Form W-3ss - Transmittal Of Wage And Tax Statements - 2014 Page 2
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1
2
3DO NOT STAPLE OR FOLD
a Control number
For Official Use Only
▶
33333
OMB No. 1545-0008
b
941-SS
Military
943
944
None apply
501c non-govt.
Third-party
sick pay
Kind
Kind
of
of
(Check if
State/local
Hshld.
Medicare
Payer
Employer
applicable)
State/local 501c
Federal govt.
non-501c
emp.
govt. emp.
(Check one)
(Check one)
c Total number of Forms W-2
d Establishment number
1 Wages, tips, other compensation
2 Income tax withheld
e Employer identification number (EIN)
3 Social security wages
4 Social security tax withheld
f Employer’s name
5 Medicare wages and tips
6 Medicare tax withheld
7 Social security tips
8
9
10
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 Employer’s territorial ID number
14 Income tax withheld by payer of third-party sick pay
18 Check the appropriate box
Type of Form
W-2AS
W-2CM
W-2GU
W-2VI
▶
Employer's telephone number
Employer's contact person
For Official Use Only
Employer's fax number
Employer's email address
Copy A—For Social Security Administration
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-3SS
Transmittal of Wage and Tax Statements
2014
Department of the Treasury
Form
Internal Revenue Service
Send this entire page with the entire Copy A page of Form(s) W-2AS, W-2CM, W-2GU, or W-2VI to the Social Security
Administration (SSA). Photocopies are not acceptable. Do not send Form W-3SS if you filed electronically with the SSA.
Do not send any payment (cash, checks, money orders, etc.) with Form(s) W-2AS, W-2CM, W-2GU, W-2VI, and W-3SS.
Reminder
• 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 Specifications
Separate instructions. See the 2014 General Instructions for Forms W-2
for Filing Forms W-2 Electronically (EFW2).
and W-3 for information on completing this form. Do not file Form W-3SS for
W-2 Online fill-in forms or file uploads will be on time if submitted by
Form(s) W-2AS, W-2CM, W-2GU, or W-2VI that were submitted electronically
March 31, 2015. For more information, go to
to the SSA.
employer and select “First Time Filers” or “Returning Filers” under “BEFORE
YOU FILE.”
Purpose of Form
When To File
A Form W-3SS Transmittal is completed only when paper Copy A of Form(s)
W-2AS, W-2CM, W-2GU, or W-2VI is being filed. Do not file Form W-3SS
Mail Copy A of Form W-3SS with Copy A of Form(s) W-2AS, W-2CM,
alone. All paper forms must comply with IRS standards and be machine
W-2GU, or W-2VI by March 2, 2015.
readable. Photocopies are not acceptable. Use a Form W-3SS even if only
one paper Form W-2AS, W-2CM, W-2GU, or W-2VI is being filed. Make sure
Where To File Paper Forms
both the Form W-3SS and Form(s) W-2AS, W-2CM, W-2GU, or W-2VI show
the correct tax year and Employer Identification Number (EIN). Make a copy
Send this entire page with the entire Copy A page of Form(s) W-2AS,
of this form and keep it with Copy D (For Employer) of Form(s) W-2AS,
W-2CM, W-2GU, or W-2VI to:
W-2CM, W-2GU, or W-2VI for your records. The IRS recommends retaining
Social Security Administration
copies of these forms for four years.
Data Operations Center
Wilkes-Barre, PA 18769-0001
E-Filing
Note. If you use “Certified Mail” to file, change the ZIP code to
The SSA strongly suggests employers report Form W-3SS and Form(s)
“18769-0002.” If you use an IRS-approved private delivery service, add
W-2AS, W-2CM, W-2GU, or W-2VI Copy A electronically instead of on paper.
“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the
The SSA provides two free e-filing options on its Business Services Online
ZIP code to “18702-7997.” See Pub. 15 (Circular E), Employer’s Tax Guide,
(BSO) website:
for a list of IRS-approved private delivery services.
• W-2 Online. Use fill-in forms to create, save, print, and submit up to 50
Forms W-2AS, W-2CM, W-2GU, or W-2VI at a time to the SSA.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10117S
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