Form 4137 - Social Security And Medicare Tax On Unreported Tip Income Page 2
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Form 4137 (2008)
Page
Form W-2, they are not included in the wages, tips, and
Column (b). For each employer’s name you entered in
other compensation box (box 1) on that form and no
column (a) enter the employer identification number or the
income tax, social security tax, or Medicare tax has been
words “applied for” exactly as shown in box b of your
withheld from these tips.
Form W-2.
Column (c). Include all cash and charge tips you
Tips you must report to your employer. You must give
received. This includes the following:
your employer a written report of cash and charge tips if
you received $20 or more in tips during a month. If, in any
Total tips you reported to your employer. Tips you
month, you worked for two or more employers and
reported, as required, by the 10th day of the month
received tips while working for each, the $20 rule applies
following the month you received them are considered
separately to the tips you received while working for each
income in the month you reported them. For example, tips
employer and not to the total you received. You must
you received in December 2007 that you reported to your
report your tips to your employers by the 10th day of the
employer after December 31, 2007, and before January
month following the month you received them. If the 10th
11, 2008, are considered income in 2008 and should be
day of the month falls on a Saturday, Sunday, or legal
included on your 2008 Form W-2 and reported on line 1
holiday, give your employer the report by the next
of Form 4137. However, tips you received in December
business day.
2008 that you reported to your employer after December
31, 2008, and before January 13, 2009, are considered
Employees subject to the Railroad Retirement Tax Act.
income in 2009. Do not include these tips on line 1.
Do not use Form 4137 to report tips received for work
Tips you did not report to your employer on time or did
covered by the Railroad Retirement Tax Act. In order to
not report at all. These tips are considered income to you
get railroad retirement credit, you must report these tips
in the month you actually received them. For example,
to your employer.
tips you received in December 2008 that you reported to
Payment of tax. Tips you reported to your employer are
your employer after January 12, 2009, are considered
subject to social security and Medicare tax (or railroad
income in 2008 because you did not report them to your
retirement tax) and income tax withholding. Your employer
employer on time.
collects these taxes from wages (excluding tips) or other
Tips you received that you were not required to report
funds of yours available to cover them. If your wages were
to your employer because they totaled less than $20
not enough to cover these taxes, you may have given your
during the month.
employer the additional amounts needed. Your Form W-2
Allocated tips you must report as income (see page 1).
will include the tips you reported to your employer and the
taxes withheld. If there was not enough money to cover
Line 5. Enter only the tips you were not required to report
the social security and Medicare tax (or railroad retirement
to your employer because the total received was less
tax), your Form W-2 will also show the tax due in box 12
than $20 in a calendar month. These tips are not subject
with codes A and B. See the instructions for Form 1040,
to social security and Medicare tax.
line 62; or Form 1040NR, line 57 to find out how to report
Line 10. If line 6 includes tips you received for work you
the tax due. If you worked in American Samoa, Guam, or
did as a federal, state, or local government employee and
the U.S. Virgin Islands, the amount of uncollected tax due
your pay was subject only to the 1.45% Medicare tax,
is identified in box 12 on Form W-2AS, W-2GU, or W-2VI
subtract the amount of those tips from the line 6 amount
with codes A and B. If you worked in Puerto Rico, Form
only for the purpose of comparing lines 6 and 9. Do not
499R-2/W-2PR, boxes 22 and 23, show the uncollected
reduce the actual entry on line 6. Enter “1.45% tips” and
tax due. See the instructions for line 5 of Form 1040-PR or
the amount you subtracted on the dotted line next to line
1040-SS, to find out how to report the tax due.
10.
Penalty for not reporting tips. If you did not report tips
to your employer as required, you may be charged a
Paperwork Reduction Act Notice. We ask for the
penalty equal to 50% of the social security and Medicare
information on this form to carry out the Internal Revenue
tax due on those tips. You can avoid this penalty if you
laws of the United States. You are required to give us the
can show reasonable cause for not reporting these tips to
information. We need it to ensure that you are complying
your employer. To do so, attach a statement to your
with these laws and to allow us to figure and collect the
return explaining why you did not report them.
right amount of tax.
You are not required to provide the information
Additional information. See Pub. 531, Reporting Tip
requested on a form that is subject to the Paperwork
Income.
Reduction Act unless the form displays a valid OMB
Specific Instructions
control number. Books or records relating to a form or its
instructions must be retained as long as their contents
Line 1. Complete a separate line for each employer. If
may become material in the administration of any Internal
you had more than 5 employers in 2008, attach a
Revenue law. Generally, tax returns and return information
statement that contains all of the information (and in a
are confidential, as required by Internal Revenue Code
similar format) as required on Form 4137, line 1, or
section 6103.
complete and attach line 1 of additional Form(s) 4137.
The average time and expenses required to complete
Complete lines 2 through 13 on only one Form 4137. The
and file this form will vary depending on individual
line 2 and line 3 amounts on that Form 4137 should be
circumstances. For the estimated averages, see the
the combined totals of all your Forms 4137 and attached
instructions for your income tax return.
statement.
If you have suggestions for making this form simpler,
Column (a). Enter your employer’s name exactly as it is
we would be happy to hear from you. See the instructions
entered in box c of your Form W-2.
for your income tax return.
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