b"W-2 PRE-PRINTED FORMSAlternate 4-Up Laser Combined FormatAPEX L275 VisittheIRSWebSite APEX L4UPW at Department of theTreasury - Internal Revenue Service Department of theTreasury - Internal Revenue ServiceOMB No. 1545-0008 1Wages, tips, other compensation 2Federal income tax withheld OMB No. 1545-0008 1Wages, tips, other compensation 2Federal income tax withheld OMBNo.1545-0008 Form W-2Wageand Tax Statement2022 OMBNo.1545-0008 Form W-2Wageand Tax Statement20223Socialsecuritywages 4 Social security tax withheld 3Socialsecuritywages 4 Social security tax withheld TFP 5214 8 7Socialsecuritytips 1 3 Wages, tips, other comp. 2 Federal income tax withheld 7 8 Socialsecuritytips 1 3 Wages, tips, other comp. 2Federal income tax withheld TFP 52165 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 Socialsecuritywages 4 Social security tax withheldc Employers name, address, and ZIP code c Employers name, address, and ZIP code 9 5 Medicare wages and tips 6 Medicare tax withheld 9 5 Medicare wages and tips 6 Medicare tax withheldc Employers name, address, and ZIP code c Employers name, address, and ZIP code7Socialsecuritytips 8Allocatedtips 9 7Socialsecuritytips 8Allocatedtips 9C 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 C e d o 11 plans 12a C e d o C e d o 10Dependentcare 11 plansC12a o e d Seinstructionsforbox1210Dependentcare 11 plansC12a o e d Seinstructionsforbox1212b 12c 12d 12b 12c 12db Employers n number (EIN) a Employees social security number b Employers iden n number (EIN)a Employees social security number b Employ umber (EIN)C12bo e d b Employ number (EIN)C12bo e d13S em tapt l u oty o e ry e R pl eatnirement T shicir k dp-ap y arty 14Other 13S em tapt l uotyoery e R pl eatnirement T shicir kdp-a p y arty14Other a Employees social security numberC12co e d a Employees social security numberC12co e d14OtherC12de d o S em taptluotyoeyr Rlatnire p ement T si hcikrdp-ap y arty 14OtherC12de d o Smt e apt l u otyoery e Rleatinrement p T si hci k rdp-apyartye Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff. 13 13e Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff.15State Employers state ID number 16 State wages, tips, etc. 15State Employers state ID number 16 State wages, tips, etc.S W-2 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 taxWtaatgeemaenndt Tax Wtaatgeem aenndt2022 C 19 Local income tax 20Localityname 2022 C 19 Local income tax 20Localityname 18Localwages,tips,etc. 19 Local income tax 20Localityname 18Localwages,tips,etc. 19 Local income tax 20LocalitynameCoitpyy, o2r TLoo cBael FInicleodm wei tTha ExmRpeltouyrne.e's State, Ciotypy, o 2rTLoocBael FInilceodm wei tTha ExmRpeltouyren.e's State,3Social www.irs.gov/ele Department of theTreasury - Internal Revenue Service This the Wages, tips, other compensation Federal income tax withheld oehnqiyus ioireunfdiofrttmohaist iionanc otisam xbeerurnfxu,arn a b linseehagenldidgteyonoctuhee fpaIenil tea (See on back of Copy B.) This information is being furnished to the Internal Revenue ServiceOMB No. 1545-0008 1Wages, tips, other compensation 2Federal income tax withheld pe OMB No. 1545-0008 SnI s a e i et re ntosi x 1 3Socialsecuritywages Department of the 2 Treasury - Internal Revenue Service7 COPY Cr T For EMPLOYEE'S en is i tg ta 1 RECORDS n Wage 2Dept. of theTreasury - IRS 7 COPYBTo Beled withemployees 1 FEDERALTaxReturn 2Dept. of theTreasury - IRSbheiinsIginntfefuorrnrnmaislahteiodntios setnuran, lto furntIo ap tioduaaneretcae 6 Medicare tax withheld OMB securitytips W-2 and Tax Statement2022 Socialsecuritytips Wages, tips, other comp. Federal income tax withheldT the Service. securitywages 4 Social security tax withheld i rm y being fa informfeiysvahoeeungeer beifthis5 Medicare wages and tips 4 Social security tax withheld __ No.1545-0008 Form tor nlrtyaelpooRr reotvtithe.neur esaSnecrtviiocnem. Iaf yyobue aimreposed Notice to Employee OMBNo.1545-0008 Form W-2Wageand Tax Statement2022Revenue 5 Medicare wages and tips 6 Medicare tax withheld reetqeruvrniircedoela.Rnomrengaoyytlihou Social Wages, tips, other comp. Federal income tax withheldinacnpocomti yd lntiosxaobrtleiat.ndouc Employers name, address, and ZIP code c Employers name, address, and ZIP code 8Allocatedtips 3Socialsecuritywages 4 Social security tax withheld 8Allocatedtips 3Socialsecuritywages 4 Social security tax withheld9 5 Medicare wages and tips 6 Medicare tax withheld 9 5 Medicare wages and tips 6 Medicare tax withheld7Socialsecuritytips 8Allocatedtips 9 7Socialsecuritytips 8Allocatedtips 9 c Employers name, address, and ZIP code c Employers name, address, and ZIP code10Dependentcare 11 plans C e d o 12a See instructions for box 1210Dependentcare 11 plans C e d o 12aSeeinstructionsforbox 12 C e d o 12b iden C e d o 12c C e d o 12d C e d o 12b iden C e d o 12c C e d o 12d 10Dependentcare 11 plansC12a o e d 10Dependentcare 11 plansC12a o e db Employers n number (EIN)a Employees social security number b Employers n number (EIN) a Employees social security number13S em tapt l uotyoery e Rleatni p rement T shicir kdp-apyarty 14Other 13Smt e apt l uotyoery e R pl eatnirement T shicir kdp-apyarty 14Other b Employ number (EIN)C12bo e d b Employ number (EIN)C12bo e de Employees name, address, and ZIP code Suff. e Employees name, address, and ZIP code Suff. a Employees social security numberC12co e d a Employees social security numberC12co e d14OtherC12de d o y o e ry e Rleatnirement p T si hci kdp-r a p y arty 14OtherC12de d o Smt e apt l u otyoery e R platinremente T si h ci k rdp-apyarty13Smt e apt l uot 1315State 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.W-2 17 State income tax 18Localwages,tips,etc. W-2 17 State income tax 18Localwages,tips,etc.Wtaatgeem aenndtS Tax WStaatgeem aenndt Tax2022 19 Local income tax 20Localityname 2022 19 Local income tax 20LocalitynameFor Privacy Act and Paperwork ReductionAct Notice, se separate instructions. APEX L276 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income tax 15State EmployersstateID no. 16 State wages, tips, etc. 17 State income tax APEX L4UPWRCopy B To Be Filed withCopy C For EMPLOYEE'S RECORDS.Employee's FEDERAL Tax Return. (See Notice to Employee on back of Copy B).OMB No. 1545-0008 L275For Privacy Act and Paperwork ReductionAct Notice, se separate instructions. OMB No. 1545-0008 5214 2 Federal income tax withheld 18Localwages,tips,etc. 19 Local income tax 20Localityname Form 18Localwages,tips,etc. 19 Local income tax 2022 20Localityname FormW-2 Wage and Tax Statement20221 Wages, tips, other compensation 2 Federal income tax withheld 1 Wages, tips, other compensation 22222W-2 Wage and Tax Statement 2222222222 3 Social security wages 4 Social security tax withheld 22222 3 Social security wages 4 Social security tax withheld TFP 5215 Copy2 ForEmployee's State,CityorLocalIncomeTax 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 withheld TFP 52177 Social security tips Copy2 ForEmployee's State,CityorLocalIncome 7 Social security tips5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 8 Allocated tips 3 Social security wages 4 Social security tax withheld 8 Allocated tips 52163 Social security wages 4 Social security tax withheldL4UPWc Employers name, address, and ZIP code c Employers name, address, and ZIP code 9 5 Medicare wages and tips 6 Medicare tax withheld 9 5 Medicare wages and tips 6 Medicare tax withheldc Employers name, address, and ZIP code c Employers name, address, and ZIP code7 Social security tips 8 Allocated tips 97 Social security tips 8 Allocated tips 9 C 10 Dependent careC d o e 11 plans C e d o C e d o 12a See instructions for box1210 Dependent careC e d o C e d o 11 plans 12a C e d o C e d oSee instructions for box1210 Dependent 11 plansCC12a o o e e d dSe instructions for box 1210 Dependent care11 plansCC12a o o e ed dSee instructions for box12 e d o 12b 12c 12d 12b 12c 12d b Employ number (EIN)12bb Employ number (EIN)12b b Employersn 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 ed13S em tapt l u ot y o e ry e Rleatni p rement T shicir kd p- a p y arty 14 Other 13Smt e apt l uotyoery e Rleatni p rement T shicir k dp-apyarty 14 Other 14 OtherC12ded o S em taptluotyoeyr R pl e atnirement T si hcikrdp-apy arty 14 OtherC12ded o S emaptt l u otyoery e Rleat pnriement T si hci k rdp- a p y rty13 13e 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.15State Employer s state ID number 16 State wages, tips, etc. 15State Employer s state ID number 16 State wages, tips, etc.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 taxStaatgeem aenndt Tax WW Staatgeem aenndt Tax 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 Void2022 19 Local income tax 20 Locality name 2022 19 Local income tax 20 Locality name COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS t COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS t State, Local, or File CopyFor Privacy Act and Paperwork ReductionAct Notice, se separate instructions. EMPLOYER'S1 Wages, tips, other compensation 2 Federal income tax withheldLOCAL OR FILE COPY FormFor PArcitv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRterudcutcioinosn. LOCAL OR FILE COPY FormFor PArcitv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRtreudcutcioinosn.EMPLOYER'S State, Local, or File CopyDepartment of the Treasury - IRS Department of the Treasury - IRSOMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheld OMB No. 1545-0008For Privacy Act and Paperwork ReductionAct Notice, se separate instructions. 22222W-2 Wage and Tax Statement2022 22222W-2 Wage and Tax Statement202222222 3 Social security wages 4 Social security tax withheld 22222 3 Social security wages 4 Social security tax withheld 7 Social security tips 1 Wages, tips, other comp. 2 Federal income tax withheld 7 Social security tips 1 Wages, tips, other comp. 2 Federal income tax withheld5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 8 Allocated tips 3 Social security wages 4 Social security tax withheld 8 Allocated tips 3 Social security wages 4 Social security tax withheldc Employers name, address, and ZIP code c Employers name, address, and ZIP code 9 5 Medicare wages and tips 6 Medicare tax withheld 9 5 Medicare wages and tips 6 Medicare tax withheldc Employers name, address, and ZIP code c Employers name, address, and ZIP code7 Social security tips 8 Allocated tips 97 Social security tips 8 Allocated tips 9 10 Dependent care11 plans C e d o 12a See instructions for box1210 Dependent care11 plans C e d o 12a See instructions for box1210 Dependent care11 plansC12a o edSee instructions for box1210 Dependent care11 plansC12a o edSee instructions for box12 C 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 edb 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 ed13Smt e apt l uotyoery e Rleatni p rement T shci i r k dp-apyarty 14 Other 13Smt e apt l uotyoery e R pl eatnirement T shci i r k dp- a p y arty 14 Other 14 OtherC12ded o Smt e apt l uot y o e ry e Rleatni p rement T si hci kdp-ra py rty 14 OtherC12ded o Smt e apt l uot y o e ry e Rleatnri p ement T si h ci k rdp-ap y arty13 13e 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.15State Employer s state ID number 16 State wages, tips, etc. 15State Employer s state ID number 16 State wages, tips, etc.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 taxStaatgeem aenndt Tax Wtaatgeem aenndt Tax S 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 VoidW2022 19 Local income tax 20 Locality name 2022 19 Local income tax 20 Locality name COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRS t COPY 1/D EMPLOYER'S - STATE, OMB No. 1545-0008 Dept. of the Treasury - IRSEMPLOYER'SEMPLOYER'SState, Local, or File CopyState, Local, or File Copy LOCAL OR FILE COPYFor APrcitv Nacoyti cAec,tsaenedsPeappaerrawteo rikn sRterudcutcioinosn. LOCAL OR FILE COPYFor PAcritv aNcoyti cAec,tsaenedsPeappaerrawteo rink sRterudcutcioinosn.tDepartment of the Treasury - IRS Department of the Treasury - IRS L4UPWR 5217L276 5215Required Envelope: Required Envelope:APEX: DW298 APEX: DW4MW or DW4MWD or DW4MWSTFP: 91911 TFP: 61611 or 61612APEX - Sheets per packTFP - Forms per pack50s500s100s500sFORM DESCRIPTIONN/AN/A 5213N/AW-2 T-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 Form(Required Envelope: TFP 31311)L275L27550052145214BW-2 M-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 FormL276L27650052155215BW-2 M-Style Alternate 4-Up Employers Copies 1/D, 1/D, 1/D, 1/D1 Page Equals 1 FormL4UPWL4UPW50052165216BW-2 W-Style Alternate 4-Up Employees Copies B, C, 2, 21 Page Equals 1 FormL4UPWRL4UPWR50052175217BW-2 W-Style Alternate 4-Up Employers Copies 1/D, 1/D, 1/D, 1/D1 Page Equals 1 Form13"