tax withheld Employers state ID number 16State wages, tips, etc. 18Local wages, tips, etc. 13 employee c Total number of Forms W-212a e dSee instructions for box 12 1 Wages, tips, other compensation 4 Social security tax withheldCopy BTo Be Filed With Employees FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. RetirementThird-party12b d Establishment number 3 Social security wagescEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld OMB No. 1545-0008 Form W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 14Other plan sick pay 12c C C ddooe e 5 Medicare wages and tips 6 Medicare tax withheld 6103E4-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 61133-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,5 Medicare wages and tips 6 Medicare tax withheld fEmployers namedControl number Last name Suff. 7 Social security tips C oe 8 Allocated tipsaEmployees social security number Safe, accurate,Visit the IRS website at15State Safe, accurate,16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 12d 20Locality name 117 Social security tips 9 108 Allocated tips 50- 5111, 100 - 5112, 3 - 1096e 9b 10FAST! Use www.irs.gov/eleFAST!Use 19Local income tax 12a Deferred compensation 50- 5111, 100 - 5112, 3 - 5100 1096, 50 - 77772 EnvelopesCopy CFor EMPLOYEES RECORDS (See Employee on the back of Copy B.) or Copy 2Notice toto be Filed With1 Wages, tips, other compensation 2 Federal income tax withheldEmployees State, City or Local Income Tax Return Employers state ID number11cEmployers name, address, and ZIP code12aSee instructions for box 12 3 Social security wages 4 Social security tax withheld13StatutoryRetirementThird-party12b C C dddooe e 5 Medicare wages and tips 6 Medicare tax withheld OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If you2023 g Employers address and ZIP code 13 For third-party sick pay use only 12b 61055-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110, 6113E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5110,employee plan sick pay 7 Social security tips aEmployees social security number may be imposed on you if this income is taxable and you fail to report it. h Other EIN used this year 14 Income tax withheld by payer of third-party sick pay14Other dControl number 12c C doe Suff. 9 b C doe 8 Allocated tips Form W-2 Wage and Tax Statement 15 State Department of the TreasuryInternal Revenue Service18 Local wages, tips, etc. 19 Local income taxFor Privacy Act and Paperwork Reduction 12d 101 Wages, tips, other compensationCity,2 Federal income tax withheld Employers state ID numberfEmployees address and ZIP code 16State wages, tips, etc.17State income tax eEmployees name, address, and ZIP code 20Locality name 11StatutorycEmployers name, address, and ZIP code12aSee instructions for box 12 C C dooe e 9 Copy1ForState, VOID orLocalTaxDepartment OMB No. 1545-000816 State wages, tips, etc. Act Notice, see separate instructions. Employers telephone number 50- 5111, 100 - 5112, 3 - 1096, 50 - 77772 Envelopes 15StateEmployers state ID number 18Local wages, tips, etc.19Local income tax 13 employee RetirementThird-party12b CopyDForEmployer. 4 Social security tax withheld Employers contact person 17 State income tax Employers email address 50- 5111, 150 - 5112, 3 - 5100 10963 Social security wages5 Medicare wages and tips 6 Medicare tax withheldplan sick pay Employers fax numberForm W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service14Other dControl number 12c C ddoe 20Locality name Suff. 13 7 Social security tips Third-partyC C ddooe e 8 Allocated tipsaEmployees social security number 1 Wages, tips, other compensation 4 Social security tax withheld Title: 2023 Date: Department of the TreasuryFOR 25 EMPLOYEES22222Copy AFor Social Security Administration. Send this entire page with not acceptable. 41-085241115State LW2AAct Notice, see the separate instructions.17State income tax 18Local wages, tips, etc. 12d 11Statutoryb Retirementsick pay 10C C dooe e See instructions for box 12 Suff. 9 Under penalties of perjury, I declare 2 Federal income tax withheldthat I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true, correct, andC doe 6103254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110, MFG ID 1099-INT PACKAGED LASER SET *complete.For Privacy Act and Paperwork ReductioneEmployees name, address, and ZIP code cEmployers name, address, and ZIP code12a 3 Social security wagesSignature:Form W-3 to the Social Security Administration; photocopies areEmployers state ID number 5201 19Local income tax employee plan 12b Form W-3 Transmittal of Wage and Tax Statements Internal Revenue Service16State wages, tips, etc. 5 Medicare wages and tips 6 Medicare tax withheldSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).14Other 12c Photocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA. Form W-2 Wage and Tax Statement 2023 15State Department of the TreasuryInternal Revenue Service 17State income tax dControl number 12d d20Locality name 11StatutoryDo not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3. C doe 25- 5111, 50 - 5112, 3 - 5100 1096 PARTS7 Social security tips 8 Allocated tipsReminder 10 66661, 66662Copy BTo Be Filed With Employees FEDERAL Tax Return.LW2B 16State wages, tips, etc. eEmployees name, address, and ZIP code 13 employee Separate instructions. See the 2023 General Instructions for Forms W-212aSee instructions for box 12This information is being furnished to the Internal Revenue Service. Employers state ID number 5202 18Local wages, tips, etc.19Local income tax W-3 for Form(s) W-2 that were submitted electronically to the SSA.Form Wage and Tax Statement Department of the TreasuryInternal Revenue Service 14Other Purpose of Form C C ddooe e FOR 50 EMPLOYEESRetirementThird-party12b 6103E254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110,plan sick pay12cpaper forms must comply with IRS standards and be machine readable. Photocopies are not acceptable. Use a Form W-3 even if only one W-2 2023 Safe, accurate,12dCopy CFor EMPLOYEES RECORDS (See15State FAST!Use 16State wages, tips, etc.17State income tax 18 number (EIN). Make a copy of this form and keep it with Copy D (ForWhen To File Paper Forms 25- 5111, 50 - 5112, 3 - 5100 1096, 25- 77772 envelopes 6104 Employee on the back of Copy B.) or Copy 2Notice toto be Filed With Employers state ID number 5203 Employer) of Form(s) W-2 for your records. The IRS recommendsMail Form W-3 with Copy A of Form(s) W-2 by January 31, 2024. 3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5120,Employees State, City or Local Income Tax Return LW2C/LW22 retaining copies of these forms for 4 years. 20Locality nameLocal wages, tips, etc.19Local income taxE-FilingForm W-2 Wage and Tax Statement 2023 The SSA strongly suggests employers report Form W-3 and Forms W-2Where To File Paper Forms 50- 5121, 100 - 5122, 3 - 5100 1096Copy1ForState, orLocalTaxDepartment Copy A electronically instead of on paper. The SSA provides two freeSend this entire page with the entire Copy A page of Form(s) W-2 to: 6105255-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5110,50 Forms W-2 at a time to the SSA.toSocial Security Administration W-2 Online.For Privacy Act and Paperwork Reduction usingDirect Operations CenterDepartment of the TreasuryInternal Revenue ServiceFile Upload.Wilkes-Barre, PA 18769-0001CopyDForEmployer.City, LW2D1Act Notice, see separate instructions.5204 .the SSAs18769-0002. If you use an IRS-approved private delivery service, add 25- 5111, 75- 5112, 3 - 5100 1096 61064-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5120,Specications for Filing Forms W-2 Electronically (EFW2) Note: January 31, 2024. For more information, go to www.SSA.gov/bso. First- ATTN: W-2 Process, 1150 E. Mountain Dr. to the address and changeRegister Log In. the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers Tax Guide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. 50- 5121, 100 - 5122, 3 - 5100, 3 - 1096LW3 41-0852411 5200 MFG ID 1099-NEC PACKAGED LASER SET * FOR 25 EMPLOYEES3 Transmittal W-3 forms are included with each set MFG ID W-2 LASER BLANK PACKAGED SETS PARTS 6106254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5120,PARTS FOR 25 EMPLOYEES 25- 5121, 50 - 5122, 3 - 5100 NEC61023-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, MFG ID W-2 PACKAGED LASER SETFOR 50 EMPLOYEES 50- NEC5111, 50 - NEC5112, 3 - 5100 MFG ID 1099-DIV PACKAGED LASER SET *57466-PART PRE-PACKAGED CONVENIENCE SET includes: 50 -NEC6102E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,PARTS PARTS 5201, 100- 5207, 50 - 5209, 3 - 5201 - 99991 Envelopes50- NEC5111, 50 - NEC5112, 3 - 5100, 50 - DW19WS Envelopes FOR 50 EMPLOYEESFOR 50 EMPLOYEES FOR 25 EMPLOYEES NEC610361074-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5130,4-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,56454-PART SET includes: 50 - 5201, 50 - 5202, 50 - 5203,5746256-PART PRE-PACKAGED CONVENIENCE SET includes: 25 -50- NEC5111, 100 - NEC5112, 3 - 5100 50- 5131, 100 - 5132, 3 - 510050 - 5204, 3 - 52005201, 50- 5207, 25 - 5209, 3 - 5200 - 99992 Envelopes NEC6103E4-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,FOR 25 EMPLOYEES 5645E4-PART SET includes: 50-5201, 50-5202, 50-5203, 50-5204, 50- NEC5111, 100 - NEC5112, 3 - 5100, 50 - DW19WS EnvelopesMFG ID W-2C CORRECTED INCOME PACKAGED LASER SETS 6107254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5130,3 - 5200 W-3, 50 - 66662 Envelopes NEC61055-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110,25- 5131, 50 - 5132, 3 - 5100PARTS 56506-PART SET includes: 50 - 5201, 50 - 5202, 25 - 5203, 50- NEC5111, 150 - NEC5112, 3 - 510050 - 5204, 3 - 5200 FOR 50 EMPLOYEES FOR 25 EMPLOYEES MFG ID 1099-R PACKAGED LASER SET NEC6103254-PART PRE-PACKAGED CONVENIENCE SET includes: PARTS5650E6-PART SET includes: 50 - 5201, 50 - 5202, 50 - 5203, 53174-PART PRE-PACKAGED CONVENIENCE SET Includes: 50-5313, 50 - 5204, 3 - 5200, 50 - 66662 Envelopes 50-5314, 50-5315, 50-5316, 3-5309 25 - NEC5110, 25- NEC5111, 50 - NEC5112 FOR 50 EMPLOYEES56558-PART SET includes: 50 - 5201, 50 - 5202, 150 - 5203, 53186-PART PRE-PACKAGED CONVENIENCE SET Includes: 50-5313,NEC6103E254-PART PRE-PACKAGED CONVENIENCE SET includes:56466-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - 5140,150 - 5204, 3 - 5200 50-5314, 100-5315, 100-5316, 3-5309 25 - NEC5110, 25- NEC5111, 50 - NEC5112,25 - DW19WS Envelopes 50- 5141, 100 - 5142, 100 - 5143, 3 - 51005655E8-PART SET includes: 50 - 5201, 50 - 5202, 150 - 5203,FOR 25 EMPLOYEESFOR 25 EMPLOYEES150 - 5204, 3 -5200, 50 -66662 Envelopes 531725 4-PART PRE-PACKAGED CONVENIENCE SET Includes: 25-5313,MFG ID 1099-NEC BLANK PACKAGED LASER SET * 5644254-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5140, FOR 25 EMPLOYEES 25-5314, 25-5315, 25-5316, 3-5309PARTS 25- 5141, 25 - 5142, 25 - 5143, 3 - 5100 5645254-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, FOR 25 EMPLOYEES5646256-PART PRE-PACKAGED CONVENIENCE SET includes: 25 - 5140,25 - 5204, 3 - 5200 531825 6-PART PRE-PACKAGED CONVENIENCE SET Includes: 25-5313,NEC61745-PART PRE-PACKAGED CONVENIENCE SET includes: 25- 5141, 50 - 5142, 50 - 5143, 3 - 51005645E254-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, 25-5314, 50-5315, 50-5316, 3-5309 50 - NEC5110, 200- NEC5144, 3 - 5100 25 - 5204, 3 - 5200, 25 - 66662 Envelopes TFP 1099-MISC LASER PACKAGED SET FOR ELECTRONIC FILING5650256-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, TFP W-2 PACKAGED LASER SETS FOR ELECTRONIC FILING MFG ID 1099-NEC PACKAGED LASER SET FOR ELECTRONIC FILING * PARTSPARTS PARTS25 - 5204, 3 - 5200 FOR 50 EMPLOYEES FOR 50 EMPLOYEES5650E256-PART SET includes: 25 - 5201, 25 - 5202, 25 - 5203, FOR 50 EMPLOYEES 6112E3-Part PRE-PACKAGED CONVENIENCE SET includes: 5144 (150),5205E4-Part SET includes: 5205 (50), Envelopes 99992 (50) NEC61133-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, 25 - 5204, 3 - 5200, 25 - 66662 Envelopes 77772 (50) Envelopes5207E50PRE-PACKAGED CONVENIENCE SET includes: 5207 (100),50- NEC5111, 100 - NEC5112, 3 - 10965655258-PART SET includes: 25 - 5201, 25 - 5202, 75 - 5203, FOR 25 EMPLOYEESEnvelopes 66662 (50) NEC6113E3-PART PRE-PACKAGED CONVENIENCE SET includes: 50 - NEC5110, 75 - 5204, 3 - 5200 61133E253-Part PRE-PACKAGED CONVENIENCE SET includes:5111 (25), 5112 5655E258-PART SET includes: 25 - 5201, 25 - 5202, 75 - 5203, 5221EPRE-PACKAGED CONVENIENCE SET includes: 5221 (50), 50- NEC5111, 100 - NEC5112, 3 - 1096, 50 - DW19WS Envelopes(50), 77772 (25) Envelopes Envelopes 99992 (50)75 - 5204, 3 - 5200, 25 - 66662 Envelopes FOR 25 EMPLOYEES *Forms have had significant changes that may require reprogramming TFP 1099-NEC LASER PACKAGED SET FOR ELECTRONIC FILING5647E25 3-Part SET includes: 5202 (25), 5203 (25), 5204 (25), EnvelopesPARTS 66662 (25) FOR 25 EMPLOYEESNEC6113E253-Part PRE-PACKAGED CONVENIENCE SET includes:NEC5111 (25), 5205E25 4-Part SET includes: 5205 (25), Envelopes 99992 (25)10 11 NEC5112 (50), DW19WS (25) Envelopes'