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

What Is IRS Form W-2AS?

This is a tax form that was released by the Internal Revenue Service (IRS) - a subdivision of the U.S. Department of the Treasury. As of today, no separate filing guidelines for the form are provided by the IRS.

Form Details:

  • A 9-page form available for download in PDF;
  • This form will be used to file next year's taxes. Choose a previous version to file for the current tax year;
  • Additional instructions and information can be found on page 5 of the document;
  • Editable, printable, and free;

Download a printable version of IRS Form W-2AS through the link below or browse more documents in our library of IRS Forms.

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

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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
Last name
Suff.
11 Nonqualified plans
12a See instructions for box 12
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
2020
Department of the Treasury—Internal Revenue Service
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
Last name
Suff.
11 Nonqualified plans
12a
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
2020
Department of the Treasury—Internal Revenue Service
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
Last name
Suff.
11 Nonqualified plans
12a See instructions for box 12
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
2020
Department of the Treasury—Internal Revenue Service
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 Instructions for Forms 1040 and 1040-SR to
(See also Notice to Employee on this page.)
determine if you are required to file a tax return. Even if you don’t have to file a tax
Box 5. You may be required to report this amount on Form 8959, Additional
return, you may be eligible for a refund if box 2 shows an amount or if you are
Medicare Tax. See the Instructions for Forms 1040 and 1040-SR to determine if
eligible for any credit.
you are required to complete Form 8959.
Copies B and C; corrections. File Copy B of this form with your 2020 American
Box 6. This amount includes the 1.45% Medicare Tax withheld on all Medicare
Samoa income tax return. Keep Copy C for your records. If your name, social
wages and tips shown in box 5, as well as the 0.9% Additional Medicare Tax on
security number (SSN), or address is incorrect, correct Copies B and C and ask
any of those Medicare wages and tips above $200,000.
your employer to correct your employment record. Be sure to ask your employer
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from
to file Form W-2c, Corrected Wage and Tax Statement, with the Social Security
a nonqualified deferred compensation or nongovernmental section 457(b) plan, or
Administration (SSA) to correct any name, amount, or SSN error reported to the
(b) included in box 3 and/or 5 if it is a prior year deferral under a nonqualified or
SSA. Be sure to get your copies of Form W-2c from your employer for all
section 457(b) plan that became taxable for social security and Medicare taxes this
corrections made so you may file them with your tax return.
year because there is no longer a substantial risk of forfeiture of your right to the
Estimated tax. If you expect to owe $1,000 or more in tax (including self-
deferred amount. This box shouldn’t be used if you had a deferral and a
employment tax) for 2021, you may have to make estimated tax payments to the
distribution in the same calendar year. If you made a deferral and received a
U.S. Internal Revenue Service. Use Form 1040-ES, Estimated Tax for Individuals.
distribution in the same calendar year, and you are or will be age 62 by the end of
Clergy and religious workers. If you aren’t subject to social security and
the calendar year, your employer should file Form SSA-131, Employer Report of
Medicare taxes, see Pub. 517, Social Security and Other Information for Members
Special Wage Payments, with the Social Security Administration and give you a
of the Clergy and Religious Workers.
copy.
Cost of employer-sponsored health coverage (if such cost is provided by the
Box 12. The following list explains the codes shown in box 12. You may need this
employer). The reporting in box 12, using code DD, of the cost of employer-
information to complete your tax return. Elective deferrals (codes D, E, F, and S)
sponsored health coverage is for your information only. The amount reported
and designated Roth contributions (codes AA, BB, and EE) under all plans are
with code DD is not taxable.
generally limited to a total of $19,500 ($13,500 if you have only SIMPLE plans;
$22,500 for section 403(b) plans if you qualify for the 15-year rule explained in
Credit for excess social security tax. If you had more than one employer in 2020
Pub. 571). Deferrals under code G are limited to $19,500. Deferrals under code H
and more than $8,537.40 in social security tax was withheld, you can have the
are limited to $7,000.
excess refunded by filing Form 843, Claim for Refund and Request for Abatement,
with the Department of the Treasury, Internal Revenue Service Center, Austin, TX
However, if you were at least age 50 in 2020, your employer may have allowed
73301-0215, USA. However, if you are required to file Form 1040 or 1040-SR with the
an additional deferral of up to $6,500 ($3,000 for section 401(k)(11) and 408(p)
United States, you must claim the excess tax as a credit on Form 1040 or 1040-SR.
SIMPLE plans). This additional deferral amount is not subject to the overall limit on
elective deferrals. For code G, the limit on elective deferrals may be higher for the
Unreported tip income. You must file Form 4137, Social Security and Medicare Tax
last 3 years before you reach retirement age. Contact your plan administrator for
on Unreported Tip Income, with your income tax return to report at least the
more information. Amounts in excess of the overall elective deferral limit must be
allocated tip amount unless you can prove with adequate records that you received
included in income. See the “Wages, Salaries, Tips, etc.” line instructions for your
a smaller amount. If you have records that show the actual amount of tips you
tax return.
received, report that amount even if it is more or less than the allocated tips. Use
(continued on back of Copy C)
Form 4137 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 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).
(See also the Instructions for Employee on this page and the back of Copy C.)