Form Pa W-2 - Reconciliation Worksheet (Pa-40 W-2 Rw)
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1
2PA W-2 RECONCILIATION WORKSHEET
START
PA-40 W-2 RW (12-14)
HERE
Name
Social Security Number
Employer’s identification number from Box b
FEDERAL WAGES
FEDERAL WAGES
MEDICARE WAGES
(Box 1)
(Box 1)
(Box 5)
PART I – STARTING POINT
PART II – Additions:
COLUMN A
COLUMN B
COLUMN C
1.
Company contribution to deferred comp plan.
2.
Elective deferrals to IRC Section 401(K) - Code “D”
in Box 12.
3.
Elec. deferrals under IRC Section 403(b) salary reduction
agreement - Code “E” in Box 12.
4.
Elec. def under IRC Section 408(k)(6) salary reduction
agreement SEP - Code “F” in Box 12.
5.
Elec. & non-elec. deferrals under IRC Section 457(b)
deferred comp. plan - Code “G” in Box 12.
6.
Elective deferrals to a Section 501 (C)(18)(D) tax-exempt
organization plan - Code “H” in Box 12.
7.
Income under IRC Section 409A nonqualified deferred comp
(NQDC) plan - Code “Z” in Box 12.
8.
Deferrals under IRC Section 409A NQDC plan - Code
“Y” in Box 12.
9.
OTHER ADDITIONS (provide full descriptions)
Fields 9a. through 9e.
9a.
9b.
9c.
9d.
9e.
TOTAL PART II (add lines 1 through 9e.)
PART III – Subtractions:
COLUMN A
COLUMN B
COLUMN C
10.
Company contribution to deferred comp plan.
11.
Cost of group-term life - Code “C” in Box 12.
12.
Income under IRC Section 409A nonqualified deferred
comp (NQDC) plan - Code “Z” in Box 12.
13.
Deferrals under IRC Section 409A NQDC plan - Code
“Y” in Box 12.
14.
Personal use of company vehicle.
15.
Distributions from an IRC Section 409A NQDC plan
16.
Distributions from an IRC Section 409A NQDC plan
previously taxed for Pennsylvania purposes.
17.
OTHER SUBTRACTIONS (provide full descriptions)
Fields 17a. through 17e.
17a.
17b.
17c.
17d.
17e.
TOTAL PART III (add lines 10 through 17e.)
PART IV – FINISHING POINT
[Add Parts I and II then subtract Part III]
MEDICARE WAGES
PA WAGES
PA WAGES
(Box 5)
(Box 16)
(Box 16)
PRINT FORM
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