Attention:
You may file Forms W-2 and W-3 electronically on the SSA’s Employer
W-2 Filing Instructions and Information web page, which is also accessible
at www.socialsecurity.gov/employer. You can create fill-in versions of
Forms W-2 and W-3 for filing with SSA. You may also print out copies for
filing with state or local governments, distribution to your employees, and
for your records.
Note: Copy A of this form is provided for informational purposes only. Copy A appears in
red, similar to the official IRS form. The official printed version of this IRS form is scannable,
but the online version of it, printed from this website, is not. Do not print and file Copy A
downloaded from this website with the SSA; a penalty may be imposed for filing forms that
can’t be scanned. See the penalties section in the current
General Instructions for Forms
W-2 and W-3, available at www.irs.gov/w2, for more information.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded, filled in, and printed and used to satisfy the requirement to provide the
information to the recipient.
To order official IRS information returns such as Forms W-2 and W-3, which include a
scannable Copy A for filing, go to IRS’
Online Ordering for Information Returns and
Employer Returns page, or visit www.irs.gov/orderforms and click on Employer and
Information returns. We’ll mail you the scannable forms and any other products you order.
See IRS Publications 1141, 1167, and 1179
for more information about printing these tax
forms.
DO NOT STAPLE OR FOLD
33333
a Control number
For Official Use Only
OMB No. 1545-0008
b
Kind
of
Payer
(Check one)
941-SS
Military 943 944
Hshld.
emp.
Medicare
govt. emp.
Kind
of
Employer
(Check one)
None apply 501c non-govt.
State/local
non-501c
State/local 501c Federal govt.
Third-party
sick pay
(Check if
applicable)
c Total number of Forms W-2
d Establishment number
e Employer identification number (EIN)
f Employer’s name
g Employer’s address and ZIP code
h Other EIN used this year
1 Wages, tips, other compensation 2 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 Deferred compensation
12b
13 For third-party sick pay use only
14 Income tax withheld by payer of third-party sick pay
15 Employer’s territorial ID number
18 Check the appropriate box
Type of Form
W-2AS W-2CM W-2GU W-2VI
Employer’s contact person Employer’s telephone number
For Official Use Only
Employer’s fax number
Employer’s email address
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
Title
Date
Form W-3SS
Transmittal of Wage and Tax Statements
2019
Department of the Treasury
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
Separate instructions. See the 2019 General Instructions for Forms W-2
and W-3 for information on completing this form. Do not file Form W-3SS for
Form(s) W-2AS, W-2CM, W-2GU, or W-2VI that were submitted electronically
to the SSA.
Purpose of Form
Complete a Form W-3SS Transmittal only when filing paper Copy A of
Form(s) W-2AS, W-2CM, W-2GU, or W-2VI. Don't file Form W-3SS alone. All
paper forms must comply with IRS standards and be machine readable.
Photocopies are not acceptable. Use a Form W-3SS even if only one paper
Form W-2AS, W-2CM, W-2GU, or W-2VI is being filed. Make sure both the
Form W-3SS and Form(s) W-2AS, W-2CM, W-2GU, or W-2VI show the
correct tax year and Employer Identification Number (EIN). Make a copy of
this form and keep it with Copy D (For Employer) of Form(s) W-2AS, W-2CM,
W-2GU, or W-2VI for your records. The IRS recommends retaining copies of
these forms for four years.
E-Filing
The SSA strongly suggests employers report Form W-3SS and Form(s)
W-2AS, W-2CM, W-2GU, or W-2VI Copy A electronically instead of on paper.
The SSA provides two free e-filing options on its Business Services Online
(BSO) website.
• W-2 Online. Use fill-in forms to create, save, print, and submit up to 50
Forms W-2AS, W-2CM, W-2GU, or W-2VI at a time to the SSA.
• 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
for Filing Forms W-2 Electronically (EFW2).
W-2 Online fill-in forms or file uploads will be on time if submitted by
January 31, 2020. For more information, go to www.SSA.gov/bso. First time
filers, select “Register”; returning filers select “Log In.”
When To File Paper Forms
Mail Copy A of Form W-3SS with Copy A of Form(s) W-2AS, W-2CM,
W-2GU, or W-2VI by January 31, 2020.
Where To File Paper Forms
Send this entire page with the entire Copy A page of Form(s) W-2AS,
W-2CM, W-2GU, or W-2VI to:
Social Security Administration
Direct Operations Center
Wilkes-Barre, PA 18769-0001
Note: If you use “Certified Mail” to file, change the ZIP code to
“18769-0002.” If you use an IRS-approved private delivery service, add
“ATTN: W-2 Process, 1150 E. Mountain Dr.” to the address and change the
ZIP code to “18702-7997.” See Pub. 15 (Circular E), Employer’s Tax Guide,
for a list of IRS-approved private delivery services.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 10117S
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signature
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dd mmm yyyy
DO NOT STAPLE OR FOLD
33333
a Control number
For Official Use Only
OMB No. 1545-0008
b
Kind
of
Payer
(Check one)
941-SS Military
943
944
Hshld.
emp.
Medicare
govt. emp.
Kind
of
Employer
(Check one)
None apply 501c non-govt.
State/local
non-501c
State/local 501c Federal govt.
Third-party
sick pay
(Check if
applicable)
c Total number of Forms W-2
d Establishment number
e Employer identification number (EIN)
f Employer’s name
g Employer’s address and ZIP code
h Other EIN used this year
1 Wages, tips, other compensation 2 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 Deferred compensation
12b
13 For third-party sick pay use only
14 Income tax withheld by payer of third-party sick pay
15 Employer’s territorial ID number
Employer’s contact person Employer’s telephone number
For Official Use Only
Employer’s fax number
Employer’s email address
Copy 1—For Local Tax Department
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
Title
Date
Form W-3SS Transmittal of Wage and Tax Statements
2019
Department of the Treasury
Internal Revenue Service
Where To File
For more information about where to file Copy 1, contact your state, city, or local tax department.
American Samoa. File Copy 1 of Form W-3SS and Forms W-2AS at the following address.
American Samoa Tax Office
Executive Office Building
First Floor
Pago Pago, AS 96799
Guam. File Copy 1 of Form W-3SS and Forms W-2GU at the following address.
Guam Department of Revenue and Taxation
P.O. Box 23607
GMF, GU 96921
U.S. Virgin Islands. File Copy 1 of Form W-3SS and Forms W-2VI at the following address.
Virgin Islands Bureau of Internal Revenue
6115 Estate Smith Bay
Suite 225
St. Thomas, VI 00802
Commonwealth of the Northern Mariana Islands. File Form OS-3710 and Copy 1 of Forms W-2CM at the following address.
Division of Revenue and Taxation
Commonwealth of the Northern Mariana Islands
P.O. Box 5234 CHRB
Saipan, MP 96950
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signature
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dd mmm yyyy