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ATION NUMBER BE SURE THIS FORM COVERS THE CORRECT PERIOD FOR YEAR 1. TOTAL NUMBER EMPLOYED DURING THE YEAR IF INCORRECT, SEE INSTRUCTIONS. DO NOT ALTER. 2. TOTAL NUMBER OF FORMS W-2 ENCLOSED BUSINESS NAME IF ANY INFORBUSINESS ADDRESS MATION IS INCORRECT, SEE CITY/ TOWN STATE INSTRUCTIONS. Check here if this is a final return. 3. TOTAL MASSACHUSETTS TAX WITHHELD AS SHOWN ON FORMS W-2 ZIP 4. TOTAL AMOUNT WITHHELD PER LINE 3 OF MONTHLY RETURNS (from reverse) 5. TOTAL AMOUNT REMITTED (from re.

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