2017 Form W-2 - E-file Your Income Tax Return …

1 22222 Voida Employee s social security numberFor Official Use Only a OMB No. 1545-0008 b Employer identification number (EIN)c Employer s name, address, and ZIP coded Control numbere Employee s first name and initialLast Employee s address and ZIP code1 Wages, tips, other compensation2 Federal Income tax withheld3 Social security wages4 Social security tax withheld5 Medicare wages and tips6 Medicare tax withheld7 Social security tips8 Allocated tips9 Verification code10 Dependent care benefits11 Nonqualified plans12a See instructions for box 12Co d e12bCo d e12cCo d e12dCo d e13 Statutory employeeRetirement planThird-party sick pay14 Other15 StateEmployer s state ID number16 State wages, tips, State Income tax18 Local wages, tips.

2 Local Income tax20 Locality nameFormW-2 Wage and Tax Statement2017 Copy A For Social Security Administration Send this entire page with form W-3 to the Social Security Administration; photocopies are not of the Treasury internal revenue Service For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 10134 DDo Not Cut, Fold, or Staple Forms on This Page 22222a Employee s social security number OMB No. 1545-0008 b Employer identification number (EIN)c Employer s name, address, and ZIP coded Control numbere Employee s first name and initialLast Employee s address and ZIP code1 Wages, tips, other compensation2 Federal Income tax withheld3 Social security wages4 Social security tax withheld5 Medicare wages and tips6 Medicare tax withheld7 Social security tips8 Allocated tips9 Verification code10 Dependent care benefits11 Nonqualified plans12a Co d e12bCo d e12cCo d e12dCo d e13 Statutory employeeRetirement planThird-party sick pay14 Other15 StateEmployer s state ID number16 State wages, tips, State Income tax18 Local wages, tips, Local Income tax20 Locality nameFormW-2 Wage and Tax Statement2017 Department of the Treasury internal revenue ServiceCopy 1 For State, City.

3 Or Local Tax Department a Employee s social security numberOMB No. 1545-0008 Safe, accurate, FAST! UseVisit the IRS website at b Employer identification number (EIN)c Employer s name, address, and ZIP coded Control numbere Employee s first name and initialLast Employee s address and ZIP code1 Wages, tips, other compensation2 Federal Income tax withheld3 Social security wages4 Social security tax withheld5 Medicare wages and tips6 Medicare tax withheld7 Social security tips8 Allocated tips9 Verification code10 Dependent care benefits11 Nonqualified plans12a See instructions for box 12Co d e12bCo d e12cCo d e12dCo d e13 Statutory employeeRetirement planThird-party sick pay14 Other15 StateEmployer s state ID number16 State wages, tips, State Income tax18 Local wages, tips.

4 Local Income tax20 Locality nameFormW-2 Wage and Tax Statement2017 Department of the Treasury internal revenue ServiceCopy B To Be Filed With Employee s FEDERAL Tax Return . This information is being furnished to the internal revenue Service. a Employee s social security numberOMB No. 1545-0008 This information is being furnished to the internal revenue Service. If you are required to file a tax Return , a negligence penalty or other sanction may be imposed on you if this Income is taxable and you fail to report Employer identification number (EIN)c Employer s name, address, and ZIP coded Control numbere Employee s first name and initialLast Employee s address and ZIP code1 Wages, tips, other compensation2 Federal Income tax withheld3 Social security wages4 Social security tax withheld5 Medicare wages and tips6 Medicare tax withheld7 Social security tips8 Allocated tips9 Verification code10 Dependent care benefits11 Nonqualified plans12a See instructions for box 12Co d e12bCo d e12cCo d e12dCo d e13 Statutory employeeRetirement planThird-party sick pay14 Other15 StateEmployer s state ID number16 State wages, tips, State Income tax18 Local wages, tips.

5 Local Income tax20 Locality nameFormW-2 Wage and Tax Statement2017 Department of the Treasury internal revenue ServiceSafe, accurate, FAST! UseCopy C For EMPLOYEE S RECORDS (See Notice to Employee on the back of Copy B.) a Employee s social security numberOMB No. 1545-0008 b Employer identification number (EIN)c Employer s name, address, and ZIP coded Control numbere Employee s first name and initialLast Employee s address and ZIP code1 Wages, tips, other compensation2 Federal Income tax withheld3 Social security wages4 Social security tax withheld5 Medicare wages and tips6 Medicare tax withheld7 Social security tips8 Allocated tips9 Verification code10 Dependent care benefits11 Nonqualified plans12a Co d e12bCo d e12cCo d e12dCo d e13 Statutory employeeRetirement planThird-party sick pay14 Other15 StateEmployer s state ID number16 State wages, tips, State Income tax18 Local wages, tips.

6 Local Income tax20 Locality nameFormW-2 Wage and Tax Statement2017 Department of the Treasury internal revenue Service Copy 2 To Be Filed With Employee s State, City, or Local Income Tax Retur