Wage and Tax Statements W-2/W-3 series

PAGER/SGML
Page 1 of 6

Userid: ________
DTD INSTR04
Fileid: IW3SS.SGM ( 9-Jan-2007)

Leading adjust: 0%

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

❏ Draft
(Init. & date)

❏

Ok to Print

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

2007

Department of the Treasury
Internal Revenue Service

Instructions for Forms
W-2AS, W-2GU, W-2VI, and
Form W-3SS
Section references are to the Internal Revenue Code unless
otherwise noted.
Contents
Page
What’s New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
When To File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Where To File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
General Instructions for Form W-3SS . . . . . . . . . . . . . . . . 1
General Instructions for Forms W-2AS, W-2CM,
W-2GU, and Form W-2VI . . . . . . . . . . . . . . . . . . . . . . . . 2
Special Reporting Situations . . . . . . . . . . . . . . . . . . . . . . 2
Specific Instructions for Forms W-2AS, W-2GU,
and Form W-2VI . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Specific Instructions for Form W-3SS . . . . . . . . . . . . . . . . 5

What’s New
New 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 this separately printed product to
make them easier to read and use.
If you have comments or suggestions for improving the
forms or instructions, we would be happy to hear from you.
Write to the address shown in the Privacy Act and Paperwork
Reduction Act Notice on page 6.
Relocation of employee’s SSN on Form W-2. We moved the
“Employee’s social security number” box on Forms W-2AS,
W-2GU, and W-2VI from box d to box a. We moved the
“Control number ” box, optionally used by some employers to
identify individual Forms W-2, from box a to box d. We also
relocated the form ID number “(22222)” and “ Void” boxes to the
top left corner of the Forms W-2. We made these changes to
protect the employee’s SSN from disclosure when employers
furnish Forms W-2 to their employees using a window envelope
and to enhance processing efficiency.
Relocation of form ID on Form W-3SS. For consistency with
the revisions to Forms W-2, we relocated the form ID number
“(33333)” to the top left corner of Form W-3SS.

Reminders
Employee instructions added to Copy B of Forms W-2. We
made the employee instructions on the back of Copy C easier
to read by increasing their type size and continuing the
instructions on the back of Copy B.
Form 944-SS. If you file Form 944-SS, Employer’s ANNUAL
Federal Tax Return, use the “944-SS” checkbox in box b on
Form W-3SS.
Notice to employers in the Commonwealth of the Northern
Mariana Islands. 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 completing and filing that
form.

When To File
File Copy A of Form W-3SS with Copy A of Form W-2AS,
W-2CM, W-2GU, or W-2VI by February 29, 2008.
However, if you file electronically, you may file by March 31,
2008. Visit SSA’s Employer Reporting Instructions and
Information website at www.socialsecurity.gov/employer for
electronic filing options.
Extension to file. You may request an automatic extension of
time to file Forms W-2AS, W-2CM, W-2GU, or Form W-2VI by
sending Form 8809, Application for Extension of Time To File
Information Returns, to the address shown on that form. You
must request the extension by the due date of Forms W-2. You
will have an additional 30 days to file. See Form 8809 for
details.
Even if you receive an extension of time to file Forms
W-2AS, W-2CM, W-2GU, or Form W-2VI, you must still
CAUTION furnish the forms to your employees by January 31,
2008. But see Extension to furnish Forms W-2 to employees on
page 2.

!

Where To File
Send the entire first page of Form W-3SS (Copy A) 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 and Shipping and mailing on
page 2.

General Instructions for Form W-3SS
Purpose of forms. Use Copy A of Form W-3SS to transmit
Copy A of Form W-2AS, W-2CM, W-2GU, or Form W-2VI to the
Social Security Administration. File Copy 1 of Form W-3SS and
Copy 1 of Form W-2AS, W-2CM, W-2GU, or W-2VI with your
local tax department. Form W-2AS is used to report American
Samoa wages, Form W-2CM is used to report the
Commonwealth of the Northern Mariana Islands wages, Form
W-2GU is used to report Guam wages, and Form W-2VI is used
to report U.S. Virgin Islands wages. Do not use these forms to
report wages subject to U.S. income tax withholding.
Instead, use Form W-2 to show U.S. income tax withheld.
Who must file. Employers and other payers in American
Samoa, the Commonwealth of the Northern Mariana Islands,
Guam, and the U.S. Virgin Islands must report wages and
withheld income, U.S. social security, and U.S. Medicare taxes
to their local tax department and to the U.S. Social Security
Administration (SSA).

Cat. No. 48440A

Page 2 of 6

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Household employers, even those with only one household
employee, must file Form W-3SS with Form W-2AS, W-2CM,
W-2GU, or Form W-2VI. On Form W-3SS, check the “Hshld.
emp.” checkbox in box b.
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.
Shipping and mailing. If you file more than one type of form,
please group forms of the same type with a separate Form
W-3SS for each type. For example, send Forms W-2GU with
one Form W-3SS and Forms W-2AS with a second Form
W-3SS. Forms W-2AS, W-2CM, W-2GU, or W-2VI are printed
two forms to a page. Send the whole page of Copies A and 1
even if one of the forms is blank or “Void.” Prepare and file
Forms W-2 either alphabetically by employees’ last names or
numerically by employees’ social security numbers. Do not
staple or tape the forms together and do not fold them. Send
the forms in a flat mailing.

information electronically by visiting Social Security’s Employer
Reporting Instructions and Information website at www.
socialsecurity.gov/employer or by contacting an SSA Employer
Services Liaison Officer (ESLO) at 212-264-1117 for the U.S.
Virgin Islands or 510-970-8247 for Guam and American Samoa.
SSA will no longer accept any type of physical media (magnetic
tape, cartridge, diskette, etc.) submissions of Form W-2 reports.
If you file electronically, do not file the same returns on
paper.
Note. You are encouraged to file electronically even if you
file fewer than 250 Forms W-2.
You may request a waiver on Form 8508, Request for
Waiver From Filing Information Returns Electronically/
Magnetically. Submit Form 8508 to the IRS at least 45 days
before the due date of Form W-2. See Form 8508 for filing
information.
Taxpayer identification numbers (TINs). Employers use an
employer identification number (EIN) (00-0000000). Employees
use a social security number (SSN) (000-00-0000). When you
list a number, separate the nine digits properly to show the kind
of number. Do not accept an individual taxpayer identification
number (ITIN) for employment purposes. You can identify an
ITIN because it is a 9-digit number, beginning with the number
“9” with either a “7” or “8” as the fourth digit and is formatted like
an SSN (for example, (9NN-7N-NNNN). For more information
about EINs and SSNs, see Pub. 80 (Circular SS).
Social security numbers are used to record employee
earnings for future social security and Medicare benefits. You
must show the correct social security number on the Form
W-2AS, W-2CM, W-2GU, or W-2VI.

General Instructions for Forms W-2AS,
W-2CM, W-2GU, and W-2VI

Special Reporting Situations

Furnishing copies B and C to employees. Furnish Copies B
and C of Forms W-2AS, W-2CM, W-2GU, and W-2VI to your
employees by January 31, 2008. If employment ends before
December 31, 2007, you may furnish the copies any time after
employment ends but not later than January 31, 2008. If the
employee asks for the form, furnish him or her the completed
copies within 30 days of the request or within 30 days of the last
wage payment, whichever is later. If an employee loses a form,
write “REISSUED STATEMENT” on the new copy (unless it
was furnished electronically), but do not send Copy A of the
reissued statement to the SSA. Employers are not prohibited
(by the Internal Revenue Code) from charging a fee for the
issuance of a duplicate Form W-2AS, W-2CM, W-2GU, or
W-2VI.
Extension to furnish Forms W-2 to employees. You may
request an extension of time to furnish Forms W-2 to
employees by sending a letter to:

Corrections. Use the current version of Form W-2c, Corrected
Wage and Tax Statement, to correct errors on previously filed
Forms W-2AS, W-2CM, W-2GU, or W-2VI. Always send Form
W-3c, Transmittal of Corrected Wage and Tax Statements, with
Forms W-2c to the SSA. See the separate Instructions for
Forms W-2c and W-3c. Also, see below for information on
correcting an employee’s address.
If you are making an adjustment in 2007 to correct social
security and Medicare taxes for a prior year, you must file Form
941c, Supporting Statement To Correct Information, with your
Form 941-SS, Employer’s QUARTERLY Federal Tax Return
(Form 941, Employer’s QUARTERLY Federal Tax Return);
Form 944-SS, Employer’s ANNUAL Federal Tax Return, (Form
944, Employer’s ANNUAL Federal Tax Return); or Form 943,
Employer’s Annual Federal Tax Return for Agricultural
Employees, in the return period that you find the error. File
Copy A of Forms W-2c and W-3c with the SSA and give the
employee a copy of Form W-2c for the prior year.
Incorrect address on employee’s Form W-2. If you filed a
Form W-2AS, W-2CM, W-2GU, or Form W-2VI with the SSA
showing an incorrect address for the employee but all other
information on the form is correct, do not file Form W-2c with
the SSA merely to correct the address.
However, if the address was incorrect on the Form W-2
furnished to the employee, you must do one of the following:
• Issue a new, corrected Form W-2 to the employee, including
the new address. Indicate “REISSUED STATEMENT” on the
new copies. Do not send Copy A to the SSA.
• Issue a Form W-2c to the employee showing the correct
address in box f and all other correct information. Do not send
Copy A to the SSA.
• Mail the Form W-2 with the incorrect address to the
employee in an envelope showing the correct address or
otherwise deliver it to the employee.
Educational assistance programs. A $5,250 exclusion for
employer-provided educational assistance applies to benefits
provided to your employees under an educational assistance
program. However, educational assistance that exceeds $5,250
may be excludable from an employee’s wages if it qualifies as a
working condition benefit. See Pub. 970, Tax Benefits for

IRS Enterprise Computing Center – Martinsburg
Information Reporting Program
Attn: Extension of Time Coordinator
240 Murall Drive
Kearneysville, VW 25430
Mail your letter on or before the due date for furnishing
Forms W-2 to employees. It must include:
• Your name and address,
• Your employer identification number (EIN),
• A statement that you are requesting an extension to furnish
“Forms W-2” to employees,
• Reason for delay, and
• Your signature or that of your authorized agent.
Undeliverable forms. Keep for 4 years any employee
copies of Forms W-2AS, W-2CM, W-2GU, or W-2VI that you
tried to deliver but could not. Do not send undeliverable
Forms W-2 to the SSA.
Calendar year basis. Base all entries on Forms W-2AS,
W-2CM, W-2GU, W-2VI, and W-3SS on a calendar year. Use
the correct year form.
Electronic reporting. If you are required to file 250 or more
Forms W-2AS, W-2CM, W-2GU, or W-2VI, you must file them
electronically. You can get specifications for filing this

-2-

Page 3 of 6

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Education, and section 2 of Pub. 15-B, Employer’s Tax Guide to
Fringe Benefits, for more information.
Election workers. Report on Form W-2AS, W-2GU, or W-2VI
payments of $600 or more to election workers for services
performed in territorial, county, and municipal elections. File
Form W-2AS, W-2GU, or W-2VI for payments of less than $600
paid to election workers if social security and Medicare taxes
were withheld under a section 218 (Social Security Act)
agreement. Do not report election worker payments on Form
1099-MISC.
Group-term life insurance. If you paid for group-term life
insurance coverage over $50,000 for an employee or a former
employee, you must report the taxable cost of excess coverage
determined by using the table in section 2 of Pub. 15-B in boxes
1, 3, and 5 of Form W-2AS, W-2CM, W-2GU, or W-2VI. Also,
show the amount in box 12 with code C. For employees, you
must withhold social security and Medicare taxes, but not
income tax. Former employees must pay the employee part of
social security and Medicare taxes on the taxable cost of
group-term life insurance coverage over $50,000 on Form
1040. You are not required to collect those taxes. However, you
must report the uncollected social security tax with code M and
the uncollected Medicare tax with code N in box 12 of Form
W-2AS, W-2CM, W-2GU, or W-2VI.
Moving expenses. Report moving expenses as follows:
• Qualified moving expenses that an employer paid to a third
party on behalf of the employee (for example, to a moving
company) and services that an employer furnished in kind to an
employee are not reported on Form W-2AS, W-2GU, or W-2VI.
• Qualified moving expense reimbursements paid directly to an
employee by an employer are reported only in box 12 of Form
W-2AS, W-2GU, or W-2VI with code P.
• Nonqualified moving expense reimbursements are reported
in boxes 1, 3, and 5 of Form W-2AS, W-2GU, or W-2VI. These
amounts are subject to income tax withholding and social
security and Medicare taxes.
Sick pay. Sick pay paid to an employee by a third party, such
as an insurance company or trust, requires special treatment
because the IRS reconciles Forms 941-SS with the Forms
W-2AS, W-2CM, W-2GU, or Form W-2VI and Form W-3SS.
See Sick Pay Reporting in section 6 of Pub. 15-A, Employer’s
Supplemental Tax Guide, for specific reporting instructions.
Terminating a business. If you terminate your business, you
must provide Forms W-2AS, W-2CM, W-2GU, or Form W-2VI
to your employees for the calendar year of termination by the
due date of your final Form 941-SS (Form 941) or Form 944-SS
(Form 944). You must also file Forms W-2AS, W-2CM, W-2GU,
or W-2VI with the SSA by the last day of the month that follows
the due date of your final Form 941-SS (Form 941), or Form
944-SS (Form 944). However, if any of your employees are
immediately employed by a successor employer, see Rev.
Proc. 2004-53. You can find Rev. Proc. 2004-53 on page 320 of
Internal Revenue Bulletin 2004-53 at www.irs.gov/pub/irs-irbs/
irb04-34.pdf. Also see Rev. Proc. 96-57, 1996-2 C.B. 389, for
information on automatic extensions for furnishing Forms
W-2AS, W-2CM, W-2GU, or W-2VI to employees and filing
them with the SSA. You can find Rev. Proc. 96-57 on page 14
of Internal Revenue Bulletin 1996-53 at www.irs.gov/pub/
irs-irbs/irb96-53.pdf.

Box a — Employee’s social security number . Enter the
number shown on the employee’s social security card. If the
employee does not have a card, he or she should apply for one
by completing Form SS-5, Application for a Social Security
Card. If the employee has applied for a card, enter “Applied
For” in box a.
Box b — Employer identification number (EIN). Show the
employer identification number (EIN) assigned to you by the
IRS (00-0000000). This should be the same number that you
used on your Form 941-SS (Form 941), Form 944-SS (Form
944), or Form 943. Do not use a prior owner’s EIN. If you do not
have an EIN, enter “Applied For” in box b; do not use your
SSN. File Form SS-4, Application for Employer Identification
Number, to get an EIN. See Terminating a business, above.
Box c — Employer’s name, address, and ZIP code. This
entry should generally be the same as shown on your Form
941-SS (Form 941), Form 944-SS (Form 944), or Form 943.
Box d — Control number. You may use this box to identify
individual forms. You do not have to use this box.
Boxes e and f — Employee’s name and address. Enter the
name as shown on the employee’s social security card (first,
middle initial, last). Generally, do not enter “Jr.”, “Sr.,” etc.
on Copy A unless the suffix appears on the card. (You may
enter an employee’s name suffix in the designated area of box
e. However, SSA prefers that you do not enter the suffix on
Copy A.) If the name does not fit, you may show first name
initial, middle initial, and last name (and ignore the vertical
lines). If the name has changed, the employee must get a
corrected card from any SSA office. Use the name on the
original card until you see the corrected one. Do not show
titles or academic degrees, such as “Dr.”, “RN”, or “Esq.”,
at the beginning or end of the employee’s name.
Include in the address the number, street, apartment or suite
number (or P.O. box number if mail is not delivered to a street
address).
Third-party payers of sick pay filing third-party sick pay
recap Forms W-2AS, W-2CM, W-2GU, or W-2VI must enter
“Third-Party Sick Pay Recap” in place of the employee’s name
in box e. See Sick Pay Reporting in Pub. 15-A.
Box 1 — Wages, tips, other compensation. Show, before any
payroll deductions, the total taxable wages, tips, and other
compensation such as: (a) wages, bonuses, prizes, and
awards, (b) noncash payments, including certain fringe benefits,
(c) tips reported, (d) taxable cost of group-term life insurance
over $50,000, (e) distributions from a nonqualified or
nongovernmental section 457(b) plan, and (f) cost of current
insurance protection under a compensatory split-dollar life
insurance arrangement. Other compensation is amounts you
pay the employee from which income tax is not withheld. You
may show other compensation on a separate Form W-2AS,
W-2GU, or W-2VI.
Note. Show payments to statutory employees that are subject
to social security and Medicare taxes but not subject to income
tax withholding in box 1 as other compensation. See Pub. 80
(Circular SS), Federal Tax Guide for Employers in the U.S.
Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands, for the
definition of a statutory employee.

Specific Instructions for Forms W-2AS,
W-2GU, and W-2VI

Box 2 — Income tax withheld. Show the total American
Samoa, Guam, or U.S. Virgin Islands income tax withheld. Do
not reduce this amount by any advance EIC payments.
Box 3 — Social security wages. Show the total wages paid
(before payroll deductions) subject to employee social security
tax. Do not include tips. The total of boxes 3 and 7 cannot be
more than $97,500 (2007 maximum social security wage base).
Generally, noncash payments are considered wages. See Pub.
80 (Circular SS) for more information.
Box 4 — Social security tax withheld. Show the total
employee social security tax (not your share) withheld or paid
by you for the employee, including social security tax on tips.
Include only tax withheld (or paid by you for the employee) for

Because Copy A of Forms W-2AS, W-2GU, and W-2VI is read
by machine, please type entries, if possible, using 12-point
Courier font. Make all dollar entries without the dollar sign
and comma but with the decimal point (00000.00). If a box
does not apply, leave it blank. Keep Copy D, and a copy of
Form W-3SS, with your records for 4 years.
Void. Check this box when an error is made on a Form W-2AS,
W-2GU, or W-2VI and you are voiding it because you will
complete a new form. Be careful not to include any amounts
shown on “Void” forms in the totals you enter on Form
W-3SS.

-3-

Page 4 of 6

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Code C — Taxable cost of group-term life insurance over
$50,000. Show the taxable cost of group-term life insurance
coverage over $50,000 provided to your employee (including a
former employee). Also include this amount in boxes 1, 3 (up to
the social security wage base), and 5.

2007 wages and tips. The amount shown should not exceed
$6,045.00 ($97,500 x 6.2%).
Box 5 — Medicare wages and tips. Show the total wages paid
and tips reported subject to employee Medicare tax. There is no
wage base limit for Medicare tax.
Box 6 — Medicare tax withheld. Show the total employee
Medicare tax (not the employer’s share) withheld or paid by you
for the employee. Include only tax withheld for 2007 wages and
tips. The rate is 1.45% of all wages and tips.
Box 7 — Social security tips. Show the tips that the employee
reported to you even if you did not have enough employee
funds to collect the social security tax for the tips. The total of
boxes 3 and 7 should not be more than $97,500 for 2007.
Report all tips in box 1 along with wages and other
compensation.
Box 9 — Advance EIC payment. (Forms W-2GU and W-2VI
only.) Show the total advance earned income credit (EIC) paid
to the employee.
Box 11 — Nonqualified plans. The purpose of box 11 is for
the SSA to determine if any part of the amount reported in box
1 or boxes 3 and/or 5 was earned in a prior year. The SSA uses
this information to verify that they have properly applied the
social security earnings test and paid the correct amount of
benefits.
Show distributions to an employee from a nonqualified or
nongovernmental section 457(b) plan. Also report the
distributions in box 1. Make only one entry in this box.
Distributions from governmental section 457(b) plans must be
reported on Form 1099-R, not in box 1 of Forms W-2AS,
W-2GU, or W-2VI.
If you did not make distributions this year, show
deferrals (plus earnings) under a nonqualified or any
section 457(b) plan that became taxable for social security
and Medicare taxes during the year (but were for prior year
services) because the deferred amounts were no longer
subject to a substantial risk of forfeiture. Also report these
amounts in boxes 3 (up to the social security wage base) and 5.
Do not report in box 11 deferrals that are included in boxes
3 and/or 5 and that are for current year services (such as,
those that have no risk of forfeiture).

Codes D through H, S, Y, AA, and BB. Use these codes to
show pre-tax elective deferrals and designated Roth
contributions made to the plans listed. Do not report amounts
for other types of plans. The Example following Code D shows
how to report elective deferrals to a section 401(k) plan.
Report as elective deferrals and designated Roth
contributions only the part of the employee’s salary (or other
compensation) that he or she did not receive because of the
deferrals or designated Roth contributions. For section 457(b)
plans, report both elective and nonelective deferrals using code
G.
For employees who were 50 years of age or older at any
time during the year and made elective deferral and/or
designated Roth “catch-up” contributions, report the elective
deferrals and the elective deferral “catch-up” contributions as a
single sum in box 12 using the appropriate code, and the
designated Roth contributions and the designated Roth
“catch-up” contributions as a single sum in box 12 using the
appropriate code.
The following are not elective deferrals and may be
reported in box 14, but not in box 12: (a) nonelective
employer contributions on behalf of an employee; (b) after-tax
contributions that are not designated Roth contributions, such
as voluntary contributions to a pension plan that are deducted
from an employee’s pay; and (c) required employee and
employer matching contributions. See the instructions below in
Codes AA and BB for reporting designated Roth contributions.
Code D — Elective deferrals to a section 401(k) cash or
deferred arrangement (plan). Also show deferrals under a
SIMPLE retirement account that is part of a section 401(k)
arrangement.
Example of reporting elective deferrals and designated
Roth contributions to a section 401(k) plan. For 2007,
Employee A (age 45) elected to defer $16,000 to a section
401(k) plan, made a designated Roth contribution of $1,000 to
the plan, and made a voluntary (non-Roth) after-tax contribution
of $600. In addition, the employer, on A’s behalf, made a
qualified nonelective contribution of $2,000 to the plan and a
nonelective profit-sharing employer contribution of $3,000.

If you made distributions and you are also reporting any
deferrals in boxes 3 and/or 5, do not complete box 11.
CAUTION See Pub. 957, Reporting Back Pay and Special Wage
Payments to the Social Security Administration, and Form
SSA-131, Employer Report of Special Wage Payments, for
special reporting instructions for these and other kinds of
compensation earned in prior years. However, do not file Form
SSA-131 if this situation applies but the employee will not be
age 62 or older by the end of that year.
Note. Do not report special wage payments, such as
accumulated sick or vacation pay, in box 11. For more
information or reporting special wage payments, see Pub. 957,
Reporting Back Pay and Special Wage Payments to the Social
Security Administration.
Box 12 — Codes. Complete and code this box for all items
described below. On Copy A, do not enter more than four items
in box 12. If more than four items need to be reported in box 12,
use a separate Form W-2AS, W-2GU, or W-2VI for additional
items. You may enter more than four items on all other copies
when using an approved substitute form.
Show the IRS code (using a capital letter or letters) to
the left of the vertical line in boxes 12a – 12d and the
money amount to the right of the vertical line using decimal
points but no dollar signs or commas, (for example, D 5300.00).
Code A — Uncollected social security tax on tips. Show
the employee social security tax on tips that you could not
collect because the employee did not have enough funds from
which to deduct it. Do not include this amount in box 4.
Code B — Uncollected Medicare tax on tips. Show the
employee Medicare tax on tips that you could not collect
because the employee did not have enough funds from which
to deduct it. Do not include this amount in box 6.

!

The total elective deferral of $16,000 is reported in box 12
with code D (D 16000.00), and the designated Roth contribution
is reported in box 12 with code AA (AA 1000.00). Even though
the 2007 limit for elective deferrals and designated Roth
contributions is $15,500, the employer must separately report
the actual amounts of $16,000 and $1,000 in box 12. The return
of excess salary deferrals and excess designated Roth
contributions, including earnings on both, is reported on Form
1099-R.
The $600 voluntary after-tax contribution may be reported in
box 14 (this is optional) but not in box 12. The $2,000
nonelective contribution and the $3,000 nonelective
profit-sharing employer contribution are not required to be
reported on Form W-2AS, W-2GU, or W-2VI, but may be
reported in box 14.
Check the “Retirement plan” box in box 13.
Code E — Elective deferrals under a section 403(b)
salary reduction agreement.
Code F — Elective deferrals under a section 408(k)(6)
salary reduction SEP.
Code G — Elective deferrals and employer contributions
(including nonelective deferrals) to any governmental or
nongovernmental section 457(b) deferred compensation
plan. Do not report either section 457(b) or section 457(f)
amounts that are subject to a substantial risk of forfeiture.

-4-

Page 5 of 6

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Code H — Elective deferrals to a section 501(c)(18)(D)
tax-exempt organization plan. Be sure to include this amount
in box 1 as wages. The employee will deduct the amount on his
or her income tax return.
Code J — Nontaxable sick pay. Show any sick pay that
was paid by a third-party and was not includible in income (and
not shown in boxes 1, 3, and 5) because the employee
contributed to the sick pay plan.
Code M — Uncollected social security tax on taxable
cost of group-term life insurance over $50,000 (for former
employees). If you provided your former employees (including
retirees) more than $50,000 of group-term life insurance
coverage for periods during which an employment relationship
no longer exists, enter the amount of uncollected social security
tax on the coverage in box 12. See Group-term life insurance
on page 3.
Code N — Uncollected Medicare tax on taxable cost of
group-term life insurance over $50,000 (for former
employees). Enter any uncollected Medicare tax on the cost of
group-term life insurance coverage over $50,000 for your
former employees. See Code M above.
Code P — Excludable moving expense reimbursements
paid directly to employee. Show the total moving expense
reimbursements that you paid directly to your employee for
qualified (deductible) moving expenses. See Moving expenses
on page 3.
Code Q — Nontaxable combat pay. If you are a military
employer, report any nontaxable combat pay in box 12.
Code R — Employer contributions to an Archer MSA.
Show any employer contributions to an Archer MSA.
Code S — Employee salary reduction contributions
under a section 408(p) SIMPLE. Show deferrals under a
section 408(p) salary reduction SIMPLE retirement account.
However, if the SIMPLE is part of a section 401(k)
arrangement, use code D.
Code T — Adoption benefits. Show the total that you paid
or reimbursed for qualified adoption expenses furnished to your
employee under an adoption assistance program. Also include
adoption benefits paid or reimbursed from the pre-tax
contributions made by the employee to a section 125 (cafeteria)
plan. However, do not include adoption benefits forfeited from a
section 125 (cafeteria) plan. Report all amounts including those
in excess of the $11,390 exclusion.
Code V — Income from the exercise of nonstatutory
stock option(s). Show the spread (that is, fair market value of
stock over the exercise price of option(s) granted to your
employee with respect to that stock) from your employee’s (or
former employee’s) exercise of nonstatutory stock option(s).
Include this amount in boxes 1, 3 (up to social security wage
base), and 5.
This reporting requirement does not apply to the exercise of
a statutory stock option, or the sale or disposition of stock
acquired pursuant to the exercise of a statutory stock option.
For more information about the taxability of employee stock
options, see Pub. 15-B, Employer’s Tax Guide to Fringe
Benefits.
Code W — Employer contributions to an employee’s
Health Savings Account (HSA). Show any employer
contributions (including amounts the employee elected to pay
under a section 125 (cafeteria) plan) to your employee’s Health
Savings Account (HSA).
See Notice 2004-2 and Notice 2004-50 for more information
about HSAs. You can find Notice 2004-2 on page 269 of
Internal Revenue Bulletin 2004-2 at www.irs.gov/pub/irs-irbs/
irb04-02.pdf. You can find Notice 2004-50 on page 196 of
Internal Revenue Bulletin 2004-33 at www.irs.gov/pub/irs-irbs/
irb04-33.pdf. See also Form 8889, Health Savings Accounts
(HSAs), and Pub. 969, Health Savings Accounts and Other
Tax-Favored Health Plans.
Code Y — Deferrals under a section 409A, nonqualified
deferred compensation plan. Include current year deferrals
under a section 409A deferred compensation plan. Any

earnings during the year on current year and prior year
deferrals must also be reported here.
Code Z — Income under section 409A on a nonqualified
deferred compensation plan. Show any income under
section 409A on a nonqualified deferred compensation plan that
was included in box 1. This income is subject to an additional
tax reported on the employee’s tax return.
Code AA — Designated Roth contributions under a
section 401(k) plan. Use this code to report designated Roth
contributions under a section 401(k) plan. Do not use this code
to report elective deferrals under code D.
Code BB — Designated Roth contributions under a
section 403(b) plan. Use this code to report designated Roth
contributions under a section 403(b) plan. Do not use this code
to report elective deferrals under code E.
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 income tax withholding. Do not check
this box for common law employees. See Pub. 80 (Circular SS)
for more information on statutory 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(b) plan).
Generally, an employee is an active participant if covered
by (a) a defined benefit plan for any tax year that he or she is
eligible to participate or (b) a defined contribution plan (for
example, a section 401(k) plan) for any tax year that employer
or employee contributions (or forfeitures) are added to his or
her account. For additional information on employees who are
eligible to participate in a plan, contact your plan administrator.
For details 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). You can find Notice 98-49 on page 5 of Internal
Revenue Bulletin 1998-38 at www.irs.gov/pub/irs-irbs/irb98-38.
pdf.
Do not check this box for contributions made to a
nonqualified or section 457(b) plan.
• Third-party sick pay. Check this box only if you are a
third-party sick pay payer filing a Form W-2AS, W-2GU, or
Form W-2VI 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 on a
separate statement to your employee. You may use this box for
any other information that you want to give to your employee,
such as health insurance premiums deducted, union dues,
voluntary after-tax contributions (but not designated Roth
contributions) to a pension plan, or nontaxable income. Clearly
label each entry.

Specific Instructions for Form W-3SS
How to complete Form W-3SS. Please type or print entries.
Make all entries without the dollar sign and comma but with the
decimal point (00000.00). If a box does not apply, leave it blank.
Box a — Control number. This is an optional box that you may
use for numbering the whole transmittal.

-5-

Page 6 of 6

Instructions for Forms W-2AS, W-2GU, W-2VI, and Form W-3SS

16:12 - 9-JAN-2007

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Box b — Kind of Payer. Check only one box unless the
second, marked checkbox is “Third-party sick pay.” If you have
more than one type of Form W-2AS, W-2CM, W-2GU, or
W-2VI, send each type with a separate Form W-3SS.
941-SS. Check this box if you file Form 941-SS and no
other category (except “Third-party sick pay”) applies. A church
or church organization should check this box even if it is not
required to file Form 941-SS or Form 944-SS.
Military. Check this box if you are a military employer
sending Forms W-2AS, W-2CM, W-2GU, or W-2VI for members
of the uniformed services.
943. Check this box if you file Form 943 and are sending
forms for agricultural employees. For nonagricultural
employees, send their Forms W-2AS, W-2CM, W-2GU, or
W-2VI with a separate Form W-3SS.
944-SS. Check this box if you file Form 944-SS and no
other category applies.
Hshld. emp. Check this box if you are a household
employer sending Form W-2AS, W-2CM, W-2GU, or W-2VI for
household employees, and you did not include the household
employee’s taxes on Form 941-SS, Form 944-SS or Form 943.
Medicare government employee. Check this box if you are
a U.S. or a U.S. Virgin Islands government employer with
employees subject only to the 1.45% Medicare tax.
Third-party sick pay. Check this box (and one other
checkbox) if you are a third-party sick pay payer (or are
reporting payments made by a third party) filing Form(s)
W-2AS, W-2CM, W-2GU, or W-2VI with the “Third-party sick
pay” box in box 13 checked.
Box c — Total number of Forms W-2. Show the number of
completed individual Forms W-2AS, W-2CM, W-2GU, or W-2VI
filed with this Form W-3SS. 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-3SS, with Forms W-2AS, W-2CM, W-2GU,
or W-2VI, for each establishment even if they all have the same
EIN, or you may use a single Form W-3SS for all Forms W-2 of
the same type.
Box e — Employer identification number (EIN). If you
received a preprinted Form W-3SS from the IRS with Pub. 80
(Circular SS), make any necessary corrections on the form. If
you are not using a preprinted IRS Form W-3SS, enter the
nine-digit EIN assigned to you by the IRS. The EIN should be
the same as shown on your Form 941-SS, Form 944-SS, or
Form 943 and in the following format: 00-0000000. Do not use
a prior owner’s EIN. If you do not have an EIN, see Box b on
page 3. See also Box h below.
Boxes f and g — Employer’s name and address. If you are
not using a preprinted Form W-3SS, enter your name and
address as shown on your Form 941-SS, Form 944-SS, or
Form 943. Make any necessary corrections on your preprinted
Form W-3SS.
Box h — Other EIN used this year. If you have used an EIN
(including a prior owner’s EIN) on Form 941-SS, Form 944-SS,
or Form 943 submitted for 2007 that is different from the EIN
reported in box e on this form, enter the other EIN used.
Contact person, telephone number, fax number, and email
address. Please enter this information for use by the SSA if
questions arise during processing.
Boxes 1 through 7. Enter the totals reported in boxes 1
through 7 of Forms W-2AS, W-2CM, W-2GU, or Form W-2VI
being filed with this Form W-3SS.
Box 9 — Advance EIC payments. Enter the total advance EIC
payments shown on Form W-2GU or Form W-2VI only.

Box 11 — Nonqualified plans. Enter the total reported in box
11 on Forms W-2AS, W-2CM, W-2GU, or W-2VI being filed with
this Form W-3SS.
Box 12 — Deferred compensation. Enter one total for all
amounts reported with codes D-H, S, Y, AA, and BB in box 12
of Forms W-2AS, W-2GU, or W-2VI. 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-3SS must enter “Third-Party
Sick Pay Recap” in this box. See Sick Pay Reporting in Pub.
15-A for details.
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 of your employees.
Although this tax is included in the box 2 total, it must be shown
separately here.
Box 15 — Type of form. Check this box for the type of forms
you are submitting with this Form W-3SS.
Signature. The signature on Copies A and 1 of Form W-3SS
must be an original (not a copy).
Privacy Act and Paperwork Reduction Act Notice. We ask
for the information on Forms W-2AS, W-2CM, W-2GU, W-2VI,
and W-3SS 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. 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. However, section 6103 allows or
requires the Internal Revenue Service to disclose or give the
information shown on your return to others as described in the
Code. For example, we may disclose your tax information to the
Department of Justice for civil and criminal litigation, and to
cities, states, and the District of Columbia for use in
administering their tax laws. We may also disclose this
information to other countries under a tax treaty, to federal and
state agencies to enforce federal nontax criminal laws, or to
federal law enforcement and intelligence agencies to combat
terrorism.
The time needed to complete and file these forms will vary
depending on individual circumstances. The estimated average
times are: Form W-2AS — 23 minutes; Form W-2GU — 24
minutes; Form W-2VI — 24 minutes; Form W-3SS — 24
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
Internal Revenue Service, Tax Products Coordinating
Committee, SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave.
NW, IR-6406, Washington, DC 20224. Do not send Forms
W-2AS, W-2GU, W-2VI, or W-3SS to this address. Instead, see
Where To File on page 1.

-6-