W-3SS Transmittal of Wage and Tax Statements

Attention:
This form is provided for informational purposes only. Copy A
appears in red, similar to the official printed IRS form. But do
not file Copy A downloaded from this website with the SSA.
The official printed IRS form is scannable, but forms downloaded
and printed from this website are not. A penalty of $50 per
information return may be imposed for filing forms that cannot be
scanned.
To order official IRS forms, call 1-800-TAX-FORM (1-800-8293676) or Order Information Returns and Employer Returns Online,
and we'll mail you the scannable forms and other products.
You may file Forms W-2 and W-3 electronically on the SSA’s
website at Employer Reporting Instructions & Information.
You can create fill-in versions of Forms W-2 and W-3 for filing
with the SSA. You may also print out copies for filing with state
or local governments, distribution to your employees, and for your
records.

W-2 / W-3 Cover page

DO NOT STAPLE OR FOLD
a

33333
b

Kind
of
Payer

Control number

For Official Use Only

䊳

OMB No. 1545-0008

䊳

941-SS

Military

943

Hshld.
emp.

Medicare
govt. emp.
d

1

Wages, tips, other compensation

2

Income tax withheld

Third-party
sick pay

3

Social security wages

4

Social security tax withheld

Establishment number

5

Medicare wages and tips

6

Medicare tax withheld

7

Social security tips

8

9

Advance EIC payments

10

11

Nonqualified plans

12

13

For third-party sick pay use only

14

Income tax withheld by payer of third-party sick pay

c

Total number of Forms W-2

e

Employer identification number (EIN)

f Employer’s name

g

Employer’s address and ZIP code

h

Other EIN used this year

i

Employer’s territorial ID number

944-SS

Deferred compensation

15 Check the appropriate box
Type
of
Form

Contact person

䊳

W-2AS

W-2CM

Telephone number

(
E-mail address

W-2GU

W-2VI

For Official Use Only

)

Fax number

(
)
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

Form

䊳

W-3SS

Title

䊳

Transmittal of Wage and Tax Statements

Date

2007

䊳

Department of the Treasury
Internal Revenue Service

Send this entire page with the entire Copy A page of Forms W-2AS, W-2CM, W-2GU, or Form W-2VI
to the Social Security Administration (SSA). Photocopies are not acceptable.
Do not send any remittance (cash, checks, money orders, etc.) with Forms W-2AS, W-2CM, W-2GU, W-2VI, and W-3SS.

What’s New

Where To File

Relocation of form ID on Form W-3. For consistency with the
revisions to Form W-2, we relocated the form ID number (“33333”) to
the top left corner of Form W-3.
Separate instructions. We moved the detailed instructions for
completing Forms W-2AS, W-2GU, W-2VI, Wage and Tax Statement,
and for Form W-3SS, Transmittal of Wage and Tax Statements, to a
separately printed product named Instructions for Forms W-2AS,
W-2GU, W-2VI, and W-3SS. You can download those instructions by
visiting the IRS website at www.irs.gov. If you are an employer in the
Commonwealth of the Northern Mariana Islands, you must contact the
Department of Revenue and Taxation, Capitol Hill, Saipan, MP 96959,
to get Form W-2CM, Wage and Tax Statement, and the instructions for
filing and completing that form.

Send this form with the entire Copy A page of Form W-2AS, W-2CM,
W-2GU, or W-2VI to:
Social Security Administration
Data 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.
Also see Where to file Copy 1 below.
Where to file Copy 1. File Copy 1 of Forms W-2AS and W-3SS with
the American Samoa Tax Office, Government of American Samoa,
Pago Pago, AS 96799.
File Copy 1 of Forms W-2GU and W-3SS with the Department of
Revenue and Taxation, Government of Guam, P.O. Box 23607, GMF,
GU 96921.
File Copy 1 of Forms W-2VI and W-3SS with the V.I. Bureau of
Internal Revenue, 9601 Estate Thomas, Charlotte Amalie, St. Thomas,
VI 00802.
Contact the Division of Revenue and Taxation, Commonwealth of the
Northern Mariana Islands at (670) 664-1000, for the address to send
Copy 1 of Forms W-2CM and W-3SS.

Purpose of Form
Use Form W-3SS to transmit Copy A of Forms W-2AS, W-2CM,
W-2GU, and W-2VI. Make a copy of Form W-3SS and keep it with
Copy D (From Employer) of Forms W-2AS, W-2CM, W-2GU, or Form
W-2VI for your records. Use Form W-3SS for the correct year. File
Form W-3SS even if only one Form W-2AS, W-2CM, W-2GU, or
W-2VI is being filed. However, if you are filing your wage and tax
information electronically, do not file Form W-3SS.

When To File
File Copy A of Form W-3SS with Copy A of Form W-2AS, W-2CM,
W-2GU, or Form W-2VI by February 29, 2008.

Cat. No. 10117S

DO NOT STAPLE OR FOLD
a

33333
b

Kind
of
Payer

Control number

For Official Use Only

䊳

OMB No. 1545-0008

䊳

941-SS

Military

943

Hshld.
emp.

Medicare
govt. emp.
d

1

Wages, tips, other compensation

2

Income tax withheld

Third-party
sick pay

3

Social security wages

4

Social security tax withheld

Establishment number

5

Medicare wages and tips

6

Medicare tax withheld

7

Social security tips

8

9

Advance EIC payments

10

11

Nonqualified plans

12

13

For third-party sick pay use only

14

Income tax withheld by payer of third-party sick pay

c

Total number of Forms W-2

e

Employer identification number (EIN)

f Employer’s name

g

Employer’s address and ZIP code

h

Other EIN used this year

i

Employer’s territorial ID number

Contact person

944-SS

Telephone number

(
E-mail address

Deferred compensation

For Official Use Only

)

Fax number

(
)
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

䊳

Title

䊳

2007

Date

䊳

Department of the Treasury
Internal Revenue Service