b"W-2 PRE-PRINTED & BLANK FORMSW-2 PRE-PRINTED FORMS Individual 2-Up Laser Packs Combined 3-Up & 4-Up Laser22222 VOID aEmployees social security number For Ofcial Use Only LW2ALW2BL b OMB No. 1545-00082 Federal income tax withheld Copy BTo Be Filed With Employee's41-0852411 a Copy 2To Be Filed With Employee's State, 1 241-0852411 L4UP Form c W-2 Wage and Tax Statement 2023 7Social security tips 1Wages, tips, other comp. 2Federal income tax withheld L87cEmployers name, address, and ZIP code 1 Wages, tips, other compensation 4 Social security tax withheld 5201 5222 a FEDERAL Tax Return. 1Wages, tips, other comp. 2Federal income tax withheld City, or Local Income Tax Return. 3 4 Federal income tax withheld Employers name, address, and ZIP code 8Allocated tips 9 3Social security wages 4Social security tax withheld3 Social security wages Employee's soc. sec. no. OMB No. 1545-0008 Employee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-0008dControl number 5 Medicare wages and tips 6 Medicare tax withheld b c Employer ID number (EIN) 5 3Social security wages 6 4Social security tax withheld b c Employer ID number (EIN) 5 Social security wages 6 Social security tax withheld 5205 eEmployees name, address, and ZIP codeSuff. 10 emtaptulotoy S eye r RetirementThird-party 5Medicare wages and tipsC C e e d d o o 6Medicare tax withheld 52067 Social security tips 8 Allocated tips Medicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 11 plans 12a See instructions for box 12 910Front Blank Employer's name, address, and ZIP code Employer's name, address, and ZIP code 13 plansick pay14Other 12be Last name Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C ddooe e Visit the IRS website atLW2Bwith W2 InstructionsdControl number dControl number15StateEmployers state ID no. 16State wages, tips, etc. b Employer number (EIN)CC e e d d o o 12c 20Locality nameaEmployees social security no.aEmployees social security number13 employee plan sick pay 12b Safe, accurate,www.irs.gov/ele17State income tax 18Local wages, tips, etc. 12db 14Other OMB No. 1545-000812c C C ddoe e FAST! Use 2 Federal income tax withheld on back side. eEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff. Copy B To Be Filed With Employees FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. 19Local income taxfEmployees address and ZIP code cEmployers name, address, and ZIP code 1 Wages, tips, other compensation o4 Social security tax withheld 5202 OMB No.1545-008 Dept. of the Treasury - IRS3 12dVisit the IRS Web Site atwww.irs.gov/eleSocial security wages15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 5 Medicare wages and tips 8 Allocated tips LW2NB10 7Social security tips 11 8Allocated tipsplans 12a 9 CodeSee inst. for box 12 10 7Social security tips 11 8Allocated tipsplans 12a 9 Code Form c W-2 Wage and TaxStatement 2023 7Social security tipsnegligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it.19Local income tax 20Locality name6 Medicare tax withheld This information is being furnished to the Internal Revenue Service.7 Social security tips Employers name, address, and ZIP code 8Allocated tips 1Wages, tips, other comp. 2Federal income tax withheld3Social security wages 4Social security tax withheldForm W-2 dControl number 2023 9 StaoryRetirementThird-party10C C ddooe e This information is being furnished to the Internal Revenue Service. If you5207 13Statutory employee 14Other 12bCode 13Statutory employee 14Other 12bCode eEmployees name, address, and ZIP codeSuff. 10 9 e Smtaptulotoyeye r Retirement nuThird-party 5Medicare wages and tipsCCC e e e d d d o o o 6Medicare tax withheldWage and Tax Statement Department of the TreasuryInternal Revenue Servicemay be imposed on you if this income is taxable and you fail to report it. LW2CLW22Retirement plan 12cCode Retirement plan 12cCode 13 Employerplansick pay 11 plans 12a See instructions for box 12 eEmployees name, address, and ZIP code Suff.For Privacy Act and Paperwork Reduction 1112aSee instructions for box 12Copy AFor Social Security Administration. Send this entire page with Act Notice, see the separate instructions.Third-party sick pay 12dCode Third-party sick pay 12dCode 14Other 12bForm W-3 to the Social Security Administration; photocopies are not acceptable. 41-0852411aEmployees social security number13 emptutloyee plan sick pay 12bDo Not Cut, Fold, or Staple Forms on This Page OMB No. 1545-0008 bmber (EIN) 12c22222 VOID b For Ofcial Use Only 14Other 1 Wages, tips, other compensation C C ddooe e 2 Federal income tax withheld 185 1 State Employer's state ID number 19Local income tax 20 1Locality name 7 1 185State Employer's state ID number 19 16State wages, tips, etc. 7State income tax 15StateEmployers state ID no. 16State wages, tips, etc. aEmployees social security no. 18Local wages, tips, etc.C e d o 12d20Locality name12ccEmployers name, address, and ZIP code 3 12d 4 Social security tax withheld 5203 Local wages, tips, etc. 16State wages, tips, etc. State income tax Local wages, tips, etc. Local income tax 20 1Locality name 17State income tax 19Local income taxaEmployees social security number Social security wagesOMB No. 1545-00086 Medicare tax withheld Form W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Form W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRSb 15StateEmployers state ID number 1 Wages, tips, other compensation 2 Federal income tax withheld5 Medicare wages and tips Locality name 8 Allocated tips This information is being furnished to the Internal Revenue Service. a 1 www.irs.gov/ele 2Federal income tax withheld a EmployersState,Local,or File 1 Copy22222 2 1545-0008 Copy C For EMPLOYEE'S RECORDS (See Notice to Employee on back of Copy B.)c 22222Void OMB No.1545-008 Dept. of the Treasury - IRS 2Federal income tax withheldcEmployers name, address, and ZIP code 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20 10EmployersState,Local,or FileCopy22222 2023 1545-0008 Employee's soc. sec. no. Wages, tips, other comp. 2023OMB No. L4UPR 2023 FormW-2 Wage andTaxStatement 7Social security tips 1Wages, tips, other comp. 4Social security tax withheld L87RL3UP3 Social security wages 4 Social security tax withheld 7 Social security tips OMB No.dControl number 5 Medicare wages and tips 9 Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Employers name, address, and ZIP code 8Allocated tips 3Social security wageseEmployees name, address, and ZIP code 6 Medicare tax withheldDepartment of the TreasuryInternal Revenue Service Notice to Employee on the back of Copy B.)(See OMB No. 1545-0008 Copy 2To Be Filed With Employee's State,se 41-0852411 2Federal income tax withhelddControl number Form W-2 Wage and Tax Statement 9employee plan 2023 C C C ddddoooe e e e Safe, accurate,Suff.11St emaptutloyeeoryReirementThird-party9 12aSee instructions for box 12 C C C C ddddooooe e e e 4 Social security tax withheld dControl number aEmployees social security number OMB No. 1545-0008 Safe, accurate,10Visit the IRS website atd b c a Copy CFor EMPLOYEE'S RECORDS5 3 1 d b e c 6 2 5 3Social41-0852411 4 6 Social security tax withheld d b c a 5 3 1 d b e c Employer ID number (EIN) 6 45 2 3SocialOMB No. 1545-0008 4 6 Social security tax withheld Form c e W-2 Wage and TaxStatement e 2023 ID no.Suff. 7Social security tips 9 Ssickpay Suff. 1Wages, tips, other comp.9eRThird-partyCCCC e e e e d d d d o o o o 5Medicare wages and tipsCCCC e e e e d d d d o o o o 6Medicare tax withheld Se instructions for box 12e Last name Suff. 7 Social security tips VOID 8 Allocated tips platn sick pay 12b 2 Federal income tax withheld LW2D1b FAST! Use www.irs.gov/eleLW2BC Employee's soc. sec. no. Employer ID number (EIN) security wages City, or Local Income Tax Return. curity wages Medicare tax withheld 5405 Employers name, address, and ZIP code Employees name, address, and ZIP code 8Allocated tips 3Social security wagesSick pay 1112aSee instructions for box 125406 5210Copy BTo Be Filed With Employees FEDERAL Tax Return.10aEmployees social security number13 OMB No. 1545-0008Wages, tips, other comp. Federal income tax withheld Medicare tax withheld Wages, tips, other comp. Federal income tax withheld 10 Smtaptluotyoerye Pleatnirement4Social security tax withheld plans 12bThis information is being furnished to the Internal Revenue Service. Medicare wages and tips Employee's soc. sec. no. Medicare wages and tips22222 Social security wages Social security tax withheld Employer ID number (EIN) Social security wages Social security tax withheld 5Medicare wages and tips 14Other11b 12aSee instructions for box 1214Other 1 Wages, tips, other compensation 1 Wages, tips, other compensation 2 Federal income tax withheld Employer ID number (EIN) Employer's name, address, and ZIP code4 Medicare tax withheld Employer's name, address, and ZIP code 10 13plans 6Medicare tax withheld 12c12c Medicare wages and tips Medicare wages and tips Medicare tax withheld 1112ab aEmployees social security number13StatutorycEmployers name, address, and ZIP code C 17State income tax www.irs.gov/ele3 Social security wages 20Locality name 6 Medicare tax withheld 5204 cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld 5212 Employer's name, address, and ZIP code Employer's name, address, and ZIP code Employees name, address, and ZIP code State Employersstate 13emtaptulotyoreye Retirement Third-party b 12b 12d 20Locality namesick pay 12d 14OtherRetirementThird-party12b FAST! Use Visit the IRS website at5 Medicare wages and tips 6 Medicare tax withheld Control number Control number15 b Employerplan aEmployees social security no. 18Local wages, tips, etc. 19Local income taxOMB No. 1545-0008 5 Medicare wages and tips 12c15StateEmployers state ID number 16State wages, tips, etc. 2 Federal income tax withheld19Local income tax 16State wages, tips, etc. number (EIN) 17State income tax14Other 1 Wages, tips, other compensation 18Local wages, tips, etc.12c7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips Employee's name, address, and ZIP code Suff. Employee's name, address, and ZIP code Suff. aEmployees social security no. 12d cEmployers name, address, and ZIP code dControl number 3 12d o4 Social security tax withheld 109 Control number Control number15StateCOPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionActNotice,seeseparateinstructions. OMB No. 1545-008 Social security wages Dept. of the Treasury - IRS Employers state ID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality namefEmployees address and ZIP code 16State wages, tips, etc.Form W-2 Wage and Tax Statement 5Sta plan 2023 C doe e 6 Medicare tax withheldDepartment of the TreasuryInternal Revenue Service 12aSee instructions for box 12 C C C ddddoooe e e e eEmployees name, address, and ZIP code Suff.11emptutloyeeoryplanrementThird-party12aSee instructions for box 12 C C C C dddoooe e e e 10 e 7 Employee's name, address, and ZIP code 8 7 14 12a 9 11 8Allocated tipsplans Suff. 12a 9 1 e 7 Employee's name, address, and ZIP code e 1 7 14Ot1h2 11 8Allocated tipsplans Suff. 12a 9 Code See inst. for box 12Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return c c e 9 8Allocated tips 22222Void OMB No. 9 1545-0S 08R Platnirement e Sick pay Dept. of the Treasury - IRSCC e e d d o o 2Federal income tax withheld 202315StateEmployers state ID number 17State income tax 18Local wages, tips, etc.19Medicare wages and tips Suff. Safe, accurate,plan sick pay 12b 13Sta Reti sick pay 12b 10 Code See inst. for box 12 10 Form 7Social security tips 1Wages, tips, other comp. 4Social security tax withheldLocal income tax 20Locality name 11 eEmployees name, address, and ZIP code7 Social security tips 8 Allocated tipsdControl number Copy CFor EMPLOYEES RECORDS (See or CopTax y 2 Notice to to be Filed With 10FAST!Use RetirementThird-partySocial security tips Social security tips 2023W-2 Wage andTaxStatement 8Allocated tips 3Social security wagesEmployee on the back of Copy B.)Return 9 13StatutoryEmployers name, address, and ZIP codeEmployees State, City or Local IncomeemployeeForm W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue ServiceC do14Other 12c C o14Other 12c doSocial security tips 1113 Allocated tips Other CodeSee inst. for box 12 12b Social security tips 11 83Allocated tips 9ear Code 12bCode Form W-2 Wage and TaxStatement 2023 7Social security tips 1Wages, tips, other comp. 5Medicare wages and tips 6Medicare tax withheld1112aSee instructions for box 12 Statutory employee 2Federal income tax withheldeEmployees name, address, and ZIP code Suff.For Privacy Act and Paperwork Reduction12d Statutory emplo plansyee Code Retirement p planslan 12cCode Employers name, address, and ZIP code 3Social security wages 1112aSee instructions for box 12Act Notice, see the separate instructions.12dCopy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411aEmployees social security numberRetirementThird-party 5201This information is being furnished to the Internal Revenue Service. If you13Statutory employee 14Other Retirement plan 12bCode 12c1C0ode 14Other Third-party sick pay 12bCode 12dCode Employees name, address, and ZIP code Suff. 10 emtaptluotoyeryeThird-party 4Social security tax withheld plans 12bForm W-3 to the Social Security Administration; photocopies areLW2A 13 emptutloyeeorysick pay 12b 5Medicare wages and tips 14OtherOMB No. 1545-0008may be imposed on you if this income is taxable and you fail to report it. Third-party sick pay 12dC3odStatutory employee 13 6Medicare tax withheldb 15State 14Other 1 Wages, tips, other compensation C ddoe e 18Local wages, tips, etc.19Local income tax 20Locality name 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name Retirement plan 18Local wages, tips, etc. 12cCode 20Retirement plan 18Local wages, tips, etc. 12cCode 20 Locality name 10 pay bplansCC e e d d o o 12aCC e e d d o o 12cEmployers state ID number 12c 17State income tax2 Federal income tax withheld 11 16State wages, tips, etc.15State cEmployers name, address, and ZIP code Wage and Tax Statement 3 12d C o20Locality name 4 Social security tax withheld Act Notice, see separate instructions. b 33333 a Control number 943 944 DO NOT STAPLE None apply501c non-govt. Third-partyLW3 Form Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 1 158 Third-party sick pay 19 15State Employer's state ID number12d 7 Code State wages, tips, etc. 17 1 Third-party sick pay 15State Employer's state ID number12dCode State wages, tips, etc. 17State income tax eEmployees name, address, and ZIP code State EmployersstateID no.Suff.13e Smtaptulotyoreye RetirementThird-party aEmployees social security no. Notice,CC e e d d o o 12b separateinstructions. 12d 0820Locality nameSocial security wages For Ofcial Use Only: This information is being furnished to the Internal Revenue Service. State Employer's state ID number Local income tax 19 16 State income tax Local income tax 19 16 Dept. of the Treasury IRS bEmployerplan sick 14Other Act 18Local wages, tips, etc. 19Local income tax5 Medicare wages and tips 6 Medicare tax withheld Local income tax Locality name Local income tax 12cEmployers state ID number 16State wages, tips, etc.17State income tax or 18Local wages, tips, etc. 13 19Local income tax St 2023 C C ddoe e Department of the TreasuryInternal Revenue Servicee (Check one) 941 Military govt. emp. OMB No. 1545-0008 State/localState/local 501cFederal govt. sick payW-2 aEmployees social security number OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If youLocal wages, tips, etc. a For Privacy Act and Paperwork Reduction 1 Copy22222 2 158Dept.Local wages, tips, etc. 19Form W-2 Wage and Tax Statement a 1 State income tax 5205 2 2023OMB No.15StateEmployer15 c Form 16State wages, tips, etc. 16State wages, tips, etc. number (EIN) 17State income tax 5206 12dDept.oftheTreasury-OMB No. 1545-0Form W-2 LocalTaxDepartment 7 Social security tips 8 Allocated tips For Privacy Act and Paperwork ReductionCopy BTo Be Filed With Employees FEDERAL Tax Return.Form W-2 Wage and Tax Statement State income tax State Employer's state ID number 16State wages, tips, etc. 20 17Locality name aEmployees social security no. see Dept. of the Treasury - IRS16State wages, tips, etc. 20 1Locality nameof the Treasury IRS Act Notice, see separate instructions.Form W-2 dControl number Copy1ForState, LW2B Suff. 9 emaptutloyeeoryRe Third-party10oKind of PayerCT-1 Hshld.MedicareKind of Employernon-501c 2 Federal income tax withheld applicable)520010Form W-2 Wage and Tax Statement Act Notice, see separate instructions. Dept. of the Treasury IRS Form W-2 Wage and Tax Statement For Privacy Act and Paperwork Reduction Copy22222 1545-0008 COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork Reduction 19Local income tax 20Locality name 2Federal income tax withheldCopyDForEmployer.City, (Check one) (Check if2023 2023 Dept. of the Treasury IRS s state ID no. 17State income tax 18Local wages, tips, etc.Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service c Total number of Forms W-2 emp. 1 Wages, tips, other compensation 4 Social security tax withheld may be imposed on you if this income is taxable and you fail to report it. penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. L4UP OMB No. EmployersState,Local,or FileCopy 2 To Be Filed With Employee's State, City, or Local Income Tax Return L87 22222Void OMB No.1545-008 1Wages, tips, other comp. IRS 4Social security tax withheldeEmployees name, address, and ZIP code VOID 11platnirementsick pay 12aSee instructions for box 12 d Establishment number 3 Social security wages orEmployersState,Local,or File 2023 1545-0008 Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld 2023W-2 Wage andTaxStatement 7Social security tips 3Social security wagesCopy BTo Be Filed With Employees FEDERAL Tax Return.aEmployees social security number 520212b Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Employers name, address, and ZIP code 8Allocated tipsThis information is being furnished to the Internal Revenue Service.b 22222 14Other OMB No. 1545-0008C C ddooe e 2 Federal income tax withheld fEmployers name 9 5 Medicare wages and tips 106 Medicare tax withheld b 1 Wages, tips, other compensation 2 Federal income tax withheld b c Employer ID number (EIN) 3 5 Social security wages 4 6 Social security tax withheld b c Employer ID number (EIN) 3 5 Social security wages 4 6 Social security tax withheld eEmployees name, address, and ZIP code Suff. 10 9e Smtaptluotyoerye P Rleatnirement Third-party 5Medicare wages and tipsCCC e e e d d d o o o 6Medicare tax withheld 2023cEmployers name, address, and ZIP code 1 Wages, tips, other compensation 4 Social security tax withheld 7 Social security tips 8 Allocated tips 520025 cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Medicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 13Sick pay 11 plans 12aSee instructions for box 12 12c12d3 Social security wages 5 Medicare wages and tips 6 Medicare tax withheld 14Other 12bEmployer's name, address, and ZIP code Employer's name, address, and ZIP code15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax Locality name6 Medicare tax withheld b 12c5 Medicare wages and tips207 Social security tips 8 Allocated tips 1112a Deferred compensation 7 Social security tips 8 Allocated tips aEmployees social security no.C e d o 12dg dControl number 9 10 Wage and Tax Statement Department of the TreasuryInternal Revenue Service 12aSee instructions for box 12 h Employers address and ZIP code 14 Income tax withheld by payer of third-party sick pay oryplan sick pay 12b Employee's name, address, and ZIP code Employee's name, address, and ZIP code COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork Reduction Notice,seeseparateinstructions. Dept. of the Treasury - IRSForm W-2 dControl number 2023 Suff. 13 9 StatutoryRetirementThird-party5203 10C C C dddooe e e eOther EIN used this year 17 State income tax 13 For third-party sick pay use only 12b eEmployees name, address, and ZIP code 16State wages, tips, etc. Suff.11Statutloyee RetirementThird-party12aSee instructions for box 12 C C C C ddddooooe e e e 10 d e 7 Control number 14 11 8Allocated tipsplans 12a 9 Code See inst. for box 12 Suff. 10 d e 7 Control number 14 11 8Allocated tipsplans 12a 9 Code See inst. for box 12 Suff.15 c State Form EmployersstateID no. 16State wages, tips, etc. Void17State income tax 9Act 18Local wages, tips, etc. 19Local income tax 20Locality name Se instructions for box 12Copy CFor EMPLOYEES RECORDS (See Notice toSafe, accurate,15 State Employers state ID numberOMB No. 1545-008 eEmployees name, address, and ZIP code FAST!Use11 Employee on the back of Copy B.)LW2C/LW22 employee plan sick pay 12b 16 State wages, tips, etc. 18 Local wages, tips, etc. 19 Local income tax 13 empEmployees State, City or Local Income or CopTax y 2 tReturno be Filed With14Other 12c14Other 12c C doEmployers contact person Employers telephone number 12d Social security tips Social security tips 2023W-2 Wage andTaxStatement22222 7Social security tips 1Wages, tips, other comp. 2Federal income tax withheld12d oEmployers fax number Employers email address Employers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheldUnder 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, and15StateEmployers state ID number 17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 13Statutory employee Other 12bCode 13Statutory employee Other 12bCode 5Medicare wages and tips 6Medicare tax withheld15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name complete. Title: Date: Copy CFor EMPLOYEES RECORDS (See Notice toDepartment of the TreasuryInternal Revenue Service 15 Retirement plan 19 16State wages, tips, etc.12c 17 Code 15 Retirement plan 19 16State wages, tips, etc.12c 17 Code eEmployees name, address, and ZIP code Suff. 10e Smtaptulotoyerye RPlatnirement e Third-party 11 plansCCCC e e e e d d d d o o o o 12aSee instructions for box 12 Signature:12d 12d 13 14Other 12bForm W-3 Transmittal of Wage and Tax Statements 2023 Department of the TreasuryForm Wage and Tax Statement Safe, accurate,Third-party sick pay Code Third-party sick pay Code b Sick pay 12cForm Wage and Tax Statement Department of the TreasuryInternal Revenue ServiceSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA). Internal Revenue Service W-2 2023 LW2BC FAST!Use 5212 18 State Employer's state ID number Local income tax 20State income tax 18 State Employer's state ID number Local income tax 20State income tax aEmployees social security no. 12dCopy W-2 orLocalTaxDepartment 2023 LW2D1For Privacy Act and Paperwork ReductionPhotocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA.Employee on the back of Copy B.)Local wages, tips, etc. Locality name Local wages, tips, etc. Locality nameCopy 1ForState, Act Notice, see separate instructions.5204 Reminder Employees State, City or Local Income or CopyTax2 toReturn be Filed With15State EmployersstateID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality nameDForEmployer.City, Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.Separate instructions. See the 2023 General Instructions for FormsForm W-2 Wage and Tax Statement Dept. of the Treasury IRS For Privacy Act and Paperwork Reduction L4UPR COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionAct Notice,seseparateinstructions.L87R 5406 OMB No. 1545-0Dept. of the Treasury - IRS08 2023Form W-2 Wage and Tax StatementW-3 for Form(s) W-2 that were submitted electronically to the SSA. For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Dept. of the Treasury IR5405SW-2Act Notice, see separate instructions.Purpose of FormDWCL or DWCLS paper forms must notcomply with IRS standards and be machine readable. Photocopies are acceptable. Use a Form W-3 even if only oneDW4S or DW4SS DW3 or DW3S66661 or 66662 required envelope number (EIN). Make a copy of this form and keep it with Copy D (ForWhen To File Paper FormsEmployer) of Form(s) W-2 for your records. The IRS recommends retaining copies of these forms for 4 years. Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2024. 99991 or 99992 required envelope 33331 or 33332 required envelopeE-FilingThe SSA strongly suggests employers report Form W-3 and Forms W-2Where To File Paper FormsCopy 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: W-2 Online. toSocial Security Administration50 Forms W-2 at a time to the SSA. Direct Operations Center File Upload. usingWilkes-Barre, PA 18769-0001Specications for Filing Forms W-2 Electronically (EFW2).the SSAs 18769-0002. If you use an IRS-approved private delivery service, addNote: 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 change Register Log In. the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers TaxGuide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. MFG SKU Sheets PER packMFG ID Forms PER pack LW3 41-0852411 52005 Transmittal W-3 forms are included with each Red Federal Copy A form order 50s500s100s500sFORM DESCRIPTION(see page 12 for required envelope)L4UPAL4UPA5005205A5205ABW-2 4-Up Box Employee Copy B, C and 2 or Extra Copy (P Style) MFG SKU Sheets PER packMFG ID Forms PER packL4UPL4UP50052055205BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy 50s500s100s1000sFORM DESCRIPTION(see page 12 for required envelope) L87L8750052065206BW-2 4-Up Horizontal Employee Copy B,C, 2 and 2 or Extra Copy (5 00 formsLW3LW3500520010 or 5200255200BPER package) Laser W-3 Transmittal of Income And Tax StatementL87BL87B50052085208BW-2 4-Up Horizontal Blank w/ Printed Backer Employee Copy B,C, 2 and 2 or Extra CopyLW2ALW2A50052015201BW-2 Federal IRS Copy A L4BLL4BL50052095209BW-2 4-Up Box Blank w/ Printed BackerLW2BLW2B50052025202BW-2 Federal Employee Copy BL3UPL3UP50052105210BW-2 3-Up Horizontal Employee Copy B, C and 2 LW2CLW22LW2CW2250052035203BW-2 Employee Copy C and/or State, City, Or Local Copy 2 L3BLL3BL50052115211BW-2 3-Up Horizontal Blank w/ Printed Backer Information (w/ Stub)LW2D1LW2D150052045204BW-2 Employer Copy D and/or State, City Or Local Copy 1#N/A#N/A5213#N/AW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (T Style) LW2NBLW2NB50052075207BW-2 Blank w/o Printed Backer L275L27550052145214BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (M Style) LW2BCLW2BC50052125212BW-2 Employee Copy B and Copy C Combined L4UPWL4UPW50052165216BW-2 4-Up Box Employee Copy B, C, 2 and 2 or Extra Copy (W Style) LW2BLLW2BL50052225222BW-2 Blank w/ Printed BackerL4DNL4DN50052185218BW-2 4-Up Horizontal Employee Copy B, C, 2 and 2 or Extra Copy (N Style)OUR BASIC W-2 FORM W-2 COPY OPTIONS L4BLNBL4BLNB50052215221BW-2 4-Up Box Blank w/o Printer BackerEach sheet contains information for two employees. All copies are printed separately and theL4UPARL4UPAR5005405A5405ABW-2 4-Up Box Employer Copy D and/or State, City, Local Copy 1 (P-Style Four Employees PER page)employee copies must be collated for envelope insertion. Forms are sold in packages of 50Simplify your Employee Copies with our Form LW2BC/5212. This form provides Employee CopyL4UPRL4UPR50054055405BW-2 4-Up Box Employer Copy D and/or State, City, Local Copy 1 (Four employees PER page)8-1/2 x 11 sheets yielding 100 individual W-2 forms. Bulk packages of 500 sheets yielding 1,000B and Employee Copy C on a single sheet. One employee PER page. L87RL87R50054065406BW-2 4-UP HORIZONTAL Employer Copy d and/or State, city, Local Copy 1 (four employees PER page)forms are available.W-3 TRANSMITTAL FORMHOW MANY COPIES DO I NEED? Form LW3/520010 or 520025 Transmittal of Income and Tax Statement forms are included with For states with no state or local tax youll use a 4-part form. the purchase of the Red Federal IRS Copy A orders at no charge. Additional copies may be4-UP BOX 3-UP HORIZONTALFor states with State Income Tax youll use a 6-part form. ordered separately. These pre-printed and blank combined formats are designed to print all employees copies onAvailable as a pre-printed form or as a blank form with Perforations and Backer copy. Provides For states with local or city tax youll use an 8-part form. W-2 BLANK FORMS FOR YOUR SOFTWARE one sheet. These pre-printed and blank combined formats eliminate collating and are availableEmployee Copy B, C, and 2 with one employee PER page. These pre-printed and blank combined Blank forms are available for use with your software and feature a center perforation. Blank formsfor Employee Copies (one employee PER page) and Employer Copies (four employees PERforms are ideal for electronic filing (if filing Copy A to the Social Security Administration, you must OK, SO HOW MANY DO I ORDER OF EACH FORM?are available with and without Copy B, Copy C and Copy 2 backer information. Two employeespage). For example, the L4UP/5205 contains employees Copies B, C, 2 and 2 pre-printed on oneuse the official format Federal Copy A). Refer to page 12 for required envelope. Note: blank If you need to order all parts for 100 Employees for a 4-part form youll order 100 forms each ofPER page. Order 100 forms for 100 employees sheet. Just fold and put in a matching window envelope. formats may not work with our stock envelopes, please request samples for testing.the Copy A, Copy B, Copy C and Copy D. For a 6-part form youll order 100 forms each of the4-UP HORIZONTALCopy A and Copy B and 200 each of the Copy C and/or Copy 2 and D and/or Copy 1 for 100Available as pre-printed forms or as a blank form with Perforations and Backer copy. For employees. Finally, for an 8-part form, youll order 100 forms each of the Copy A and B and 300example, the L87R/5406 contains employees Copies D, D, 1 and 1 pre-printed on one sheet. forms each of the Copy C and/or Copy 2 and D and/or Copy 2 for 100 employees. Available in regular and bulk packages.4 5"