Box 13 - Checkboxes.   Check all boxes that apply.

• Statutory employee. Check this box for statutory employees whose earnings are subject to social security and Medicare taxes but not subject to Federal income tax withholding. Do not check this box for common-law employees. There are workers who are independent contractors under the common-law rules but are treated by statute as employees. They are called statutory employees.
  1. A driver who distributes beverages (other than milk), or meat, vegetable, fruit, or bakery products; or who picks up and delivers laundry or dry cleaning, if the driver is your agent or is paid on commission.
  2. A full-time life insurance sales agent whose principal business activity is selling life insurance or annuity contracts, or both, primarily for one life insurance company.
  3. An individual who works at home on materials or goods that you supply and that must be returned to you or to a person you name, if you also furnish specifications for the work to be done.
  4. A full-time traveling or city salesperson who works on your behalf and turns in orders to you from wholesalers, retailers, contractors, or operators of hotels, restaurants, or other similar establishments. The goods sold must be merchandise for resale or supplies for use in the buyer's business operation. The work performed for you must be the salesperson's principal business activity.

  See Pub. 15-A for details on statutory employees and common-law employees.

• Retirement plan. Check this box if the employee was an active participant (for any part of the year) in any of the following:
  1. A qualified pension, profit-sharing, or stock bonus plan described in section 401(a) (including a 401(k) plan).
  2. An annuity plan described in section 403(a).
  3. An annuity contract or custodial account described in section 403(b).
  4. A simplified employee pension (SEP) plan described in section 408(k).
  5. A SIMPLE retirement account described in section 408(p).
  6. A trust described in section 501(c)(18).
  7. A plan for Federal, state, or local government employees or by an agency or instrumentality thereof (other than a section 457 plan).
      For information on the active participant rules, see Notice 87-16, 1987-1 C.B. 446, Notice 98-49, 1998-2 C.B. 365, section 219(g)(5), and Pub. 590, Individual Retirement Arrangements (IRAs).
       Do not check this box for contributions made to a nonqualified or section 457 plan.
• Third-party sick pay. Check this box only if you are a third-party sick pay payer filing a Form W-2 for an insured's employee or are an employer reporting sick pay payments made by a third party. See Sick Pay Reporting in section 6 of Pub. 15-A.

Box 14 - Other.   The lease value of a vehicle provided to your employee and reported in box 1 must be reported here or in a separate statement to your employee. You may also use this box for any other information you want to give your employee. Please label each item. Examples include state disability insurance taxes withheld, union dues, uniform payments, health insurance premiums deducted, nontaxable income, educational assistance payments, or a member of the clergy's parsonage allowance and utilities. In addition, you may enter the following contributions to a pension plan: (a) nonelective employer contributions made on behalf of an employee, (b) voluntary after-tax contributions that are deducted from an employee's pay, (c) required employee contributions, and (d) employer matching contributions.

If you are reporting prior year contributions under USERRA (see the TIP above Code D on page 9 and USERRA makeup amounts to a pension plan on page 6), you may report in box 14 makeup amounts for nonelective employer contributions, voluntary after-tax contributions, required employee contributions, and employer matching contributions. Report such amounts separately for each year.

Railroad employers, see Railroad employers on page 5.

Boxes 15 through 20 - State and local income tax information.   Use these boxes to report state and local income tax information. Enter the two-letter abbreviation for the name of the state. The employer's state I.D. numbers are assigned by the individual states. The state and local information boxes can be used to report wages and taxes for two states and two localities. Keep each state's and locality's information separated by the broken line. If you need to report information for more than two states or localities, prepare a second Form W-2. See Multiple forms on page 7.

Specific Instructions for Form W-3

How to complete Form W-3.   The instructions under How to complete Form W-2 on page 6 generally apply to Form W-3. See those instructions. Darkly type all entries, if possible.

Amounts reported on related employment tax forms (e.g., W-2, 941, or 943) should agree with the amounts reported on Form W-3. If there are differences, you may be contacted by the IRS and SSA. You should retain a reconciliation for future reference. See Reconciling Forms W-2, W-3, 941, and 943 on page 11.

Box a - Control number.   This is an optional box that you may use for numbering the whole transmittal. Make certain that entries do not cross over into the form identification number box (33333).

Box b - Kind of Payer.   Check the box that applies to you. Check only one box unless the second, checked box is Third-party sick pay. If you have more than one type of Form W-2, send each type (except Third-party sick pay) with a separate Form W-3.

941.   Check this box if you file Form 941, Employer's Quarterly Federal Tax Return, and no other category (except Third-party sick pay) applies.

Military.   Check this box if you are a military employer sending Forms W-2 for members of the uniformed services.

943.   Check this box if you file Form 943, Employer's Annual Tax Return for Agricultural Employees, and you are sending Forms W-2 for agricultural employees. For nonagricultural employees, send their Forms W-2 with a separate Form W-3, checking the appropriate box.

CT-1.   Check this box if you are a railroad employer sending Forms W-2 for employees covered under the Railroad Retirement Tax Act (RRTA). Do not show employee RRTA tax in boxes 3 through 7. These boxes are only for social security and Medicare information. If you also have employees who are subject to social security and Medicare taxes, send that group's Forms W-2 with a separate Form W-3 and check the 941 box on that Form W-3.

Hshld. emp.   Check this box if you are a household employer sending Forms W-2 for household employees and you did not include the household employee's taxes on Form 941.

Medicare government employee.   Check this box if you are a U.S., state, or local agency filing Forms W-2 for employees subject only to the 1.45% Medicare tax. See Government employers on page 5.

Third-party sick pay.   Check this box if you are a third-party sick pay payer (or are reporting sick pay payments made by a third party) filing Forms W-2 with the Third-party sick pay box in box 13 checked. If more than one box applies (e.g., this box and the 941 box), check both this box and the 941 box, and file a single Form W-3 for the regular and Third-party sick pay Forms W-2. See also 941 above.

Box c - Total number of Forms W-2.   Show the number of completed individual Forms W-2 you are transmitting with this Form W-3. Do not count Void forms.

Box d - Establishment number.   You may use this box to identify separate establishments in your business. You may file a separate Form W-3, with Forms W-2, for each establishment even if they all have the same EIN; or you may use a single Form W-3 for all Forms W-2 of the same type.

Box e - Employer identification number.   If you received a preprinted Form W-3 from the IRS with Pub. 393, Federal Employment Tax Forms, or Pub. 2184, Alternative Ways To Get Employment Tax Forms and Instructions, verify that your EIN is correct. Make any necessary corrections on the form.

If you did not receive a form with a preprinted EIN, enter the nine-digit EIN assigned to you by the IRS. The number should be the same as shown on your Form 941, 943, or CT-1 and in the following format: 00-0000000. Do not use a prior owner's EIN. See Box h on page 11.

If you do not have an EIN when filing your Form W-3, enter Applied For in box e, not your social security number, and see the Box b instructions for Form W-2 on page 7.

Box f - Employer's name.   If you are not using a preprinted Form W-3, enter the same name as shown on your Form 941, 943, or CT-1. Make any necessary corrections on your preprinted Form W-3.

Box g - Employer's address and ZIP code.   If you are not using a preprinted Form W-3, enter your address. Make any necessary corrections on your preprinted Form W-3.

Box h - Other EIN used this year.   If you have used an EIN (including a prior owner's EIN) on Form 941, 943, or CT-1 submitted for 2002 that is different from the EIN reported on Form W-3 in box e, enter the other EIN used. In addition, agents must report the employer's EIN in box h. See Agent reporting on page 3.

Contact person, telephone number, fax number, and e-mail address.   Please enter this information for use by the SSA if any questions arise during processing.

The amounts to enter in boxes 1 through 19 described below are totals from only the Forms W-2 you are sending with this Form W-3.

Boxes 1 through 10.   Enter the totals reported in boxes 1 through 10 on the Forms W-2.

Box 11 - Nonqualified plans.   Enter the total reported in box 11 on Forms W-2. Do not enter a code.

Box 12 - Deferred compensation.   Enter one total of all amounts reported with codes D-H and S in box 12 on Forms W-2. Do not enter a code.

Box 13 - For third-party sick pay use only.   Third-party payers of sick pay (or employers using the optional rule for Form W-2 described in section 6 of Pub. 15-A) filing third-party sick pay recap Forms W-2 and W-3 must enter Third-Party Sick Pay Recap in this box.

Box 14 - Income tax withheld by payer of third-party sick pay.   Complete this box only if you are the employer and have employees who had income tax withheld on third-party payments of sick pay. Show the total income tax withheld by third-party payers on payments to all your employees. Although this tax is included in the box 2 total, it must be separately shown here.

Box 15 - State/Employer's state ID number.   Enter the two-letter abbreviation for the name of the state being reported on Form(s) W-2. Also enter your state-assigned I.D. number. If the Forms W-2 being submitted with this Form W-3 contain wage and income tax information from more than one state, enter an X under State and do not enter any state I.D. number.

Boxes 16-19.   Enter the total of state/local wages and income tax shown in their corresponding boxes on the Forms W-2 included with this Form W-3. If the Forms W-2 show amounts from more than one state or locality, report them as one sum in the appropriate box on Form W-3. Please verify that the amount reported in each box is an accurate total of the Forms W-2.

Reconciling Forms W-2, W-3, 941, and 943

Reconcile the amounts shown in boxes 2, 3, 5, 7, and 9 from all 2002 Forms W-3 with their respective amounts from the 2002 yearly totals from the quarterly Forms 941, or Form 943. When there are discrepancies between amounts reported on Forms W-2 and W-3 filed with the SSA and Forms 941 or 943 filed with the IRS, we must contact you to resolve the discrepancies. To help reduce discrepancies on Forms W-2:

• Report bonuses as wages and as social security and Medicare wages on Forms W-2 and 941/943.
• Report both social security and Medicare wages and taxes separately on Forms W-2, W-3, and 941/943.
• Report social security taxes withheld on Form W-2 in box 4, not in box 3.
• Report Medicare taxes withheld on Form W-2 in box 6, not in box 5.
• Make sure the social security wage amount for each employee does not exceed the annual social security wage base limit ($84,900 for 2002).
• Do not report noncash wages that are not subject to social security or Medicare taxes as social security or Medicare wages.
• If you use an EIN on any quarterly Form 941 for the year (or annual Form 943) that is different from the EIN reported in box e on Form W-3, enter the other EIN in box h on Form W-3.

To reduce the discrepancies between amounts reported on Forms W-2, W-3, and Form 941/943:

• Be sure the amounts on Form W-3 are the total amounts from Forms W-2.
• Reconcile Form W-3 with your four quarterly Forms 941 (or annual Form 943) by comparing amounts reported for -

1. Income tax withholding (box 2).
2. Social security wages, Medicare wages and tips, and social security tips (boxes 3, 5, and 7). Form W-3 should include Form 941 or 943 adjustments only for the current year. If the Form 941 or 943 adjustments include amounts for a prior year, do not report those prior year adjustments on the current year Forms W-2 and W-3.
3. Social security and Medicare taxes (boxes 4 and 6). The amounts shown on the four quarterly Forms 941 (or annual Form 943), including current year adjustments, should be approximately twice the amounts shown on Form W-3.

Amounts reported on Forms W-2, W-3, and 941/943 may not match for valid reasons. If they do not match, you should determine that the reasons are valid. Keep your reconciliation in case there are inquiries from the IRS or the SSA.

Privacy Act and Paperwork Reduction Act Notice.

We ask for the information on Forms W-2 and W-3 to carry out the Internal Revenue laws of the United States. We need it to figure and collect the right amount of tax. Section 6051 and its regulations require you to furnish wage and tax statements to employees and to the Social Security Administration. Section 6109 requires you to provide your employer identification number. Routine uses of this information include giving it to the Department of Justice for civil and criminal litigation, and to cities, states, and the District of Columbia for use in administrating their tax laws. We may also disclose this information to Federal, state, or local agencies that investigate or respond to acts or threats of terrorism or participate in intelligence or counterintelligence activities concerning terrorism. If you fail to provide this information in a timely manner, you may be subject to penalties.

You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. Generally, tax returns and return information are confidential, as required by section 6103.

The time needed to complete and file these forms will vary depending on individual circumstances. The estimated average times are:

Form W-2	30 minutes
Form W-3	29 minutes

If you have comments concerning the accuracy of these time estimates or suggestions for making these forms simpler, we would be happy to hear from you. You can write to the Tax Forms Committee, Western Area Distribution Center, Rancho Cordova, CA 95743-0001. Do not send these tax forms to this address. Instead, see Where to file on page 2.

Form W-2 Reference Guide for Box 12 Codes (See box 12 instructions for information.)

A	Uncollected social security or RRTA tax	G	Elective deferrals and employer	N	Uncollected Medicare tax on cost of
	on tips		contributions (including nonelective		group-term life insurance over $50,000
B	Uncollected Medicare tax on tips		deferrals) to a section 457(b) deferred		(for former employees)
C	Cost of group-term life insurance		compensation plan (state and local	P	Excludable moving expense
	over $50,000		government and tax-exempt employers)		reimbursements paid directly to employee
D	Elective deferrals to a section 401(k) cash	H	Elective deferrals to a section	R	Employer contributions to an Archer MSA
	or deferred arrangement (including a		501(c)(18)(D) tax-exempt	S	Employee salary reduction contributions
	SIMPLE 401(k) arrangement)		organization plan		under a section 408(p) SIMPLE
E	Elective deferrals under a section 403(b)	J	Nontaxable sick pay	T	Adoption benefits
	salary reduction agreement	K	20% excise tax on excess golden	V	Income from exercise of nonstatutory
F	Elective deferrals under a section		parachute payments		stock option(s)
	408(k)(6) salary reduction SEP	L	Substantiated employee business expense
			reimbursements (Federal rate)
		M	Uncollected social security or RRTA tax on
			cost of group-term life insurance over
			$50,000 (for former employees)

Reference Guide for Box 12 Codes

Form W-2 Reference Guide for Box 12 Codes (See box 12 instructions for information.)

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