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 Federal 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 Allocated tips
9 Verification code 10 Dependent care benefits
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
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20
Locality name
Form
W-2
Wage and Tax Statement
2018
Copy A For Social Security Administration — Send this entire page with
Form W-3 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. 10134D
Do Not Cut, Fold, or Staple Forms on This Page
