Form W-2
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Form W-2 Select Tax Year* 2024 2023 2022 2021
How many W-2 forms you need? 1 2 3 4
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Contact Info Email*
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Employer Info Employer Name*
Employer Address*
Employer’s Tax Id* Federal Employer Identification Number or simply – EIN, is a unique nine-digit tax id assigned to the company for purposes of identification on all business documents. EIN can be found on tax forms and statements for previous years or obtained from the IRS if employer does not have one.
Employer’s State Id Similar to EIN, this is a state issued tax id number. Most states use Federal EIN for tax reporting purposes, so this field can be left blank or copy EIN.
Employee Info Employee Name*
First
Last
Employee Address*
SSN*
Employee Marital Status* Single Married
Enter the amount paid to the employee – not including tips.Annual income* This field is hidden when viewing the form
Wages, tips, other compensation Federal Income Tax*
State Income Tax*
Social Security Tax*
Medicare Tax*
This field is hidden when viewing the form
Show More First Employee Additional Information Additional Info
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Control Number Control number identifies each employee’s unique W-2 in the company’s records. If not available – you can simply leave it blank.
Dependent Care Benefits Use this field to report income you reimbursed an employee for dependent care expenses, including through a flexible spending account.
Social Security Tips Include employee’s reported tips in this field.
Allocated Tips If the amount of tips an employee reported fell below the IRS’s approved percentage rate, employer may assess additional compensation in the form of allocated tips.
This field is hidden when viewing the form
Other (14)
This field is hidden when viewing the form
Other (Amount) Other (14)
Statutory Employee Employee that doesn’t receive compensation in the form of a regular paycheck – for instance, they work 100 percent on commission.
Retirement Plan Employee has access to a 401k or 403b at work, which may limit their ability to get tax incentives normally associated with an IRA.
Third-Party Sick Pay Employee received some form of compensation from an outside party for sick pay, such as an insurance company.
Tax Code (12A) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12A)
Tax Code (12B) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12B)
Tax Code (12C) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12C)
Tax Code (12D) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12D)
Local Wages, Tips, etc.
Local Income Tax
Locality Name
This field is hidden when viewing the form
Section Break Second Employee Info Employee Name*
First
Last
Employee Address*
SSN*
Employee Marital Status* Single Married
Enter the amount paid to the employee – not including tips.Annual Income* This field is hidden when viewing the form
Wages, tips, other compensation Federal Income Tax*
State Income Tax*
Social Security Tax*
Medicare Tax*
This field is hidden when viewing the form
Show More Second Employee Additional Information Additional Info
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Control Number Control number identifies each employee’s unique W-2 in the company’s records. If not available – you can simply leave it blank.
Dependent Care Benefits Use this field to report income you reimbursed an employee for dependent care expenses, including through a flexible spending account.
Social Security Tips Include employee’s reported tips in this field.
Allocated Tips If the amount of tips an employee reported fell below the IRS’s approved percentage rate, employer may assess additional compensation in the form of allocated tips.
This field is hidden when viewing the form
Other (14)
This field is hidden when viewing the form
Other (Amount) Other (14)
Statutory Employee Employee that doesn’t receive compensation in the form of a regular paycheck – for instance, they work 100 percent on commission.
Retirement Plan Employee has access to a 401k or 403b at work, which may limit their ability to get tax incentives normally associated with an IRA.
Third-Party Sick Pay Employee received some form of compensation from an outside party for sick pay, such as an insurance company.
Tax Code (12A) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12A)
Tax Code (12B) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12B)
Tax Code (12C) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12C)
Tax Code (12D) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12D)
Local Wages, Tips, etc.
Local Income Tax
Locality Name
This field is hidden when viewing the form
Section Break Third Employee Info Employee Name*
First
Last
Employee Address*
SSN*
Employee Marital Status* Single Married
Enter the amount paid to the employee – not including tips.Annual Income* This field is hidden when viewing the form
Wages, tips, other compensation Federal Income Tax*
State Income Tax*
Social Security Tax*
Medicare Tax*
This field is hidden when viewing the form
Show More Third Employee Additional Information Additional Info
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Control Number Control number identifies each employee’s unique W-2 in the company’s records. If not available – you can simply leave it blank.
Dependent Care Benefits Use this field to report income you reimbursed an employee for dependent care expenses, including through a flexible spending account.
Social Security Tips Include employee’s reported tips in this field.
Allocated Tips If the amount of tips an employee reported fell below the IRS’s approved percentage rate, employer may assess additional compensation in the form of allocated tips.
This field is hidden when viewing the form
Other (14)
This field is hidden when viewing the form
Other (Amount) Other (14)
Statutory Employee Employee that doesn’t receive compensation in the form of a regular paycheck – for instance, they work 100 percent on commission.
Retirement Plan Employee has access to a 401k or 403b at work, which may limit their ability to get tax incentives normally associated with an IRA.
Third-Party Sick Pay Employee received some form of compensation from an outside party for sick pay, such as an insurance company.
Tax Code (12A) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12A)
Tax Code (12B) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12B)
Tax Code (12C) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12C)
Tax Code (12D) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12D)
Local Wages, Tips, etc.
Local Income Tax
Locality Name
This field is hidden when viewing the form
Section Break Fourth Employee Info Employee Name*
First
Last
Employee Address*
SSN*
Employee Marital Status* Single Married
Enter the amount paid to the employee – not including tips.Annual Income* This field is hidden when viewing the form
Wages, tips, other compensation Federal Income Tax*
State Income Tax*
Social Security Tax*
Medicare Tax*
This field is hidden when viewing the form
Show More Fourth Employee Additional Information Additional Info
The following fields are not very common and are only necessary to complete if you meet the requirements. Please read description for each field carefully.
Control Number Control number identifies each employee’s unique W-2 in the company’s records. If not available – you can simply leave it blank.
Dependent Care Benefits Use this field to report income you reimbursed an employee for dependent care expenses, including through a flexible spending account.
Social Security Tips Include employee’s reported tips in this field.
Allocated Tips If the amount of tips an employee reported fell below the IRS’s approved percentage rate, employer may assess additional compensation in the form of allocated tips.
This field is hidden when viewing the form
Other (14)
This field is hidden when viewing the form
Other (Amount) Other (14)
Statutory Employee Employee that doesn’t receive compensation in the form of a regular paycheck – for instance, they work 100 percent on commission.
Retirement Plan Employee has access to a 401k or 403b at work, which may limit their ability to get tax incentives normally associated with an IRA.
Third-Party Sick Pay Employee received some form of compensation from an outside party for sick pay, such as an insurance company.
Tax Code (12A) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12A)
Tax Code (12B) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12B)
Tax Code (12C) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12C)
Tax Code (12D) Code A—Uncollected social security or RRTA tax on tips Code B—Uncollected Medicare tax on tips Code C—Taxable cost of group-term life insurance over $50,000 Code D—Elective deferrals under a section 401(k) cash or deferred arrangement (plan) Code E—Elective deferrals under a section 403(b) salary reduction agreement Code F—Elective deferrals under a section 408(k)(6) salary reduction SEP Code G—Elective deferrals and employer contributions (including nonelective deferrals) to any governmental or nongovernmental section 457(b) deferred compensation plan Code H—Elective deferrals under section 501(c)(18)(D) tax-exempt organization plan Code J—Nontaxable sick pay Code K—20% excise tax on excess golden parachute payments (not applicable to Forms W-2AS, W-2CM, W-2GU, or W-2VI) Code L—Substantiated employee business expense reimbursements Code M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (for former employees) Code P—Excludable moving expense reimbursements paid directly to employee Code Q—Nontaxable combat pay Code R—Employer contributions to an Archer MSA Code S—Employee salary reduction contributions under a section 408(p) SIMPLE plan Code T—Adoption benefits Code V—Income from the exercise of nonstatutory stock option(s) Code W—Employer contributions to a health savings account (HSA) Code Y—Deferrals under a section 409A nonqualified deferred compensation plan Code Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A Code AA—Designated Roth contributions under a section 401(k) plan Code BB—Designated Roth contributions under a section 403(b) plan Code CC—HIRE exempt wages and tips (2010 only) Code DD—Cost of employer-sponsored health coverage Code EE—Designated Roth contributions under a governmental section 457(b) plan Code FF—Permitted benefits under a qualified small employer health reimbursement arrangement
Amount (12D)
Local Wages, Tips, etc.
Local Income Tax
Locality Name