Form 4137 - Social Security And Medicare Tax On Unreported Tip Income - 2012 Page 3
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Form 4137 (2012)
Page
General Instructions
Payment of tax. Tips you reported to your employer are
subject to social security and Medicare tax (or railroad
What's New
retirement tax) and income tax withholding. Your
employer collects these taxes from wages (excluding
For 2012, the maximum wages and tips subject to social
tips) or other funds of yours available to cover them. If
security increased to $110,100. The social security tax
your wages were not enough to cover these taxes, you
rate an employee must pay on tips is 4.2% (.042).
may have given your employer the additional amounts
Purpose of form. Use Form 4137 only to figure the
needed. Your Form W-2 will include the tips you reported
social security and Medicare tax owed on tips you did not
to your employer and the taxes withheld. If there was not
report to your employer, including any allocated tips
enough money to cover the social security and Medicare
shown on your Form(s) W-2 that you must report as
tax (or railroad retirement tax), your Form W-2 will also
income. You must also report the income on Form 1040,
show the tax due in box 12 with codes A and B. See the
line 7; Form 1040NR, line 8; or Form 1040NR-EZ, line 3.
instructions for Form 1040, line 60, or Form 1040NR, line
By filing this form, your social security and Medicare tips
59, to find out how to report the tax due. If you worked in
will be credited to your social security record (used to
American Samoa, Guam, or the U.S. Virgin Islands, the
figure your benefits).
amount of uncollected tax due is identified in box 12 on
If you believe you are an employee and you
▲
!
Form W-2AS, W-2GU, or W-2VI with codes A and B. If
received Form 1099-MISC, Miscellaneous
you worked in Puerto Rico, Form 499R-2/W-2PR, boxes
Income, instead of Form W-2, Wage and Tax
22 and 23, show the uncollected tax due. See the
CAUTION
Statement, because your employer did not
instructions for line 5 of Form 1040-PR or 1040-SS to find
consider you an employee, do not use this form to report
out how to report the tax due.
the social security and Medicare tax on that income.
Penalty for not reporting tips. If you did not report tips
Instead, use Form 8919, Uncollected Social Security and
to your employer as required, you may be charged a
Medicare Tax on Wages.
penalty equal to 50% of the social security and Medicare
Who must file. You must file Form 4137 if you received
tax due on those tips. You can avoid this penalty if you
cash and charge tips of $20 or more in a calendar month
can show that your failure to report tips to your employer
and did not report all of those tips to your employer. You
was due to reasonable cause and not due to willful
must also file Form 4137 if box 8 of your Form(s) W-2
neglect. To do so, you can attach a statement to your
shows allocated tips that you must report as income.
return explaining why you did not report them.
Allocated tips. You must report all your tips from 2012,
Additional information. See Pub. 531, Reporting Tip
including both cash tips and noncash tips, as income on
Income.
Form 1040, line 7; Form 1040NR, line 8; or Form 1040NR-
Specific Instructions
EZ, line 3. Any tips you reported to your employer in 2012
are included in the wages shown in box 1 of your Form
Line 1. Complete a separate line for each employer. If
W-2. Add to the amount in box 1 only the tips you
you had more than five employers in 2012, attach a
received in 2012 and did not report to your employer.
statement that contains all of the information (and in a
This should include any allocated tips shown in box 8 on
similar format) as required on Form 4137, line 1, or
your Form(s) W-2, unless you have adequate records to
complete and attach line 1 of additional Form(s) 4137.
show that your unreported tips are less than the amount
Complete lines 2 through 13 on only one Form 4137. The
in box 8. Although allocated tips are shown on your Form
line 2 and line 3 amounts on that Form 4137 should be
W-2, they are not included in the wages, tips, and other
the combined totals of all your Forms 4137 and attached
compensation box (box 1) on that form and no income
statement. Include your name, social security number,
tax, social security tax, or Medicare tax has been withheld
and calendar year (2012) on the top of any attachment.
from these tips.
Column (a). Enter your employer’s name exactly as it is
Tips you must report to your employer. You must give
entered in box c of your Form W-2.
your employer a written report of cash and charge tips if
Column (b). For each employer’s name you entered in
you received $20 or more in tips during a month. If, in any
column (a), enter the employer identification number or
month, you worked for two or more employers and
the words “applied for” exactly as shown in box b of your
received tips while working for each, the $20 rule applies
Form W-2.
separately to the tips you received while working for each
Column (c). Include all cash and charge tips you
employer and not to the total you received. Your
received. This includes the following:
reportable tips include cash tips received from
customers, charged tips (credit and debit card charges)
• Total tips you reported to your employer on time. Tips
distributed to you by your employer, and tips received
you reported, as required, by the 10th day of the month
from other employees under any tip-sharing arrangement.
following the month you received them are considered
You must report your tips to your employer by the 10th
income in the month you reported them. For example,
day of the month following the month you received them.
tips you received in December 2011 that you reported to
If the 10th day of the month falls on a Saturday, Sunday,
your employer after December 31, 2011, but by January
or legal holiday, give your employer the report by the next
10, 2012, are considered income in 2012 and should be
business day.
included on your 2012 Form W-2 and reported on line 1
of Form 4137. However, tips you received in December
Employees subject to the Railroad Retirement Tax
2012 that you reported to your employer after December
Act. Do not use Form 4137 to report tips received for
31, 2012, but by January 10, 2013, are considered
work covered by the Railroad Retirement Tax Act. In
income in 2013. Do not include these tips on line 1.
order to get railroad retirement credit, you must report
these tips to your employer.
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