CSS (Cascading Style Sheets) Best viewed with Internet Explorer 5+
This is a sample of what CSS could be used for. CSS is a technology developed for rendering the visual
style of web pages. Virtually any kind of form can be created or made to reasonably look like actual preprinted forms.
If you print-preview or print this web page, only the form will be visible. This is also accomplished by using simple CSS code.
This page is best printed and previewed using left and right margins that are less than 1 inch.
Your margins can be adjusted by going to page setup within your browser settings. You should
experiment with the margins to get optimal form positioning for printing.
Most browsers are CSS compliant. CSS1 is in wide use and CSS2 is a close runner. CSS3 is under
development. If your browser does not support CSS or somewhat supports it, then the results are
unpredictable and elements using CSS will not be rendered as expected within the browser.
a. Control number
For Official Use Only ->
OMB No. 1545-0008
b. Employer identification number (EIN)
1 Wages, tips, other compensation
2 Federal income tax withheld
c Employers name, adddres, and ZIP code
3 Social security wages
4 Social security tax withheld
5 Medicare wages and tips
6 Medicare tax withheld
7 Social security tips
8 Allocated tips
9 Advance EIC payment
10 Department care benefits
d Employee's social security number
e Employee's first name and initial
11 Nonqualified plans
12a See instructions for box 12
f Employee's address and ZIP code
15 State Employer's state ID number
16 State wages, tips, etc.
17 State income tax
18 Local wages, tips, etc.
19 Local income tax
19 Locality name
Wage and Tax
Department of the Treasury---Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see back of Copy D.
Copy A For Social Security Administration -- Send this
entire page with Form W-3 to this Social Security
Administration: photocopies are not acceptable.
Cat. No. 10134D
Do Not Cut, Fold, or Staple Forms on This Page -- Do Not Cut, Fold, or Staple Forms on This Page