b"W-2 PRE-PRINTED FORMS W-2 PRE-PRINTED FORMSCombined 4-Up Laser Alternate 4-Up Laser Combined Formata Copy BTo Be Filed With Employee's 1 5 3 2 6 441-0852411 b a Copy 2To Be Filed With Employee's State, 5 3 1 6 4 241-0852411 APEX L4UP Form c W-2 Wage and Tax Statement 2023 7Social security tips 9 S r Third-party 1 Wages, tips, other comp.C C e e d d o o 2Federal income tax withheld APEX L87 OMB No. 1545-0008 1 3 Wages, tips, other compensation 2Federal income tax withheld OMB No. 1545-0008 1 3 Wages, tips, other compensation 2Federal income tax withheld APEX L275 9 8 7 OMBNo.1545-0008 Form 1 3 W-2Wageand Tax Statement2023 9 8 7 OMBNo.1545-0008 Form 1 3 W-2Wage 2 VisittheIRSWebSite APEX L4UPW FEDERAL Tax Return. OMB No. 1545-0008 City, or Local Income Tax Return. Federal income tax withheld Employers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheld Department of theTreasury - Internal Revenue Service Department of theTreasury - Internal Revenue Service at Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Employee's soc. sec. no. Wages, tips, other comp. OMB No. 1545-0008b c Employer ID number (EIN) Social security wages Social security tax withheld c Employer ID number (EIN) Social security wages Social security tax withheld TFP 5205 eEmployees name, address, and ZIP codeSuff. 10 emtaptulotoyeye Retirement sickpay 5Medicare wages and tips 6Medicare tax withheld TFP 5206 Socialsecuritywages 4 Social security tax withheld Socialsecuritywages 4 Social security tax withheld TFP 5214 Socialsecuritytips Wages, tips, other comp. 2 Federal income tax withheld Socialsecuritytips Socialsecuritywages and Tax Statement2023 TFP 5216Wages, tips, other comp. Federal income tax withheldMedicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 11 plans 12a See instructions for box 125 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld Allocatedtips Socialsecuritywages 4 Social security tax withheld Allocatedtips 4 Social security tax withheldEmployer's name, address, and ZIP code Employer's name, address, and ZIP code 13 plan 14Other 12b c Employers name, address, and ZIP code c Employers name, address, and ZIP code 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheldb Employer number (EIN)C ed d o 12c c Employers name, address, and ZIP code c Employers name, address, and ZIP codeaEmployees social security no.C e o 12d7Socialsecuritytips 8Allocatedtips 9 7Socialsecuritytips 8Allocatedtips 9dControl number dControl numbereEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff.15State Employers state ID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name C e d o 10Dependentcare C d o e 11 plans C e d o C e d o 12a 10 C e d o Dependentcare r a p C e d o 11 y arty14Other plans 12a C e d o C e d o 10Dependentcare 11 plansCCC12a o o o e e e d d d Seinstructionsforbox1210Dependentcare 11 plansCCC12a o o o e e e d d d Seinstructionsforbox12Copy B To Be Filed With Employees FEDERAL Tax Return This information is being furnished to the Internal Revenue Service. Dept. of the Treasury - IRS 12b 12c 12d 12b 12c 12dOMB No.1545-008Visit the IRS Web Site atwww.irs.gov/eleThis information is being furnished to the Internal Revenue Service. b Employers n number (EIN) a Employees social security number b Employers iden n number (EIN)a Employees social security number b Employ umber (EIN)12bb Employ number (EIN)12bnegligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. a Employees social security number12ca Employees social security number12c 10 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 Tax Statement 2023 7Social security tips 1 Wages, tips, other comp. 2Federal income tax withheld 13Smt e apt l u otyoery e R pl eatnirement T shicir kdp- a p y arty 14Other Suff. 13S em tapt l uotyoery e R pl eatnirement T shici kdp- Suff. 14OtherC12de d o Smt e aptluotyoeyr R platnireement T si hcikrdp-apyarty 14OtherC12de d o S emaptt l u otyoery e Rleatinrement p T si hci k rdp- a p y artyEmployers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheld13Statutory employee 14Other 12bCode 13Statutory employee 14Other 12bCode 9 5Medicare wages and tips 6Medicare tax withhelde Employees name, address, and ZIP code e Employees name, address, and ZIP code 13 13Retirement plan 12cCode Retirement plan 12cCode 10pay11 plansCC e e d d o o 12a See instructions for box 12e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff.Third-party sick pay 12dCode Third-party sick pay 12dCode eEmployees name, address, and ZIP codeSuff.13e Smtaptulotoyeye r Retirement Third-party 14Other 12bplansickb Employer number (EIN)C ed o 12c 15State Employers state ID number 16 State wages, tips, etc. 15State Employers state ID number 16 State wages, tips, etc.1 158 State Employer's state ID number 19 16State wages, tips, etc. 7State income tax 158 1State Employer's state ID number 19 16State wages, tips, etc. 7State income tax 15State Employers state ID no. 16State wages, tips, etc. aEmployees social security no. 18Local wages, tips, etc.C e d o 12d20Locality name S W-2 Tax 17 State income tax 18Localwages,tips,etc. S W-2 Tax 17 State income tax 18Localwages,tips,etc. 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income tax 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income taxLocal wages, tips, etc. Local income tax 20 1Locality name Local wages, tips, etc. Local income tax 20 1Locality name17State income tax 19Local income tax Wtaatgeemaenndt Wtaatgeem aenndtForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS Form W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS C 19 Local income tax 20Localityname Ciotypy, o 2rTLoocBael FInilceodm wei tTha ExmRpeltouyren.e's State, C 19 Local income tax 20Localityname 18Localwages,tips,etc. 19 Local income tax 20Localityname 18Localwages,tips,etc. 19 Local income tax 20LocalitynameThis information is being furnished to the Internal Revenue Service. www.irs.gov/ele Copy C For EMPLOYEE'S RECORDS (See Notice to Employee on back of Copy B.)OMB No.1545-008 Dept. of the Treasury - IRS 2023 2023Coitpyy, o2r TLoo cBael FInicleodm wei tTha ExmRpeltouyrne.e's State,OMB No. 1545-0008 Employee's soc. sec. no. 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This information is being furnished to the Internal Revenue Service 2023 41-0852411 a City, or Local Income Tax Return. 3 1 4 241-0852411 Form c W-2 Wage and Tax Statement 2023 7Social security tips 9 1 Wages, tips, other comp. 2Federal income tax withheld OMB No. 1545-0008 b 1 3 Wages, tips, other compensation 2Federal income tax withheld i OMB No. 1545-0008 r y s SnI a re ntosi x 1 3Socialsecuritywages Department of the 2 Treasury - Internal Revenue Service7 COPY Cr T For EMPLOYEE'S eni 1 RECORDS n Wage 2Dept. of theTreasury - IRS 7 COPYBTo Beled withemployees 1 FEDERALTaxReturn 2Dept. of theTreasury - IRSa Copy CFor EMPLOYEE'S RECORDS3 1 4 2Federal income tax withheld b Copy 2To Be Filed With Employee's State, OMB No. 1545-0008 5Medicare wages and tips 6Medicare tax withheld TheiinsIginntfefuorrnrnmaislahteiodntios securitywages 4 Social security tax withheld being informfeiysvahoeeungeer this5 Medicare wages and tips 4 Social security tax withheld OMBNo.1545-0008 Form tor nlrtyaelpooRr reotvtithe.neur esaSnecrtviiocnem. Iaf yyobue aimreposed Notice to Employee OMBNo.1545-0008 Form W-2Wageand Tax StatementNotice to Employee on the back of Copy B.)(See Social security wages Social security tax withheld peetnuran, furntIo tioduaaneretcae Socialsecuritytips and Tax Statement2023 Socialsecuritytips Wages, tips, other comp. Federal income tax withheldEmployee's soc. sec. no. Wages, tips, other comp. Social security tax withheld Employer ID number (EIN) 12a Revenue 5 Medicare wages and tips 6 Medicare tax withheld an ela.Rnomrengaoyytlihou 6 Medicare tax withheld 8Allocatedtips 3 Wages, tips, other comp. Federal income tax withheld 8Allocatedtips 3Socialsecuritywages 4 Social security tax withheldeetqeruvrniircedoSocial security wages inou cofamielntiostapxaobrtleiat.ndbEmployer ID number (EIN) 5Medicare wages and tips 6Medicare tax withheld 5Medicare wages and tips 6Medicare tax withheld eEmployees name, address, and ZIP codeSuff. 10 emtaptulotyoreye planThird-party11 plansCC e e d d o o 12b c Employers name, address, and ZIP code c Employers name, address, and ZIP code 9 Socialsecuritywages 4 Social security tax withheld 9 5 Medicare wages and tips 6 Medicare tax withheldcEmployer's name, address, and ZIP code cEmployer's name, address, and ZIP code 13S Retirement sickpay 14Other 5 Medicare wages and tips 6 Medicare tax withheldb Employer number (EIN)C ed o 12c 7Socialsecuritytips 8Allocatedtips 9 7Socialsecuritytips 8Allocatedtips 9 c Employers name, address, and ZIP code c Employers name, address, and ZIP coded e Control number Suff. d e Control number Suff.15State Employers state ID no. 16State wages, tips, etc. aEmployees social security no. 18Local wages, tips, etc.C e d o 12d20Locality name C e d 10 o Dependentcare C e d o 11 plans C e d o C e d o 12a Se instructions for box 12C e d o 10Dependentcare C e d o 11 plans C e d o C e d o 12aSeinstructionsforbox 1210Dependentcare 11 plansC12a o e d 10Dependentcare 11 plansC12a o e d17State income tax 19Local income tax 12b 12c 12d 12b 12c 12dEmployee's name, address, and ZIP code Employee's name, address, and ZIP code b Employersiden n number (EIN)a Employees social security number b Employersiden n number (EIN) a Employees social security number Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return OMB No.1545-008 Dept. of the Treasury - IRS 13S em tapt l uotyoery e Rleatni p rement T shicir kdp-ap y arty 14Other 13Smt e apt l uotyoery e R pl eatnirement T shicir kdp-ap y arty 14Other b Employ number (EIN)C12bo e d b Employ number (EIN)C12bo e d7Social security tips 8Allocated tips 9 7Social security tips 8Allocated tips 9 c Form W-2 Wage and Tax Statement 2023 7Social security tips 1 Wages, tips, other comp. 2Federal income tax withheld e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff. a Employees social security numberCC12co e e d d o y e Rleatnirement p T si hci k rdp-apyarty a Employees social security numberCC12co e e d d o Smt e apt l uot y o e ry e Rlatinrement p e T si hci k rdp-apyarty10 11plans 12aCodeSee inst. for box 12 10 11plans 12aCode Employers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheld 14Other12d14Other12d 13Statutory employee 14Other 12bCode 13Statutory employee 14Other 12bCode 9 5Medicare wages and tips 6Medicare tax withheld 13Smt e apt l uot y oer 13Retirement plan 12cCode Retirement plan 12cCode 10 r Retirement Third-party 11 plansCC e e d d o o 12a 15State Employers state ID number 16 State wages, tips, etc. 15State Employers state ID number 16 State wages, tips, etc. e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff.Third-party sick pay 12dCode Third-party sick pay 12dCode eEmployees name, address, and ZIP codeSuff.13e Smtaptulotoyeye plansick pay14OtherC e d d o 12b 2Federal income tax withheld S W-2 17 State income tax 18Localwages,tips,etc. W-2 17 State income tax 18Localwages,tips,etc. 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income tax 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income tax185 1 State Employer's state ID number 19 16State wages, tips, etc. 7State income tax a EmployersState,1 Local,or FileCopy22222 2023 1545-0008 7 a EmployersState,Local,or File 1 Copy22222 2 2023 1545-0008 APEX L4UPR c 2023 bEmployer number (EIN) Statement22222Void C e o 12c 1 Wages, tips, other comp. 4Social security tax withheld APEX L87R Wtaatgeem aenndt Tax 19 Local income tax 20Localityname W 19 Local income tax 20LocalitynameStaatgeem aenndt TaxLocal wages, tips, etc. Local income tax 20 1Locality name Employee's soc. sec. no.158 State Employer's state ID number 3 16State wages, tips, etc. 4 OMB No. Employee's soc. sec. no. 3 Wages, tips, other comp. 4 OMB No.15State Employers state ID no. 16State wages, tips, etc. aEmployees social security no. 18Local wages, tips, etc. 12d9R 20Locality name e3Social security wagesCC e ed d o o 6 Medicare tax withheld Copy B To Be Filed withOMB No. 1545-0008 Copy C For EMPLOYEE'S RECORDS. Act Notice, se separate instructions. OMB No. 1545-0008 5214For Privacy Act and Paperwork ReductionAct Notice, se separate instructions. 18Localwages,tips,etc. 19 Local income tax Income 20Localityname Form 18Localwages,tips,etc. 19 Local income tax 2023 20Localityname FormW-2 Wage and Tax Statement2023State income tax FormW-2 Wage and Tax7Social security tipsForm W-2 Wage and Tax Statement 2023 Dept. of the Treasury IRS b Local wages, tips, etc.1 5 Wages, tips, other comp.19Local income tax2 6 Federal income tax withheld20 1Locality name bEmployer ID number (EIN) 5 Social security wages 6 Federal income tax withheld Employers name, address, and ZIP code OMB No.1545-008 5206 8Allocated tips Treasury-IRS 5Medicare wages and tips 12aSe e instructions for box 122023 2023 2 Federal income tax withheld 1 Wages, tips, other compensation 2 Federal income tax withheld APEX L276 22222W-2 Wage and Tax Statement 22222 APEX L4UPWRpenalty or other sanction may be imposed on you if this income is taxable and you fail to report it. Form W-2 Wage and Tax Statement Social security tax withheld 5205 Medicare wages and tips Social security tax withheld TFP 5405Copy 2 To Be Filed With Employee's State, City, or Local Income Tax Return 17State income tax 19Local income tax Dept.oftheThird-party 11 plans 12b TFP 5406 Employee's FEDERAL Tax Return. 22222 (See Notice to Employee on back of Copy B). 22222 3 Social security wages 4 Social security tax withheld Copy2 ForEmployee's State,CityorLocal Tax Return Dept. of theTreasury - IRS 1 Wages, tips, other comp. 2 Federal income tax withheld Tax Return Dept. of theTreasury - IRS 1 Wages, tips, other comp. 2 Federal income tax withheldEmployer ID number (EIN) Social security wages 2023 Dept. of the Treasury IRS Medicare tax withheld L87 10 L275For Privacy Act and Paperwork ReductionL4UP Medicare wages and tips Medicare tax withheld 1 Wages, tips, other compensationcEmployer's name, address, and ZIP code cEmployer's name, address, and ZIP code eEmployees name, address, and ZIP code Suff.13 e Smtaptluotoyerye Platnirement Sick pay 14OtherC e e d d o o 12c 3 Social security wages 4 Social security tax withheld 5 Medicare wages and tips 6 Medicare tax withheld TFP 5215 9 7 Social security tips Copy2 ForEmployee's State,CityorLocalIncome 9 7 Social security tips 52163 Social security wages 4 Social security tax withheld TFP 5217b 5 Medicare wages and tips 6 Medicare tax withheld 8 Allocated tips 3 Social security wages 4 Social security tax withheld 8 Allocated tipsL4UPWaEmployees social security no.C 12dc Employers name, address, and ZIP code c Employers name, address, and ZIP code 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withhelddControl number dControl number c Employers name, address, and ZIP code c Employers name, address, and ZIP codeeEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff.15State EmployersstateID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality nameCOPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionActNotice,seeseparateinstructions. OMB No. 1545-0087 Social security tips 8 Allocated tips 97 Social security tips 8 Allocated tips 9 Dept. of the Treasury - IRS10 Dependent care11 plans C o 12a Se instructions for box 12 10 Dependent care11 plans 12a C e d oSe instructions for box 12 10 Dependent 11 plansC12a o edSe instructions for box 1210 Dependent care11 plansC12a o edSee instructions for box 12 Form e d o 12b C d o e 12c e d C e d o 12d C e 12b d o C e d o 12c 12d C e d o b Employ number (EIN)C12bo ed b Employ number (EIN)C12bo ed7Social security tips 8Allocated tips 9 7Social security tips 8Allocated tips 9 2023W-2 Wage and Tax Statement22222Void 7Social security tipspay 1 Wages, tips, other comp.C e e d d o o 2Federal income tax withheld C b Employersl uy e Rleatni p rement n number (EIN) a Employees social security number T shicir a p y artySuff. b Employers iden Smt e apt l y e p rement n number (EIN)a Employees social security number T i r k drtySuff. a Employees social security numberCC12co e e d d o S emaptluotyoeyrt R pl e atnirement T si hcikrdp-apy art Suff. y a Employees social security numberCC12co e e d d o Smt e apt l u otyoery e Rleat pnriement T si hci k rdp- a p y rt Suff. y10 11plans 12aCode See inst. for box 12 10 11plans 12aCode See inst. for box 12 cEmployers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheld13Statutory employee 14Other 12bCode 13Statutory employee 14Other 12bCode 9 5Medicare wages and tips 6 Medicare tax withheld 13Smt e apt otyoer kd p- 14 Other 13 uotyoer Rleatni shcip-apya 14 Other 14 Other12d14 Other12d Retirement plan 12cCode Retirement plan 12cCode 10 11 plansC 12aSee instructions for box 1213 13Third-party sick pay 12dCode Third-party sick pay 12dCode eEmployees name, address, and ZIP code Suff.13 S emtaptulotyoerye R Pleatnirement Third-party 14Other 12b e Employees name, address, and ZIP code e Employees name, address, and ZIP code e Employees name, address, and ZIP code e Employees name, address, and ZIP code SickState income tax bCC e e d d o o 12c 15State Employer s state ID number 16 State wages, tips, etc. 15State Employer s state ID number 16 State wages, tips, etc.1 158 State Employer's state ID number19 16State wages, tips ,etc.7State income tax 1851State Employer's state ID number19 16State wage s ,tips ,etc .20 1Locality name 7 aEmployees social security no. 12d Local wages, tips, etc. Local income tax 20 1Locality name Local wages, tips, etc. Local income taxForm W-2 Wage and Tax Statement Dept. of the Treasury IRS Form W-2 Wage and Tax Statement Dept. of the Treasury IRS15State EmployersstateID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name W-2 17 State income tax 18 Local wages, tips, etc. W-2 17 State income tax 18 Local wages, tips, etc. 15 State Employers state ID number16 State wages, tips, etc. 17 State income tax 15 State Employers state ID number16 State wages, tips, etc. 17 State income taxFor Privacy Act and Paperwork Reduction For Privacy Act and Paperwork Reduction COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork ReductionActNotice,seeseparateinstructions. OMB No. 1545-008W W 18 Local wages, tips, etc. 19 Local income tax 20 Locality name Void 18 Local wages, tips, etc. 19 Local income tax 20 Locality name VoidAct Notice, see separate instructions. Act Notice, see separate instructions. Dept. of the Treasury - IRS Staatgeem aenndt Tax Staatgeem aenndt Tax2023 19 Local income tax 20 Locality name 2023 19 Local income tax 20 Locality name COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRSOMB No. OMB No. 7Social security tips 2Federal income tax withheld EMPLOYER'SEMPLOYER'SLOCAL OR FILE COPY LOCAL OR FILE COPYa EmployersState,Local,or File 1 3 Copy22222 2 4 2023 1545-0008 a EmployersState,Local,or File 1 3 Copy22222 2 4 2023 1545-0008 c 2023 FormW-2 Wage and Tax Statement22222Void9 8Allocated tips 1 Wages, tips, other comp. 4Social security tax withheld Department of the Treasury - IRSFor Privacy Act and Paperwork ReductionAct Notice, se separate instructions. Department of the Treasury - IRSFor Privacy Act and Paperwork ReductionAct Notice, se separate instructions. 7 Social security tips FormFor PArcitv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRterudcutcioinosn.t 22222 FormFor PArcitv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRtreudcutcioinosn.t State, Local, or File CopyState, Local, or File CopyEmployee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Employee's soc. sec. no. Wages, tips, other comp. Federal income tax withheld Employers name, address, and ZIP code 3Social security wages 6 Medicare tax withheld OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheld OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheld 22222W-2 Wage and Tax Statement2023 7 Social security tipsW-2 Wage and Tax Statement2023bEmployer ID number (EIN) 5 Social security wages 6 Social security tax withheld bEmployer ID number (EIN) 5 Social security wages 6 Social security tax withheld 10RPelatnirement Third-party 5Medicare wages and tipsCC e e d d o o 12aSee instructions for box 1222222 3 Social security wages 4 Social security tax withheld 22222 3 Social security wages 4 Social security tax withheld 9 8 Allocated tips 1 Wages, tips, other comp. 2 Federal income tax withheld 9 8 Allocated tips 1 Wages, tips, other comp. 2 Federal income tax withheldMedicare wages and tips Medicare tax withheld Medicare wages and tips Medicare tax withheld 11 plans 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheldcEmployer's name, address, and ZIP code cEmployer's name, address, and ZIP code eEmployees name, address, and ZIP code Suff.13 e Smtaptulotoyerye Sick pay 14Other 12b c Employers name, address, and ZIP code c Employers name, address, and ZIP code 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheldbC ed d o 12c 7 Social security tips 8 Allocated tips 97 Social security tips 8 Allocated tips 9c Employers name, address, and ZIP code c Employers name, address, and ZIP codeaEmployees social security no.C e o 12d dControl number dControl numbereEmployee's name, address, and ZIP code Suff. eEmployee's name, address, and ZIP code Suff.15State EmployersstateID no. 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name 10 Dependent care11 plans C e d o 12a Se instructions for box 1210 Dependent care11 plans C e d o 12a Se instructions for box 1210 Dependent care11 plansC12a o edSee instructions for box 1210 Dependent care11 plansC12a o edSee instructions for box 12 COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork Reduction ActNotice,seeseparateinstructions. OMB No. 1545-008C e d o 12b C e d o 12c C e d o 12d C e d o 12b C e d o 12c C e d o 12d b Employ number (EIN)C12bo ed b Employ number (EIN)C12bo edDept. of the Treasury - IRSb Employers iden n number (EIN)a Employees social security number b Employers iden n number (EIN) a Employees social security number a Employees social security numberC12co ed a Employees social security numberC12co ed7Social security tips 8Allocated tips 9 7Social security tips 8Allocated tips 9 2023 FormW-2 Wage and Tax Statement22222Void 7Social security tips 1 Wages, tips, other comp. 2Federal income tax withheld 13Smt e apt l uotyoery e Rleatni p rement T shci i r kd p- a p y arty 14 Other 13Smt e apt l uotyoery e R pl eatnirement T shci i r kd p-apyarty 14 Other 14 OtherC12ded o Smt e apt l uot y oery e Rleatni p rement T si hci k rdp-a py rty 14 OtherC12ded o Smt e apt l u ot y o e ry e Rleatnri p ement T si hci k rdp-ap y arty10 11plans 12aCode See inst. for box 12 10 11plans 12aCode See inst. for box 12 cEmployers name, address, and ZIP code 8Allocated tips 3Social security wages 4Social security tax withheld 13 1313Statutory employee 14Other 12bCode 13Statutory employee 14Other 12bCode 9 5Medicare wages and tips 6 Medicare tax withheld e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff.Retirement plan 12cCode Retirement plan 12cCode15State EmployersstateID no. 16State wages, tips, etc. 10eSickpay11 plansCCC e e e e d d d d o o o o 12aSe e instructions for box 12W 15State Employer s state ID number 16 State wages, tips, etc. S 15State Employer s state ID number 16 State wages, tips, etc. 15 State Employers state ID number16 State wages, tips, etc. 17 State income tax Void 15 State Employers state ID number16 State wages, tips, etc. 17 State income tax VoidThird-party sick pay 12dCode Third-party sick pay 12dCode eEmployees name, address, and ZIP code Suff.13Smtaptluotyoerye PRelatnirement Third-party14Other 12bbC 12c1581 State Employer's state ID number 19 16State wages, tips ,etc .20 1Locality name 7 1581 State Employer's state ID number19 16State wage s ,tips, etc. 20 1Locality name 7 aEmployees social security no. 12dW-2 17 State income tax 18 Local wages, tips, etc. W-2 17 State income tax 18 Local wages, tips, etc.Local wages, tips, etc. Local income tax State income tax Local wages, tips, etc. Local income tax State income tax 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name Staatgeem aenndt Tax 19 Local income tax 20 Locality name Wtaatgeem aenndt Tax 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality nameForm W-2 Wage and Tax Statement Dept. of the Treasury IRS Form W-2 Wage and Tax Statement L4UPR COPY 1/D EMPLOYER'S - STATE, LOCAL OR FILE COPYFor Privacy Act and Paperwork Reduction ActNotice,seseparateinstructions.L87R 5406 OMB No. 1545-0Dept. of the Treasury - IRS08 2023 2023 COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS tFor Privacy Act and Paperwork Reduction For Privacy Act and Paperwork Reduction Dept. of the Treasury IR540S5State, Local, or File CopyState, Local, or File Copy LOCAL OR FILE COPYFor APrcitv Nacoyti cAec,tsaenedsPeappaerrawteo rikn sRterudcutcioinosn.t LOCAL OR FILE COPYFor PAcritv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRterudcutcioinosn.Act Notice, see separate instructions. Act Notice, see separate instructions. EMPLOYER'SEMPLOYER'S Department of the Treasury - IRS Department of the Treasury - IRS L4UPWR 5217L276 5215Required Envelope: Required Envelope: Required Envelope: Required Envelope:APEX: DW4S or DW4SS APEX: DW387 or DW387S APEX: DW298 APEX: DW4MW or DW4MWD or DW4MWSTFP: 99991 or 99992 TFP: 44441 or 44442 TFP: 91911 TFP: 61611 or 61612A full PDF image library is available at complyrightdealer.comAPEX - Sheets per packTFP - Forms per pack APEX - Sheets per packTFP - Forms per pack50s500s100s500sFORM DESCRIPTION 50s500s100s500sFORM DESCRIPTIONL4UP L4UP500 5205 5205B W-2 4-Up Box Employees Copies B, C, 2 & 2 Combined1 Page Equals 1 Form N/AN/A 5213N/AW-2 T-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 FormL4UPR L4UPR500 5405 5405B W-2 4-Up Box Employers Copies 1/D, 1/D, 1/D, 1/D1 Page Equals 1 Form (Required Envelope: TFP 31311)N/A L4UP24500 N/A N/AAvailable On 24# Paper Stock1 Page Equals 1 Form L275L27550052145214BW-2 M-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 FormL87 L87500 5206 5206B W-2 4-Up Horizontal Employees Copies B, C, 2 & 2 Combined1 Page Equals 1 Form L276L27650052155215BW-2 M-Style Alternate 4-Up Employers Copies 1/D, 1/D, 1/D, 1/D1 Page Equals 1 FormL87R L87R500 5406 5406B W-2 4-Up Horizontal Employers Copies 1/D, 1/D, 1/D, 1/D Combined1 Page Equals 1 Form L4UPWL4UPW50052165216BW-2 W-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 FormN/A L8724500 N/A N/AAvailable On 24# Paper Stock1 Page Equals 1 Form L4UPWRL4UPWR50052175217BW-2 W-Style Alternate 4-Up Employers Copies 1/D, 1/D, 1/D, 1/D1 Page Equals 1 Form20 21"