IRS Form W-2AS 2019 American Samoa Wage and Tax Statement

What Is W-2AS Form?

IRS Form W-2AS, American Samoa Wage and Tax Statement is a document you need to fill out to report American Samoa wages and taxes withheld on them. Do not submit it to report income subject to United States tax withholdings. Use IRS Form W-2, Wage and Tax Statement instead.

The issuing department of the IRS W-2AS Form is the Internal Revenue Service (IRS). The form is updated on a yearly basis with the most recent revision released in 2019. The latest version of the document is available for download through the link below.

ADVERTISEMENT
Attention:
You may file Forms W-2 and W-3 electronically on the SSA’s
Employer
W-2 Filing Instructions and Information
web page, which is also accessible
at www.socialsecurity.gov/employer. You can create fill-in versions of
Forms W-2 and W-3 for filing with SSA. You may also print out copies for
filing with state or local governments, distribution to your employees, and
for your records.
Note: Copy A of this form is provided for informational purposes only. Copy A appears in
red, similar to the official IRS form. The official printed version of this IRS form is scannable,
but the online version of it, printed from this website, is not. Do not print and file Copy A
downloaded from this website with the SSA; a penalty may be imposed for filing forms that
can’t be scanned. See the penalties section in the current
General Instructions for Forms
W-2 and
W-3, available at www.irs.gov/w2, for more information.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded, filled in, and printed and used to satisfy the requirement to provide the
information to the recipient.
To order official IRS information returns such as Forms W-2 and W-3, which include a
scannable Copy A for filing, go to IRS’
Online Ordering for Information Returns and
Employer Returns
page, or visit
www.irs.gov/orderforms
and click on Employer and
Information returns. We’ll mail you the scannable forms and any other products you order.
See IRS Publications 1141, 1167, and
1179
for more information about printing these tax
forms.
Attention:
You may file Forms W-2 and W-3 electronically on the SSA’s
Employer
W-2 Filing Instructions and Information
web page, which is also accessible
at www.socialsecurity.gov/employer. You can create fill-in versions of
Forms W-2 and W-3 for filing with SSA. You may also print out copies for
filing with state or local governments, distribution to your employees, and
for your records.
Note: Copy A of this form is provided for informational purposes only. Copy A appears in
red, similar to the official IRS form. The official printed version of this IRS form is scannable,
but the online version of it, printed from this website, is not. Do not print and file Copy A
downloaded from this website with the SSA; a penalty may be imposed for filing forms that
can’t be scanned. See the penalties section in the current
General Instructions for Forms
W-2 and
W-3, available at www.irs.gov/w2, for more information.
Please note that Copy B and other copies of this form, which appear in black, may be
downloaded, filled in, and printed and used to satisfy the requirement to provide the
information to the recipient.
To order official IRS information returns such as Forms W-2 and W-3, which include a
scannable Copy A for filing, go to IRS’
Online Ordering for Information Returns and
Employer Returns
page, or visit
www.irs.gov/orderforms
and click on Employer and
Information returns. We’ll mail you the scannable forms and any other products you order.
See IRS Publications 1141, 1167, and
1179
for more information about printing these tax
forms.
a Employee’s social security number
For Official Use Only
22222
Void
OMB No. 1545-0008
b Employer identification number (EIN)
1 Wages, tips, other compensation
2 Samoa 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
d Control number
9
10
e Employee’s first name and initial
11 Nonqualified plans
12a See instructions for box 12
Last name
Suff.
C
o
d
e
13
Statutory
Retirement
Third-party
12b
employee
plan
sick pay
C
o
d
e
14 Other
12c
C
o
d
e
12d
C
o
f Employee’s address and ZIP code
d
e
W-2AS
American Samoa
Department of the Treasury—Internal Revenue Service
2019
Wage and Tax Statement
Form
For Privacy Act and Paperwork Reduction Act
Notice, see the separate instructions.
Copy A For Social Security Administration—Send this entire page with Copy A of
Form W-3SS to the Social Security Administration; photocopies are not acceptable.
Cat. No. 10140H
Do Not Cut, Fold, or Staple Forms on This Page
a Employee’s social security number
22222
Void
OMB No. 1545-0008
b Employer identification number (EIN)
1 Wages, tips, other compensation
2 Samoa 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
d Control number
9
10
e Employee’s first name and initial
11 Nonqualified plans
12a
Last name
Suff.
C
o
d
e
13
Statutory
Retirement
Third-party
12b
employee
plan
sick pay
C
o
d
e
14 Other
12c
C
o
d
e
12d
C
o
f Employee’s address and ZIP code
d
e
W-2AS
American Samoa
Department of the Treasury—Internal Revenue Service
2019
Wage and Tax Statement
Form
Copy 1—For American Samoa Treasurer
a Employee’s social security number
OMB No. 1545-0008
b Employer identification number (EIN)
1 Wages, tips, other compensation
2 Samoa 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
d Control number
9
10
e Employee’s first name and initial
11 Nonqualified plans
12a See instructions for box 12
Last name
Suff.
C
o
d
e
13
Statutory
Retirement
Third-party
12b
employee
plan
sick pay
C
o
d
e
14 Other
12c
C
o
d
e
12d
C
o
f Employee’s address and ZIP code
d
e
W-2AS
American Samoa
Department of the Treasury—Internal Revenue Service
2019
Wage and Tax Statement
Form
This information is being furnished to
the American Samoa Tax Office,
Copy B—To Be Filed With Employee’s American Samoa Tax Return
Government of American Samoa.
Notice to Employee
Instructions for Employee
Do you have to file? Refer to the Form 1040 instructions to determine if you are
(Also see Notice to Employee on this page.)
required to file a tax return. Even if you don’t have to file a tax return, you may be
Box 5. You may be required to report this amount on Form 8959, Additional
eligible for a refund if box 2 shows an amount or if you are eligible for any credit.
Medicare Tax. See the Form 1040 instructions to determine if you are required to
Copies B and C; corrections. File Copy B of this form with your 2019 American
complete Form 8959.
Samoa income tax return. Keep Copy C for your records. If your name, social
Box 6. This amount includes the 1.45% Medicare Tax withheld on all Medicare
security number (SSN), or address is incorrect, correct Copies B and C and ask
wages and tips shown in box 5, as well as the 0.9% Additional Medicare Tax on
your employer to correct your employment record. Be sure to ask your employer
any of those Medicare wages and tips above $200,000.
to file Form W-2c, Corrected Wage and Tax Statement, with the Social Security
Administration (SSA) to correct any name, amount, or SSN error reported to the
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from
SSA. Be sure to get your copies of Form W-2c from your employer for all
a nonqualified deferred compensation or nongovernmental section 457(b) plan or
corrections made so you may file them with your tax return.
(b) included in box 3 and/or 5 if it is a prior year deferral under a nonqualified or
section 457(b) plan that became taxable for social security and Medicare taxes this
Estimated tax. If you expect to owe $1,000 or more in tax (including self-
year because there is no longer a substantial risk of forfeiture of your right to the
employment tax) for 2020, you may have to make estimated tax payments to the
deferred amount. This box shouldn’t be used if you had a deferral and a
U.S. Internal Revenue Service. Use Form 1040-ES, Estimated Tax for Individuals.
distribution in the same calendar year. If you made a deferral and received a
Clergy and religious workers. If you aren’t subject to social security and
distribution in the same calendar year, and you are or will be age 62 by the end of
Medicare taxes, see Pub. 517, Social Security and Other Information for Members
the calendar year, your employer should file Form SSA-131, Employer Report of
of the Clergy and Religious Workers.
Special Wage Payments, with the Social Security Administration and give you a
copy.
Cost of employer-sponsored health coverage (if such cost is provided by the
employer). The reporting in box 12, using code DD, of the cost of employer-
Box 12. The following list explains the codes shown in box 12. You may need this
sponsored health coverage is for your information only. The amount reported
information to complete your tax return. Elective deferrals (codes D, E, F, and S)
with code DD is not taxable.
and designated Roth contributions (codes AA, BB, and EE) under all plans are
generally limited to a total of $19,000 ($13,000 if you have only SIMPLE plans;
Credit for excess social security tax. If you had more than one employer in 2019
$22,000 for section 403(b) plans if you qualify for the 15-year rule explained in
and more than $8,239.80 in social security tax was withheld, you can have the
Pub. 571). Deferrals under code G are limited to $19,000. Deferrals under code H
excess refunded by filing Form 843, Claim for Refund and Request for Abatement,
are limited to $7,000.
with the Department of the Treasury, Internal Revenue Service Center, Austin, TX
73301-0215, USA. However, if you are required to file Form 1040 with the United
However, if you were at least age 50 in 2019, your employer may have allowed
States, you must claim the excess tax as a credit on Form 1040.
an additional deferral of up to $6,000 ($3,000 for section 401(k)(11) and 408(p)
SIMPLE plans). This additional deferral amount is not subject to the overall limit on
Unreported tip income. You must file Form 4137, Social Security and Medicare
elective deferrals. For code G, the limit on elective deferrals may be higher for the
Tax on Unreported Tip Income, with your income tax return to report at least the
last 3 years before you reach retirement age. Contact your plan administrator for
allocated tip amount unless you can prove a smaller amount with adequate
more information. Amounts in excess of the overall elective deferral limit must be
records. If you have records that show the actual amount of tips you received,
included in income. See the “Wages, Salaries, Tips, etc.” line instructions for your
report that amount even if it is more or less than the allocated tips. Use Form 4137
tax return.
to figure the social security and Medicare tax owed on tips you didn’t report to
your employer. Enter this amount on the wages line of your tax return. (Form
(continued on back of Copy C)
1040-SS filers, see the instructions for Form 1040-SS, Part I, line 6.) By filing this
form, your social security tips will be credited to your social security record (used
to figure your benefits).
(Also see the Instructions for Employee on this page and the back of Copy C.)

Download IRS Form W-2AS 2019 American Samoa Wage and Tax Statement

1412 times
Rate
4.8(4.8 / 5) 71 votes
ADVERTISEMENT

​Form W-2AS Instructions

The form is filled out by the employers to report their employees' salaries and the American Samoa wage tax withheld from these salaries. It consists of five copies. Send copy A to the Social Security Administration (SSA). Submit Copy 1 to the American Samoa Treasurer. Provide copies B and C to the employee. Keep copy D for your records.

The due date for W-2AS Form is January 31. If you cannot file on time, you can request one extension to file the form with the SSA by submitting the Form 8809, Application for Extension of Time to File Information Returns. The extension can be granted for 30 days and in exceptional situations only. No additional extension is allowed.

Mail the paper version of the Copy A and the Copy A of the IRS Form W-3 (SS), Transmittal of Wage and Tax Statements to the Social Security Administration Direct Operations Center (Wilkes-Barre, PA 18769-0001).

Do not staple or tape the forms and do not include any cash, checks, or any other payments. File Copy 1 of the Form W-2AS and Form W-3SS at: American Samoa Tax Office, Executive Office Building, First Floor, Pago Pago, AS 96799

If you need to submit 250 forms and more, you must do it electronically. Otherwise, you may be subjected to penalties. Even if you are not required to e-file your forms, the SSA still recommends doing it to save your time and efforts.

If you do not file the correct forms on time, you can be subject to the following penalties:

  • If you submit forms within 30 days after the due date, the penalty is $50 per form. The maximum amount is $556,500 per year. For small businesses, the maximum amount is reduced to $194,500 per year;
  • If you file forms more than 30 days after the deadline but before August 1, the fine amount will be $110 per form but no more than $ 1,669,500 per year or $556,500 if you are a small business owner;
  • If you submit forms after August 1, or do not submit them at all, you will have to pay $270 per form. The maximum amount, in this case, will be $3,339,000 per year or $1,113,000 for small businesses;
  • For willful disregard of filing requirements, the penalty is $550 per form with no maximal penalty.

The detailed information regarding completing and submitting the American Samoa wage and tax statement can be found in the IRS-distributed General Instructions for Forms W-2 and W-3.

​IRS W-2AS Related Forms

There are several forms related to the IRS Form W-2AS:

Page of 9