Form W-3ss - Transmittal Of Wage And Tax Statements

941-SS. Check this box if you file Form 941-SS and no other

Box 11—Nonqualified plans. Enter the total reported in box 11 on

category (except “Third-party sick pay”) applies. A church or church

Forms W-2AS, W-2GU, W-2CM, or W-2VI being filed with this Form

organization should check this box even if it is not required to file Form

W-3SS.

941-SS or Form 944-SS.

Box 12—Deferred compensation. Enter one total for all amounts

Military. Check this box if you are a military employer sending Forms

reported with codes D-H, S, Y, AA, and BB in box 12 of Forms

W-2AS, W-2GU, W-2CM, or W-2VI for members of the uniformed

W-2AS, W-2GU, or W-2VI. Do not enter a code.

services.

Box 13—For third-party sick pay use only. Third-party payers of sick

943. Check this box if you file Form 943 and are sending forms for

pay (or employers using the optional rule for Form W-2 described in

agricultural employees. For nonagricultural employees, send their

section 6 of Pub. 15-A) filing third-party sick pay recap Forms W-2 and

Forms W-2AS, W-2GU, W-2CM, or W-2VI with a separate Form

W-3SS must enter “Third-Party Sick Pay Recap” in this box. See Sick

W-3SS.

Pay Reporting in Pub. 15-A for details.

Box 14—Income tax withheld by payer of third-party sick pay.

944-SS. Check this box if you file Form 944-SS and no other

Complete this box only if you are the employer and have employees

category applies.

who had income tax withheld on third-party payments of sick pay.

Hshld. emp. Check this box if you are a household employer

Show the total income tax withheld by third-party payers on payments

sending Form W-2AS, W-2GU, W-2CM, or W-2VI for household

to all of your employees. Although this tax is included in the box 2

employees, and you did not include the household employee’s taxes

total, it must be shown separately here.

on Form 941-SS, Form 944-SS or Form 943.

Box 15—Type of form. Check this box for the type of forms you are

Medicare government employee. Check this box if you are a U.S.

submitting with this Form W-3SS.

or a U.S. Virgin Islands government employer with employees subject

only to the 1.45% Medicare tax.

Signature. The signature on Copies A and 1 of Form W-3SS must be

an original (not a copy).

Third-party sick pay. Check this box (and one other checkbox) if

Privacy Act and Paperwork Reduction Act Notice. We ask for the

you are a third-party sick pay payer (or are reporting payments made

information on Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS to

by a third party) filing Form(s) W-2AS, W-2GU, or W-2VI with the

“Third-party sick pay” box in box 13 checked.

carry out the Internal Revenue laws of the United States. We need it to

figure and collect the right amount of tax. Section 6051 and its

Box c—Total number of Forms W-2. Show the number of completed

regulations require you to furnish wage and tax statements to

individual Forms W-2AS, W-2GU, W-2CM, or W-2VI filed with this Form

employees and to the Social Security Administration. Section 6109

W-3SS. Do not count “Void” forms.

requires you to provide your employer identification number. If you fail

Box d—Establishment number. You may use this box to identify

to provide this information in a timely manner, you may be subject to

separate establishments in your business. You may file a separate

penalties.

Form W-3SS, with Forms W-2AS, W-2GU, W-2CM, or W-2VI, for each

You are not required to provide the information requested on a form

establishment even if they all have the same EIN, or you may use a

that is subject to the Paperwork Reduction Act unless the form

single Form W-3SS for all Forms W-2 of the same type.

displays a valid OMB control number. Books or records relating to a

Box e—Employer identification number (EIN). If you received a

form or its instructions must be retained as long as their contents may

preprinted Form W-3SS from the IRS with Pub. 80 (Circular SS), make

become material in the administration of any Internal Revenue law.

any necessary corrections on the form. If you are not using a

Generally, tax returns and return information are confidential, as

preprinted IRS Form W-3SS, enter the nine-digit EIN assigned to you

required by section 6103. However, section 6103 allows or requires the

by the IRS. The EIN should be the same as shown on your Form

Internal Revenue Service to disclose or give the information shown on

941-SS, Form 944-SS, or Form 943 and in the following format:

your return to others as described in the Code. For example, we may

00-0000000. Do not use a prior owner’s EIN. If you do not have an

disclose your tax information to the Department of Justice for civil and

EIN, see Box b on page 4. See also Box h below.

criminal litigation, and to cities, states, and the District of Columbia for

Boxes f and g—Employer’s name and address. If you are not using

use in administering their tax laws. We may also disclose this

a preprinted Form W-3SS, enter your name and address as shown on

information to other countries under a tax treaty, to federal and state

your Form 941-SS, Form 944-SS or Form 943. Make any necessary

agencies to enforce federal nontax criminal laws, or to federal law

corrections on your preprinted Form W-3SS.

enforcement and intelligence agencies to combat terrorism.

Box h—Other EIN used this year. If you have used an EIN (including

The time needed to complete and file these forms will vary

a prior owner’s EIN) on Form 941-SS, Form 944, or Form 943

depending on individual circumstances. The estimated average times

submitted for 2006 that is different from the EIN reported in box e on

are: Form W-2AS—23 minutes; Form W-2GU—24 minutes; Form

this form, enter the other EIN used.

W-2VI—24 minutes; Form W-3SS—24 minutes.

Contact person, telephone number, fax number, and e-mail

If you have comments concerning the accuracy of these time

address. Please enter this information for use by the SSA if questions

estimates or suggestions for making these forms simpler, we would be

arise during processing.

happy to hear from you. You can write to the Internal Revenue Service,

Boxes 1 through 7. Enter the totals reported in boxes 1 through 7 of

Tax Products Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111

Forms W-2AS, W-2GU, W-2CM, or Form W-2VI being filed with this

Constitution Ave. NW, IR-6406, Washington, DC 20224. Do not send

Form W-3SS.

Forms W-2AS, W-2GU, W-2VI, or W-3SS to this address. Instead, see

Box 9—Advance EIC payments. Enter the total advance EIC

Where To File Copy A on page 2.

payments shown on Form W-2GU or Form W-2VI only.

Page 7

Form W-3ss - Transmittal Of Wage And Tax Statements - 2006 Page 7

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