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W2 PDF
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W2 Form Template
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
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Select Tax Year
Select
2022
2021
2020
2019
2018
2017
2016
2015
Employer Information
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Employer's Identification No.
Employer's State ID
Company Name
Street Address
City
State
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP Code
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Employee Information
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
First Name
Last Name
Street Address
City
State
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
ZIP Code
SSN
Employee Marital Status
Single
Married
Annual income
Enter the amount paid to the employee - not including tips.
Exemptions
0
1
2
3
4
5
6
7
8
9
Federal Income Tax
State Income Tax
Social Security Tax
Medicare Tax
Wages, Tips, other Compensation
Social security wages
Medicare wages and tips
State wages, tips, etc.
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Additional Information
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Control Number
Dependent Care Benefits
Social Security Tips
Allocated Tips
Nonqualified Plans
Verification Code
Retirement Plan
Statutory Employee
Statutory Employee
Retirement Plan
Third-Party Sick Pay
Third-Party Sick Pay
Tax Code (12A)
Select
Code A—Uncollected social security or RRTA tax on tips
Code B—Uncollected Medicare tax on tips
Code C—Taxable cost of group-term life insurance over $50,000
Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan)
Code E—Elective deferrals under a section 403(b) salary reduction agreement
Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP
Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan
Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan
Amount (12A)
Tax Code (12B)
Select
Code A—Uncollected social security or RRTA tax on tips
Code B—Uncollected Medicare tax on tips
Code C—Taxable cost of group-term life insurance over $50,000
Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan)
Code E—Elective deferrals under a section 403(b) salary reduction agreement
Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP
Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan
Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan
Amount (12B)
Tax Code (12C)
Select
Code A—Uncollected social security or RRTA tax on tips
Code B—Uncollected Medicare tax on tips
Code C—Taxable cost of group-term life insurance over $50,000
Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan)
Code E—Elective deferrals under a section 403(b) salary reduction agreement
Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP
Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan
Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan
Amount (12C)
Tax Code (12D)
Select
Code A—Uncollected social security or RRTA tax on tips
Code B—Uncollected Medicare tax on tips
Code C—Taxable cost of group-term life insurance over $50,000
Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan)
Code E—Elective deferrals under a section 403(b) salary reduction agreement
Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP
Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan
Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan
Amount (12D)
Local wages, Tips, etc.
Local Income Tax
State
Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Locality Name
Other
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