W2

Front 1

Box 1.

Back 1

Enter this amount on the wages line of your tax return.

Front 2

Box 2.

Back 2

Enter this amount on the federal income tax withheld line of your tax return.

Front 3

Box 5.

Back 3

You may be required to report this amount on Form 8959, Additional Medicare Tax. See the Form 1040 instructions to determine if you are required to complete Form 8959.

Front 4

Box 6.

Back 4

This amount includes the 1.45% Medicare Tax withheld on all Medicare wages and tips shown in Box 5, as well as the 0.9% Additional Medicare Tax on any of those Medicare wages and tips above $200,000.

Front 5

Box 8.

Back 5

Allocated tips. Box 8 reports any tip income allocated to you by your employer.This amount is not included in boxes 1, 3, 5, or 7. For information on how to report tips on your tax return, see your Form 1040 instructions.

Front 6

You mu

Back 6

st file Form 4137, Social Security and Medicare Tax on Unreported Tip Income, with your income tax return to report at least the allocated tip amount unless you can prove that you received a smaller amount. If you have records that show the actual amount of tips you received, report that amount even if it is more or less than the allocated tips. On Form 4137 you will calculate the social security and Medicare tax owed on the allocated tips shown on your Form(s) W-2 that you must report as income and on other tips you did not report to your employer. By filing Form 4137, your social security tips will be credited to your social security record (used to figure your benefits).

Front 7

Box 10

Back 7

. This amount includes the total dependent care benefits that your employer paid to you or incurred on your behalf (including amounts from a section 125 (cafeteria) plan). Any amount over $5,000 is also included in box 1. Complete Form 2441, Child and Dependent Care Expenses, to compute any taxable and nontaxable amounts.

Front 8

A—

Back 8

Uncollected social security or RRTA tax on tips. Include this tax on Form 1040. See “Other Taxes” in the Form 1040 instructions.

Front 9

B—

Back 9

Uncollected Medicare tax on tips. Include this tax on Form 1040. See “Other Taxes” in the Form 1040 instructions.

Front 10

C—

Back 10

Taxable cost of group-term life insurance over $50,000 (included in boxes 1, 3 (up to social security wage base), and 5)

Front 11

D—

Back 11

Elective deferrals to a section 401(k) cash or deferred arrangement. Also includes deferrals under a SIMPLE retirement account that is part of a section 401(k) arrangement.

Front 12

E—

Back 12

Elective deferrals under a section 403(b) salary reduction agreement

Front 13

F—

Back 13

Elective deferrals under a section 408(k)(6) salary reduction SEP

Front 14

G—

Back 14

Elective deferrals and employer contributions (including nonelective deferrals) to a section 457(b) deferred compensation plan

Front 15

H—

Back 15

Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See “Adjusted Gross Income” in the Form 1040 instructions for how to deduct.

Front 16

J—

Back 16

Nontaxable sick pay (information only, not included in boxes 1, 3, or 5)

Front 17

K—

Back 17

20% excise tax on excess golden parachute payments. See “Other Taxes” in the Form 1040 instructions.

Front 18

L—

Back 18

Substantiated employee business expense reimbursements (nontaxable)

Front 19

M—

Back 19

Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (former employees only). See “Other Taxes” in the Form 1040 instructions.

Front 20

N—

Back 20

Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (former employees only). See “Other Taxes” in the Form 1040 instructions.

Front 21

P—

Back 21

Excludable moving expense reimbursements paid directly to employee (not included in boxes 1, 3, or 5)

Front 22

Q—

Back 22

Nontaxable combat pay. See the instructions for Form 1040 or Form 1040A for details on reporting this amount.

Front 23

R—

Back 23

Employer contributions to your Archer MSA. Report on Form 8853, Archer MSAs and Long-Term Care Insurance Contracts.

Front 24

S—

Back 24

Employee salary reduction contributions under a section 408(p) SIMPLE plan (not included in box 1)

Front 25

T—

Back 25

Adoption benefits (not included in box 1). Complete Form 8839, Qualified Adoption Expenses, to compute any taxable and nontaxable amounts.

Front 26

V—

Back 26

Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3 (up to social security wage base), and 5). See Pub. 525 and instructions for Schedule D (Form 1040) for reporting requirements.

Front 27

W—

Back 27

Employer contributions (including amounts the employee elected to contribute using a section 125 (cafeteria) plan) to your health savings account. Report on Form 8889, Health Savings Accounts (HSAs).

Front 28

Y—

Back 28

Deferrals under a section 409A nonqualified deferred compensation plan

Front 29

Z—

Back 29

Income under a nonqualified deferred compensation plan that fails to satisfy section 409A. This amount is also included in box 1. It is subject to an additional 20% tax plus interest. See “Other Taxes” in the Form 1040 instructions.

Front 30

AA

Back 30

—Designated Roth contributions under a section 401(k) plan

Front 31

BB

Back 31

—Designated Roth contributions under a section 403(b) plan

Front 32

DD

Back 32

—Cost of employer-sponsored health coverage. The amount reported with Code DD is not taxable.

Front 33

EE

Back 33

—Designated Roth contributions under a governmental section 457(b) plan. This amount does not apply to contributions under a tax-exempt organization section 457(b) plan.

Front 34

Box 13

Back 34

If the “Retirement plan” box is checked, special limits may apply to the amount of traditional IRA contributions you may deduct. See Pub. 590, Individual Retirement Arrangements (IRAs).

Front 35

Box 14

Back 35

Employers may use this box to report information such as state disability insurance taxes withheld, union dues, uniform payments, health insurance premiums deducted, nontaxable income, educational assistance payments, or a member of the clergy's parsonage allowance and utilities. Railroad employers use this box to report railroad retirement (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax and Additional Medicare Tax. Include tips reported by the employee to the employer in railroad retirement (RRTA) compensation.