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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 , and1179 for more information about printing these tax
forms.

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DO NOT CUT, FOLD, OR STAPLE
a Tax year/Form corrected For Official Use Only:
55555 / W- OMB No. 1545-0008
b Employer’s name, address, and ZIP code c Kind of Payer (Check one) Kind of Employer (Check one) Third-party
941/941-SS Military 943 944 None apply 501c non-govt. sick pay

Hshld. Medicare State/local State/local Federal (Check if
CT-1 emp. govt. emp. non-501c 501c govt. 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 h Employer’s originally reported EIN i Incorrect establishment number j Employer’s incorrect state ID number
incorrect on last form filed.
Total of amounts previously reported Total of corrected amounts as Total of amounts previously reported Total of corrected amounts as
as shown on enclosed Forms W-2c. shown on enclosed Forms W-2c. as shown on enclosed Forms W-2c. 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 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? Yes No
If “Yes,” give date the return was filed:
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 For Official Use Only

Employer’s fax number Employer’s email address

Department of the Treasury
Form W-3c (Rev. 8-2023) Transmittal of Corrected Wage and Tax Statements Internal Revenue Service
Purpose of Form For more information, go to www.SSA.gov/employer. First-time filers, select
“Register”; returning filers, select “Log In.”
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 When To File
copy of Form W-3c and keep it with Copy D (For Employer) of Forms W-2c for File this form and Copy A of Form(s) W-2c with the Social Security Administration
your records. File Form W-3c even if only one Form W-2c is being filed or if those as soon as possible after you discover an error on Forms W-2, W-2AS, W-2GU,
Forms W-2c are being filed only to correct an employee’s name and social security W-2CM, W-2VI, or W-2c. Provide Copies B, C, and 2 of Form W-2c to your
number (SSN) or the employer identification number (EIN). See the General employees as soon as possible.
Instructions for Forms W-2 and W-3 for information on completing this form.
Where To File Paper Forms
E-Filing
Send this entire page with Copy A of Form W-2c to:
The SSA strongly suggests employers report Form W-3c and Forms W-2c Copy A Social Security Administration
electronically instead of on paper. The SSA provides two free e-filing options on its Direct Operations Center
Business Services Online (BSO) website: P.O. Box 3333
• W-2c Online. Use fill-in forms to create, save, print, and submit up to 25 Forms Wilkes-Barre, PA 18767-3333
W-2c at a time to the SSA. Note: If you use “Certified Mail” or an IRS-approved private delivery service to file,
• File Upload. Upload wage files to the SSA you have created using payroll or tax add “Attn: W-2c Process, 1150 E. Mountain Dr.” to the address and change the
software that formats the files according to the SSA’s Specifications for Filing ZIP code to “18702-7997.” See Pub. 15 (Circular E), Employer’s Tax Guide, for a
Forms W-2c Electronically (EFW2C). list of IRS-approved private delivery services.
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 10164R

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