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Get and Sign W 2g Form 2017-2022
Second I.D.
Street address (including apt. no.)
13 State/Payer’s state identification no.
14 State winnings
City or town, province or state, country, and ZIP or foreign postal code
15 State income tax withheld
For Privacy Act and
Paperwork Reduction
Act
Notice, see the 2017
General
Instructions for
Certain Information
Returns.
$
16 Local winnings
File with Form 1096
$
$
17 Local income tax withheld
18 Name of locality
$
Copy A
For Internal Revenue
Service Center
Under penalties of...
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