Form 8922 - Third-Party Sick Pay Recap - 2017 Page 2

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Form 8922 (2017)
Page
supplying the name and EIN, and then file one Form 8922 for the
Generally, tax returns and return information are confidential, as
wages and taxes related to the employers for which it isn’t supplying
required by section 6103. However, section 6103 allows or requires
the name and EIN.
the Internal Revenue Service to disclose or give the information shown
on your return to others as described in the Code. For example, we
Box 1. Enter the total amount of sick pay subject to federal income
may disclose your tax information to the Department of Justice for
tax.
civil and/or criminal litigation, and to cities, states, the District of
Box 2. Enter the total amount of federal income tax withheld from the
Columbia, and U.S. commonwealths and possessions for use in
sick pay.
administering their tax laws. We may also disclose this information to
Box 3. Enter the total amount of sick pay subject to social security
other countries under a tax treaty, to federal and state agencies to
tax.
enforce federal nontax criminal laws, or to federal law enforcement
Box 4. Enter the total amount of social security tax withheld from the
and intelligence agencies to combat terrorism.
sick pay.
You’re not required to provide the information requested on a form
Box 5. Enter the total amount of sick pay subject to Medicare tax.
that is subject to the Paperwork Reduction Act unless the form
Box 6. Enter the total amount of the Medicare tax (including Additional
displays a valid OMB control number. Books or records relating to a
Medicare Tax) withheld from the sick pay.
form or its instructions must be retained as long as their contents may
Corrected Form 8922. If you filed Form 8922 with the IRS and later
become material in the administration of any Internal Revenue law.
discover that you made an error on it, you must correct it as soon as
The time needed to complete and file this form will vary depending
possible. Complete all entries on Form 8922 when making a
on individual circumstances. The estimated burden for business
correction. Enter an “X” in the “CORRECTED” checkbox only when
taxpayers filing this form is approved under OMB control number
correcting a Form 8922 previously filed with the IRS.
1545-0123 and is included in the estimates shown in the instructions
Recordkeeping. Keep all records of employment taxes for at least 4
for their business income tax return.
years. These should be available for IRS review.
If you have comments concerning the accuracy of these time
estimates or suggestions for making Form 8922 simpler, we would be
Privacy Act and Paperwork Reduction Act Notice. We ask for the
happy to hear from you. You can send us comments from
information on this form to carry out the Internal Revenue laws of the
Or you can send your comments to
United States. We need it to figure and collect the right amount of tax.
Internal Revenue Service, Tax Forms and Publications Division, 1111
Section 6051 and its regulations require you to furnish wage and tax
Constitution Ave. NW, IR-6526, Washington, DC 20224. Don’t send
statements to employees, the Social Security Administration, and the
Form 8922 to this address. Instead, see Where To File, earlier.
Internal Revenue Service. Section 6109 requires you to provide your
identification number. Failure to provide this information in a timely
manner or providing false or fraudulent information may subject you to
penalties.

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