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Form option
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Select the check box to print either your employer copy or a copy for
the Social Security Administration (SSA).
When printing the SSA copy of the W-3, it is not required to include state information in boxes 15-19 when providing copies of the W-2 to the SSA with no state information included.
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Contact name, phone, fax, email
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Enter this information for the person the SSA should contact if any
questions arise during the processing of this form.
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Signer's title
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The title of the person who signs the form
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Kind of payer
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Select the check box that indicates what kind
of payer that describes your company.
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Kind of employer
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Select the check box that indicates what kind
of employer that describes your company.
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Third-party sick pay
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Select this check box to select the Third-party sick pay check box on Form W-3.
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| Third-party sick pay recap |
If you select the Third-party sick pay check box above, enter the words Third-Party Sick Pay Recap in this box.
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| Third-party sick pay withholding |
Complete this box only if you are the employer
and have employees who had federal income tax withheld
on third-party payments of sick pay. Enter 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 separately shown here.
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