Complete the W-3 Form for J. Dodds, Inc. (employer identification #22-5555555), based on the employee information listed below. The company is located at 876 James Street, Charleston, SC 29401, and its South Carolina State ID number is the same as its federal identification number. The form is signed by the President of the company, Donald Baron (telephone #843-555-2245), and is submitted on the due date for e-filing. The company files Form 941 during the year and selects "none apply" in the Kind of Employer section.

• Employee #1: Donald Baron is an employee of J. Dodds, Inc. Gross earnings for federal income tax withholding, Social Security tax, and Medicare tax were $92,450.05 for the year, while these taxes were $9,180, $5,731.90, and $1,340.53, respectively. Charitable contributions totaled $5,890 for the year, while the annual union dues were $750. South Carolina income tax withholding was $5,994 (based on the above gross earnings for federal income tax), with no local taxes withheld.
• Employee #2: Damian South is an employee of J. Dodds, Inc. Gross earnings for federal income tax withholding, Social Security tax, and Medicare tax were $144,050.02 for the year, while these taxes were $14,160, $8,537.40, and $2,088.73, respectively. Annual union dues were $750, and Damian elects to have charitable contributions of $250 withheld. South Carolina income tax withholding was $9,134 (based on the above gross earnings for federal income tax), with no local taxes withheld.

DO NOT STAPLE a Control number For Official Use Only EEEEE OMB No. 1545-0008 b 941 Military Kind None apply 501c non-govt. Third-party Kind 944 sick pay of of (Check if Payer Hshld Medicare Employer State/local applicable) (Check one) CT-1 emp govt. emp. (Check one) non-501c State/local 501c Federal govt c Total number of Forms W-2 d Establishment number 1 Wages, tips, other compensation 2 Federal income tax withheld 2 $ S Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld 22-5555555 S S f Employer's name 5 Medicare wages and tips 6 Medicare tax withheld S S 7 Social security tips B Allocated tips S S 9 10 Dependent care benefits S 11 Nonqualified plans 12a Deferred compensation g Employer's address and ZIP code S h Other EIN used this year 13 For third-party sick pay use only 12b 15 State Employer's state ID number 14 Income tax withheld by payer of third-party sick pay 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc 19 Local income tax S $ S S Employer's contact person Employer's telephone number For Official Use Only Employer's fax number Employer's email address Under penalties of perjury, I declare that I have examined this return and accompanying documents and, to the best of my knowledge and belief, they are true, correct, and complete. Signature Donald Baran Title . President Date - 01/31/2021 Form W-3 Transmittal of Wage and Tax Statements Department of the Treasury 20XX Internal Revenue Service Send this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration (SSA). Photocopies are not acceptable. Do not send Form W-3 if you filed electronically with the SSA. Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3