Using the information from P6-10A for Leda, Inc., completed Form W-3 must accompany the company’s W-2 forms. Leda, Inc., is a 941 payer and is a private, for-profit company. Kieran Leda is the owner; the phone number is 207-555-1212; no email address to disclose; the fax number is 207-555- 9898. No third-party sick pay was applied for 2022. The form was signed on January 20, 2023.

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b 33333 Kind of a Control number Payer (Check one) c Total number of Forms W-2 f Employer's name 15 State 941 CT-1 e Employer identification number (EIN) g Employer's address and ZIP code h Other EIN used this year 16 State wages, tips, etc. Form Military Employer's contact person Employer's fax number Employer's state ID number Hshld. Medicare emp. govt. emp. 943 d Establishment number For Official Use Only OMB No. 1545-0008 944 17 State income tax Kind of Employer (Check one) 1 Wages, tips, other compensation 3 Social security wages 7 Social security tips 5 Medicare wages and tips. 9 11 Nonqualified plans None apply State/local non-501c 13 For third-party sick pay use only 18 Local wages, tips, etc. Employer's telephone number Employer's email address. Title ► 501c non-govt. State/local 501c Federal govt. 2 Federal income tax withheld 4 Social security tax withheld 6 Medicare tax withheld 8 Allocated tips 14 Income tax withheld by payer of third-party sick pay 10 Dependent care benefits 12a Deferred compensation 12b 19 Local income tax For Official Use Only 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 ► W-3 Transmittal of Wage and Tax Statements 2022 Third-party sick pay Date ► (Check if applicable) Department the Treasury Internal Revenue Service