b'W-2 PRE-PRINTED & BLANK FORMS W-2 PRE-PRINTED FORMSPressure Seal W-2 Forms 1-Wide ContinuousAPEX PS1280Z 1A S2032B 851020606 APEX LW2PS W-2 COPY A W-2 COPY B W-3OMB No. 1545-0008 1Wages, tips, other compensation 2Federal income tax withheld OMB No. 1545-0008 1Wages, tips, other compensation 2Federal income tax withheldA COPY C - For 3Social security wages 4Social security tax withheld c COPY B - 3Social security wages 4Social security tax withheld b aEmployees social security number For Ofcial Use Only2 Federal income tax withheld b aEmployees social security number Safe, accurate,Visit the IRS website atb 33333 a Control number 943 944 DO NOT STAPLE None apply 501c non-govt. Third-party c EMPLOYEES Medicare wages and tips 6Medicare tax withheld To BeFEDERAL 5Medicare wages and tips 6Medicare tax withheld 22222 VOID OMB No. 1545-0008OMB No. 1545-0008 FAST! Use www.irs.gov/ele941 Military For Ofcial Use Only: sick pay RECORDS Emp Filedloyee WithsEmployers name, address,5on theNotice backtoofEmployeeCopy B.) Employers name, address, and ZIP code(See and ZIP code Tax Return 1 Wages, tips, other compensation 1 Wages, tips, other compensation 2 Federal income tax withheld OMB No. 1545-0008cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Kind of PayerCT-1 Hshld.govt. emp. Kind of EmployerState/localState/local 501cFederal govt. applicable) (Check one) emp. Medicare(Check one) non-501c (Check if 85107086 7Social security tips 8Allocated tips 12a C C d e e d o e o d d e e See instructions for box 12 p 1 9 7 a b Social security tips number (EIN) 8 10 Allocated tips care benefits 12a C C C C o d e d e o o d e o d e em See instructions for box 12 p dControl number Last name Suff. 5 Medicare wages and tips C C ddooe e 6 Medicare tax withheld dControl number Suff. 13 5 Medicare wages and tips C C ddooe e 6 Medicare tax withheld c Total number of Forms W-2 e d Establishment number 9 1 Wages, tips, other compensation 2 Federal income tax withheld9 10Dependent care benefits 12b C o Dependent12b 7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips 3 Social security wages 4 Social security tax withheld1Nonqualified plans 14Other 12c Nonqualified plans 14Other 12c910 bEmployer identication number (EIN) 12d C o Employer identication12d 9 10fEmployers name 5 Medicare wages and tips 6 Medicare tax withhelda Sm taptulotoyerye Rleantirement Third-party Staptulotoyreye Rlaetnirement Third-partyA S2035 Employees social security number 13 sick pay Employees social security number 13 sick pay e 11StatutoryRetirementThird-party12aSee instructions for box 12 eEmployees name, address, and ZIP code 11StatutoryRetirementThird-party12aSee instructions for box 12 7 Social security tips 8 Allocated tipsControl1545-0008 Federal incomeInternal taxRevenue withheldControlnumber Federal incomeInternal taxRevenue withheldeEmployees name, address, and ZIP code eEmployees name, address, and ZIP code 13 employee plan sick pay 12bFORM 9811-4 4PT/X-17 FORM 7933-22PT 1A dOMB No. number 1Wages, tips, other compensationDepartment of the2Treasury Service d OMB No.1545-0008 1Wages, tips, other compensationDepartment of the2Treasury Service employee plan sick pay 12b 10 FORM 7640-3 3PT/X-13A FORM 7640-3 3PT/X-13Ac 3Social security wages 4Social security tax withheld c 3Social security wages 4Social security tax withheld fEmployees address and ZIP code 14Other 12c C C ddooe e 14Other 12c C C ddooe e g Employers address and ZIP code 1112a Deferred compensation5Medicare wages and tips 6Medicare tax withheld 5Medicare wages and tips 6Medicare tax withheld 15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 12d 12d h Other EIN used this year 13 For third-party sick pay use only 12bEmployers name, address, and ZIP code Employers name, address, and ZIP code18Local wages, tips, etc. 19Local income tax 20Locality name 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 15 State Employers state ID number 14 Income tax withheld by payer of third-party sick pay15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name7 C b d e o Social security tips 8 C d e o Allocated tips aEmployees social security number C C d o o d e 9 7 b C o d e Social security tips 8 C d o e Allocated tips aEmployees social security number C C e d o e o d 9 This required isabeingfurnished 3 1 isto theW-2 Wage and Tax Statement it. 4 2 2023 furnished to the is being 3 1 Form W-2 Wage and Tax Statement 4 2 2023 Form Wage and Tax Statement 41-0852411 Department of the TreasuryInternal Revenue ServiceForm Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue Service 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income taxFormyou This information10Dependent care benefits 1Nonqualified plans 12a 10Dependent care benefits 1Nonqualified plans 12a are informationontofileyouiftax return, Internalor other Service. Ifmay Dept. of the TreasuryIRSInternal Revenue Service. Dept. of the TreasuryIRS Employers contact person Employers telephone numbere 12b 12c 12d Dept. of the TreasuryIRS taxable penaltyandyouRevenue fail tosanction2023 Dept. Form W-2 Wage and Tax Statement 2023 For Privacy Act and Paperwork Reduction be imposed this income a negligence reportOMBNo.of the 1545-0008 TreasuryIRS12b Employer identification number (EIN) 12c 12d Employer identification number (EIN) OMB No. 1545-0008 Form W-2 Wage and Tax Statement COPY 2 - Wages, tips, other compensation Federal income tax withheld W-2 2023Act Notice, see the separate instructions.Employers fax number Employers email addressCOPY 2 - Wages, tips, other compensation Federal income tax withheld To Be Filed With Social security wages Social security tax withheld Copy AFor Social Security Administration. Send this entire page with not acceptable. W-2To Be Filed With Social security wages Social security tax withheld Employees Form W-3 to the Social Security Administration; photocopies areCopy BTo Be Filed With Employees FEDERAL Tax Return. 13 em Rlaentirement p Third-party 14Other 13Sme taptulotoyerye Rlaetnirement p Third-party 14Other O City, orLocalTaxReturnState, Medicare wages and tips 6Medicare tax withheld City, orLocalTaxState,Return5Medicare wages and tips 6Medicare tax withheld O Do Not Cut, Fold, or Staple Forms on This Page This information is being furnished to the Internal Revenue Service. Under 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, and EmployeesStaptulotoyreye sick pay sick pay Income Income complete.G cEmployers name, address,5and ZIP code cEmployers name, address, and ZIP code G Signature: Title: Date:eEmployees name, address, and ZIP code eEmployees name, address, and ZIP code Department of the Treasury 22222 VOID aEmployees social security number For Ofcial Use OnlyForm W-3 Transmittal of Wage and Tax Statements 2023 Internal Revenue ServiceOMB No. 1545-0008aEmployees social security number Safe, accurate,Visit the IRS website at 1 7Social security tips 8 14 Allocated tips 12a C C d e d o e d o e e d R Third-party 1 9 7 a b Social security tips number (EIN) 8 10 Allocated tips care benefits 12a C C C C o d e o d e e o d d o e Sme taptulotoyreye R plaentirement Third-party b 1 Wages, tips, other compensation 2 Federal income tax withheld b OMB No. 1545-0008 FAST! Use www.irs.gov/eleSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).LW2PSPhotocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA. Form 15StateEmployers state ID number 16State wages, tips, etc. Form 15StateEmployers state ID number 16State wages, tips, etc. 9 10Dependent care benefits 12b Dependent12b 1 Wages, tips, other compensation 2 Federal income tax withheld Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.W-2 17State income tax 18Local wages, tips, etc. W-2 17State income tax 18Local wages, tips, etc. b Nonqualified plans number (EIN) Other 12c C C o o Nonqualified plans 14Other 12c cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Reminder See the 2023 General Instructions for Forms 8510007086 2022. - 0221Wage and Tax Wage and Tax Employer identication12d Employer identication12d 5 Medicare wages and tips 6 Medicare tax withheld Separate instructions. G d Statement 1 19Local income tax 20Locality name Statementbeing 1 Wages, 19 Local income taxon you Service.if2If20Locality name to youafail taxtoreturn, G O a e Employees social security number 13 em plaetnirement sick pay e Employees social security number 13 sick pay e APEXSuff. 7 Social security tips TFP C doe dControl number 5 Medicare wages and tips 6 Medicare tax withheld W-2 acceptable. Use a Form W-3 even if only one W-3 for Form(s) W-2 that were submitted electronically to the SSA.2023 2023 Staptulotoyerye 8 Allocated tips Purpose of FormO Em number Wages, tips, other compensationDepartment of the2Treasury Service Em information is orotherfurnished maybe InternalRevenue this incometaxabletax file reportait. Employees name, address, and ZIP code Employees name, address, and ZIP code EccentricdControl number Last name 9107 Social security tips 8 Allocated tips Photocopies are Coppyl o2y e- eTsoSBtea tFei,l eCdi tyW, iothr Local Income Tax Return. 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Make a copy of this form and keep it with Copy D (ForWhen To File Paper FormsControl Social security wages Social security tax withheldThis information to the Medicare wages and tips Medicare tax withheld OMB No. 1545-0008 Medicare wages and tips Medicare tax withheld employee plan sick pay Employer) of Form(s) W-2 for your records. The IRS recommends FORM 9811-4 4PT/X-17furnishedInternal Revenue Service. Employers name, address, and ZIP code 18Local wages, tips, etc. Local income tax Locality name 18Local wages, tips, etc. Local income tax Locality name X1714Other 98114C doe 4-Part W-2 Carbonless Copy A, B, C, 1/D 13 employee plan sick pay 12b C doe retaining copies of these forms for 4 years. Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2024.Employers name, address, and ZIP code 12c12d 14Other 12c E-Filing Where To File Paper FormsThe SSA strongly suggests employers report Form W-3 and Forms W-2 b d e Employer identification number (EIN) 12c C e d o a 12d C e d d o 12b b C d o e Employer identification number (EIN) 12c C o d e a 12d C d e e o d SEE REVERSE SIDE FOR OPENING INSTRUCTIONS Department of the TreasuryInternal Revenue Service15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 12d C doe 20Locality name 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:fEmployees address and ZIP code7 10 C o Social security tips benefits 8 1 Allocated tips plans 12a C e o 9 See instructions for box 12 7 10 Social security tips benefits 8 1 Allocated tips plans 12a C o 9 See instructions for box 12 15State X1816State wages, tips, etc.17State income tax 9811620Locality name 6-Part W-2 Carbonless Copy A, 1/D, B, C, 2, 1/D 19Local income tax 50 Forms W-2 at a time to the SSA.the SSAs toNote:Social Security AdministrationDependent careNonqualifiedDependent careNonqualifiedEmployers state ID number 18Local wages, tips, etc.19Local income taxW-2 Online.Direct Operations Center12bFile Upload. usingWilkes-Barre, PA 18769-0001Specications for Filing Forms W-2 Electronically (EFW2). 18769-0002. If you use an IRS-approved private delivery service, addATTN: W-2 Process, 1150 E. Mountain Dr. to the address and change13Sme taptulotoyerye pleantirementR Third-party 14Other Employees social security number 13 em p Rlaetnirement Third-party 14Other Employees social security number Form W-2 X132023 760033-Part Twin Set W-2 Employers Carbonless Copy A, 1/D, 1/D January 31, 2024. For more information, go to www.SSA.gov/bso. First- the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers Tax sick pay Staptulotoyreye sick pay Wage and Tax StatementAct Notice, see the separate instructions.Register Log In. Guide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction PRINTED IN USACopy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411 Wage and Tax Statement Department of the TreasuryInternal Revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.eEmployees name, address, and ZIP code eEmployees name, address, and ZIP code Form W-3 to the Social Security Administration; photocopies areForm W-2 2023 41-0852411Form 15StateEmployers state ID number 16State wages, tips, etc. Form 15StateEmployers state ID number 16State wages, tips, etc. IMPORTANT TAX RETURN DOCUMENT ENCLOSED X13A764033-Part Twin Set W- 2 Employees Carbonless Copy B, C, 2Copy BTo Be Filed With Employees FEDERAL Tax Return. This information is being furnished to the Internal Revenue Service.W-2 17State income tax 18Local wages, tips, etc. W-2 17State income tax 18Local wages, tips, etc. W3793322-Part W-3 Transmittal Of Income and Tax StatementsMW1280ZWage and Tax Wage and TaxStatement Statement2023 19Local income tax 20Locality name 2023 19Local income tax 20Locality name APEX PS1279Copy B- To Be Filed With Employees FEDERAL Tax Return. Copy C- For EMPLOYEES RECORDS (See Notice to Employee on the back of Copy B.) W3C795422-Part W-3C Transmittal Of Corrected Income and Tax StatementsDepartment of the TreasuryInternalRevenue ServiceA 85102754 S20351AO OG G (5) W-3 Transmittal forms are included with each Federal Copy A (Red) form order2-Wide ContinuousW2-COPY B W2-COPY CPRINTED IN USA22222 Void a Employee\'s soc. sec. no 1 Wages, tips, other comp. 2 Federal income tax withheld 22222 VOID aEmployees social security number For Ofcial Use Only OMB No. 1545-0008 b Employer ID number (EIN) 3 Social security wages 4 Social security tax withheld b 1 Wages, tips, other compensation 2 Federal income tax withheldStatutory13 Employee 9 5 Medicare wages and tips 6 Medicare tax withheld cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheldRet. plan sick payty 11 plans 7 Social security tips 8 Allocated tips 5 Medicare wages and tips 6 Medicare tax withheld3rd-parEccentricc Employers name, address, and ZIP code 10 Dependent care7 Social security tips 8 Allocated tipsMW1279 O C D E 12a See instructions for box 12 dControl number 910All non-mailersZFold d Control number O O D C C E E 12b e Last name Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C ddooe e on this page fit:e Employees name, address, and ZIP code Suff.12c 13 employee plan sick pay 12bBlank face with backer instructions O D C D E 12d 14Other 12c C C dooe e APEX: DWCL or DWCLS14Other 12d15 State Employers state ID number 16 State wages, tips, etc. d 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name fEmployees address and ZIP code 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name TFP: 66661 or 6666215StateEmployers state ID numberForm DForState, Statement 2023 DepartmentFor Priv of the Act Notice, see separate instructions. Form W-2 Wage and Tax Statement 2023 Department of the TreasuryInternal Revenue ServiceDouble Window For Privacy Act and Paperwork Reduction Copy W-2Wage and Tax Treasury - Internal Revenue Service Copy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411Act Notice, see the separate instructions. acy Act and Paperwork ReductionCopy 1For Employer City, or Local tax Department OMB No. 1545-0008 Form W-3 to the Social Security Administration; photocopies areEnvelopeDo Not Cut, Fold, or Staple Forms on This Page22222 Void a Employee\'s soc. sec. no 1 Wages, tips, other comp. 2 Federal income tax withheld 22222 VOID aEmployees social security number For Ofcial Use Only OMB No. 1545-0008 b Employer ID number (EIN) 3 Social security wages 4 Social security tax withheld b 1 Wages, tips, other compensation 2 Federal income tax withheldStatutory13 Employee 9 5 Medicare wages and tips 6 Medicare tax withheld cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheldRet. plan sick payty 11 plans 7 Social security tips 8 Allocated tips 5 Medicare wages and tips 6 Medicare tax withheld3rd-parc Employers name, address, and ZIP code 10 Dependent care7 Social security tips 8 Allocated tipsO C D E 12a See instructions for box 12 dControl number 910 d Control number e Suff. O O O C C D D D C E E 12b e Last name Suff.11Statutoryplan W-2 FORM PARTS DESCRIPTION C C C ddooe e e12aSee instructions for box 12 Employees name, address, and ZIP code 12c 13 RetirementThird-party12bAPEX - Sheets per packTFP - Forms per pack E 12d employee sick pay 12c do 14Other14Other 12d500s500sFORM DESCRIPTION 15 State Employers state ID number 16 State wages, tips, etc. fEmployees address and ZIP code 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax C doe 20Locality name17 State income tax 18 Local wages, tips, etc. 19 Local income tax EMPLOYERS COPIES EMPLOYEES COPIES15StateEmployers state ID numberPS1280ZN/A14" W-2 Employees 4-Up BoxCopy B, C, 2, 2EZ-Fold Duplex1 Page Equals 1 Form 20 Locality name Form Wage and Tax Statement Department of the TreasuryInternal Revenue Service FormW-2 Statement 2023 DepartmentFor Priv of the Act Notice, see separate instructions. W-2 2023 For Privacy Act and Paperwork Reduction Copy Wage and Tax Copy AFor Social Security Administration 41-0852411Act Notice, see the separate instructions.Copy BTo be filed with Employees Federal Tax ReturnCopy D 1ForForState,Employer City, or Local tax Department Treasury - Internal Revenue Service Copy AFor Social Security Administration. Send this entire page with not acceptable.PS1279N/A14" Blank W-2 4-Up Box With Backer InstructionsEZ-Fold Duplex1 Page Equals 1 Form acy Act and Paperwork Reduction Form W-3 to the Social Security Administration; photocopies are OMB No. 1545-0008LW2PSN/A14" W-2 Employees 4-Up BoxCopy B, C, 2, 2EZ-Fold Duplex1 Page Equals 1 Form Copy 1For State, City, or Local Tax Department Copy CFor Employees Records To be filed with Employees State, City or Local Income Tax ReturnCopy DFor Employers Records Copy 2 28 29'