DO NOT STAPLE OR FOLD
a
Control number
For Official Use Only
33333
OMB No. 1545-0008
b
941-SS
Military
943
944-SS
1
Wages, tips, other compensation
2
Income tax withheld
Kind
of
Hshld.
Medicare
Third-party
3
Social security wages
4
Social security tax withheld
Payer
emp.
govt. emp.
sick pay
c
Total number of Forms W-2
d Establishment number
5
Medicare wages and tips
6
Medicare tax withheld
e
Employer identification number (EIN)
7
Social security tips
8
f
Employer’s name
9
Advance EIC payments
10
11
Nonqualified plans
12
Deferred compensation
13
For third-party sick pay use only
14
Income tax withheld by payer of third-party sick pay
g
Employer’s address and ZIP code
h
Other EIN used this year
i
Employer’s territorial ID number
Contact person
Telephone number
For Official Use Only
(
)
E-mail address
Fax number
(
)
Copy 1—For Local Tax Department
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
W-3SS
2 0
0 6
Department of the Treasury
Transmittal of Wage and Tax Statements
Form
Internal Revenue Service
Contact the Division of Revenue and Taxation, Commonwealth of the
Extension to furnish Forms W-2 to employees. You may request an
Northern Mariana Islands, for the address to send Copy 1 of
extension of time to furnish Forms W-2 to employees by sending a letter to:
Forms W-2CM and W-3SS.
IRS Enterprise Computing Center—Martinsburg
Information Reporting Program
Shipping and mailing. If you file more than one type of form, please
Attn: Extension of Time Coordinator
group forms of the same type with a separate Form W-3SS for each
240 Murall Drive
type. For example, send Forms W-2GU with one Form W-3SS and
Kearneysville, WV 25430
Forms W-2AS with a second Form W-3SS. Forms W-2AS, W-2GU,
W-2CM, or W-2VI are printed two forms to a page. Send the whole
Mail your letter on or before the due date for furnishing Forms W-2 to
page of Copies A and 1 even if one of the forms is blank or “Void.”
employees. It must include:
Prepare and file Forms W-2 either alphabetically by employees’ last
● Your name and address,
names or numerically by employees’ social security numbers. Do not
● Your employer identification number (EIN),
staple or tape the forms together and do not fold them. Send the forms
● A statement that you are requesting an extension to furnish "Forms W-2"
in a flat mailing.
to employees,
● Reason for delay, and
General Instructions for Forms W-2AS,
● Your signature or that of your authorized agent.
W-2GU, W-2CM, and W-2VI
Undeliverable forms. Keep for 4 years any employee copies of Forms
Furnishing Copies B and C to employees. Furnish Copies B and C of
W-2AS, W-2GU, W-2CM, or W-2VI that you tried to deliver but could not.
Forms W-2AS, W-2GU, W-2CM, and W-2VI to your employees by
Do not send undeliverable Forms W-2 to the SSA.
January 31, 2007. If employment ends before December 31, 2006, you may
Calendar year basis. Base all entries on Forms W-2AS, W-2GU, W-2CM,
furnish the copies any time after employment ends but no later than
W-2VI, and W-3SS on a calendar year. Use the correct year form.
January 31, 2007. If the employee asks for the form, furnish him or her the
completed copies within 30 days of the request or within 30 days of the
Electronic reporting. If you are required to file 250 or more Forms W-2AS,
last wage payment, whichever is later. If an employee loses a form, write
W-2GU, W-2CM, or W-2VI, you must file them electronically. You can get
“REISSUED STATEMENT” on the new copy (unless it was furnished
specifications for filing this information electronically by visiting Social
electronically), but do not send Copy A of the reissued statement to the
Security’s Employer Reporting Instructions and Information website at
SSA. Employers are not prohibited (by the Internal Revenue Code) from
or by contacting an SSA Employer
charging a fee for the issuance of a duplicate Form W-2AS, W-2GU,
Services Liaison Officer (ESLO) at 212-264-1117 for the U.S. Virgin Islands
W-2CM, or W-2VI.
or 510-970-8247 for Guam and American Samoa. SSA will no longer accept
any type of physical media (magnetic tape, cartridge, diskette, etc.)
submissions of Form W-2 reports.
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