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If you are 13 em Rleatnirement p sick pay 12dStaptulotoreyeyrequiredmay beimposed to on file you a if tax this return, income a negligence is taxable and penalty you or fail other to report sanction it.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 name15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19 20Locality 1 Local income of the taxTreasuryInternal 2 Revenue nameService Copy 2ToBe Filed With Employees State, City, or Local Income Tax Return Dept. of the Treasury - IRSDepartment Wage and Tax OMB No. 1545-0008 Wages, tips, other compensation Federal income tax withheldForm W-2Statement 2022 7Social security tips 3Social security wages 4Social security tax withheld OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheldCopy 2ToBe Filed With Employees State, City, or LocalIncome Tax Return. 2022 7 Social security tipscEmployers name, address, and ZIP code 8Allocated tips 5Medicare wages and tips 6Medicare tax withheld FormW-2 Wage and Tax Statement 8 Allocated tips 3 Social security wages 4 Social security tax withheldO 9 10Dependent care benefits 11Nonqualified plans O c Employers name, address, and ZIP codeG 1 12a C C o e d 12b C e d o em pleantirementR Third-party 12c C e o d Other G e Employees name, address, and ZIP code 9 10 Dependent care benefits 5 Medicare wages and tips C C o d e d e o 6 Medicare tax withheldeEmployees name, address, and ZIP code d o 2d 13Staptutory sick pay 14 b Employer identification number (EIN) 11 Nonqualified plans 12ae aEmployees social security number 14 Other 12bbEmployer identification number (EIN)a Employees social security number R C C o e d o e d 12c13Sme taptulotoyerye plaetnirement Third-party 12dsick pay15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 1 19 Department2 20Locality15 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 nameLocal income of the taxTreasuryInternalRevenue nameServicec Form To Wage and Tax 8Allocated tips tips 5 Wages, tips, other compensation 6 Federal income tax withheld This information penalty is being or other furnished sanction to may the Internal be imposed Revenue on you Service. if this income If you are is taxable and you fail to report it. OMB No. 1545-0008 1 Wages, tips, other compensation 2 Federal income tax withheldCopyW-2 2 Statement 2022 7Social securityOMB No. 1545-0008 3Social security wages 4Social security tax withheld Copy2To Be Filed with Employees State, City, or Local Income Tax Return Dept. of the Treasury - IRSPRINTED IN USABe Filed With Employees State, City, or LocalIncome Tax Return. Medicare wages and tips Medicare tax withheld negligencerequired to file a tax return, a 7 Social security tipsEmployers name, address, and ZIP code 9 10Dependent care benefits 11Nonqualified plans FormW-2 Wage and Tax Statement 2022 8 Allocated tips 3 Social security wages 4 Social security tax withheldc Employers name, address, and ZIP code12a C o d e C o d e 12b 1 C o d e 3 a Staptutory Rlaentirement p Third-party 1 12c C o e d 4Other e Employees name, address, and ZIP code 9 10 Dependent care benefits 5 Medicare wages and tips C C e d o o e d 6 Medicare tax withheldeEmployees name, address, and ZIP code 12d em sick pay 11Nonqualified plans 12a See instructions for box 1286 12 W M 8510021792 2019 RR Donnelley - 0667bEmployer identification number (EIN) Employees social security number b Employer identification number (EIN) 14Other 12ba Employees social security number C o d e 12c13 emy Rlaentirement p Third-party C o d e 12dStaptulotoerye sick pay15StateEmployers state ID number 16State wages, tips, etc. 17State income tax 18Local wages, tips, etc. 19Local income tax 20Locality name15 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 nameFROM:Copy CForEMPLOYEES RECORDS (See Notice to Employee on the back of Copy B.) Dept. of the Treasury - IRSOMB No. 1545-0008FormW-2 Wage and Tax Statement 2022 7 Social security tips 1 Wages, tips, other compensation 2 Federal income tax withheldc Employers name, address, and ZIP code 8 Allocated tips 3 Social security wages 4 Social security tax withheldSEE REVERSE INSTRUCTIONSSIDE FOR OPENING 9 5 Medicare wages and tips 6 Medicare tax withheldImportant Tax Document Enclosed 1A 806314/1095979 First-Class Mail APEX PS1288 1A 10 Dependent care benefits 11Nonqualified plans C C o e d e d o 12a See instructions for box 12 APEX LW287PSBe Employees name, address, and ZIP code b Employer identification number (EIN) 14Other 12bA S2032B a Employees social security number R C C o d e o e 12cTFP 5227 15 State Employers state ID number 16 State wages, tips, etc. 13 em plaentirement Third-party 18 Local wages, tips, etc. 19d 12d 20 Locality nameStaptulotoyerye sick pay17 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 - IRSS14EZ073O OG GPRINTED IN USA 8 8 2 1 MW 8710039512 2021 RR Donnelley. All rights reserved. - 0221O OG GFROM:SEE REVERSE INSTRUCTIONSSIDE FOR OPENING Important Tax Document Enclosed First-Class MailEccentricEccentric ZFold ZFoldBlank face with backer instructions Blank face with backer instructionsAPEX - Sheets per packTFP- Forms per pack500s500sFORM DESCRIPTIONPS1288522714" Blank W-2 Employees 4-Up HorizontalBlank with Backer Instructions B,C,2, 2EZ-Fold Simplex1 Page Equals 1 FormPS1286522814" W-2 Employees 4-Up HorizontalCopy B, C, 2, 2EZ-Fold Simplex1 Page Equals 1 FormLW287PSN/A14" W-2 Employees 4-Up HorizontalCopy B, C, 2, 2EZ-Fold Simplex1 Page Equals 1 FormLW287PSBN/A14" Blank W-2 Employees 4-Up Horizontal With Backer InstructionsEZ-Fold Simplex1 Page Equals 1 Form19'