Welcome!
Wilmer is pleased to welcome you
to our family of superior-quality
products and excellent service.
Working hard since 1926 to offer
you a full line of elite business
products and services, Wilmer
will help your customers run smarter,
more efficiently and cost effectively.
45 SUPERIOR AVENUE GREEN WAY BANK 1001
PROSPECT, IL 67890 ANYWHERE, U.S.A
(123) 456-7890 MP
12-345/321
PAY AMOUNT
TO THE TotalVantage
ORDER OF NON-NEGOTIABLE
"112124" :124697811:9112-124697"
PS Mailers | Healthcare | Financial Products | Compatible Filing
Welcome to Wilmer!
We are pleased to welcome you into the Wilmer family of superior
products, customer service and business success. As part of Wilmer, you
will find everything you need to succeed.
Serving businesses since 1926, Wilmer is dedicated to providing business
documents and services to the trade only. We offer a wide variety of
products - customizable to your needs - drop-shipped directly to your
customer’s door. Headquartered in Dayton, Ohio, Wilmer has a
nationwide network of manufacturing and distribution facilities, and Sales
Representatives, strategically located around the country to provide
optimal customer response. The Wilmer Customer Service Team is
equally ready to provide the assistance you need with account setup,
product inquiries, pricing, ordering, and more. Our website 4wilmer.com
is an excellent resource for product information, current promotions, and
other special offers.
Inside this folder, you will find information on Wilmer’s most popular
products, including Pressure Seal Mailers, Financial Checks and Forms,
Solutions for the Healthcare Industry, Compatible Filing Products,
Envelopes, Custom Labels, as well as Presentation Folders and Custom
Products. You will see how Wilmer works to help you succeed.
Again, thank you for joining Wilmer. We think you’ll find your experience
with Wilmer to be pleasant and profitable! As you begin your journey,
remember that we are available any time you need us.
Wilmer Customer Service
Toll Free 800.4WILMER (800.494.5637)
Fax 800.553.4849
Email [email protected]
Wilmer Sales Team
See reverse to locate a Wilmer Sales Representative near you.
Wilmer Online
4wilmer.com
yourwilmer.com
National Sales Representatives
Wilmer will work for you - Bob Post
our greatest asset!
The path to success requires 800.653.3622, Los Angeles, CA
time, effort and dedication. Arizona, California, Hawaii, Nevada
Wilmer sales representatives
understand that inherently Eric Schroeder
and are commited to
devloping a long term 800.983.8660, Chicago, IL
relationship that will lead to N. Illinois, NE & NW Indiana, Iowa,
your continued success. W. Michigan, Minnesota, Nebraska,
North Dakota, South Dakota, Wisconsin
Tom Jackson
Greg Stalker
800.497.8687, Portland, OR
Alaska, Colorado, Idaho, Montana, 770.713.3409, Atlanta, GA
Oregon, Utah, Washington, Wyoming Alabama, Georgia, Mississippi,
North Carolina, South Carolina,
Bob Menker SE & SW Tennessee
800.408.2372, Dayton, OH Jack Techtmann
S. Illinois, S & E Indiana, Kentucky,
E. Michigan, Ohio, W. Pennsylvania, 215-219-0752, Philidelphia, PA
N & S Central Tennessee, West Virginia Connecticut, Delaware, Maine,
Maryland, Massachusetts, New
Rick Osterholt Hampshire, New Jersey, New York,
E. Pennsylvania, Rhode Island,
800.767.9979, Orlando, FL Vermont, Virginia, Washington D.C.
Florida, Puerto Rico
Mark Travers
877.977.0085, Dallas, TX
Arkansas, Kansas, Louisiana, Missouri,
New Mexico, Oklahoma, Texas
Strategic Dealer Consultants
Mark Christian Dan Wilson
937.972.7461, Dayton, OH 714.604.6833, Orange, CA
East/Midwest West Coast
Rhonda Perry
614.949.0685, St. Petersburg, FL
Southeast/Southwest
TAX FORMS
Quality, Expertise and Accuracy from
your trusted tax forms partner!
W-2’s 1099’s
Accuracy Guaranteed! All W-2’s & 1099’s available in:
With nearly 100 years of industry leadership, Laser Sheets
we understand the importance of providing Pressure Seal
high-quality, IRS-compliant tax forms that 11” and 14” forms
address all changes and requirements. Packaged sets
Pre-printed or blank forms
See reverse for additional options
TAX FORMS
Tax Form Envelopes Additional Forms Available
1096 W-9
1095 Continuous forms
1098 Correction forms
W-3 So much more!
W-2 & 1099 Packaged Sets Order your tax form flyer
and catalog today!
__
W-TAX-FLY
9595 VOID CORRECTED CORRECTED (if checked) VOID CORRECTED Do Not Staple 6969 W-TAX-CAT
PAYER’S name, street address, city or town, state or province, country, ZIP 1 Rents OMB No. 1545-0115PAYER’S name, street address, city or town, state or province, country, ZIP 1 Rents OMB No. 1545-0115 PAYER’S name, street address, city or town, state or province, country, ZIP 1 Rents 1096OMB No. 1545-0115 Annual Summary and Transmittal of OMB No. 1545-0108
or foreign postal code, and telephone no. or foreign postal code, and telephone no. or foreign postal code, and telephone no. Form U.S. Information Returns
201
$ 201 Miscellaneous $ 201 Miscellaneous $ 201 Department of the TrMeasiusrycellaneous
2 Royalties Income 2 Royalties Income 2 Royalties Internal Revenue Service Income
FILER'S name
$ Form 1099-MISC $ Form 1099-MISC $ Form 1099-MISC
3 Other income 4 Federal income tax withheld 3 Other income 4 Federal income tax withheld 3 Other income
$ $ Copy A $ $ Copy B $ 4 Federal income tax withheld Copy C
5 Fishing boat proceeds 6 Medical and health care payments 5 Fishing boat proceeds 6 Medical and health care payments For Recipient 5 Fishing boat proceeds
For $ Street address (including roFoomroPr sauyitee rnumber)
Internal Revenue
6 Medical and health care payments or State Copy
Service Center or Copy 2
City or town, state or province, country, and ZIP or foreign postal code
$$ File with Form 1096. $$ $$ For Official Use Only
RECIPIENT’S name 7 Nonemployee compensation 8 Substitute paymenRtEsCiInPIEliNeTu'Sonfame,Fstroeert aPddrreisvs,acicty yor tAowcn, tstate or province, country, and ZIP or foreign postal code 7 Nonemployee compensation 8 Substitute paymentsRiEnClIiPeIEuNoT'fS naTmhe,isstrieset iamddpresosr, tcaitynotr ttoawxn, state or province, country, and ZIP or foreign postal code 7 Nonemployee compensation 8 SubstituteNpaamyemoefntpseirnsolienutoofcontact Telephone number 4 Federal income tax withheld 5 Total amount reported with this Form 1096
Street address (including apt. no.) For Privacy Act Fax number $$
City or town, state or province, country, and ZIP or foreign postal code $ dividends or interest and Paperwork $ dividends or interest information and is $ dividends or interest 3 Total number of forms
9 Payer made direct sales of 9 Payer made direct sales of 9 Payer made direct sales of 1099-K
Reduction Act being furnished to Email address and Paperwork
$5,000 or more of consumer $5,000 or more of consumer $5,000 or more of consumer Reduction Act
products to a buyer $ Notice, see the products to a buyer the Internal Revenue products to a buyer $
(recipient) for resale ▶ $ Service. If you are 10 Crop insu1rance proceeds Notice, see the
2017 General 20172GSeocniael sreaclurity number
10 Crop insurance proceeds 10 Crop insurance proceeds
Instructions for return, a negligence Instructions for
Certain penalty or other
11
Account number (see instructions) 2nd TIN not. 13 Excess golden parachute
requirement payments
$ 5498-SA
15a Section 409A deferrals 15b Section 409A income 16 State tax withheld
$
$$$
Form 1099-MISC 41-0852411 www.irs.gov/form1099misc
Do Not Cut or Separate Forms on This Page — Do Not Cut or Separate Forms on This Page
22222 Void a Employee’s social security number For Official Use Only DO NOT STAPLE
b OMB No. 1545-0008
9595 VOID a Employee’s social security number Safe, accurate, Visit the IRS weabsEitme paltoyee’s social security number This information is being furnished to the Internal Revenue SaervEicmep. lIof yyoeue’s social security number 33333 a Control number For Official Use Only ▶
or foreign postal code, and telephone no. 1 Wages, tips, other compensation 2 Federal income tax withheld OMB No. 1545-0008 FAST! Use www.irs.gov/efile OMB No. 1545-0008 may be imposed on you2if2th2is i2nc2ome is taxaVboleidand you fail to report it. OMB No. 1545-0008
b OMB No. 1545-0008
1 Wages, tips, other compensatbion 2 Federal income tax withheld
1 Wages, tips, other compebnsation 2 Federal income tax withheld 1 Wages, tips, other compenbsation 2 Federal inco9m41e tax wiMthihlietaldry 943 944 None apply 501c non-govt.
Medicare State/local State/local 501c Federal govt.
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld Kind govt. emp. Kind non-501c Third-party
of sick pay
c Employer’s name, address, and ZIP code 3 Social security wages c Employ4er’Ssoncaiaml es,eacdudrirteystsa,xawndithZhIePldcode 3 Social security wages c Employer’s4naSmoec,iaaldsderceusrsit,yatnadx ZwIiPthchoedlde 3 Social security wages of 4 Social security tax withHhsehldld. Employer (Check if
Payer
CT-1 emp. applicable)
5 Medicare wages and tips 6 Medicare tax withheld (Check one) (Check one)
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tipcs Total num6berMoefdFicoarmrestaWx-w2ithheld d Establishment number
1 Wages, tips, other compensation 2 Federal income tax withheld
7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips
7 Social security tips 8 Allocated tips 7 Social security tips 8 Allocated tips
e 3 Social security wages 4 Social security tax withheld
d Control number 9 10 9 d Contr1o0l number 9 d Control nu1m0 ber 9 10
e d Control number f Employer’s name
5 Medicare wages and tips 6 Medicare tax withheld
Last name Suff. 11 12a See instructions for box 12 Suff. 11 e Empl1o2yeae’Sseneaimnset,ruacdtdiorensssf,oarnbdoZxIP12code Suff. 11 e Employee1C’s2anaSmeee, iandsdtrruecstsio, nasndfoZr IbPocxo1d2e
13 Statutory e EmployCee’s name, address, and ZIP code 13 Statutory 13 Statutory o
employee employee C employee d Suff. 11 12a See instructions for box 12
14 Other o 14 Other o 14 Other e 13 Statutory
d d employee C 7 Social security tips 8 Allocated tips
e e 14 Other o
d
RECIPIENT’S name Retirement Third-party 12b Retirement Third-party Retirement Third-party 12b e
plan sick pay C plan sick pay plan sick pay C
o 12b o Retirement Third-party 12b
d C d plan sick pay C 9 10
e o e o 11 12a Deferred compensation
d d
e e
12c 12c 12c 12c
C
Street address (including apt. no.) C C o C
o o d o
d d e d
e e e
g Employer1’2sdaddress and ZIP code
12d 12d 12d
C C C Department of the Treasury h Other EINoC used this year 13 For third-party sick pay use only
o o o d
d d d e
e e e Internal Revenue Service Center 12b
City or town, state or province, country, and ZIP or foreign postal code f Employee’s address and ZIP code
15 State Employer’s state ID number
16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, 1e5tc.State 19 ELomcpalloiynecro’ms setatatxe ID nu2m0beLrocality name 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, et1c5. Sta1te9 LoEcmalpinlocyoemr’estsatxate ID 2n0umLbocearlity name 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19EmLpolcoayleinr’csosmtaetteaxID num2b0erLocality name 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips1,5etSct.ate 19 LoEcaml pinlcooymere’stasxtate ID20nuLmocbaelitry name 14 Income tax withheld by payer of third-party sick pay
15 State
Account number (see instructions) 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax
requirement
201 W-2Department of the TreasuryW—InatgerenalaRnevdenTuae xService 201 W-2Department of the Treasury—WIntearngael ReavnendueTSaerxvice 201 Department of the Treasury—Internal Revenue Service DepartmEemntpolof ytheer'sTrceoanstuarcyt—pIenrtseornnal Revenue Service Employer's telephone number
FormFor Privacy Act aSntdaPtaepemrweonrkt Reduction Form Statement Employer's email address
15a Section 409A deferrals 15b Section 409A income W-2 Wage and Tax Statement W-2Safe, accurate, Wage and Tax 201 (2017) For Privacy Act and Paperwork Reduction
Statement EmploAyecrt'sNfoatxicneu, msebeerseparate instructions.
$ Form Copy C—For EMPLOYEE’S RECORDS (See Notice to FormFAST! Use
Form 1099-MISC LMA Copy A For Social Security Administration — Send this entire page with CopyAcBt—NoTtoicBe,esFeeilethdeWseitphaEramtepilnosyteruec’stioFnEsD. ERAL Tax Return.
Employee on the back of Copy B.) or Copy 2 to be Filed With Copy 1—For State, City, or Local Tax Department
$ Form W-3 to the Social Security Administration; photocopies are not acceptable. This information is being furnished to the Internal Revenue Service. Copy D—For Employer.
41-0852411 41-0852411 Employee’s State, City or Local Income Tax Return
5110 Do Not Cut, Fold, or Staple Forms on This Page 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.
b 22222 Signature ▶ Title ▶ Date ▶
22222 Void a Employee’s social security number W-2 SWtaagteemaenndtTax W-2 2017 W-2W-SW2taagteemaenndtTax 2017 W-2 SWtaagteemaenndtTax 201 RPE-ueFrmipWliionnsgd-ee3rof TFroarmnsmittal of Wage and Tax StatemWWehhneetnrseTTooFFil2ieleP0Paa1ppe7errFFoorrmmss222221OF7oMrSBOtafNfiteoc.iiSna1cul5ofU4fm.5s-ee1110tO371593410a0nxO8WlSSMeSymttooaaheptccguedlotiieoraaiy1csrelly8,easstrieeepLccoswuu,crrpRaoaiilettlgatyythnwiereewtsamripgacaeesngoDnstmed,estppitpieapTssnrCFihs,ctsi1mokerebcdaod5tprt-cepmapioE.CEnyaSynrmmttotayBotnppeft1—llrooto9hyylT11111ddCeeedeCCoCoodoeeenEL248622220oreu’Tombadc’smsrcBpeFSAMnanSbealeaolloaleeesodimcynmFdreuceieceaiireacrroliy,lna’e,tams—aselsadrdedisteednIrcdtnWudcattturataicrtoeperexeixtsimtsritsohnsIywsDe,na,tiEalstatnahanRmxnufhxdoe2dmweprv0wZlbZiedlbtIoieIPahntoLPhryhuoxcheEcceeoea1olmeddlSl2iddt’peyseelnrovFaymiEceeeeDF’s1EoC6rsRmooFASpcoWtyirLaam-tAl3eTsFwteaoocaxrugthRerSeistoey,Scttnioiup1auc5srlmi,naSfSelb.tetaSEcteceme.WrucpruliaotrEyyig1tmeOyA7eepM’AdlsoSmdaBaymtednianrNdi’tdnsireoseissst.iTStnrtsa1racautaa5eteofntxi4fioImdo.D5nnSZ-en;1110I—dPuttp397513140maach0CxSbotoO8WoSSMSeedeetnmtroteoonaamthepctrdccguodelooFStiieleoraaiyt1pcAsnahrellyn8i,ueaifeSsssemtrtseeiTepL,ebcca!osnaewuur,Uctcrce1irrpRaoarii6csleettlgatEnyyethunwimeSrpoerewtsatapbamtriapglgtatcaaeoeesenDegocnyswt,emecde,warstp’gpsit2petaiehpsnsTsr2n,iahs,tcstmimkierF2ECpadtp1eso-temcbdco2eap,i,5onLr.yaeapmanprt2tdECtcEsSyyol.dtmtoFomarfn1CoetnypeatCps9rtheml—m1srloo11111oeeedooCdedoCedoCCeoF,7eypL248622202yaolWFTeooyneabdcVSrnErrmodcoet-nue’AmFSAMaa3si’rSZdmatseolletpFleInsteEodPihcbonndilouaenoceiMecaceairrmctaycrooyirhmolanSetaPd—bmeemselsreore,eaL’dieteeS,nsIcracnVwcOuoatcitttd1uasataLiaickdcwosep5xdtYrWlxxatiadiimrsawrittSonEfotS2eyrwlEetteeea.AnfasShEEimtticsrlessItametCesW1D’hsuRpaD,xSc.8fp,hIlrgxoaeoeoRu2nliawaepoontyvrRLpr0wEuSynyaleiodvegidtbmmyte1reEdciy/AnAhttweo4Le’aeZmphsFcbCuhB’AoldZxfilseIhotewoceeOsePamdIlaO.bnareyaNPeo1aSrl)tmdSteld1gshcnilPc2iDioutRdtEnoroe3cdiyeiyeorif’attdsnfsmfirriiooreDrl.nnsvcd,eeitvssdsmuaathestSpeTCaiSietrmptmcN1spet,ecaalractls1aoyosttaoeeaTuu,etyeo(eytntAebxireSropioeeeIedtrtoecDycaeynertnt.SZshCne9’;auI—s12edOPutnpru6pmyNassMdhc1lFtR—CateoSbotn9ooeoBPo,oSptced7eIeitrantrnatroNeeLinFibaatpmtmrOcoecrodatSleeooecreefontnrosfialetetelpwwaln5cehcddFt.niiloiiuonocieaan1CsiRs,mctrulgls1is5McTkoeesek2t4ehrob5mvaereiienddpRrse3tued2ddrcraye,tcro-eecn1y0uiipCctrWtduSt61anr1iSaeaiEprineuott2xuorytymsSecpoiencS1cmdat,tttsaptoiaehwiieaCpo.pblgtraoWlt1eavsnceescly2giwac.eeere2cbegdeacr0soe’gusCFsear1L,sinnoot2i1t,yaadicapt7OramliwsptlmUii,t5MSespayS1os,-,egsLns00teBtaeaehata0dmecessi0tNon.dreteO8scrnonetoni8ar.nsSmulm1syTc1cup,7Aeo5thefailfom4nlnVS.oi6ns5dotceasa-i5111atZdt0iMftt2o39571e341oIea0P4nerdix4n10dbcOWc1SSMtSe8iooicompttooSxdaaahmesptoeccgrau1edleeomT2ctiie2oraaiyg1ihtctsareaalaly8i,ealFsxyxssstareeieweeibpLdncccEieoseftwuuuohm,rcriasrrhpRramoa1ipDtiilmleett8lygatilyypethlnonPwidaetrpceoyaeLDwttsaaeomroixisopg1eremcaecAaetwne4’sapmngdosnFcelsiteatmieotewd,OsshotrnarsNoatSCFhtpntbittx1ghcmPpeo1uioeeope3edcbioeylwTssrfat5dnsreffriiiiohs,lc.nvpc,imseFStintksuerEmaCEtheghaSdSyAiaettppc1pte,hm-tmtiacocflaaspfifoS1yosetou.Tue1uty,nayptelepftTnAerdrerroh,t—teeneilrlttyrt!coiyocahaysiotst.ysycheFl19nhiauUeenecun9EeonrTrcepymsuusd’d11111moeedCedoedoCCdCor1lroR—’saeeremsL24b86n022229ePmtapptaSenoo7IadbcirannbtarelsLecatoetpmatrFSAMeoueamahaSSeiy,eOmcrresollrnetnroleteayeteeodMiewFceatnle5cdrd—Ie,aceoiiln’oiicoB,n,aainsCxasRacrrtociralI1islManeacCTNkdtnoaeOssmVk2tdhserlbsmverertdioetndpRfrieo3dudieteeaeddldfictan.eeraro-eccniyrrytuiecpuC1dcctlttneetdutuaar1aSiaai,5scaiRoriapeausottrn2xx4osxryItyloimeecslesDncdit5S1c,dUoytv,tRwsro-iewiieaanyCpes0o.naretWli1naoeLv0snsntauntsv2ghid0auuacxoeOmde2efbeh8gxdeeoc02fsZnncoeweabZurC0wsSluIalaiyr1eLiPI,adlbitneePot2itlrhttyodiLcraophcvSahoETcwxstlhoiicreie,tcomSapayeea1d1olerdegsdplnxl0vt2ipe.detaeheoyimlIescoifDrnnreetyyasceiometot8r.mpueuec’paAs1teirlo6nlsot6nsomcasSactiMfttoeioeaanredntl4edbsttioicwepSxascaor1ueg2c2eritaiastlFxy,setwenidpciuetsuhrm,rahitelebyitlncdetca.roxmweit1htOa7hxeMlwSdBittahNhteeoldi.Sn1cu5off4m.5e-1110t357191340ax0OW8SMSSemttooaaheptccgudelotiieoraaiy1csrelly8,easstrieeepLccoswuu,crrpRaoaiilettlgatyythnwiereewtsamripgacaeesnDgonstmede, stppitpaiESNWDCSTPeJ•rW5•ISFepPpnesTsrnoma0hmiepheshuo,tcWFao.hts--mri”kneerapemapnm23podipFoptplt-e-iunccaeyedanSpiotltlo2bfFno.yooaaioororifirnSrtoAneUyatycmtrOtcrycforAhergyeotopeaoFfsesnPr1(irArp3ltt.clEssoe)mp9rloehicWiii1iootIoren1111nnveedCedoCeodoCedoCciatrN1ems,enL42p680222aosfdst-e2NdTno)r2cbdscs2inmFat(..reoaco.sty0areFSMAgoMfasrintaau)auo1neSriAeolllrlectisyWrceodiomsar8cceycndeueancetietfka.cstFair,-ip(apcrooyeolstuFalc2itainsltanlh—maiayst)einlegnoomronsaeetdigyeeWdeagnmrsItihgctnsnremceccttt.euasmPutaea-ispaooepFccesSrttx2axetwimroloctsppefotteypnweinyoswofrapcyeraaeietoetnrwmettrihlertedtmatrahosawhr(Rateiimxpcsetnhtfhybxfoseeoh2toawefteSotpWvlfsh0rworaehiflseikuIdnSluoot2ebRrio.ibnhh-tsrsLmbrRAnho02UuyRhSot,lerhxmrefe1cfe.eeaepesocuoEeandls71.rtdcSleigclahuirsliutdtt2teDomyoettiapGriecsaiecrrrnnorneotvcyeteadedti,naeFidmroerpkcnss.gonrnonCeaaeeso.e.Tdonrolrr,rrTeomdshitatcmtkch.pseolFaesteWyIoroalSenewloyInrnp-AsSRnnmw3edt(AidSEircypwtuebWFapwrFacv.oeWelsrle-tgoirycooit3mdno2herovctmne)aoaiimi.CdfoasrntcshtolemofdWhshf,esnopeFieenFelr-cyStyoneotw3SFucSrdDuorSroromm.iAssienf)trA(iyafm’eFsnw(ysr..sdoeggosWLi)taertouoohWb-vg2lfi/Fe-l.o2erdtmoestlheWt“s“SEMNhec1Aemeo-ea8trT2nStvrip7lTZedoiolac6FN:oInPcten9oyh:is-idrceciaW0m.sraol0W’WSD-esldS0W2lny-oei2Tei3rtP-l.aciwcte3”kr.roxeiuoceIiawft“Gcrpthsl1iyieattu-oO8ShysgtiB7udhseeCpA0,eeaucowe21d,srSpu-1frmireot7ya5Srehr9aii0tAA,nt9atniyhEoiP.7osleIi..RnsAAft”MretSFsSdano1oo-tetmCafru8iiermopInee7RipnPtn(n6SsCaruio()i9-tsonSbaWve-ptlSepDir0rcy-dpAar2a0.Ar)”ttpo0b.iiorptvo1yionveanJadgt1hate5epenDord(uiaeCvfIeapdnaiFaltrridetrcvyoterrmeunre3maedrlsal1yneRs(rt,ssleoiE2a)vvefe0)nWetr,hnv1dreuy-i8ec2Tc.eSrhet,eaoarasv:nuidcgreyde
b
c Employer’s name, address, and ZIP code
d Control number Last name
e
f Employee’s address and ZIP code 16 State wages, tips, etc.
15 State Employer’s state ID number
W-2 Wage and Tax Statement 201 ThisFionrfoPrrmivaatcioynAicstbaenidngPafuprenriwshoerkd RtoedthuectIinotnernal Revenue Service. LW2B Employee’s State, City or Local Inc5o2m02e Tax Return LWC2oCp/LyWD22—For Employer. 5203 LW2D1 For Priv5a2c0y4 Act and Paperwork Reduction Act Notice, see the separate instructions.
Form Act Notice, see the separate instructions.
Copy A For Social Security Administration — Send this entire page with
LW3 41-0852411 5200
Form W-3 to the Social Security Administration; photocopies are not acceptable. 41-0852411 LW2A 5201
*Packaged sets available with and without envelopes
CUSTOM
Custom Products Printed, Stored and Delivered
Lower costs and increase bottom line with Wilmer complete
custom services
Custom Services World Headquarters
Sales Locations
Custom print a Manufacturing
wide range of Distribution
products
Ship from the
warehouse when
you need it
Store your
custom stock in
one of our five
strategically
located
warehouse
facilities
Bill upon release
See reverse for additional information
CUSTOM
Custom Products Custom Capabilities
Carbon Wax or OPAS/ Integrated Products Custom Imprint
Jumbo Rolls Up to four colors, including
Clearstripe Labels
Compatible Filing Laser Checks & Forms four-color process
Narcotic Control Sets
Products Prescription Pads envelopes
Compatible Pegboard Presentation Folders Custom Die-Cuts
Pressure Seal Self-Mailers BIG Volume Discounts
Products LOW Minimum Orders
Compatible Punch Styles - all popular fold types,
availble including including the patented
Safeguard, McBee, NBS, High-Speed cohesive
and others compatible with Xerox
Deposit Bags & Deposit
High-Speed Printers
Tickets
Envelopes - Double, eccentric (uneven)
Single & No Window EZ-Fold
Filebacks & Dividers Superbills
Folders Tax Forms
HCFA/CMS Unit Sets & Snap Sets
Healthcare-Related
Products
ENVELOPES
Envelopes For Every Aspect of Business
Wilmer offers a complete line of envelopes for every
type of business mailing and application.
Available in standard plain or custom imprinted.
Single Window Double Window Commercial Envelopes
Compatible with laser, Compatible with laser, Available plain or
continuous, pegboard continuous and imprinted ... 4 color
checks and forms, plus pegboard checks and process available
Sizes: 6 3/4, 7, 7 3/4,
CMS claim forms forms
One lower window One lower window 8 5/8, 9, 10 and 11
Single, double or
for address information for address information
Plain or imprint One upper window without window
Gummed seal Plain or imprint, 4 color
With or without inside for return address
Plain or Imprint process available
tint Gummed or self-seal Gummed or self-seal
Special window With or without inside With or without inside
available for #9 and tint tint
#10 envelopes
See reverse for additional envelope options
ENVELOPES
Pre-inserted Claim Form Envelopes Booklet/Catalog
Envelope Sets Envelopes
Ideal for invoicing and For submitting For larger size mailings
statement purposes, healthcare claim forms 6” x 9” or 6” x 10 1/2”
healthcare ro general to insurance carriers Plain or imprint
Healthcare claim Gummed or self-seal
office use
Set of two envelopes form envelopes
Smaller envelope Designed for claim
inserted into a larger forms allowing
envelope insurance carrier’s
Variety of colors name to appear in
Inside envelope window
imprinted with return Self-seal
address
Gummed or self-seal Order your envelope flyer today!
W-ENV-FLYER
W-ENV-KIT
Envelope samples, distributor price list & dimensional guide W-ENV-FLYER
DEPOSIT TICKETS & BAGS
Deposit Bags Provide Ultimate Durability,
Flexibility and Security
Tamper-evident deposit bags provide safe transport for valuables.
CoinLok® TripLok® SafeLok®
CoinLok® is the safe, TripLok® meets SafeLok® is the
secure alternative to stringent Federal Cash economical option for
transfer/deposit bags
canvas coin bags Security Bag
High-strength High-strength
requirements and construction and
construction and write-on ability
specifications 9” x 12” and 12” x 16”
write-on ability High-strength clear or white
12” x 25” clear construction and Tamper-evident
Tamper-evident write-on ability
9” x 12” & 12” x 16” See reverse for deposit tickets
clear or white with
pocket
15” x 20” clear with
pocket
DEPOSIT TICKETS & BAGS
Deposit Tickets Ensure Accuracy and Security
Our ICR (Image Character Recognition) deposit tickets are produced using
high quality, non-reproducible blue ink for bank scanning and meet ANSI
(American National Standards Institute) Image Ready standards.
Standard and Basic ICR Image Character Recognition
Deposit Tickets
Personalization available
Standard: available in book bound or loose and can
be ordered in up to four parts
Basic: available in book-bound horizontal or vertical
option and can be ordered in up to three parts
MICR numbering available
Quantities as low as 200 tickets
Laser Deposit Tickets For Use In Laser or Ink-Jet Printers
Compatible with many
Order your Deposit software packages
ticket and bag Personalize with name,
address, bank name and
brochures today!
account MICR number for
added security
Available in one, two or
three parts
Quantities as low as 250
tickets
W-SDB-EU W-SDB-EU W-DPT-ICR
Security bag brochure
W-SDB-KIT
Security bag brochure & samples
W-DPT-ICR
Deposit ticket brochure
COMPATIBLE FILING
Your One-Stop Solution For Your Filing Needs
Wilmer’s complete line of filing products includes superior quality
labels, filing folders and many other filing accessories.
File Folders Labels
Standard Folders Classification Folders Wilmer compatible filing
labels are compatible with
11 and 14 pt options 11 to 18 pt options more than ten of the most
Match Barkley, Jeter Fasteners in positions popular systems.
1 and 3 with other
and Smead systems
Manilla stock available options available Label Selection
6 manila stock colors includes:
in 10 colors available in six colors
Cheshire linen stock Brown Kraft dividers Alphabetic Check out our
available Numeric Year and
available in 4 colors Year
With or without Heavyweight Folders Communication Communication
Month Guide
standard fasteners and 18 and 20 pt options
Many with reinforced Special Classification
pockets spines
Mini sizes available Pocket and divider Solid Color
End-tab folders are
double-ply
Medicare/Medicaid
options
W-CFP-YLG
25 Year and Communication Label guides
W-CFP-YLG-X W-CFP-YLG
25 Year and Communication Label guides
plus one distributor price list
See reverse for filing accessories
CCOOMMPPAATTIIBBLLEE FFIILLIINNGG
File Folder Accessories
Customize your file folder system with Wilmer’s complete
line of accessories.
Fasteners
Medical Radiology & Self-Adhesive
Dental Jackets Pockets
Vinyl, Poly and Outguides Check out our
Lock-It Pockets Compatible Filing
products in our
Healthcare Catalog
Filebacks Index Tabs Self-Adhesive W-CFP-CAT
Dividers
CUSTOM FOLDERS & LABELS
Brand Image is Everything
Help your customers create dynamic presentations with
custom folders, report covers, document holders, key card
holders and other quality presentation products.
65% of people are Presentation Products
visual learners.
Standard Presentation Folders
Custom Presentation Mini Folders
Folders are an excellent Gift Card and Key Card Holders
Legal Folders
way to make a quick, Box Pocket Folders
positive impression. Report and Tax Covers
File Folders
Product Options
Gloss or Matte Finish
Lamination
Foil Stamping
Embossing or Debossing
Aqueous Coatings
Die-Cut Windows
Business Card Slits
Order your W-PF-DE W-PF-DE
presentation folder Presentation Folder brochure See reverse for custom label options
kit today! W-PF-KIT-X
Presentation Folder brochure, order information,
distributor price list
W-PF-PSG
Presentation Folder paper selection swatch book
CUSTOM FOLDERS & LABELS
Make Your Message Stick
Help your customers say it with a label with the Wilmer
Custom Label program.
Wilmer custom labels, Custom Labels
stickers, seals and bumper
stickers are available in a Outdoor Labels
variety of shapes, sizes, FreeForm Labels
materials and colors, on Food and Beverage Labels
pre-cut rolls or sheets. Cannibis Labels
Whatever your labeling Healthcare Labels
requirements, Wilmer can Sticker Sheets
Make Your Message Stick! Coupons and Scratch-Offs
Window Decals
So Much More!
LABELS
• Advertising & Self-Promotion
• Mailing & Shipping
• Durable & Industrial
Order your 12 Page Label Brochure
custom label Non-branded label brochure
materials today!
W-LBL-CAT-RPL
Retail pricing brochure 12 Page
Label
W-LBL-CAT-NPL Brochure W-LBL-CAT-RPL
Distributor pricing brochure
PRESCRIPTION PADS
Meeting and Exceeding Regulations
Wilmer is an approved Security printer for prescription pads,
books and laser sheets, meeting or exceeding all State and
Federal regulations for both Medicaid and controlled
substance prescriptions.
Standard Prescription Pads &
Standard Laser Prescription Sheets
Wilmer’s multiple security features come
standard on each script securing your
customers fight against fraud.
Chemical protection paper
Scallop VOID pantograph
Blue or Green colored background on
white paper
Preprinted prescriber information
Invisible fluorescent fibers
Mircroprinting
Thermochromic ink
Security feature listing
Artificial watermark
Watermark in coin reactive ink
Reverse Rx (when required by state)
Other Available Options Include:
Thermal rolls - Medicaid compliant and in stock
Bond Rx - Color bond paper scripts with no security
features for non-controlled substance scripts
See reverse for additional prescription pad information
PRESCRIPTION PADS
Compliant Across the Country
Our scripts are compliant with state guidelines and are
approved to print in California, Delaware, Florida, Indiana,
Kentucky, Maine, New Jersey, Washington State, West Virginia
and Wyoming. Our standard-secure prescription pads exceed
federal guidelines in all other states.
California Delaware Florida Indiana
W-PR-CA-EU W-PR-DE-EU W-PR-FL-EU W-PR-IN-EU
Kentucky Massachusetts Maine New Jersey
W-PR-KY-EU W-PR-MA-EU W-PR-ME-EU W-PR-NJ-EU
Washington West Virginia Wyoming Rx Pad Flyer
W-PR-WA-EU W-PR-WV-EU W-PR-WY-EU W-PR-EU
100% guaranteed Submit and process health
compliance! insurance claims to Medicare
Wilmer’s ADA dental and Medicaid clearinghouses
claim forms meet the Printed in red ink on special
American Dental bond paper in strict compliance
Associations with government regulations and
guidelines specifications
Available in laser cut sheets and
continuous forms
Provides a comman format for
reporting dental services to a
patient’s dental benefit plan
Available in laser, 1-part and
2-part continuous forms
2012 and old ADA forms
available
See reverse for additional healthcare products
Wilmer has the confidential patient sign-in form for any location.
W-CFP-CAT
Healthcare Catalog
W-HC-FLY-EU
Healthcare Flyer
W-HIPAA-EU
Sign-In & HIPAA Flyer
W-HLTH-TOOLS-KIT W-CPF-CAT W-HC-FLY-EU
Healthcare catalog, W-HIPAA-EU
product flyers, Year Label Guide, and samples
PSMailers provide everything you need in one complete package,
including equipment, sotfware, and documents. Available in
several models to accommodate a wide range of applications
and volume, from 1,800 sheets to 10,000 sheets per hour.
Low Volume
PSM1800,PSM3000 & PSM3000C
Designed for small businesses looking to
streamline document processing
Additional Option for Low Volume
PSM6400
Easily attaches to HP LaserJet M604, M605
and M606 series printers
Output is based on printer speed
Medium Volume
PSM5000-PSM7000
Integrated conveyor output with up to an
impressive 7,000 sheets per hour productivity
High Volume
PSM10K
Robust, high volume machine with a
duty cycle of 200,000 sheets per month
See how they run! Order your PSMailers
Go to PSMailers.com kit today!
for exclusive videos
W-PSE-D
PSMailers® PSMailers Catalog
W-PSM-KIT
PSMailers Catalog, document samples
and distributor price list
W-PSE-D
See reverse for additional Pressure Seal Information
PRESSURE SEAL
Checks & Forms Stock Program
Guaranteed to work with all models of PSMailers, Wilmer
checks and forms are available in six fold styles and a wide
variety of fraud prevention security features to choose from!
X 8.5” x 11” WLPSC8511GNWDO (1215) 8.5” x 14”
4-3/8” Checks & Forms Checks & Forms
3-11/16” C-Fold, V-Fold V-Fold, Z-Fold,
# 52980 FACTORY EC-Fold, EZ-Fold &
1”
ZX-Fold
WLPSC11WHFMS (2100) & Z-Fold
Quantities as low
FOLD FOLD
REMOVE DOCUMENT ALONG THIS PERFORATION as 500 sheets
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER • THERMOCHROMIC INK ON BACK
Built-in security
REMOVE DOCUMENT ALONG THIS PERFORATION
THE FACE OF THIS DOCUMENT HAS A COLORED BACKGROUND ON WHITE PAPER. THERMOCHROMIC INK ON BACK.
FOLD FOLD (6126) WLPSEZ8514PMBY (4130) AMP
AMP
Quantities as WLPSEZ8514VTL
ORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOC low as 500 sheets 1B
FOLD Built-in security Security Features Included, Details On Back.
FOLD
Job # 52980 - PMS 336 GREEN PLATE X - NO VOID
MENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGINALDOCUMENTORIGI
*SEE REVERSE SIDE FOR EASY OPENING INSTRUCTIONS*
features
Built-In Security Features
Chemical Stain: Sensitized paper reacts to chemical attempts to
alter check.
Invisible Fluorescent Fibers in Paper: Fibers are revealed under black light.
Microprinting Below Endorsement Area: Line copy reads “Original Document.”
When copied, the wording is not readable.
Padlock Icon: Indicates check meets industry standard security guidelines
listed on back
Screened Check Back: Deters duplication. Screen does not reproduce
when copied.
Heat Sensitive Thermochromic Ink: Red Key disappears when subject to
heat or touch.
Toner Adhesion: Prevents erasure and tampering with laser printed data.
Photocopy Void: The word “Void” will appear when photocopied.
! Security Warning Band Border: The most popular security border available.
Available Imprint Colors
Warm Red Blue (300) Green (357) Brown (471)
Red (185) Blue (314) Green (348) Brown (464)
Orange (151) Reflex Blue Pantone Purple Brown (175)
Pantone Yellow Blue (281) Plum (249) Gray (423)
Process Blue Teal (328) Burgundy (208) Black
CHECKS
Unmatched Security and Flexibility
Wilmer’s Total Vantage program offers high quality security paper, adhering to
the latest ANSI standards (Check 21 Compliant) for image readiness and up to a
minimum of 10 free security features.
3 Tiers of Security
Tier 1 Basic Laser Black Imprint Laser Checks: Our most economical option with 10 printed security
features and available in one pantograph and four color options.
Tier 2 Standard Black Imprint Laser Checks: Offering a minimum of 12 security features, along with
new hologram security plus 14 color and pantograph options and a variety of perforation positions.
Tier 3 Standard Plus Laser Checks: Offering a minimum of 12 security features, including Toner
Adhesion and True Watermark, plus over 50 pantographs and border options and 20 colors to
choose from.
11
13 14
4 GREEN WAY BANK 1001 15
ANYWHERE, U.S.A
1 245 SUPERIOR AVENUE ! 16
PROSPECT, IL 67890 12-345/321
(123) 456-7890 Check 21
PAY AMOUNT Compliant
6 5
TO THE 3 MP NON
ORDER OF 9MP
8 17
TotalVantage
"112124" 7 NON-NEGOTIABLE
10
:124697811:9112-124697"
1 Microprint Warning Band Border: Reads “Original 11 Padlock Icon on Back: Lists additional visible
Document.” When copied, the wording is not and concealed security features.
readable. 12 True Fourdrinier Watermark*: A diamond
2 Toner Adhesion**: Prevents erasure and shaped watermark can be seen only when held
tampering with laser printed data. at a 45 degree angle and cannot be altered or
3 Photocopy Void***: The word “Void” will appear reproduced.
when photocopied. 13 Check Security Watermark: When held at an
4 Security Warning Band Border: The most popular angle, words “Original Document” appear.
security border available. 14 Screened Check Back: Deters duplication.
5 Padlock Icon: Indicates check meets industry Screen does not reproduce when copied.
standard security guidelines listed on back. 15 Microprinting Below Endorsement Area: Line
6 Invisible Fluorescent Fibers in Paper: Fibers are copy reads “Original Document.” When copied,
revealed under black light. the wording is not readable.
7 Heat Sensitive Thermochromic Ink***** : Red Key 16 Coin Reactive Ink******: When rubbed with a
disappears when subject. coin, a key will appear underneath the image.
8 Chemical Stain: Sensitized paper reacts to 17 Non-Negotiable Phrase: Secures voucher from
chemical attempts to alter check.to heat or alteration.
touch. *True watermark available only on Standard Plus Laser Checks
9 Microprinting on Signature Line: Reads **Toner Adhesion available only on Standard Plus and Stock Laser
“Authorized Signature.” When copied or altered, Checks
this line is not readable. ***Photocopy Void, optional on Standard Plus Checks, available
10 Hologram****: Three dimensional metallic with Scallop Void on Standard and Stock Laser Checks
image fused on paper. ****Hologram available only on Standard and Stock Laser Checks
with Scallop Void
*****This appears on the back of Standard Plus checks and forms
Ask about our ******For basic, standard and stock checks
promotional
literature! W-FIN-CAT
Brochure encapsulating laser & continuous products, voucher
checks, PSMailers & more
W-SWCOMP2-E
Software compatible checks & forms brochure
W-ILP-KIT
Checks brochures, samples and pricing
See reverse for additional Checks and
W-FIN-CAT W-SWCOMP2-E Forms information
CHECKS
Additional Checks and Forms Options
Laser Cut-Sheet Forms: Designed for a
variety of business communications, our software
compatible forms work with the most popular
software titles and versions on the market today.
Standard Plus Laser: Over 20 PMS ink colors and
multiple perforation positions.
Stock Laser Forms: Background design and color
pre-printed with multiple perforation positions.
Continuous Checks and Forms:
Guaranteed to be compatible with today’s most
popular software packages!
Standard Continuous Checks: Black imprint, up to 3
parts, warning band border with padlock icon and 12
free security features!
Standard Plus Continuous Checks: 16 ink color options,
over 50 different background designs, 59 different border
desings, up to 3 parts, multiple perforation positions and
11 freee security features!
Stanrdad Plus Continuous Forms: Choose from over 150
layouts, multiple perforation positions, up to 4 parts and
16 PMS ink colors!
3-On-A-Page Checks: Available as single or
duplicate in several styles, colors and background
pantographs. These checks are designed to
protect you from fraud with a minimum of six
security features.
Compact 3-On-A-Page Checks: These
smaller 3-On-A-Page checks use a detailed
register instead of stubs for recording transactions.
Pocket Checks: Ideal for the business
traveler, offering a portable record-keeping
solution.
Pegboard, One-Write System: With this
one-step system, users write a check once and
eliminate all of the duplicate entries adn transposition
errors. No entries in check stubs or registers required
and no envelopes to address.
Ten specialized systems available
Accounts Payable Gift Certificates
Accounts Receivable Medical Receipts
Cash Disbursement Payroll
Cash Dispersement/Payroll Persaonal Check-Writing
Cash Receipt - OTC Rental Receipts
Manual Voucher Checks: Wilmer voucher
checks are a simple, yet flexible solution to your
small business needs. With designs for payroll,
accounts payable, or general business, these
checks make record keeping easy.
3 designs to choose from
2 or 3 part checks
7 standard security features
World Headquarters 4Wilmer.com 800.4WILMER (800.494.5637)
600 Albany St.
Dayton, OH 45417
Customer Service
515 W. Sycamore St.
Coldwater, OH 45828
800.4WILMER
(800.494.5637)
W-WEL-KIT 0618