Form Rev-20 As - Employer Withholding For Pennsylvania Taxable Compensation Guide - Directions For Completing Federal Form W-2 Block 16 Page 6

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Part B continued-ADD the following items to the Box 1 amount:
Item
Withhold
Amount
20 Difference between FMV of employee
Yes
Amount to the extent not already included
stock purchase plan stock option at the
in block 1
time limitations or restrictions on
transferability or alienability of the stock
lapse and the amounts paid for the option
Yes
21 Dues paid for a membership in a business,
Amount to the extent not already included
athletic, country, social, hotel, airline,
in block 1
luncheon or sporting club when the
employer elects not to treat the club usage
as compensation for federal income tax
purposes, membership is not in the name
of the employer, and the club is not used
primarily for trade or business
Yes
Amount to the extent not already included
22 Reimbursements for home office expenses
when the employee has a principal place
in block 1
of work separate from the home office
Part C-DEDUCT the following items from the Box 1 amount:
Item
Withhold
1
Fair market value of personal use of employer's vehicle
No
Irrespective of
whether employer
elects not to
withhold federal tax
2
Personal use of company owned or commercial transportation
No
unless already excluded as federal no-additional-cost service
3
Personal use of property belonging to, or held under a lease by,
No
To the extent
the employer, such as educational or training facilities, housing,
taxable for
clothing, day care facilities, passenger cars and commuter high
federal income
way vehicles, aircraft or watercraft, construction or recreation
tax purposes
vehicles, athletic facilities or equipment, entertainment facilities or
equipment, parking facilities, eating facilities, office facilities or
equipment, tools, equipment or supplies
4
Third party sick payments:
a. Third party sick payments when premium is paid by
No
employer under nondiscriminatory plan
Yes
b. Third party sick payments are subject to state withholding if
third party is administrator/agent of employer for employer's
sick leave plan (When employer bears insurance risk of
extent of payment of benefits).
No
5
Premiums paid by employer for nondiscriminatory term life
insurance coverage when they exceed the cost (based on the
IRS uniform premium cost tables) of more than $50,000 of
group-term life insurance provided by employer. If program
discriminates in regard to eligibility to participate, coverage or
entitlement to benefits, then no adjustment to federal box 1
wages.
No
6
Income in respect of a decedent includible in income for federal
income tax purposes, including after death payments of wages
earned through the date of death or for vacation or time off with
pay accumulated to date of death
Page 4

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