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

DO NOT STAPLE OR FOLD

a Control number

For Official Use Only

▶

33333

OMB No. 1545-0008

941-SS

Military

943

944

None apply

501c non-govt.

Third-party

sick pay

Kind

(Check if

State/local

Hshld.

Medicare

Payer

Employer

applicable)

non-501c

State/local 501c

Federal govt.

emp.

govt. emp.

(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

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

2012

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 2012 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 April

Purpose of Form

1, 2013. For more information, go to 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)

When To File

W-2AS, W-2GU, or W-2VI is being filed. Do not file Form W-3SS alone. Do

not file Form W-3SS for Form(s) W-2AS, W-2GU or W-2VI that were

Mail Copy A of Form W-3SS with Copy A of Form(s) W-2AS, W-2CM,

submitted electronically to the SSA (see below). All paper forms must

W-2GU, or W-2VI by February 28, 2013.

comply with IRS standards and be machine readable. Photocopies are not

Where To File Paper Forms

acceptable. Use a Form W-3SS even if only one paper Form W-2AS, W-2GU,

or W-2VI is being filed. Make sure both the Form W-3SS and Form(s) W-2AS,

Send this entire page with the entire Copy A page of Form(s) W-2AS,

W-2GU, or W-2VI show the correct tax year and Employer Identification

W-2CM, W-2GU, or W-2VI to:

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

Social Security Administration

recommends retaining 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-2GU, or W-2VI Copy A electronically instead of on paper. The

“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the

SSA provides two free e-filing options on its Business Services Online (BSO)

ZIP code to “18702-7997.” See Pub. 15 (Circular E), Employer’s Tax Guide,

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-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

Form W-3ss - Transmittal Of Wage And Tax Statements - 2012 Page 2

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