b"W-2 PRE-PRINTED & BLANK FORMS Individual 2-Up Laser PacksAPEX LW2A APEX LW2BL22222 VOID aEmployees social security number For Ofcial Use Only b OMB No. 1545-00082 Federal income tax withheld TFP 5201 TFP 52221 Wages, tips, other compensationcEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld5 Medicare wages and tips 6 Medicare tax withheld7 Social security tips 8 Allocated tips Front BlankdControl number 910 e Last name Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C dooe e with W-2 Instructions 13 employee plan sick pay 12b d 14Other 12c C C ddooe e Safe, accurate,Visit the IRS website atAPEX LW2B on back side.fEmployees address and ZIP code b 16State wages, tips, etc. aEmployees social security number 12d FAST! Use 20Locality name www.irs.gov/eleAPEX LW2NBOMB No. 1545-000815StateEmployers state ID number 17State income tax 18Local wages, tips, etc.19Local income tax 2 Federal income tax withheld TFP 52021 Wages, tips, other compensationcEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheldForm W-2 Wage and Tax Statement 2022 5 Medicare wages and tips 6 Medicare tax withheld TFP 5207Copy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411 Department of the TreasuryInternal Revenue Service8 Allocated tips APEX LW2CLW227 Social security tipsFor Privacy Act and Paperwork ReductionAct Notice, see the separate instructions. Form W-3 to the Social Security Administration; photocopies areaEmployees social security number9 10 dControl number This information is being furnished to the Internal Revenue Service. If you Do Not Cut, Fold, or Staple Forms on This Page OMB No. 1545-0008 may be imposed on you if this income is taxable and you fail to report it.VOID eEmployees name, address, and ZIP codeb For Ofcial Use OnlySuff.11StatutoryRetirementsick pay 1 Wages, tips, other compensation C C ddooe e 2 Federal income tax withheld TFP 520312aSee instructions for box 12Third-party12b22222 aEmployees social security numbercEmployers name, address, and ZIP code 13 employee plan 3 Social security wages 4 Social security tax withheldb OMB No. 1545-000814Other 5 Medicare wages and tips C doe 6 Medicare tax withheld1 Wages, tips, other compensation 2 Federal income tax withheld 12ccEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld 7 Social security tips C doe 8 Allocated tips12d15State dControl number16State wages, tips, etc. 919Local income tax 10 Employers state ID numbereEmployees name, address, and ZIP code5 Medicare wages and tips 8 Allocated tips 11StatutoryRetirement20Locality name C C ddooe e APEX LW2D1aEmployees social security number OMB No. 1545-0008 Safe, accurate,Visit the IRS website atAPEX LW2BC17State income tax6 Medicare tax withheld18Local wages, tips, etc.Suff. 12aSee instructions for box 127 Social security tipsaEmployees social security number13 employee plan Third-party12b FAST! Use www.irs.gov/ele dControl number 922222 VOID10sick paye Form W-2 Wage and Tax Statement b 2022 C C dooe e Department of the TreasuryInternal Revenue ServiceOMB No. 1545-0008 12c C C ddooe e 2 Federal income tax withheld b 1 Wages, tips, other compensation 2 Federal income tax withheldCopy BTo Be Filed With Employees FEDERAL Tax Return.RetirementThird-party12aSee instructions for box 1214Other 1 Wages, tips, other compensation 4 Social security tax withheld TFP 5204 cEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld TFP 5212Last name Suff.11 This information is being furnished to the Internal Revenue Service. sick pay 12b C d3 12d 5 Medicare wages and tips 6 Medicare tax withheld13StatutorycEmployers name, address, and ZIP code Social security wagesemployee plan12c 5Local income tax 20Locality name6 Medicare tax withheld15StateEmployers state ID number14Other 16State wages, tips, etc. doe 17State income tax 18Local wages, tips, etc.19Medicare wages and tips 8 Allocated tips 7 Social security tips 8 Allocated tips12d C doe Safe, accurate,Visit the IRS website at 7 Social security tips 10dControl number 9 10 fEmployees address and ZIP code b aEmployees social security numberdControl numberOMB No. 1545-0008 FAST! Use 20Locality name www.irs.gov/ele9sick pay 12aSee instructions for box 12 C C ddooe e eEmployees name, address, and ZIP code Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C ddooe e15StateEmployers state ID number 16State wages, tips, etc.Form W-2 Wage and Tax Statement 1 Wages, tips, other compensation 2 Federal income tax withheld17State income tax 18Local wages, tips, etc. 2022 Department of the TreasuryInternal Revenue ServicecEmployers name, address, and ZIP code eEmployees name, address, and ZIP code19Local income tax Suff. Safe, accurate, 11 Copy CFor EMPLOYEES RECORDS (See Notice to 3 Social security wages 4 Social security tax withheldFAST!Use13StatutoryRetirementThird-party12b 13 employee plan sick pay 12bEmployee on the back of Copy B.)ed With employee planEmployees State, City or Local Income or CopTax y 2 tReturno be Fil 5 Medicare wages and tips 6 Medicare tax withheldForm W-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue Service8 Allocated tips 14Other 12c C doe 14Other 12c C doe7 Social security tipsFor Privacy Act and Paperwork Reduction Copy AFor Social Security Administration. Send this entire page with not acceptable. LW2AAct Notice, see the separate instructions. 52011012d C doe LW2BL 5222 12d C doeForm W-3 to the Social Security Administration; photocopies are41-0852411aEmployees social security number9 This information is being furnished to the Internal Revenue Service. If you dControl numberSuff.11OMB No. 1545-0008 C doe may be imposed on you if this income is taxable and you fail to report it. 20Locality name 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality nameeEmployees name, address, and ZIP codeb 15StateEmployers state ID number 16State wages, tips, etc.12aSee instructions for box 122 Federal income tax withheld 19Local income tax1 Wages, tips, other compensation 18Local wages, tips, etc.17State income taxcEmployers name, address, and ZIP code 13StatutoryRetirementThird-party12b C oe 4 Social security tax withheldemployee plan sick pay 3 Social security wages d 12c14Other 5 Medicare wages and tips 6 Medicare tax withheldForm W-2 Wage and Tax Statement 12d C C ddooe e 2022 Department of the TreasuryInternal Revenue ServiceForm W-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue ServiceCopy 1For Employer.City, 7 Social security tips 8 Allocated tips For Privacy Act and Paperwork ReductionCopy BTo Be Filed With Employees FEDERAL Tax Return. Act Notice, see separate instructions.Copy DFor State, orLocalTaxDepartment 9 10This information is being furnished to the Internal Revenue Service.15State dControl number16State wages, tips, etc.17State income tax Local income tax 20Locality nameEmployers state ID numbereEmployees name, address, and ZIP code VOID 18Local wages, tips, etc.Suff.11 19 plan sick pay 12aSee instructions for box 12 C C ddooe e e b 33333 a Control number 943 944 DO NOT STAPLENone apply 501c non-govt. Federal govt. Third-partyb aEmployees social security number OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If you dFor Ofcial Use Only Form b 22222 aEmployees social security number13StatutoryRetirementThird-party12b C doe 2 Federal income tax withheld of 941 Military MedicareOMB No. 1545-0008 State/localState/local 501c sick pay cEmployers name, address, and ZIP code may be imposed on you if this income is taxable and you fail to report it.employeeW-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue Service Kind CT-1 Hshld.govt. emp. Kind non-501c (Check if1 Wages, tips, other compensation 2 Federal income tax withheldCopy BTo Be Filed With Employees FEDERAL Tax Return.LW2B 14Other OMB No. 1545-0008 12c C o4 Social security tax withheld Payeremp. of 2 Federal income tax withheld applicable)3 Social security wages 4 Social security tax withheld1 Wages, tips, other compensationThis information is being furnished to the Internal Revenue Service. 12d (Check one) Employer cEmployers name, address, and ZIP code 3 5202 (Check one)Social security wages5Local income tax 20Locality name6 Medicare tax withheld c Total number of Forms W-2 e d Establishment number 1 Wages, tips, other compensation 4 Social security tax withheld LW2NB 5207 5 Medicare wages and tips 6 Medicare tax withheld15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Medicare wages and tips 3 Social security wages 7 Social security tips 8 Allocated tips7 Social security tips 8 Allocated tipsfEmployers name 5 Medicare wages and tips 6 Medicare tax withheld dControl number 9 10 dControl number 9 10 Form W-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue Service C C ddoe e 119 7 Social security tips 108 Allocated tips eEmployees name, address, and ZIP code Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C C ddooe eeEmployees name, address, and ZIP code Suff. Safe, accurate,12aSee instructions for box 1211 Copy CFor EMPLOYEES RECORDS (See Notice to o be Filed With FAST!Use RetirementThird-party5203 o12a Deferred compensation 13 employee plan sick pay 12bEmployee on the back of Copy B.)LW2C/LW22 13Statutoryplan sick pay 12bEmployees State, City or Local Income or CopTax y 2 tReturn employee14Other 12c C C doe g h Employers address and ZIP code 13 For third-party sick pay use only 12b 14Other 12c C ddooe e12d doeOther EIN used this year 14 Income tax withheld by payer of third-party sick pay 12d15 State Employers state ID number15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality nameForm W-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue ServiceEmployers contact person Employers telephone number APEX LW3 Form W-2 Wage and Tax Statement 2022 Department of the TreasuryInternal Revenue ServiceEmployers fax number Employers email address Safe, accurate, For Privacy Act and Paperwork Reduction Copy1ForState, orLocalTaxDepartment LW2D1Act Notice, see separate instructions.5204 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, andCopy CFor EMPLOYEES RECORDS (See Notice toLW2BC FAST!Use 5212CopyDForEmployer.City, complete. Employee on the back of Copy B.) SignatureTitle2022 DateDepartment of the TreasuryTFP 5200 Employees State, City or Local Income or CopyTax2 toReturn be Filed WithForm W-3 Transmittal of Wage and Tax Statements Internal Revenue ServiceSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA).Photocopies are not acceptable. Do not send Form W-3 if you led electronically with the SSA. Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.ReminderSeparate instructions. See the 2022 General Instructions for Forms W-2 W-3 for Form(s) W-2 that were submitted electronically to the SSA.Purpose of Formpaper forms must notcomply with IRS standards and be machine readable. Photocopies are acceptable. Use a Form W-3 even if only one 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.E-Filing Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2023.APEX: DWCL or DWCLS Copy A electronically instead of on paper. The SSA provides two freeWhere To File Paper FormsThe SSA strongly suggests employers report Form W-3 and Forms W-2 Send this entire page with the entire Copy A page of Form(s) W-2 to:50 Forms W-2 at a time to the SSA.toSocial Security Administration W-2 Online. TFP: 66661 or 66662File Upload. usingNote:Direct Operations CenterWilkes-Barre, PA 18769-0001Specications for Filing Forms W-2 Electronically (EFW2).the SSAs 18769-0002. If you use an IRS-approved private delivery service, addJanuary 31, 2023. For more information, go to www.SSA.gov/bso. First- the ZIP code to 18702-7997. See Pub. 15 (Circular E), Employers TaxATTN: W-2 Process, 1150 E. Mountain Dr. to the address and changeRegister Log In. Guide, for a list of IRS-approved private delivery services.For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.LW3 41-0852411 5200(5) W-3 Transmittal forms are included with each Federal Copy A (Red) Form orderAPEX - Sheets per packTFP - Forms per pack50s500s100s1000'sFORM DESCRIPTION(10 or 25 forms(500 forms LW3 LW3500 5200 5200B per package) W-3 Transmittal Of Income And Tax Statement1 Page Equals 1 Formper package)LW2A LW2A500 5201 5201B W-2 IRS Federal Copy A1 Page Equals 2 FormsLW2B LW2B500 5202 5202B W-2 Employees IRS Federal Copy B1 Page Equals 2 FormsLW2CLW22 LW2CW22500 5203 5203B W-2 Employees Copy C and/or State, City Or Local Copy 21 Page Equals 2 FormsLW2D1 LW2D1500 5204 5204B W-2 Employers Copy D and/or State, City Or Local Copy 21 Page Equals 2 FormsLW2BL LW2BL500 5222 5222B W-2 Blank Face, With W-2 Backer Instructions1 Page Equals 2 FormsLW2NB LW2NB500 5207 5207B W-2 Blank Face, No Backer1 Page Equals 2 FormsLW2BC LW2BC500 5212 5212B W-2 Employees Copies B & C Combined1 Page Equals 1 Form50s500s100s500sFORM DESCRIPTIONLW3C N/A 5309 N/AW-3C Transmittal of Corrected Income and Tax Statement1 Page Equals 1 FormLW2CA LW2CA500 5313 5313B W-2C Corrected Income Fed Copy A1 Page Equals 1 FormLW2CB LW2CB500 5314 5314B W-2C Corrected Income Employees Fed Copy B1 Page Equals 1 FormLW2CC LW2CC500 5316 5316B W-2C Corrected Income Employees Copy C and/or State, City, Local Copy 21 Page Equals 1 FormLW2C2 LW2C2500 5316 5316B W-2C Corrected Income Employees Copy C and/or State, City, Local Copy 21 Page Equals 1 FormLW2CD1 LW2CD1500 5315 5315B W-2C Corrected Income Employers Copy D and/or State, City, local Copy 11 Page Equals 1 FormWE OFFER W-2 CORRECTION FORMS IN SETS, SEE PAGE 16 & 17.11"