Form W-3ss - Transmittal Of Wage And Tax Statements - 2013 Page 2

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DO 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)
non-501c
State/local 501c
Federal govt.
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
Telephone number
Contact person
For Official Use Only
Email address
Fax number
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
2013
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-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 2013 General Instructions for Forms W-2
for Filing Forms W-2 Electronically (EFW2).
and W-3 for information on completing this form.
W-2 Online fill-in forms or file uploads will be on time if submitted by
Purpose of Form
March 31, 2014. For more information, go to
employer and select “First Time Filers” or “Returning Filers” under “BEFORE
YOU FILE.”
A Form W-3SS Transmittal is completed only when paper Copy A of Form(s)
W-2AS, W-2GU, or W-2VI is being filed. Do not file Form W-3SS alone. Do
When To File
not file Form W-3SS for Form(s) W-2AS, W-2GU or W-2VI that were
submitted electronically to the SSA (see below). All paper forms must
Mail Copy A of Form W-3SS with Copy A of Form(s) W-2AS, W-2CM,
comply with IRS standards and be machine readable. Photocopies are not
W-2GU, or W-2VI by February 28, 2014.
acceptable. Use a Form W-3SS even if only one paper Form W-2AS, W-2GU,
Where To File Paper Forms
or W-2VI is being filed. Make sure both the Form W-3SS and Form(s) W-2AS,
W-2GU, or W-2VI show the correct tax year and Employer Identification
Send this entire page with the entire Copy A page of Form(s) W-2AS,
Number (EIN). Make a copy of this form and keep it with Copy D (For
Employer) of Form(s) W-2AS, W-2GU, or W-2VI for your records. The IRS
W-2CM, W-2GU, or W-2VI to:
recommends retaining copies of these forms for four years.
Social Security Administration
Data Operations Center
E-Filing
Wilkes-Barre, PA 18769-0001
The SSA strongly suggests employers report Form W-3SS and Form(s)
Note. If you use “Certified Mail” to file, change the ZIP code to
W-2AS, W-2GU, or W-2VI Copy A electronically instead of on paper. The
“18769-0002.” If you use an IRS-approved private delivery service, add
SSA provides two free e-filing options on its Business Services Online (BSO)
“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the
website:
ZIP code to “18702-7997.” See Pub. 15 (Circular E), Employer’s Tax Guide,
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-2GU, or W-2VI at a time to the SSA. The SSA currently
does not offer this service for Form W-2CM.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10117S

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