b'W-2 PRE-PRINTED & BLANK FORMS W-2 PRE-PRINTED & BLANK FORMSPressure Seal W-2 Forms Pressure Seal W-2 Forms1A OMB No. 1545-0008 1Wages, tips, other compensation Department of the TreasuryInternal 2 Revenue ServiceOMB No. 1545-0008 1Wages, tips, other compensation Department of the TreasuryInternal 2 S2001 85102743 APEX PS285Department of the TreasuryInternal d 1 3 Revenue Service 4 2Federal income tax withheld dControl number 1 3 Wages, tips, other compensation 4 2Federal income tax withheld 851020607 APEX PS1287 Form To Wage and Tax 7 OMB No. 1545-0008 1 3Social security wages Department of the Treasury 2 4 8069567 InternalRevenue Service APEX PS1286 1A APEX LW287PSA 3 5 Social security wages 6 4Social security tax withheld 3 5 Social security wages 6 4Social security tax withheld TFP 5220 5224/PS1287 c Medicare wages and tips Medicare tax withheld This information cis being Medicare wages and tips Medicare tax withheld TFP 5224 c This information being With furnished Employees to the Internal FEDERAL Revenue Tax Return. Service. 8 9 Allocated tips 10 5Medicare wages and tips 11 6Medicare tax withheld TFP 5228Control number Wages, tips, other compensation 3104/10Revenue Service Wages, tips, other compensation Federal income tax withheldFederal income tax withheld Federal income tax withheld OMB NO. 1545-0008 5 Social security wages 6 Social security tax withheld OMB NO. 1545-0008 5 Social security wages 6 Social security tax withheld Copy B W-2 Statement 2023 Social security tips Social security tax withheldfurnished to the Be is FiledEmployers name, address and ZIP code Internal Revenue Service. 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If you areStatement Statement dControl number 1Wages, tips, other compensation2Federal income tax withheld dControl number 1Wages, tips, other compensation2Federal income tax withheld imposedtoon file you aiftax this return, income a negligence is taxableandpenalty youorfail other to report sanction it.may be 15 State Employers state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality nameO 2023 19Local income tax 20Locality name 2023 19Local income tax 20Locality name O OMB NO. 1545-0008 5 3Social security wages 6 4Social security tax withheld OMB NO. 1545-0008 5 3Social security wages 6 4Social security tax withheld 15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 1 19Local income tax 2Federal 20tax Locality name Copy 2ToBe Filed With Employees State, City, or Local Income Tax Return Dept. of the Treasury - IRSG GDepartment of the TreasuryInternalRevenue ServiceCopy2City, - To or Be Local Filed Income With Employees Tax Return. Department of the TreasuryInternal 2 Revenue Service Copy2City, - To or Be Local Filed Income With Employees Tax Return. 1 Department of the TreasuryInternal 2 Revenue Service c Medicare wages and tips Medicare tax withheld c Medicare wages and tips Medicare tax withheld c Form Wage and Tax 7 8Allocated tips OMB No. 1545-0008 3 5 Wages, tips, other compensation 6 4incomewithheld FormW-2 Wage and Tax Statement OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheldState, State,OMB No. 1545-0008 1Wages, tips, other compensation Federal income tax withheld OMB No. 1545-0008 Wages, tips, other compensation Federal income tax withheld Employers name, address and ZIP code Employers name, address and ZIP code Copy 2 W-2 Statement 2023 Social security tips Social security wages Social security tax withheld 7 Social security tipsInternal Revenue to is theThis information 3Social security wages 4Social security tax withheld 7 8Allocated tips 9 7Social security tips 8Allocated tips 9 Income Tax Be Filed With Employees State, City, or Local 9 10 Medicare wages and tips 11 Medicare tax withheld c Employers name, address, and ZIP code 2023 8 Allocated tips 3 Social security wages 4 Social security tax withheldThis information 3Social security wages 4Social security tax withheld being furnished To Return.being furnished requiredyou Employers name, address, and ZIP codeService.the Internal return, a Iftonegligence file are tax aRevenue Service.tois 5Medicare wages and tips 6Medicare tax withheld penalty or may 5Medicare wages and tips 6Medicare tax withheld C d Social security tips C d e o aEmployees social security number C e o d C o d e bEmployer identification number (EIN) C e o d aEmployees social security number C C e d o e eEmployees name, address, and ZIP code 12d C e o d d o bEmployer identification number (EIN) 12b 1 C e d o 3 a em Dependent care benefits t 1 12c C e o d 4 Nonqualified plans e Employees name, address, and ZIP code 9 10 Dependent care benefits 5 Medicare wages and tips C C o d e o e d 6 Medicare tax withheldsanctionother beincome istaxableimposedon you ifandthiscEmployers name, address, and ZIP code you fail to report it. c 10Dependent care benefits 11Nonqualified plans C 12a o e d 10Dependent care benefits 11Nonqualified plans 12a o d 12a C e RetiremenThird-party Other 11 Nonqualified plans 12aEmployers name, address, and ZIP codeo 12b 12c 12d 12b 12c 12d Staptutory plan sick pay b Employer identification number (EIN) 14 Other 12be bEmployer identification number (EIN) Employees social security number7Social security tips 8Allocated tips 9 7Social security tips 8Allocated tips 9 13Sme taptulotoyeryepleantirementR Third-party 14Other 13 em Rlaetnirement p Third-party 14Other a Employees social security number C d o e 12csick pay Staptulotoyreye sick payo b 10Dependent care benefits d e o 11Nonqualified plans a C e e o d o d 12aSee instructions for box 12 e d o b 10Dependent care benefits d o e 11Nonqualified plans a C d e o o e d 12aSee instructions for box 12 eEmployees name, address and ZIP code eEmployees name, address and ZIP code 15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 1 19 Department 2 20Locality 15 State Employers state ID number 16 State wages, tips, etc. 13Sme taptulotoyerye p Rlaentirement Third-party 18 Local wages, tips, etc. 19C o d e 12d 20 Locality namesick payC d e 12b C 12c C 12d C 12b C 12c C 12d Local income of the tax TreasuryInternalRevenue name Service 17 State income tax Local income taxEmployer identification number (EIN) Employees social security number Employer identification number (EIN) Employees social security number Wages, tips, other compensation Federal income tax withheld13Sme taptulotoyeryepleantirementR Third-party14Other 13 em Rlaetnirement p Third-party14Other 15StateEmployers state ID No. 16State wages, tips, etc. 15StateEmployers state ID No. 16State wages, tips, etc. Copy 2 W-2Wage and Tax 2023 7Social security tips 3Social security wages 4Social security tax withheld Copy2To Be Filed with Employees State, City, or Local Income Tax Return Dept. of the Treasury - IRSOMB No. 1545-0008sick pay Staptulotoyreye sick pay Form To Statement This information required to file you a fail tax to return, report a it. OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheldBe Filed With Employees State, City, or Local negligence penalty isbeingor other furnished sanction to may theInternalbe imposed Revenue on you Service. if thisincomeIf you are istaxable and2023 17State income tax 18Local wages, tips, etc. 2023 17State income tax 18Local wages, tips, etc. c Income Tax Return. 8 9 Allocated tips 10 5Medicare wages and tips 11 6Medicare tax withheld FormW-2 Wage and Tax Statement 2023 7 Social security tips 3 Social security wages 4 Social security tax withheldEmployers name, address, and ZIP codeeEmployees name, address, and ZIP code eEmployees name, address, and ZIP code W-2Wage and Tax W-2Wage and Tax Dependent care benefits Nonqualified plans c Employers name, address, and ZIP code 8 Allocated tipsForm Statement Form StatementCopy2-ToIncome Be State,TaxFiledReturn.City, With or 19Local income tax 20Locality name Service Copy2-ToIncome Be State,TaxFiledReturn.City, With or 19Local income tax 20Locality name Service eEmployees name, address, and ZIP code 12a C d e o C o d e 12b 1 C o d e 3 a Sme taptutory RetirementThird-party 1 1 C e o d 4 2c Other e Employees name, address, and ZIP code 9 10 Dependent care benefits 5 Medicare wages and tips C C o d o e d 6 Medicare tax withheldEmployees EmployeesLocal LocalW-2 17State income tax 18Local wages, tips, etc. W-2 17State income tax 18Local wages, tips, etc. FROM: 6 2 8 5 2 S1 / 8 2 P a Employees social security number C e d o e 12cDepartment of the TreasuryInternalRevenueDepartment of the TreasuryInternalRevenue12d plan sick pay 11Nonqualified plans 12a See instructions for box 128510021792 2019 RR Donnelley - 0667Form 15StateEmployers state ID number 16State wages, tips, etc. Form 15StateEmployers state ID number 16State wages, tips, etc. bEmployer identification number (EIN) Employees social security number b Employer identification number (EIN) 14Other 12bWage and Tax 19Local income tax 20Locality name Wage and Tax 19Local income tax 20Locality name APEX15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name 13Sme taptulotoreyey Rleatnirement p Third-party C o d e 12dStatement Statement sick pay2023 2023 PS283 FROM: 15 State Employers state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality nameEmployees (See C - For to EMPLOYEESCopy B - ToFEDERALBe Filed With Tax Return. CopyNotice Employee on the RECORDS back of Copy B.)Copy CForEMPLOYEES RECORDS (See Notice to Employee on the back of Copy B.) Dept. of the Treasury - IRS5223/PS283 TFP 5223 Important Tax Document Enclosed First-Class Mail FormW-2 Wage and Tax Statement 2023 OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheldSEE REVERSE INSTRUCTIONS SIDE FOR OPENING7 Social security tipsc Employers name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheldSEE REVERSE INSTRUCTIONS SIDE FOR OPENING851020608 APEX PS1289 Important Tax Document Enclosed 806314/1095979 First-Class Mail APEX PS1288 1A 9 10 Dependent care benefits 5 Medicare wages and tips C C o d e e o d 6 Medicare tax withheld APEX LW287PSB11Nonqualified plans 12a See instructions for box 12e Employees name, address, and ZIP code b Employer identification number (EIN) 14Other 12bTFP 5225 TFP 5227 15 State Employers state ID number 16 State wages, tips, etc. a Employees social security number p 18 Local wages, tips, etc. 19C C o d e o d e 12c 20 Locality nameStaptulotoyreye sick pay13 em Rleatnirement Third-party 12d17 State income tax Local income taxCopy BToBe Filed With Employees FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service. Dept. of the Treasury - IRS5225/PS1289Front Blank Front Blank S14EZ073with W2 Instructionswith W2 Instructions W 2 - COPY CW 2 - COPY Bon back side. on back side. G OO GFront Blank Front Blankwith W2 Instructionswith W2 Instructions This panel This panelcontains W2 Backer contains W2 Backeron back side. on back side.Information InformationFront Blank Front Blankwith W2 Instructionswith W2 Instructions VFold on back side. on back side. 8 8 2 S1 5227/P 8710039512 2021 RR Donnelley. All rights reserved. - 0221FROM:FROM:Important Tax Document Enclosed First-Class MailSEE REVERSE INSTRUCTIONS SIDE FOR OPENINGSEE REVERSE INSTRUCTIONS SIDE FOR OPENINGImportant Tax Document Enclosed First-Class MailEccentric ZFold EccentricEccentric ZFold ZFoldBlank face with backer instructions Blank face with backer instructionsAPEX - Sheets per packTFP - Forms per pack APEX - Sheets per packTFP- Forms per pack500s500sFORM DESCRIPTION 500s500sFORM DESCRIPTIONPS285522011" W-2 4-Up Box Employees Copy B, C, 2 And 2 or Extra CopyV-Fold Duplex1 Page Equals 1 Form PS1288522714" Blank W-2 Employees 4-Up HorizontalBlank with Backer Instructions B,C,2, 2EZ-Fold Simplex1 Page Equals 1 FormPS283522311" W-2 4-Up Box With Printed Backer Copy BV-Fold Duplex1 Page Equals 1 Form PS1286522814" W-2 Employees 4-Up HorizontalCopy B, C, 2, 2EZ-Fold Simplex1 Page Equals 1 FormPS1287522414" W-2 4-Up Box Employees Copy B, C, 2 Or Extra CopyEZ-Fold Simplex1 Page Equals 1 Form LW287PSN/A14" W-2 Employees 4-Up HorizontalCopy B, C, 2, 2EZ-Fold Simplex1 Page Equals 1 FormPS1289522514" W-2 4-Up Box With Printed Backer Copy B and CEZ-Fold Simplex1 Page Equals 1 Form LW287PSBN/A14" Blank W-2 Employees 4-Up Horizontal With Backer InstructionsEZ-Fold Simplex1 Page Equals 1 Form26 27'