ARW-3
                                                  STATE OF ARKANSAS
 TAX YEAR                     Transmittal of Wage and Tax Statements

 Total number of Forms W-2

 Federal Employer Identification Number (FEIN)

 Employer’s name, address, and zip code

 Other FEIN used this year

 State ID number                                  Total state wages, tips, other compensation Total state income tax withheld

 Contact person                                   Telephone number                            FOR OFFICE USE ONLY

 Email address                                    Fax number

  Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge 
  and belief, they are true, correct and complete.

                    Signature                         Title                                   Date

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Purpose of Form                                             Where To File Paper Forms
A Form ARW-3 Transmittal is completed when state copies  Send this entire page with the state copies of Forms W-2 to:
of Forms W-2, Wage and Tax Statement, are being filed.  Do 
not file Form ARW-3 alone.  Use a Form ARW-3 even if only  
one Form W-2 is being filed. Make sure both the Form ARW-3         Withholding Branch
and Forms W-2 show the correct tax year and Federal                P.O. Box 8055
Employer IdentificationNumber (FEIN).  Make a copy of              Little Rock, AR 72203-8055
this form and keep it for your records.
 
                                                            Do Not Send any payment (cash, checks, money 
                                                            orders, etc.) with Forms W-2 and ARW-3.
When To File                                                The ARW-3 does not replace the AR3MAR or the 
                                                            AR941A. 
Send Forms W-2 under cover of this Form ARW-3 Transmittal 
by

ARW-3 (R09 26 7/ /1 )