Form Rev-20 As - Employer Withholding For Pennsylvania Taxable Compensation Guide - Directions For Completing Federal Form W-2 Block 16 Page 8
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12Part D continued-DEDUCT the following items from the Box 1 figure in
the circumstances noted:
Item
Withhold
When
10 Amount reported for federal
No
income tax purposes at sale of
stock purchased under an
employee stock purchase plan
No
11 Amount reported for federal
income tax purposes at sale of
stock purchased under an
incentive stock option
12 Federally taxable compensation
No
When NOT for service in a combat zone or for a
received while serving as a
month during any part of which serviceman was
U.S. serviceman in a combat
hospitalized as a result of wounds, disease, or
zone
injury incurred while serving in a combat zone
13 Federally taxable compensation
No
received for active duty as a
member of the Armed Forces of
the U.S. outside PA
No
When the membership is titled in the name of the
14 Dues paid for a membership in
employer
a business, athletic, country,
social, hotel, airline, luncheon
or sporting club, to extent the
employer elects to treat the
club usage as compensation
for federal income tax
purposes
When both of the following apply:
15 Moving and relocation expense
No
reimbursements
1)
The reimbursement would be wholly
excludible for federal income tax purposes
but for the fact that the new principal place of
work is less than 50 miles farther from the
individual’s old resident than was his or her
former principal place of work; and
2)
The new principal place of work is at least
35 miles farther from the individual’s old
residence than was his or her former
principal place of work
Part E-NO ADJUSTMENT is made for the following items:
1
a) Health and accident insurance plan premiums paid by the employer under nondiscriminatory
health or accident plan
b) Employer contributions to Medical Savings Account, if program is nondiscriminatory.
If program in a. or b. is discriminatory, add to box 1 wages
2
Medical reimbursement account. Payments to reimburse the employee for expenses incurred for
medical care under self-insured medical reimbursement plan under IRC § 105(h)(6) when employee
precluded from receiving unused contributions or carrying benefit to subsequent taxable year
3
Awards, gifts, prizes and length of service achievement or safety with value in excess of $400 or in
excess of $1,600 for qualified plan awards
4
Periodic sick or disability payments by employer if payment based on nature of sickness, injury or
disability and not with reference to employee’s absence from work. If in lump sum form or based on
employee’s rate of compensation, then subject to withholding
Page 6
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