W-3 C Transmittal of Corrected Wage and Tax Statements

Note: The draft you are looking for begins on the next page.

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DO NOT CUT, FOLD, OR STAPLE
55555

a Tax year/Form corrected

For Official Use Only:

/ W-

OMB No. 1545-0008
c Kind of Payer (Check one)

b Employer’s name, address, and ZIP code

941/941-SS Military

943

944

Kind of Employer (Check one) Third-party
sick pay

None apply 501c non-govt.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 8, 2023
DO NOT FILE
Hshld.
emp.

CT-1

Medicare
govt. emp.

State/local State/local
non-501c
501c

Federal
govt.

(Check if
applicable)

d Total number of Forms W-2c

e Employer identification number (EIN)

f Establishment number

g Employer’s state ID number

Complete boxes h, i, or j only if
incorrect on last form filed.

h Employer’s originally reported EIN

i Incorrect establishment number

j

Employer’s incorrect state ID number

Total of amounts previously reported
as shown on enclosed Forms W-2c.

Total of corrected amounts as
shown on enclosed Forms W-2c.

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

Total of amounts previously reported
as shown on enclosed Forms W-2c.

Total of corrected amounts as
shown on enclosed Forms W-2c.

10 Dependent care benefits

10 Dependent care benefits

11 Nonqualified plans

11 Nonqualified plans

12a Deferred compensation

12a Deferred compensation

14 Inc. tax w/h by third-party sick pay payer

14 Inc. tax w/h by third-party sick pay payer

12b

12b

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

Explain decreases here:

Has an adjustment been made on an employment tax return filed with the Internal Revenue Service?
If “Yes,” give date the return was filed:

Yes

No

Under penalties of perjury, I declare that I have examined this return, including accompanying documents, and, to the best of my knowledge and belief, it is true,
correct, and complete.
Signature:

Title:

Date:

Employer’s contact person

Employer’s telephone number

Employer’s fax number

Employer’s email address

Form

W-3c

(Rev. 8-2023)

For Official Use Only

Transmittal of Corrected Wage and Tax Statements

Purpose of Form
Complete a Form W-3c transmittal only when filing paper Copy A of the most
recent version of Form(s) W-2c, Corrected Wage and Tax Statement. Make a
copy of Form W-3c and keep it with Copy D (For Employer) of Forms W-2c for
your records. File Form W-3c even if only one Form W-2c is being filed or if those
Forms W-2c are being filed only to correct an employee’s name and social security
number (SSN) or the employer identification number (EIN). See the General
Instructions for Forms W-2 and W-3 for information on completing this form.

E-Filing
The SSA strongly suggests employers report Form W-3c and Forms W-2c Copy A
electronically instead of on paper. The SSA provides two free e-filing options on its
Business Services Online (BSO) website:
• W-2c Online. Use fill-in forms to create, save, print, and submit up to 25 Forms
W-2c 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-2c Electronically (EFW2C).

Department of the Treasury
Internal Revenue Service

For more information, go to www.SSA.gov/employer. First-time filers, select
“Register”; returning filers, select “Log In.”

When To File
File this form and Copy A of Form(s) W-2c with the Social Security Administration
as soon as possible after you discover an error on Forms W-2, W-2AS, W-2GU,
W-2CM, W-2VI, or W-2c. Provide Copies B, C, and 2 of Form W-2c to your
employees as soon as possible.

Where To File Paper Forms
Send this entire page with Copy A of Form W-2c to:
Social Security Administration
Direct Operations Center
P.O. Box 3333
Wilkes-Barre, PA 18767-3333
Note: If you use “Certified Mail” or an IRS-approved private delivery service to file,
add “Attn: W-2c 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. 10164R