a Control number Void For Official Use Only 䊳

22222 OMB No. 1545-0008

b Employer identification number 1 Wages, tips, other compensation 2 VI income tax withheld

c Employer’s name, address, 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 Benefits included in box 1

d Employee’s social security number 9 Advance EIC payment 10

e Employee’s name (first, middle initial, last) 11 Nonqualified plans 12

13 See Form W-3SS instructions 14 Other

15 Statutory Pension Deferred

employee plan compensation
f Employee’s address and ZIP code

U.S. Virgin Islands Cat. No. 49977C Department of the Treasury—Internal Revenue Service

Wage and Tax

W-2VI
Form

Statement
Copy A—For Social Security Administration
2000 For Privacy Act and Paperwork Reduction Act Notice
and instructions, see Form W-3SS.

Send this entire page with Copy A of Form W-3SS to the

Social Security Administration; photocopies are not acceptable.

Do NOT Cut, Fold, or Staple Forms on This Page—Do NOT Cut, Fold, or Staple Forms on This Page
 a Control number Void
22222 OMB No. 1545-0008
b Employer identification number 1 Wages, tips, other compensation 2 VI income tax withheld

c Employer’s name, address, 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 Benefits included in box 1

d Employee’s social security number 9 Advance EIC payment 10

e Employee’s name, address, and ZIP code 11 Nonqualified plans 12

13 14 Other

15 Statutory Pension Deferred

employee plan compensation

U.S. Virgin Islands Department of the Treasury—Internal Revenue Service

Wage and Tax

W-2VI
Form

Statement 2000
Copy 1—For VI Bureau of Internal Revenue
 a Control number
OMB No. 1545-0008
b Employer identification number 1 Wages, tips, other compensation 2 VI income tax withheld

c Employer’s name, address, 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 Benefits included in box 1

d Employee’s social security number 9 Advance EIC payment 10

e Employee’s name, address, and ZIP code 11 Nonqualified plans 12

13 See instructions on back of Copy C 14 Other

15 Statutory Pension Deferred

employee plan compensation

U.S. Virgin Islands Department of the Treasury—Internal Revenue Service

Wage and Tax

W-2VI
Form

Statement 2000 This information is being furnished to the

VI Bureau of Internal Revenue.
Copy B—To Be Filed With Employee’s VI Tax Return
 a Control number
OMB No. 1545-0008
b Employer identification number 1 Wages, tips, other compensation 2 VI income tax withheld

c Employer’s name, address, 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 Benefits included in box 1

d Employee’s social security number 9 Advance EIC payment 10

e Employee’s name, address, and ZIP code 11 Nonqualified plans 12

13 See instructions on back 14 Other

15 Statutory Pension Deferred

employee plan compensation

U.S. Virgin Islands Department of the Treasury—Internal Revenue Service

Wage and Tax

W-2VI
Form

Statement 2000 This information is being furnished to the

VI Bureau of Internal Revenue.
Copy C—For EMPLOYEE’S RECORDS
 G—Elective and nonelective deferrals to a section 457(b) deferred
Notice to Employee compensation plan
Earned income credit (EIC). You must file a tax return regardless of H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization
your income if any amount is shown in box 9, Advance EIC payment. If plan (You may be able to deduct.)
you qualify, you can get the earned income credit in advance by giving
Form W-5, Earned Income Credit Advance Payment Certificate, to your J—Nontaxable sick pay (not included in box 1, 3, or 5)
employer. See Pub. 596, Earned Income Credit, for more details. M—Uncollected social security tax on cost of group-term life insurance
Copies B and C; corrections. File Copy B of this form with your 2000 over $50,000 (former employees only)
U.S. Virgin Islands income tax return. Keep Copy C for your records. If N—Uncollected Medicare tax on cost of group-term life insurance over
your name, social security number (SSN), or address is incorrect, $50,000 (former employees only)
correct Copies B and C, and ask your employer to correct your P—Excludable moving expense reimbursements paid directly to
employment record. Be sure to ask the employer to file Form W-2c, employee (not included in box 1, 3, or 5)
Corrected Wage and Tax Statement, with the Social Security Q—Military employee basic housing, subsistence, and combat zone
Administration (SSA) to correct any name, amount, or SSN error compensation (use this amount if you qualify for EIC)
reported to the SSA.
R—Employer contributions to your medical savings account (MSA)
Estimated tax. If you expect to owe self-employment tax of $1,000 or
more for 2001, you may have to make estimated tax payments to the S—Employee salary reduction contributions under a section 408(p)
U.S. Internal Revenue Service. Use Form 1040-ES, Estimated Tax for SIMPLE (not included in box 1)
Individuals. T—Adoption benefits (not included in box 1)
Box 8. If there is an amount in this box, you may be able to deduct Box 15. If the “Pension plan” box is checked, special limits may apply
expenses that are related to fringe benefits; see the instructions for to the amount of traditional IRA contributions you may deduct. If the
your income tax return. “Deferred compensation” box is checked, the elective deferrals in box
Box 9. Enter this amount on the advance earned income credit 13 (codes D, E, F, G, H, and S) (for all employers, and for all such
payments line of your tax return. plans to which you belong) are generally limited to $10,500. Elective
deferrals for section 403(b) contracts are limited to $10,500 ($13,500 in
Box 11. This amount is (a) reported in box 1 if it is a distribution from a some cases; see Pub. 571). Section 457(b) plans are limited to $8.000.
nonqualified deferred compensation or section 457 plan or (b) included Amounts over these limits must be included in income.
in box 3 and/or 5 if it is a prior year deferral under a nonqualified or
section 457 plan that became taxable for social security and Medicare Credit for excess social security tax. If one employer paid you wages
taxes this year because there is no longer a substantial risk of during 2000 and more than $4,724.40 in social security tax was
forfeiture of your right to the deferred amount. withheld, you may claim a refund of the excess on Form 1040 by filing
it with the VI Bureau of Internal Revenue, 9601 Estate Thomas,
Box 13. The following list explains any codes shown in box 13. You Charlotte Amalie, St. Thomas, VI 00802. If you had more than one
may need this information to complete your tax return. employer in 2000 and more than $4,724.40 in social security tax was
A—Uncollected social security tax on tips withheld, you may have the excess refunded by filing Form 843, Claim
B—Uncollected Medicare tax on tips for Refund and Request for Abatement, with the Internal Revenue
C—Cost of group-term life insurance over $50,000 (included in boxes Service Center in Philadelphia. If you must file Form 1040 with the
1, 3 (up to social security wage base), and 5) United States, claim the excess tax as a credit on Form 1040.
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Note: Keep Copy C of Form W-2VI for at least 3 years after the due
Also includes deferrals under a SIMPLE retirement account that is part date for filing your income tax return. However, to help protect your
of a section 401(k) arrangement. social security benefits, keep Copy C until you begin receiving social
security benefits, just in case there is a question about your work
E—Elective deferrals under a section 403(b) salary reduction agreement record and/or earnings in a particular year. The SSA suggests you
F—Elective deferrals under a section 408(k)(6) salary reduction SEP confirm your work record with them from time to time.
 a Control number Void
OMB No. 1545-0008
b Employer identification number 1 Wages, tips, other compensation 2 VI income tax withheld

c Employer’s name, address, 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 Benefits included in box 1

d Employee’s social security number 9 Advance EIC payment 10

e Employee’s name, address, and ZIP code 11 Nonqualified plans 12

13 See Form W-3SS instructions 14 Other

15 Statutory Pension Deferred

employee plan compensation

U.S. Virgin Islands Department of the Treasury—Internal Revenue Service

Wage and Tax

W-2VI
Form

Statement 2000 For Privacy Act and Paperwork Reduction Act Notice
and instructions, see Form W-3SS.
Copy D—For Employer
Instructions for Preparing employee asks for Form W-2VI, furnish the
completed copies within 30 days of the request or
Form W-2VI within 30 days of the final wage payment,
Who must file. File Form W-2VI for each employee whichever is later. You may also file Copy A and
to whom any of the following items applied during Form W-3SS, Transmittal of Wage and Tax
2000: Statements, with the Social Security Administration
at the same time.
a. You withheld income tax or social security and
Medicare taxes. Note: If you terminate your business, see the rules
on furnishing and filing Forms W-2VI and W-3SS
b. You would have withheld income tax if the under Terminating a business in the Form W-3SS
employee had not claimed more than one instructions.
withholding allowance.
When to file. By February 28, 2001, send Copy A
c. You paid any amount for services if you are in of Forms W-2VI and W-3SS to the Social Security
a trade or business. Include the cash value of any Administration. However, if you file electronically
payment you made that was not in cash. (not by magnetic media), the due date is April 2,
d. You made any advance EIC (earned income 2001. See Form W-3SS.
credit) payments. Reporting on magnetic media. If you must file
Distribution of copies. By January 31, 2001, 250 or more Forms W-2VI, you must file using
furnish Copies B and C to each person who was magnetic media or electronically. For information,
your employee during 2000. For anyone who contact your Employer Service Liaison Officer
stopped working for you before the end of 2000, (ESLO) at 787-766-5574.
you may furnish Copies B and C any time after See Form W-3SS for more information on how
employment ends but by January 31. If the to complete Form W-2VI.