Payroll One Month Project
Attention: This form is provided for informational purposes only. Copy A appears in red, similar to the official IRS form. Do not file Copy A downloaded from this website with the SSA. The official printed version of this IRS form is scannable, but the online version of it, printed from this website, is not. A penalty may be imposed for filing forms that can’t be scanned. See the penalties section in the current General Instructions for Forms W-2 and W-3 for more information.
To order official IRS forms, go to Online Ordering for Information Returns and Employer Returns, and we’ll mail you the scannable forms and other products.
You may file Forms W-2 and W-3 electronically on the SSA’s website at Employer W-2 Filing Instructions and Information. You can create fill-in versions of Forms W-2 and W-3 for filing with SSA. You may also print out copies for filing with state or local governments, distribution to your employees, and for your records.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information about printing these tax forms.
DO NOT STAPLE
33333 a Control number For Official Use Only ▶
OMB No. 1545-0008
b Kind of Payer (Check one)
▲ 941 Military 943 944
CT-1 Hshld. emp.
Medicare govt. emp.
Kind of Employer (Check one)
▲ None apply 501c non-govt.
State/local non-501c State/local 501c Federal govt.
Third-party sick pay
(Check if
applicable)
c Total number of Forms W-2 d Establishment number
e Employer identification number (EIN)
f Employer’s name
g Employer’s address and ZIP code
h Other EIN used this year
1 Wages, tips, other compensation 2 Federal income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8 Allocated tips
9 10 Dependent care benefits
11 Nonqualified plans 12a Deferred compensation
12b13 For third-party sick pay use only
14 Income tax withheld by payer of third-party sick pay15 State Employer’s state ID number
16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax
Employer's contact person Employer's telephone number For Official Use Only
Employer's fax number Employer's email address
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 complete.
Signature ▶ Title ▶ Date ▶
Form W-3 Transmittal of Wage and Tax Statements 2016 Department of the Treasury Internal Revenue Service Send 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 filed electronically with the SSA. Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.
Reminder Separate instructions. See the 2016 General Instructions for Forms W-2 and W-3 for information on completing this form. Do not file Form W-3 for Form(s) W-2 that were submitted electronically to the SSA.
Purpose of Form A Form W-3 Transmittal is completed only when paper Copy A of Form(s) W-2, Wage and Tax Statement, is being filed. Do not file Form W-3 alone. All paper forms must comply with IRS standards and be machine readable. Photocopies are not acceptable. Use a Form W-3 even if only one paper Form W-2 is being filed. Make sure both the Form W-3 and Form(s) W-2 show the correct tax year and Employer Identification Number (EIN). Make a copy of this form and keep it with Copy D (For Employer) of Form(s) W-2 for your records. The IRS recommends retaining copies of these forms for four years.
E-Filing The SSA strongly suggests employers report Form W-3 and Forms W-2 Copy A electronically instead of on paper. The SSA provides two free e-filing options on its Business Services Online (BSO) website: • W-2 Online. Use fill-in forms to create, save, print, and submit up to 50 Forms W-2 at a time to the SSA. • File Upload. Upload wage files to the SSA you have created using payroll or tax software that formats the files according to the SSA’s Specifications for Filing Forms W-2 Electronically (EFW2).
W-2 Online fill-in forms or file uploads will be on time if submitted by January 31, 2017. For more information, go to www.socialsecurity.gov/ employer. First time filers, select “Go to Register”; returning filers select “Go To Log In.”
When To File Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2017.
Where To File Paper Forms Send this entire page with the entire Copy A page of Form(s) W-2 to:
Social Security Administration Data Operations Center Wilkes-Barre, PA 18769-0001
Note: If you use “Certified Mail” to file, change the ZIP code to “18769-0002.” If you use an IRS-approved private delivery service, add “ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the ZIP code to “18702-7997.” See Publication 15 (Circular E), Employer’s Tax Guide, for a list of IRS-approved private delivery services.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10159Y
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