Fillable Form W-2 - 2015 Wage And Tax Statement (Page 2 of 2) in pdf

Instructions for Employee (Also see Notice to Employee, on the back of Copy

Notice to Employee

Do you have to file? Refer to the Form 1040 Instructions to determine if you are required to file a tax return. Even if

B.)

you do not have to file a tax return, you may be eligible for a refund if box 2 shows an amount or if you are eligible

Box 1. Enter this amount on the wages line of your tax return.

for any credit.

Box 2. Enter this amount on the federal income tax withheld line of your tax return.

Earned income credit (EIC). You may be able to take the EIC for 2015 if your adjusted gross income (AGI) is less

Box 5. You may be required to report this amount on Form 8959, Additional Medicare Tax. See the Form 1040 instructions to

than a certain amount. The amount of the credit is based on income and family size. Workers without children could

determine if you are required to complete Form 8959.

qualify for a smaller credit. You and any qualifying children must have valid social security numbers (SSNs). You

cannot take the EIC if your investment income is more than the specified amount for 2015 or if income is earned for

Box 6. 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%

services provided while you were an inmate at a penal institution. For 2015 income limits and more information, visit

Additional Medicare Tax on any of those Medicare wages and tips above $200,000.

Also see Pub. 596, Earned Income Credit. Any EIC that is more than your tax liability is refunded

Box 8. 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

to you, but only if you file a tax return.

1040 instructions. You must file Form 4137, Social Security and Medicare Tax on Unreported Tip Income, with your income tax

Clergy and religious workers. If you are not subject to social security and Medicare taxes, see Pub. 517, Social

return to report at least the allocated tip amount unless you can prove that you received a smaller amount. If you have records that

Security and Other Information for Members of the Clergy and Religious Workers.

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

Corrections. If your name, SSN, or address is incorrect, correct Copies B, C, and 2 and ask your employer to correct

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

your employment record. Be sure to ask the employer to file Form W-2c, Corrected Wage and Tax Statement, with the

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 Administration (SSA) to correct any name, SSN, or money amount error reported to the SSA on Form

social security record (used to figure your benefits).

W-2. Be sure to get your copies of Form W-2c from your employer for all corrections made so you may file them with

Box 10. This amount includes the total dependent care benefits that your employer paid to you or incurred on your behalf

your tax return. If your name and SSN are correct but are not the same as shown on your social security card, you

(including amounts from a section 125 (cafeteria) plan). Any amount over $5,000 is also included in box 1. Complete Form 2441,

should ask for a new card that displays your correct name at any SSA office or by calling 1-800-772-1213. You also

Child and Dependent Care Expenses, to compute any taxable and nontaxable amounts.

may visit the SSA at

Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from a nonqualified deferred compensation or

Cost of employer-sponsored health coverage (if such cost is provided by the employer). The reporting in box 12,

nongovernmental section 457(b) plan or (b) included in box 3 and/or 5 if it is a prior year deferral under a nonqualified or section

using code DD, of the cost of employer-sponsored health coverage is for your information only. The amount reported

with code DD is not taxable.

457(b) plan that became taxable for social security and Medicare taxes this year because there is no longer a substantial risk of

Credit for excess taxes. If you had more than one employer in 2015 and more than $7,347 in social security and/or

forfeiture of your right to the deferred amount. This box should not be used if you had a deferral and a distribution in the same

Tier 1 railroad retirement (RRTA) taxes were withheld, you may be able to claim a credit for the excess against your

calendar year. If you made a deferral and received a distribution in the same calendar year, and you are or will be age 62 by the

federal income tax. If you had more than one railroad employer and more than $4,321.80 in Tier 2 RRTA tax was

end of the calendar year, your employer should file Form SSA-131, Employer Report of Special Wage Payments, with the Social

withheld,

Security Administration and give you a copy.

you also may be able to claim a credit. See your Form 1040 or Form 1040A instructions

Box 12. The following list explains the codes shown in box 12. You may need this information to complete your tax return. Elective

and Pub. 505, Tax Withholding and Estimated Tax.

deferrals (codes D, E, F, and S) and designated Roth contributions (codes AA, BB, and EE) under all plans are generally limited to

(Also see Instructions for Employee on the back of Copy C.)

a total of $18,000 ($12,500 if you only have SIMPLE plans; $21,000 for section 403(b) plans if you qualify for the 15-year rule

explained in Pub. 571). Deferrals under code G are limited to $18,000. Deferrals under code H are limited to $7,000.

However, if you were at least age 50 in 2015, your employer may have allowed an additional deferral of up to $6,000 ($3,000 for

section 401(k)(11) and 408(p) SIMPLE plans). This additional deferral amount is not subject to the overall limit on elective

deferrals. For code G, the limit on elective deferrals may be higher for the last 3 years before you reach retirement age. Contact

your plan administrator for more information. Amounts in excess of the overall elective deferral limit must be included in income.

See the “Wages, Salaries, Tips, etc.” line instructions for Form 1040.

(continued on back of Copy 2)

Instructions

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

(continued from back of Copy C)

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

Note. If a year follows code D through H, S, Y, AA, BB, or EE, you made a make-up pension contribution for a prior

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

year(s) when you were in military service. To figure whether you made excess deferrals, consider these amounts for the

Contracts.

year shown, not the current year. If no year is shown, the contributions are for the current year.

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

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

T—Adoption benefits (not included in box 1). Complete Form 8839, Qualified Adoption Expenses, to compute any

instructions.

taxable and nontaxable amounts.

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

V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3 (up to social security wage base),

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

and 5). See Pub. 525 and instructions for Schedule D (Form 1040) for reporting requirements.

W—Employer contributions (including amounts the employee elected to contribute using a section 125 (cafeteria)

D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also includes deferrals under a SIMPLE

plan) to your health savings account. Report on Form 8889, Health Savings Accounts (HSAs).

retirement account that is part of a section 401(k) arrangement.

Y—Deferrals under a section 409A nonqualified deferred compensation plan

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

Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A. This amount is also

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

included in box 1. It is subject to an additional 20% tax plus interest. See “Other Taxes” in the Form 1040

G—Elective deferrals and employer contributions (including nonelective deferrals) to a section 457(b) deferred

instructions.

compensation plan

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

H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See “Adjusted Gross Income” in the Form

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

1040 instructions for how to deduct.

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

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

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

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

contributions under a tax-exempt organization section 457(b) plan.

L—Substantiated employee business expense reimbursements (nontaxable)

Box 13. If the “Retirement plan” box is checked, special limits may apply to the amount of traditional IRA

M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (former

contributions you may deduct. See Pub. 590, Individual Retirement Arrangements (IRAs).

employees only). See “Other Taxes” in the Form 1040 instructions.

Box 14. Employers may use this box to report information such as state disability insurance taxes withheld, union

N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (former employees only). See

dues, uniform payments, health insurance premiums deducted, nontaxable income, educational assistance

“Other Taxes” in the Form 1040 instructions.

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.

Note. Keep Copy C of Form W-2 for at least 3 years after the due date for filing your income tax return. However, to

help protect your social security benefits, keep Copy C until you begin receiving social security benefits, just in

case there is a question about your work record and/or earnings in a particular year.

Form W-2 - 2015 Wage And Tax Statement Page 2

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