EFTA00176033¶
DO NOT STAPLE OR FOLD¶
| a | Control number | for Official Use Only | ||
|---|---|---|---|---|
| b | 941-89 Military 845 Kind of Payer Holding emp Medicare gov. emp. Third party slot pay | 1 Wages, tips, other compensation $ 710836.58 | 2 Income tax withheld $ 116848.00 | |
| c | 3 Social security wages $ 574878.61 | 4 Social security tax withhold $ 35642.47 | ||
| e | Total number of Forms W-2 14 | 8 Medicare wages and tips $ 743059.78 | 9 Medicare tax withhold $ 10774.36 | |
| f | Employer identification number 66-0567418 | 7 Social security tips $ | ||
| g | FINANCIAL TRUST COMPANY, INC. | 9 Advance EIO payments $ | ||
| 11 Nonqualified plans $ | 12 Obtained compensation $ 32223.20 | |||
| 13 For third-party slot pay use only | ||||
| h | Other EIN used this year | 14 Income tax withheld by payer of third-party slot pay | ||
| i | Employer's territorial ID number | 15 Check the appropriate box Type of Form W-2AS W-2OM W-2GU W-2VI | ||
| Contact person Jeanne Brennan | Telephone number (340) 775-2525 | For Official Use Only | ||
| E-mail address | Fax number (340) 775-2528 | |||
Form W-3SS Transmittal of Wage and Tax Statements 2003¶
Send this entire page with the entire Copy A page of Forms W-2AS, W-2GU, W-2CM, or W-2VI to the Social Security Administration (SSA). Photocopies are not acceptable.¶
Do not send any remittance (cash, checks, money orders, etc) with Forms W-2AS, W-2GU, W-2CM, W-2VI, and W-3SS.¶
Instructions for Forms W-2AS, W-2GU, W-2VI, and W-3SS¶
Section references are to the Internal Revenue Code unless otherwise noted.¶
Items to Note¶
Reporting Code Q for box 12.¶
Recent legislation has eliminated the use of Code Q in box 12.¶
When To File¶
File Copy A of Form W-3SS with Copy A of Form W-2AS, W-2GU, W-2CM, or W-2VI by March 1, 2004. However, if you file electronically, you may file by March 31, 2004. See the SSA Web Site at www.ssa.gov/employer/for electronic filing options.¶
Extension to file. You may request an extension of time to file Forms W-2AS, W-2GU, W-2CM, or W-2VI by sending Form 8B09, Request 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 the forms for your request to be considered. If approved, you will have an additional 30 days to file. See Form 8B09 for more details.¶
Where To File Copy A¶
Send the entire first page of this form (Copy A) with the entire Copy A page of Form W-2AS, W-2GU, W-2CM, or W-2VI to:¶
Social Security Administration¶
Data Operations Center¶
Wilkes-Barre, PA 19769-0001¶
Note: If you use “Certified Mall” to file, change the ZIP code to “18769-0002.” If you use an IRS approved private delivery service, add “18702-7907.” See Circular E. Employer’s Tax Guide (Pub. 15) for a list of IRS approved private delivery services.¶
Also see Where to file Copy 1 and Shipping and mailing on page 2.¶
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 Division of Revenue and Taxation, Capitol Hill, Salpani, MP 86950, to get Form W-2CM and the instructions for completing and filing that form.¶
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-2GU, W-2CM, or W-2VI to the Social Security Administration. File Copy 1 of Form W-3$$ and Copy 1 of Form W-2AS.¶
FTC0023¶
Cat. No, 10117S¶