Company:          Taxpayer ID No:       (Required)
Submitted by:    Your Email Address: (Required)

Supplemental Form W-2 Information
Employee No. 1 Employee No. 2 Employee No. 3
Name

Social Security Tips

Allocated Tips

Advance EIC Pmt

Dep. Care Benefits

Nonqualified Plans

Benefits in W2 Box 1

W2 - Box 13

W2 - Box 14

Statutory Employee

Deceased

Pension Plan

Legal Rep

Household Employee

Deferred Compensation

Other Information, Comments, Questions:

NOTE: If you have additional employees to enter - press "Send to Jack Burson, CPA"
below, then press "Clear Form" and enter additional employees.

    
   
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