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The Internal Revenue Service (IRS) is a government agency responsible for collecting taxes and administering the federal statutory tax laws of the United States. The IRS provide tax assistance to taxpayers and pursue and resolve fraudulent tax filings.

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Caution: DRAFT—NOT FOR FILING
This is an early release draft of an IRS tax form, instructions, or publication,
which the IRS is providing for your information. Do not file draft forms and do
not rely on draft forms, instructions, and publications for filing. We do not
release draft forms until we believe we have incorporated all changes (except
when explicitly stated on this coversheet). However, unexpected issues
occasionally arise, or legislation is passed—in this case, we will post a new draft
of the form to alert users that changes were made to the previously posted draft.
Thus, there are never any changes to the last posted draft of a form and the
final revision of the form. Forms and instructions generally are subject to OMB
approval before they can be officially released, so we post only drafts of them
until they are approved. Drafts of instructions and publications usually have
some changes before their final release.
Early release drafts are at IRS.gov/DraftForms and remain there after the
final release is posted at IRS.gov/LatestForms. All information about all forms,
instructions, and pubs is at IRS.gov/Forms.
Almost every form and publication has a page on IRS.gov with a friendly
shortcut. For example, the Form 1040 page is at IRS.gov/Form1040; the Pub.
501 page is at IRS.gov/Pub501; the Form W-4 page is at IRS.gov/W4; and the
Schedule A (Form 1040/SR) page is at IRS.gov/ScheduleA. If typing in a link
above instead of clicking on it, be sure to type the link into the address bar of
your browser, not a Search box.
If you wish, you can submit comments to the IRS about draft or final forms,
instructions, or publications at IRS.gov/FormsComments. We cannot respond to
all comments due to the high volume we receive and may not be able to
consider many suggestions until the subsequent revision of the product.
If you have comments on reducing paperwork and respondent (filer) burden,
with respect to draft or final forms, please respond to the relevant information
collection through the Federal Register process; for more info, click here.
DO NOT FILE
November 15, 2021
DRAFT AS OF
22222
VOID
a Employee’s social security number
For Official Use Only
▶
OMB No. 1545-0008
b Employer identification number (EIN)
c Employer’s name, address, and ZIP code
d Control number
e Employee’s first name and initial Last name Suff.
f Employee’s address and ZIP code
1 Wages, tips, other compensation
2 VI income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8
9 10
11 Nonqualified plans 12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other
Form
W-2VI
U.S. Virgin Islands
Wage and Tax Statement
2022
Copy A—For Social Security Administration. Send this entire page with Copy A of
Form W-3SS to the Social Security Administration; photocopies are not acceptable.
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction Act
Notice, see the separate instructions.
Cat. No. 49977C
Do Not Cut, Fold, or Staple Forms on This Page
DO NOT FILE
November 15, 2021
DRAFT AS OF
22222
VOID
a Employee’s social security number
OMB No. 1545-0008
b Employer identification number (EIN)
c Employer’s name, address, and ZIP code
d Control number
e Employee’s first name and initial Last name Suff.
f Employee’s address and ZIP code
1 Wages, tips, other compensation
2 VI income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8
9 10
11 Nonqualified plans 12a
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other
Form
W-2VI
U.S. Virgin Islands
Wage and Tax Statement
2022
Copy 1—For VI Bureau of Internal Revenue
Department of the Treasury—Internal Revenue Service
DO NOT FILE
November 15, 2021
DRAFT AS OF
a Employee’s social security number
OMB No. 1545-0008
b Employer identification number (EIN)
c Employer’s name, address, and ZIP code
d Control number
e Employee’s first name and initial Last name Suff.
f Employee’s address and ZIP code
1 Wages, tips, other compensation
2 VI income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8
9 10
11 Nonqualified plans 12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other
Form
W-2VI
U.S. Virgin Islands
Wage and Tax Statement
2022
Copy B—To Be Filed With Employee’s VI Tax Return
Department of the Treasury—Internal Revenue Service
This information is being furnished to the
V.I. Bureau of Internal Revenue.
DO NOT FILE
November 15, 2021
DRAFT AS OF
Notice to Employee
Do you have to file? Refer to the Form 1040 instructions to determine if you are
required to file a tax return. Even if you don’t have to file a tax return, you may be
eligible for a refund if box 2 shows an amount or if you are eligible for any credit.
Copies B and C; corrections. File Copy B of this form with your 2022 U.S. Virgin
Islands income tax return. Keep Copy C for your records. If your name, social
security number (SSN), or address is incorrect, correct Copies B and C and ask
your employer to correct your employment record. Be sure to ask your employer
to file Form W-2c, Corrected Wage and Tax Statement, with the Social Security
Administration (SSA) to correct any name, amount, or SSN error reported to the
SSA. Be sure to get your copies of Form W-2c from your employer for all
corrections made so you may file them with your tax return.
Estimated tax. If you expect to owe $1,000 or more in tax for 2023, you may have
to make estimated tax payments to your local territory tax department. You may
also have to make estimated tax payments to the U.S. Internal Revenue Service if
you are subject to self-employment taxes. See Pub. 570, Tax Guide for Individuals
With Income From U.S. Possessions, for additional information.
Employee’s social security number (SSN). For your protection, this form may
show only the last four digits of your SSN. However, your employer has reported
your complete SSN to the V.I. Bureau of Internal Revenue and the SSA.
Clergy and religious workers. If you aren’t subject to social security and
Medicare taxes, see Pub. 517, Social Security and Other Information for Members
of the Clergy and Religious Workers.
Cost of employer-sponsored health coverage (if such cost is provided by the
employer). The reporting in box 12, using code DD, of the cost of employer-
sponsored health coverage is for your information only. The amount reported
with code DD is not taxable.
Credit for excess social security tax. If one employer paid you wages during
2022 and more than $9,114 in social security tax was withheld, you can claim a
refund of the excess by filing Form 1040 or 1040-SR with the V.I. Bureau of
Internal Revenue, 6115 Estate Smith Bay, Suite 225, St. Thomas, VI 00802.
If you had more than one employer in 2022 and more than $9,114 in social
security tax was withheld, you can have the excess refunded by filing Form 843,
Claim for Refund and Request for Abatement, with the Department of the
Treasury, Internal Revenue Service Center, Austin, TX 73301-0215, USA. However,
if you are required to file Form 1040 or 1040-SR with the United States, you must
claim the excess tax as a credit on Form 1040 or 1040-SR.
Unreported tip income. You must file Form 4137, Social Security and Medicare
Tax on Unreported Tip Income, with your income tax return to figure the social
security and Medicare tax owed on tips you didn’t report to your employer. Enter
this amount on the wages line of your tax return. (Form 1040-SS filers, see the
instructions for Form 1040-SS, Part I, line 6.) By filing this form, your social
security tips will be credited to your social security record (used to figure your
benefits).
(See also the Instructions for Employee on this page and the back of Copy C.)
Instructions for Employee
(See also Notice to Employee on this page.)
Box 5. You may be required to report this amount on Form 8959, Additional
Medicare Tax. See the Form 1040 instructions to determine if you are required to
complete Form 8959.
Box 6. This amount includes the 1.45% Medicare Tax withheld on all Medicare
wages and tips shown in box 5, as well as the 0.9% Additional Medicare Tax on
any of those Medicare wages and tips above $200,000.
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from
a nonqualified deferred compensation or nongovernmental section 457(b) plan, or
(b) included in box 3 and/or box 5 if it is a prior year deferral under a nonqualified
or section 457(b) plan that became taxable for social security and Medicare taxes
this year because there is no longer a substantial risk of forfeiture of your right to
the deferred amount. This box shouldn’t be used if you had a deferral and a
distribution in the same calendar year. If you made a deferral and received a
distribution in the same calendar year, and you are or will be age 62 by the end of
the calendar year, your employer should file Form SSA-131, Employer Report of
Special Wage Payments, with the Social Security Administration and give you a
copy.
Box 12. The following list explains the codes shown in box 12. You may need this
information to complete your tax return. Elective deferrals (codes D, E, F, and S)
and designated Roth contributions (codes AA, BB, and EE) under all plans are
generally limited to a total of $20,500 ($14,000 if you have only SIMPLE plans;
$23,500 for section 403(b) plans if you qualify for the 15-year rule explained in
Pub. 571). Deferrals under code G are limited to $20,500. Deferrals under code H
are limited to $7,000.
(continued on back of Copy C)
DO NOT FILE
November 15, 2021
DRAFT AS OF
a Employee’s social security number
OMB No. 1545-0008
b Employer identification number (EIN)
c Employer’s name, address, and ZIP code
d Control number
e Employee’s first name and initial Last name Suff.
f Employee’s address and ZIP code
1 Wages, tips, other compensation
2 VI income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8
9 10
11 Nonqualified plans 12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other
Form
W-2VI
U.S. Virgin Islands
Wage and Tax Statement
2022
Copy C—For EMPLOYEE’S RECORDS
(See Notice to Employee on the back of Copy B.)
Department of the Treasury—Internal Revenue Service
This information is being furnished to the
V.I. Bureau of Internal Revenue.
DO NOT FILE
November 15, 2021
DRAFT AS OF
Instructions for Employee (continued from back of
Copy B)
Box 12 (continued)
However, if you were at least age 50 in 2022, your employer may have allowed an
additional deferral of up to $6,500 ($3,000 for section 401(k)(11) and 408(p) SIMPLE
plans). This additional deferral amount is not subject to the overall limit on elective
deferrals. For code G, the limit on elective deferrals may be higher for the last 3
years before you reach retirement age. Contact your plan administrator for more
information. Amounts in excess of the overall elective deferral limit must be included
in income. See the “Wages, Salaries, Tips, etc.” line instructions for your tax return.
Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made a make-up
pension contribution for a prior year(s) when you were in military service. To figure
whether you made excess deferrals, consider these amounts for the year shown,
not the current year. If no year is shown, the contributions are for the current year.
A—Uncollected social security tax on tips. Report on U.S. Form 1040 or 1040-SR.
Report on Form 1040-SS if not required to file Form 1040 or 1040-SR.
B—Uncollected Medicare tax on tips. Report on U.S. Form 1040 or 1040-SR.
Report on Form 1040-SS if not required to file Form 1040 or 1040-SR.
C—Taxable cost of group-term life insurance over $50,000 (included in boxes 1, 3
(up to the social security wage base), and 5)
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also
includes deferrals under a SIMPLE retirement account that is part of a section
401(k) arrangement.
E—Elective deferrals under a section 403(b) salary reduction agreement
F—Elective deferrals under a section 408(k)(6) salary reduction SEP
G—Elective deferrals and employer contributions (including nonelective deferrals)
to a section 457(b) deferred compensation plan
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. (You
may be able to deduct.)
J—Nontaxable sick pay (information only, not included in box 1, 3, or 5)
M—Uncollected social security tax on taxable cost of group-term life insurance
over $50,000 (former employees only). Report on U.S. Form 1040 or 1040-SR.
Report on Form 1040-SS if not required to file Form 1040 or 1040-SR.
N—Uncollected Medicare tax on taxable cost of group-term life insurance over
$50,000 (former employees only). Report on U.S. Form 1040 or 1040-SR. Report
on Form 1040-SS if not required to file Form 1040 or 1040-SR.
P—Excludable moving expense reimbursements paid directly to a member of the
U.S. Armed Forces (not included in box 1, 3, or 5)
Q—Nontaxable combat pay. See your tax return instructions for details on
reporting this amount.
R—Employer contributions to your Archer MSA. Report on Form 8853, Archer
MSAs and Long-Term Care Insurance Contracts.
S—Employee salary reduction contributions under a section 408(p) SIMPLE plan
(not included in box 1)
T—Adoption benefits (not included in box 1). Complete Form 8839, Qualified
Adoption Expenses, to figure taxable and nontaxable amounts.
V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3
(up to the social security wage base), and 5). See Pub. 525, Taxable and
Nontaxable Income, for reporting requirements.
W—Employer contributions (including amounts the employee elected to contribute
using a section 125 (cafeteria) plan) to your health savings account (HSA). Report
on Form 8889, Health Savings Accounts (HSAs).
Y—Deferrals under a section 409A nonqualified deferred compensation plan
Z—Income under a nonqualified deferred compensation plan that fails to satisfy
section 409A. This amount is also included in box 1. It is subject to an additional
20% tax plus interest. See “Other Taxes” in the instructions for your tax return.
AA—Designated Roth contributions under a section 401(k) plan
BB—Designated Roth contributions under a section 403(b) plan
DD—Cost of employer-sponsored health coverage. The amount reported with
code DD is not taxable.
EE—Designated Roth contributions under a governmental section 457(b) plan.
This amount does not apply to contributions under a tax-exempt organization
section 457(b) plan.
FF—Permitted benefits under a qualified small employer health reimbursement
arrangement
GG—Income from qualified equity grants under section 83(i)
HH—Aggregate deferrals under section 83(i) elections as of the close of the
calendar year
Box 13. If the “Retirement plan” box is checked, special limits may apply to the
amount of traditional IRA contributions that you may deduct. See Pub. 590-A,
Contributions to Individual Retirement Arrangements (IRAs).
Note: Keep Copy C of Form W-2VI for at least 3 years after the due date for filing
your income tax return. However, to help protect your social security benefits,
keep Copy C until you begin receiving social security benefits just in case there is
a question about your work record and/or earnings in a particular year.
DO NOT FILE
November 15, 2021
DRAFT AS OF
VOID
a Employee’s social security number
OMB No. 1545-0008
b Employer identification number (EIN)
c Employer’s name, address, and ZIP code
d Control number
e Employee’s first name and initial Last name Suff.
f Employee’s address and ZIP code
1 Wages, tips, other compensation
2 VI income tax withheld
3 Social security wages 4 Social security tax withheld
5 Medicare wages and tips 6 Medicare tax withheld
7 Social security tips 8
9 10
11 Nonqualified plans 12a See instructions for box 12
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
12d
C
o
d
e
13
Statutory
employee
Retirement
plan
Third-party
sick pay
14 Other
Form
W-2VI
U.S. Virgin Islands
Wage and Tax Statement
2022
Copy D—For Employer
Department of the Treasury—Internal Revenue Service
This information is being furnished to the
V.I. Bureau of Internal Revenue.
DO NOT FILE
November 15, 2021
DRAFT AS OF
Employers, Please Note—
Specific information needed to complete Form W-2VI is
available in a separate booklet titled the 2022 General
Instructions for Forms W-2 and W-3. Also, see Pub. 80, Federal
Tax Guide for Employers in the U.S. Virgin Islands, Guam,
American Samoa, and the Commonwealth of the Northern
Mariana Islands, for employment-related information for
employers with territory employees. You can order these
instructions and additional forms at www.irs.gov/OrderForms.
Caution: Do not send the SSA any Forms W-2VI and W-3SS
that you have printed from IRS.gov. The SSA is unable to
process these forms. Instead, you can create and submit them
online. See E-filing, later.
Due dates. By January 31, 2023, furnish Copies B and C to
each person who was your employee during 2022. Mail or
electronically file Copy A of Form(s) W-2VI and W-3SS with the
SSA by January 31, 2023. See the separate instructions.
Need help? If you have questions about reporting on Form
W-2VI, call the information reporting customer service site toll
free at 866-455-7438 or 304-263-8700 (not toll free). For TTY/
TDD equipment for persons who are deaf, hard of hearing, or
have a speech disability, call 304-579-4827 (not toll free).
E-filing. See the 2022 General Instructions for Forms W-2 and
W-3 for information on when you’re required to file
electronically. Even if you aren’t required to file electronically,
doing so can save you time and effort. Employers may now use
the SSA’s W-2 Online service to create, save, print, and submit
up to 50 Form(s) W-2VI at a time over the Internet. When you
e-file with the SSA, no separate Form W-3SS filing is required.
An electronic Form W-3SS will be created for you by the W-2
Online service. For information, visit the SSA’s Employer W-2
Filing Instructions & Information website at www.SSA.gov/
employer or contact your Employer Services Liaison Officer
(ESLO) at 212-264-3865 (not toll free) or
NY.RO.CDPS.ESLO@ssa.gov.
Future developments. Information about any future
developments affecting Form W-2VI and its instructions (such
as legislation enacted after we release them) will be posted at
www.irs.gov/FormW2VI.
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Caution: DRAFTNOT FOR FILING (IRS)

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Completed 28 December 2022

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