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Use www.irs.gov/ele employee plan sick pay14Otherb 12c C doe 1 Wages, tips, other compensation 2 Federal income tax withheldcEmployers name, address, and ZIP code12d C oe 3 Social security wages 4 Social security tax withheldd5 Medicare wages and tips 6 Medicare tax withheldfEmployees address and ZIP code15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 7 Social security tips 8 Allocated tipsForm Wage and Tax Statement dControl number For Privacy Act and Paperwork ReductionSuff. 13 9 StatutoryRetirementThird-party10C C ddooe e aEmployees social security number OMB No. 1545-0008 This information is being furnished to the Internal Revenue Service. If youAPEX LW2CLW22 W-2 2021 eEmployees name, address, and ZIP code 1112aSee instructions for box 12Department of the TreasuryInternal Revenue Service Copy AFor Social Security Administration. Send this entire page with not acceptable. 41-0852411Act Notice, see the separate instructions.employee plan sick pay 12b may be imposed on you if this income is taxable and you fail to report it.Form W-3 to the Social Security Administration; photocopies are Do Not Cut, Fold, or Staple Forms on This Page 14Other b 12c C oe 1 Wages, tips, other compensation 2 Federal income tax withheldd cEmployers name, address, and ZIP code12d C doe 3 Social security wages 4 Social security tax withheld22222 VOID aEmployees social security number For Ofcial Use Only5 Medicare wages and tips 6 Medicare tax withheldOMB No. 1545-000815StateEmployers state ID number2 Federal income tax withheld16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name 7 Social security tips 8 Allocated tipsb 1 Wages, tips, other compensationcEmployers name, address, and ZIP code 3 Social security wages 4 Social security tax withheld 2021 dControl number Suff. 9 Statutory 22222Third-party10C C ddooe e aEmployees social security number OMB No. 1545-00082 Federal income tax withheld APEX LW2D1 Form W-2 6 Medicare tax withheld Department of the TreasuryInternal Revenue Service Retirementsick pay VOID12b5 Medicare wages and tipsWage and Tax Statement eEmployees name, address, and ZIP code 1112aSee instructions for box 12Copy BTo Be Filed With Employees FEDERAL Tax Return. 7 Social security tips 8 Allocated tips 13 employee planThis information is being furnished to the Internal Revenue Service.dControl number 91014Other b 12c C oe 1 Wages, tips, other compensation 4 Social security tax withheldd3 Social security wagese Last name Suff.11employee plan sick pay 12aSee instructions for box 12 C C dooe e OMB No. 1545-0008 Safe, accurate,Visit the IRS website at17State income tax cEmployers name, address, and ZIP code12d C doe 20Locality name 5 Medicare wages and tips 6 Medicare tax withhelddaEmployees social security number FAST! 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Send this entire page with not acceptable. 41-0852411 LW2AAct Notice, see the separate instructions. 5201 14Other 12c oe aEmployees social security number 15StateEmployers state ID number2 Federal income tax withheld16State wages, tips, etc. dControl number 19Local income tax 7 Social security tips 8 Allocated tipsForm W-3 to the Social Security Administration; photocopies are 1 Wages, tips, other compensationC d3 Social security wages 4 Social security tax withheld 9 10 cEmployers name, address, and ZIP code12d oe 5 Medicare wages and tipsWage and Tax Statement eEmployees name, address, and ZIP code Suff.1112aSee instructions for box 12 C doe15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax d20Locality name Form W-2 City,or 6 Medicare tax withheld 2021 Department of the TreasuryInternal Revenue Service13StatutoryRetirementThird-party12b C oeFor Privacy Act and Paperwork Reduction 7 Social security tips State, 8LocalTaxDepartment Act Notice, see separate instructions. employee plan sick pay d CopyDForrCopy1Fo Employer. Allocated tipsdControl number 9 1014Other 12c C doeForm W-2 Wage and Tax Statement 2021 eEmployees name, address, and ZIP code Suff.11StatutoryRetirementThird-party12aSee instructions for box 12 C C doe OMB No. 1545-000815StateEmployers state ID number2 Federal income tax withheld16State wages, tips, etc.17State income tax 18Local wages, tips, etc. 12d C doe 20Locality nameDepartment of the TreasuryInternal Revenue ServiceCopy BTo Be Filed With Employees FEDERAL Tax Return.LW2B 5202 13 employee b 22222 sick pay VOID12b doe aEmployees social security number 1 Wages, tips, other compensation 19Local income taxThis information is being furnished to the Internal Revenue Service. plan14Other 12c C doe 3 Social security wages 4 Social security tax withheldcEmployers name, address, and ZIP code12d C oe 5 Medicare wages and tipsWage and Tax Statement Department of the TreasuryInternal Revenue Service 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax d20Locality name Form W-2 or 6 Medicare tax withheld 2021 For Privacy Act and Paperwork Reduction 7 Social security tips State, LocalTaxDepartment Act Notice, see separate instructions.Copy1ForrEmployer.City, 8 Allocated tipsCopyDFodControl number 9 10 Form W-2 Wage and Tax Statement 2021 eEmployees name, address, and ZIP code Suff.11Statutory 22222Third-party12a C C ddooe e See instructions for box 12 OMB No. 1545-00082 Federal income tax withheldDepartment of the TreasuryInternal Revenue ServiceSafe, accurate,employee Retirementsick pay VOID12b aEmployees social security numberCopy CFor EMPLOYEES RECORDS (See Notice to to be Filed With FAST!Use 13 planEmployee on the back of Copy B.) Employees State, City or Local Incomeor Cop Taxy 2Return LW2C/LW22 5203 14Other b 12c C doe 1 Wages, tips, other compensation 4 Social security tax withheldcEmployers name, address, and ZIP code 3 Social security wages12d C oe 5 Medicare wages and tips 6 Medicare tax withheldd 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality name3 Transmittal W3 forms included with each set dControl number Suff. 7 Social security tips Third-partyC C doe 8 Allocated tips9 10 Form W-2 Wage and Tax Statement 2021 eEmployees name, address, and ZIP code 11StatutoryRetirementsick pay 12aSee instructions for box 12 doeDepartment of the TreasuryInternal Revenue Service For Privacy Act and Paperwork Reduction CopyDFoEmployer.City, Act Notice, see separate instructions.Copy1Forr State, orLocalTaxDepartment LW2D15204 13 employee plan 12b14Other 12c C C ddooe e12d APEX W-2 Packaged Laser Set 15StateEmployers state ID number 16State wages, tips, etc.17State income tax 18Local wages, tips, etc.19Local income tax 20Locality nameCopy W-2 orLocalTaxDepartment For Privacy Act and Paperwork Reduction STANDARD SETS 50 Sheets (100 Employees) Form 1Forr State, Wage and Tax Statement 2021 Department of the TreasuryInternal Revenue Service CopyDFoEmployer.City, LW2D1Act Notice, see separate instructions.5204952144-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D952166-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 2952188-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2STANDARD SETS W/Envelopes 50 Sheets (100 Employees)95214E4-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, + 100 DWCL95216E6-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 2,+ 100 DWCL95218E8-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2, APEX W-2 Packaged Laser Set (continued)+ 100 DWCL MINI SETS W/Self-Seal Envelopes 25 Sheets (50 Employees)STANDARD SETS W/Self-Seal Envelopes 50 Sheets (100 Employees) 95211ES4-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 95214ES4-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, + 50 DWCLS+ 100 DWCLS 95212ES6-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 2, 95216ES6-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 2, + 50 DWCLS+ 100 DWCLS 95213ES8-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2, 95218ES8-Part SET includes: 50 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2, + 50 DWCLS+ 100 DWCLS VALUE SETS W/Self-Seal Envelopes 10 Sheets (20 Employees)MINI SETS 25 Sheets (50 Employees) 95204ES4-Part SET includes: 10 Sheets EA W-2 Copy A, B, C,D, 952114-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D + 20 DWCLS952126-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 2 95206ES6-Part SET includes: 10 Sheets EA W-2 Copy A, B, C, D, 1, 2 952138-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2 + 20 DWCLLSMINI SETS W/Envelopes 25 Sheets (50 Employees) 95208ES8-Part SET includes: 10 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2 95211E4-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D,+ 20 DWCL+ 50 DWCL APEX W-2C Corrected Income Set95212E6-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 2, + 50 DWCL STANDARD SET W/Envelopes 50 Sheets (50 Employees)95213E8-Part SET includes: 25 Sheets EA W-2 Copy A, B, C, D, 1, 1, 2, 2,952196-Part SET Includes: 50LW2CA, 50LW2CB, 100LW2CC,+ 50 DWCL 100LW2D1, 3LW3C + 50DWW2C18'