IRS Form W-3

IRS Form W-3 is used by the Social Security Administration (SSA) to summarize and transmit an employer’s W-2 forms.

The form_type parameter W3 for the Upload PDF endpoint is required for this Form Type.

Learn more about how we process W-3 forms here.

Optional fields captured

📘
Configuration-Driven Output
All fields below are optionally captured, depending on your order form. To adjust fields captured, please speak with your Ocrolus Account Manager.

JSON Attribute	Data Type	Description
`w3-Part1:year`	Text	Numerical description of the Form's pre-printed year, e.g. "2020" for a 2020 Q1 form.
`w3-Part1:(boxA)ControlNumber`	Text	Control number
`w3-Part1:(boxB)(I)KindOfPayer`	`941-SS` `MILITARY` `943` `944` `HSHLD EMP` `MEDICARE GOVT EMP`	Kind of Payer
`w3-Part1:(boxB)(Ii)KindOfEmployer`	`NONE APPLY` `501C NON-GOVT` `STATE/LOCAL NON-501C` `STATE/LOCAL 501C` `FEDERAL GOVT`	Kind of Employer
`w3-Part1:(boxB)(Iii)Third-PartySickPay`	`CHECKED` `NOT CHECKED`	`Checked` if third party sick pay is applicable
`w3-Part1:(boxC)TotalNumberOfFormsW-2`	Text	Total number of W-2 Forms summarized
`w3-Part1:(boxD)EstablishmentNumber`	Text	Establishment number
`w3-Part1:(boxE)EmployerIdentificationNumber(Ein)`	Text	Employer identification number (EIN)
`w3-Part1:(boxF)EmployersName`	Text	Name of the Employer
`w3-Part1:(boxG)EmployersAddress:addressLine1`	Text	Address of the employer
`w3-Part1:(boxG)EmployersAddress:addressLine2`	Text	Address 2 of the employer
`w3-Part1:(boxG)EmployersAddress:city`	Text	City of the employer address
`w3-Part1:(boxG)EmployersAddress:state`	Text	Formatted 2 character state code. State of employer address
`w3-Part1:(boxG)EmployersAddress:zip`	Text	Formatted 5 digits. Zip Code
`w3-Part1:(boxH)OtherEinUsedThisYear`	Text	Default `is_empty = true`. Additional TIN used by company in filing year
`w3-Part2:(box1)WagesTipsOtherComp`	Money	Amount in wages, tips, other compensation
`w3-Part2:(box2)IncomeTaxWithheld`	Money	Amount of federal income tax withheld
`w3-Part2:(box3)SocialSecurityWages`	Money	Amount of social security wages
`w3-Part2:(box4)SocialSecurityTaxWithheld`	Money	Amount of social security tax withheld
`w3-Part2:(box5)MedicareWagesAndTips`	Money	Amount of medicare wages and tops
`w3-Part2:(box6)MedicareTaxWithheld`	Money	Amount of medicare tax withheld
`w3-Part2:(box7)SocialSecurityTips`	Money	Amount of social security tips
`w3-Part2:(box8)AllocatedTips`	Text	Amount of allocated tips
`w3-Part2:(box9)NotInUse`	Text	Default `is_emply = true`
`w3-Part2:(box10)DependentCareBenefits`	Text	Amount of dependent care benefits
`w3-Part3:(box11)NonqualifiedPlans`	Money	Amount in unqualified plans
`w3-Part3:(box12A)DeferredCompensation`	Money	Amount in deferred compensation
`w3-Part3:(box12B)NotInUse`	Text
`w3-Part3:(box13)ForThirdPartySickPayUseOnly`	Text	Amount in pay only for third-party sick
`w3-Part3:(box14)IncomeTaxWithheldByPayerOfThirdPartySickPay`	Money	Amount of income tax withheld by payer of third-party sick pay
`w3-Part3:(box15)State`	Text	Formatted 2 character state code. State employer is registered in
`w3-Part3:(box15)EmployersTerritorialIdNumber`	Text	Employer's state ID number
`w3-Part3:(box16)StateWagesTipsEtc`	Money	Amount in state wages, tips, etc.
`w3-Part3:(box17)StateIncomeTax`	Money	Amount in state income tax
`w3-Part3:(bok18)LocalWagesTipsEtc`	Money	Amount in local wages, tips, etc.
`w3-Part3:(box19)LocalIncomeTax`	Money	Amount in local income tax
`w3-Part3:employersContactPerson`	Text	Contact person for employer
`w3-Part3:employersTelephoneNumber`	Text	Formatted (XXX) XXX-XXXX. Telephone number of employer
`w3-Part3:employersFaxNumber`	Text	Fax number of employer
`w3-Part3:employersEmailAddress`	Text	Email address of employer
`w3-Part3:signature`	`SIGNED` `NOT SIGNED`	Signature of employer contact person
`w3-Part3:title`	Text	Title of signatory
`w3-Part3:dateOfSignature`	Date	Date of signature

Sample Form

The below Ocrolus Sample PDF (input) matches the below Sample JSON Result (output).

Sample JSON Result

{
  "form_type": "W3",
  "pk": 4606751,
  "form_config_pk": 1493,
  "raw_fields": {
    "w3-Part1:(boxA)ControlNumber": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part1:(boxB)(I)KindOfPayer": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "941-SS"
    },
    "w3-Part1:(boxB)(Ii)KindOfEmployer": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "NONE APPLY"
    },
    "w3-Part1:(boxB)(Iii)Third-PartySickPay": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "NOT CHECKED"
    },
    "w3-Part1:(boxC)TotalNumberOfFormsW-2": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "17"
    },
    "w3-Part1:(boxD)EstablishmentNumber": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part1:(boxE)EmployerIdentificationNumber(Ein)": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "12-3456789"
    },
    "w3-Part1:(boxF)EmployersName": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "OCROLUS INC."
    },
    "w3-Part1:(boxG)EmployersAddress:addressLine1": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "101 GREENWICH STREET"
    },
    "w3-Part1:(boxG)EmployersAddress:addressLine2": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "FLOOR 23"
    },
    "w3-Part1:(boxG)EmployersAddress:city": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "NEW YORK"
    },
    "w3-Part1:(boxG)EmployersAddress:state": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "NY"
    },
    "w3-Part1:(boxG)EmployersAddress:zip": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "10006"
    },
    "w3-Part1:(boxH)OtherEinUsedThisYear": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part1:year": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "2019"
    },
    "w3-Part2:(box1)WagesTipsOtherComp": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "23284.60"
    },
    "w3-Part2:(box10)DependentCareBenefits": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part2:(box2)IncomeTaxWithheld": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "2873.00"
    },
    "w3-Part2:(box3)SocialSecurityWages": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "23284.60"
    },
    "w3-Part2:(box4)SocialSecurityTaxWithheld": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "1474.60"
    },
    "w3-Part2:(box5)MedicareWagesAndTips": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "23284.60"
    },
    "w3-Part2:(box6)MedicareTaxWithheld": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "344.80"
    },
    "w3-Part2:(box7)SocialSecurityTips": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "0.00"
    },
    "w3-Part2:(box8)AllocatedTips": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "0.00"
    },
    "w3-Part2:(box9)NotInUse": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(bok18)LocalWagesTipsEtc": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "0.00"
    },
    "w3-Part3:(box11)NonqualifiedPlans": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(box12A)DeferredCompensation": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(box12B)NotInUse": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(box13)ForThirdPartySickPayUseOnly": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(box14)IncomeTaxWithheldByPayerOfThirdPartySickPay": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:(box15)EmployersTerritorialIdNumber": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "WTH123456789"
    },
    "w3-Part3:(box15)State": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "NY"
    },
    "w3-Part3:(box16)StateWagesTipsEtc": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "23284.00"
    },
    "w3-Part3:(box17)StateIncomeTax": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "675.00"
    },
    "w3-Part3:(box19)LocalIncomeTax": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:dateOfSignature": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:employersContactPerson": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "SAM BOBLEY"
    },
    "w3-Part3:employersEmailAddress": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "[email protected]"
    },
    "w3-Part3:employersFaxNumber": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "646-850-9090"
    },
    "w3-Part3:employersTelephoneNumber": {
      "alias_used": null,
      "is_empty": false,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": "646-850-9090"
    },
    "w3-Part3:signature": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    },
    "w3-Part3:title": {
      "alias_used": null,
      "is_empty": true,
      "page_doc_pk": 63652535,
      "source_filename": "Ocrolus Sample PDF W-3.pdf",
      "value": ""
    }
  },
  "tables": []
}

Updated 6 months ago

Optional fields captured

📘Configuration-Driven Output

Sample Form

Sample JSON Result

📘
Configuration-Driven Output