Form 4137 - Social Security And Medicare Tax On Unreported Tip Income
Download a blank fillable Form 4137 - Social Security And Medicare Tax On Unreported Tip Income in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 4137 - Social Security And Medicare Tax On Unreported Tip Income with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
24137
Social Security and Medicare Tax
OMB No. 1545-0074
2010
Form
on Unreported Tip Income
See instructions below and on back.
▶
Department of the Treasury
Attachment
24
Sequence No.
Internal Revenue Service (99)
Attach to Form 1040, Form 1040NR, Form 1040NR-EZ, Form 1040-SS, or Form 1040-PR.
▶
Name of person who received tips. If married, complete a separate Form 4137 for each spouse with unreported tips.
Social security number
(a) Name of employer to whom
(b) Employer
(c) Total cash and charge
(d) Total cash and charge
1
you were required to, but did not
identification number
tips you received (including
tips you reported to your
report all your tips (see instructions)
(see instructions)
unreported tips) (see instructions)
employer
A
B
C
D
E
2 Total cash and charge tips you received in 2010. Add the
amounts from line 1, column (c) .
.
.
.
.
.
.
.
.
.
.
2
3 Total cash and charge tips you reported to your employer(s) in 2010. Add the amounts from
line 1, column (d) .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
3
4 Subtract line 3 from line 2. This amount is income you must include in the total on Form 1040,
4
line 7; Form 1040NR, line 8; or Form 1040NR-EZ, line 3 .
.
.
.
.
.
.
.
.
.
.
.
.
5 Cash and charge tips you received but did not report to your employer because the total was
less than $20 in a calendar month (see instructions).
.
.
.
.
.
.
.
.
.
.
.
.
.
.
5
6 Unreported tips subject to Medicare tax. Subtract line 5 from line 4
6
.
.
.
.
.
.
.
.
.
7 Maximum amount of wages (including tips) subject to
106,800 00
social security tax .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
7
8 Total social security wages and social security tips (total of boxes
3 and 7 shown on your Form(s) W-2) or railroad retirement (tier 1)
compensation .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
8
9 Subtract line 8 from line 7. If line 8 is more than line 7, enter -0- here and on line 10 and go to
line 12.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
9
10 Unreported tips subject to social security tax. Enter the smaller of line 6 or line 9. If you
received tips as a federal, state, or local government employee, see instructions .
.
.
.
.
10
11 Multiply line 10 by .062 (social security tax rate) .
11
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
12 Multiply line 6 by .0145 (Medicare tax rate).
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
12
13 Add lines 11 and 12. Enter the result here and on Form 1040, line 57; Form 1040NR, line 55; or
Form 1040NR-EZ, line 16 (Form 1040-SS and 1040-PR filers, see instructions.)
.
.
.
.
.
13
General Instructions
Who must file. You must file Form 4137 if you received cash
and charge tips of $20 or more in a calendar month and did
Purpose of form. Use Form 4137 only to figure the social
not report all of those tips to your employer. You must also
security and Medicare tax owed on tips you did not report to
file Form 4137 if box 8 of your Form(s) W-2 shows allocated
your employer, including any allocated tips shown on your
tips that you must report as income.
Form(s) W-2 that you must report as income. You must also
Allocated tips. You must report as income on Form 1040,
report the income on Form 1040, line 7; Form 1040NR, line
line 7; Form 1040NR, line 8; or Form 1040NR-EZ, line 3, at
8; or Form 1040NR-EZ, line 3. By filing this form, your social
least the amount of allocated tips shown in box 8 of your
security and Medicare tips will be credited to your social
Form(s) W-2 unless you can prove a smaller amount with
security record (used to figure your benefits).
adequate records. If you have records that show the actual
▲
If you believe you are an employee and you
amount of tips you received, report that amount even if it is
!
received Form 1099-MISC, Miscellaneous Income,
more or less than the allocated tips. Although allocated tips
instead of Form W-2, Wage and Tax Statement,
are shown on your Form W-2, they are not included in the
CAUTION
because your employer did not consider you an
wages, tips, and other compensation box (box 1) on that
employee, do not use this form to report the social security
form and no income tax, social security tax, or Medicare tax
and Medicare tax on that income. Instead, use Form 8919,
has been withheld from these tips.
Uncollected Social Security and Medicare Tax on Wages.
4137
For Paperwork Reduction Act Notice, see your tax return instructions.
Form
(2010)
Cat. No. 12626C
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Financial