Form W-3 - Transmittal Of Wage And Tax Statements (Info Copy Only) - 2017 Page 2
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1
2DO NOT STAPLE
a Control number
For Official Use Only
▶
33333
OMB No. 1545-0008
b
941
Military
943
944
None apply
501c non-govt.
Third-party
sick pay
Kind
Kind
of
of
(Check if
Hshld.
Medicare
State/local
Payer
Employer
applicable)
CT-1
emp.
govt. emp.
non-501c
State/local 501c
Federal govt.
(Check one)
(Check one)
c Total number of Forms W-2
d Establishment number
1 Wages, tips, other compensation
2 Federal income tax withheld
e Employer identification number (EIN)
3 Social security wages
4 Social security tax withheld
6 Medicare tax withheld
f Employer’s name
5 Medicare wages and tips
7 Social security tips
8 Allocated tips
10 Dependent care benefits
9
11 Nonqualified plans
12a Deferred compensation
g Employer’s address and ZIP code
h Other EIN used this year
13 For third-party sick pay use only
12b
15 State
Employer’s state ID number
14 Income tax withheld by payer of third-party sick pay
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
Date
Title
▶
▶
▶
W-3
2017
Transmittal of Wage and Tax Statements
Department of the Treasury
Form
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 2017 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
Complete a Form W-3 Transmittal only when filing paper Copy A of
Form(s) W-2, Wage and Tax Statement. Don't 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
When To File Paper Forms
retaining copies of these forms for four years.
E-Filing
Mail Form W-3 with Copy A of Form(s) W-2 by January 31, 2018.
Where To File Paper Forms
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
Send this entire page with the entire Copy A page of Form(s) W-2 to:
e-filing options on its Business Services Online (BSO) website:
Social Security Administration
• W-2 Online. Use fill-in forms to create, save, print, and submit up to
Direct Operations Center
50 Forms W-2 at a time to the SSA.
Wilkes-Barre, PA 18769-0001
• 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
Note: If you use “Certified Mail” to file, change the ZIP code to
Specifications for Filing Forms W-2 Electronically (EFW2).
“18769-0002.” If you use an IRS-approved private delivery service, add
W-2 Online fill-in forms or file uploads will be on time if submitted by
“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change
January 31, 2018. For more information, go to
the ZIP code to “18702-7997.” See Publication 15 (Circular E),
employer. First time filers, select “Register”; returning filers select “Log
Employer’s Tax Guide, for a list of IRS-approved private delivery
In.”
services.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10159Y
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