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You may request a waiver from filing on magnetic media by filing

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

Form 8508, Request for Waiver From Filing Information Returns

not have an EIN when filing Form W-3PR, enter “Applied For” in

Magnetically. Submit Form 8508 to the IRS at least 45 days before

box c, not your social security number (SSN). You can get an EIN

the due date of the return. See Form 8508 for filing information.

by filing Form SS-4PR, Solicitud de N ´ umero de Identificaci ´ on

Patronal (EIN).

If you are filing Forms 499R-2/W-2PR using diskette, you will

need to complete Form 6559, Transmitter Report and Summary of

Boxes d and e — Employer’s name and address. If you are not

using the preprinted Form W-3PR, enter the employer’s name,

Magnetic Media. You may also need Form 6559-A, Continuation

Sheet for Form 6559. Do not use Form W-3PR.

street address, city, state, and ZIP code.

Box f — Other EIN used this year. If you have used an EIN

Magnetic media reporting specifications for Form 499R-2/

(including a prior owner’s EIN) on Form 941-PR or 943-PR

W-2PR are in the SSA’s MMREF-1, Magnetic Media Reporting and

submitted for 2005 that is different from the EIN reported in box c

Electronic Filing. They can be downloaded from the SSA’s

on Form W-3PR, enter the other EIN used. Also, agents generally

Employer Reporting Instructions and Information by accessing

report the employer’s EIN in box f. (If an agent is reporting for more

SSA’s website at You can also

than one employer, leave box f blank.)

get magnetic media (or electronic) specifications by contacting the

SSA’s Employer Services Liaison Officer (ESLO) in Puerto Rico at

Contact person, telephone number, fax number, and email

787-766-5574.

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

questions arise during processing.

Making corrections. Use Form W-3c PR, Transmittal of Corrected

Wage and Tax Statements, to transmit Form(s) 499R-2c/W-2cPR,

Boxes 1-4 and 6-16. In these boxes on Form W-3PR, report

Corrected Withholding Statement, or to make corrections to a

respective totals from the Forms 499R-2/W-2PR that you are

previously filed Form W-3PR.

sending with this Form W-3PR.

Specific Instructions

Reconciling Forms 499R-2/W-2PR, W-3PR,

941-PR, 943-PR and Schedule H-PR (Form

Form W-3PR is read by machines, so please type entries, if

possible, or print as darkly as possible. Send the entire page of

1040-PR)

Form W-3PR with the Original copy of all Forms 499R-2/W-2PR.

Reconcile the related amounts shown on your 2005 Form(s)

Make all dollar entries without the dollar sign ($) and comma, but

499R-2/W-2PR with the amounts shown in boxes 10 through 16 of

with the decimal point (00000.00).

your Form W-3PR, as well as with the applicable lines on the

Note. Amounts reported on related employment forms (for

quarterly Forms 941-PR, the annual Form 943-PR, and Schedule

example, Form 499R-2/W-2PR, Form 941-PR, Form 943-PR, or

H-PR (Form 1040-PR) for 2005. When there are discrepancies

Schedule H-PR (Form 1040-PR)) should agree with the amounts

between amounts reported on Forms 499R-2/W-2PR and W-3PR,

reported on Form W-3PR. If there are any differences, you may be

filed with the SSA and Forms 941-PR, 943-PR, and Schedule H-PR

contacted by the IRS and SSA. You should retain a reconciliation

(Form 1040-PR) filed with the IRS, we must contact you to resolve

for future reference.

the discrepancies.

Box a — Kind of payer. Check the box that applies. Check only

Amounts reported on Forms 499R-2/W-2PR, W-3PR, 941-PR,

one box (see Third-party sick pay, below, for an exception). If more

943-PR, and Schedule H-PR (Form 1040-PR) may not match for

than one box applies (except for third-party sick pay), send each

valid reasons. If the amounts do not match, you should determine

type of Form 499R-2/W-2PR with a separate Form W-3PR.

that the reasons are valid. Keep your reconciliation in case there

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

are inquiries from the IRS or the SSA.

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

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

Privacy Act and Paperwork Reduction Act

Form 941-PR.

Notice

943-PR. Check this box if you are an agricultural employer and

file Form 943-PR and you are sending Forms 499R-2/W-2PR for

We ask for the information on Form W-3PR to carry out the Internal

agricultural employees. For nonagricultural employees, send their

Revenue laws of the United States. We need it to figure and collect

Forms 499R-2/W-2PR with a separate Form W-3PR, checking the

the right amount of tax. Section 6051 of the Internal Revenue Code

appropriate box.

and its regulations require you to furnish wage and tax statements

to employees and to the Social Security Administration. Code

Household. Check this box if you are a household employer

section 6109 requires you to provide your employer identification

sending Forms 499R-2/W-2PR for household employees, and you

number (EIN). If you fail to provide this information in a timely

did not include the household employee’s taxes on Form 941-PR or

manner, you may be subject to penalties.

Form 943-PR.

You are not required to provide the information requested on a

Third-party sick pay. Check this box if you are a third-party

form that is subject to the Paperwork Reduction Act unless the form

payer of sick pay (or are reporting sick pay payments made by a

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

third party) filing Forms 499R-2/W-2PR with third-party sick pay

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

reported in box 8 (“Wages”). Do not check this box if the third-party

may become material in the administration of any Internal Revenue

payer is filing the Forms 499R-2/W-2PR and you are filing a recap

law.

form (see Pub. 15-A for details). If more than one box applies (for

example, this box and the Form 941-PR box), check both boxes

Generally, tax returns and return information are confidential, as

and file a single Form W-3PR for the regular and third-party sick

stated in section 6103. However, section 6103 allows or requires

pay Forms 499R-2/W-2PR.

the IRS to disclose or give the information shown on your tax return

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

Medicare employees only. Check this box if you are a

your tax information to the Department of Justice for civil and

government agency with employees subject only to the 1.45%

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

Medicare tax.

for use in administering their tax laws. And we may give it to certain

Box b — Total number of Forms 499R-2/W-2PR. Enter the

foreign governments under tax treaties they have with the United

number of completed individual Forms 499R-2/W-2PR you are

States. We may also disclose this information to federal and state

sending with this Form W-3PR.

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

Third-party payers of sick pay (or employers using the optional

enforcement and intelligence agencies to combat terrorism.

rule for Form W-2 described in section 6 of Pub. 15-A) must enter

The time needed to complete and file this form will vary

“Third-Party Sick Pay Recap” in this space if the insured employers

depending on individual circumstances. The estimated average

are filing Forms 499R-2/W-2PR reporting the sick pay, and the

time is 27 minutes. If you have comments concerning the accuracy

third-party payer is filing recap forms. See Pub. 15-A for details.

of this time estimate or suggestions for making this form simpler,

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

we would be happy to hear from you. You can write to the Internal

preprinted Form W-3PR from the IRS with Pub. 179 (Circular PR),

Revenue Service, Tax Products Coordinating Committee,

verify that your EIN is correct in box e. Make any necessary

SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6406,

corrections on the form.

Washington, DC 20224. Do not send Forms 499R-2/W-2PR or

If you are not using the preprinted Form W-3PR, enter the

W-3PR to this office. Instead, see Where to file, on page 3.

nine-digit number assigned to you by the IRS. This should be

-4-

Instrucciones Para La Forma W-3pr (Instructions For Form W-3pr) - Informe De Comprobantes De Retencion (Transmittal Of Withholding Statements) - 2005 Page 4

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