Form W-2 - Submitter/transmitter Federal Identification Number

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(Rev. 04/01)
W-2 Magnetic Media Transmitter Report
Massachusetts
Department of
Revenue
Please print or type. For each type of media submitted, complete a separate Magnetic Media Report.
Mail all completed W-2 reports and media to: Massachusetts Department of Revenue P.O. Box 7084, Boston, MA 02204
SUBMITTER/TRANSMITTER FEDERAL IDENTIFICATION NUMBER
--
--
Submitter FID #:
(YOUR TAPE CANNOT BE PROCESSED WITHOUT THE SUBMITTER FID NUMBER)
1
2. Tax Year Filing:
. Submitter name
Contact Person
Street Address
Contact Telephone Number
3.
Media Filed:
City/Town
State
Zip Code
!
Magnetic Tape
!
IBM 3480 Cartridge
!
Check if your organization’s address or name has changed since filing its last report.
!
Diskette
3. Specifications used to file this report. Check either 3a or 3b.
!"
!
3a.
MMREF
3b.
TIB-4
(Prior Approval Required for Tax Year 2001 Reporting)
MMREF Magnetic Media Record Length:
TIB-4 Magnetic Media Record Length:
" !
!
!
275 Bytes
276 Bytes
128 Bytes
!
"512 Bytes only
(Diskette)
4. Magnetic Media Information
Blocking Factor
__________
!"
!"
!"
Format
ASCII
EBCDIC
VMS Backup
!"
!"
!"
Density
1600 BPI
6250 BPI
37,871
(Note: 36 Track not accepted)
!"
!"
Internal Label
IBM Standard
Unlabeled
!
!
5. Is the tape submitted a multiple reel file?
NO
YES (Enter tape numbers on next line)
Tape numbers for multi reel files:
/
/
/
/
6. What is the total number of employers reported?
7. What is the total number of employees reported?
8. Does your company currently file, or plan to file, Form W-2 Reports to the Social Security Administration via
!
!
OWRS, the Online Wage Reporting Service?
NO
YES
8.
Signature I declare I have examined this report and to the best of my knowledge and belief it is true, correct, and complete.
Signature
Title
Date
This report is the only documentation needed to accompany your W-2 filing. Tape dumps and other reports are not required.

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