Page 2 - Pressure Seal Tax Catalog

Stock Pressure Seal W-2 Stock Pressure Seal Multi-Purpose

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2025 Instructions for Employee Future developments. For the latest information about Instructions for Employee (See also Notice to
Instructions for Employee (See also Notice to Copy 2 - To Be Filed With Employee’s Box 12 (continued) S—Employee salary reduction contributions under a enacted after it was published, go to Box 1. Enter this amount on the wages line of your tax
developments related to Form W-2, such as legislation
Employee on the back of Copy B.)
(continued from back of Copy B)
State, City, or Local Income Tax Return.
www.irs.gov/FormW2.
section 408(p) SIMPLE plan (this includes salary
return.
Notice to Employee
However, if you were at least age 50 in 2025, your
Box 1. Enter this amount on the wages line of your tax
Box 2. Enter this amount on the federal income tax
withheld line of your tax return.
employer may have allowed an additional elective deferral
reduction contributions made to a Roth SIMPLE IRA)
Box 2. Enter this amount on the federal income tax
TXE W2-CNB
Future developments. For the latest information about Employee on the back of Copy B.) 2025 OMB No. 1545-0029 or designated Roth contribution (catch-up contribution) to T—Adoption benefits (not included in box 1). Complete Do you have to file? Refer to the Form 1040 instructions Box 5. You may be required to report this amount on Form 11” Z-Fold Multi-Purpose
to determine if you are required to file a tax return. Even if
developments related to Form W-2, such as legislation
Form 8839 to figure any taxable and nontaxable
8959. See the Form 1040 instructions to determine if you
Box 5. You may be required to report this amount on Form
your plan. For information about the limits on these catch-
Copy 2 - To Be Filed With Employee’s
amounts.
return.
withheld line of your tax return.
up contributions, including the higher limit if you were age
you don’t have to file a tax return, you may be eligible for
are required to complete Form 8959.
enacted after it was published, go to
V—Income from exercise of nonstatutory stock option(s)
a refund if box 2 shows an amount or if you are eligible for
60 through 63 as of December 31, 2025, see Pub. 525.
8959. See the Form 1040 instructions to determine if you
Box 6. This amount includes the 1.45% Medicare tax
State, City, or Local Income Tax Return.
any credit.
(included in boxes 1, 3 (up to the social security wage
Contact your plan administrator for more information.
withheld on all Medicare wages and tips shown in box 5,
base), and 5). See Pub. 525 for reporting requirements.
Do you have to file? Refer to the Form 1040 instructions
withheld on all Medicare wages and tips shown in box 5,
are required to complete Form 8959.
W—Employer contributions (including amounts the
Earned income tax credit (EITC). You may be able to
as well as the 0.9% Additional Medicare Tax on any of
Amounts in excess of the overall elective deferral limit
Notice to Employee
as well as the 0.9% Additional Medicare Tax on any of
instructions.
Box 8. This amount is not included in box 1, 3, 5, or 7. For
to determine if you are required to file a tax return. Even if
is less than a certain amount. The amount of the credit is
(cafeteria) plan) to your health savings account. Report
Note: If a year follows code D through H, S, Y, AA, BB, or
you don’t have to file a tax return, you may be eligible for
information on how to report tips on your tax return, see
S—Employee salary reduction contributions under a www.irs.gov/FormW2. Box 6. This amount includes the 1.45% Medicare tax OMB No. 1545-0029 must be included in income. See the Form 1040 employee elected to contribute using a section 125 take the EITC for 2025 if your adjusted gross income (AGI) those Medicare wages and tips above $200,000. ALSO AVAILABLE IN
section 408(p) SIMPLE plan (this includes salary
those Medicare wages and tips above $200,000.
on Form 8889.
based on income and family size. Workers without children
Y—Deferrals under a section 409A nonqualified deferred
the Form 1040 instructions.
could qualify for a smaller credit. You and any qualifying
information on how to report tips on your tax return, see
EE, you made a make-up pension contribution for a prior
year(s) when you were in military service. To figure
T—Adoption benefits (not included in box 1). Complete
You must file Form 4137 with your income tax return to
Instructions for Employee reduction contributions made to a Roth SIMPLE IRA) a refund if box 2 shows an amount or if you are eligible for Box 8. This amount is not included in box 1, 3, 5, or 7. For whether you made excess deferrals, consider these compensation plan children must have valid social security numbers (SSNs). report at least the allocated tip amount unless you can
Blank
(continued from back of Copy B)
You can’t take the EITC if your investment income is more
You must file Form 4137 with your income tax return to
Earned income tax credit (EITC). You may be able to
Form 8839 to figure any taxable and nontaxable
prove with adequate records that you received a smaller
amounts for the year shown, not the current year. If no
Z—Income under a nonqualified deferred compensation
report at least the allocated tip amount unless you can
than the specified amount for 2025 or if income is earned
plan that fails to satisfy section 409A. This amount is
However, if you were at least age 50 in 2025, your
also included in box 1. It is subject to an additional 20%
prove with adequate records that you received a smaller
amount. If you have records that show the actual amount
any credit.
year is shown, the contributions are for the current year.
is less than a certain amount. The amount of the credit is
employer may have allowed an additional elective deferral
Box 12 (continued) V—Income from exercise of nonstatutory stock option(s) take the EITC for 2025 if your adjusted gross income (AGI) the Form 1040 instructions. FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST TXE W2-CNP REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION A—Uncollected social security or RRTA tax on tips. tax plus interest. See the Form 1040 instructions. for services provided while you were an inmate at a penal of tips you received, report that amount even if it is more FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST 55414 2-WIDE FORMAT Block Out on Backer - Simplex
based on income and family size. Workers without children
(included in boxes 1, 3 (up to the social security wage
Include this tax on Form 1040 or 1040-SR. See the Form
amount. If you have records that show the actual amount
or less than the allocated tips. Use Form 4137 to figure the
institution. For 2025 income limits and more information,
base), and 5). See Pub. 525 for reporting requirements.
or designated Roth contribution (catch-up contribution) to
amounts.
could qualify for a smaller credit. You and any qualifying
AA—Designated Roth contributions under a section
visit www.irs.gov/EITC. See also Pub. 596. Any EITC that
your plan. For information about the limits on these catch-
of tips you received, report that amount even if it is more
1040 instructions.
W—Employer contributions (including amounts the
or less than the allocated tips. Use Form 4137 to figure the
401(k) plan
children must have valid social security numbers (SSNs).
social security and Medicare tax owed on tips you didn’t
up contributions, including the higher limit if you were age
B—Uncollected Medicare tax on tips. Include this tax on
You can’t take the EITC if your investment income is more
employee elected to contribute using a section 125
BB—Designated Roth contributions under a section
report to your employer. Enter this amount on the wages
social security and Medicare tax owed on tips you didn’t
is more than your tax liability is refunded to you, but
Form 1040 or 1040-SR. See the Form 1040 instructions.
line of your tax return. By filing Form 4137, your social
(cafeteria) plan) to your health savings account. Report
60 through 63 as of December 31, 2025, see Pub. 525.
than the specified amount for 2025 or if income is earned
only if you file a tax return.
403(b) plan
security tips will be credited to your social security record
report to your employer. Enter this amount on the wages
Contact your plan administrator for more information.
C—Taxable cost of group-term life insurance over $50,000
DD—Cost of employer-sponsored health coverage. The
for services provided while you were an inmate at a penal
Employee’s social security number (SSN). For your
Amounts in excess of the overall elective deferral limit
(included in boxes 1, 3 (up to the social security wage
Y—Deferrals under a section 409A nonqualified deferred
line of your tax return. By filing Form 4137, your social
(used to figure your benefits).
amount reported with code DD is not taxable.
protection, this form may show only the last four digits of
security tips will be credited to your social security record
base), and 5)
institution. For 2025 income limits and more information,
EE—Designated Roth contributions under a governmen-
must be included in income. See the Form 1040
visit www.irs.gov/EITC. See also Pub. 596. Any EITC that
Box 10. This amount includes the total dependent care
your SSN. However, your employer has reported your
on Form 8889.
Z—Income under a nonqualified deferred compensation
benefits that your employer paid to you or incurred on
D—Elective deferrals to a section 401(k) cash or deferred
tal section 457(b) plan. This amount does not apply to
arrangement. Also includes deferrals under a SIMPLE
is more than your tax liability is refunded to you, but
Box 10. This amount includes the total dependent care
your behalf (including amounts from a section 125
Note: If a year follows code D through H, S, Y, AA, BB, or
plan that fails to satisfy section 409A. This amount is
complete SSN to the IRS and the Social Security
compensation plan
retirement account that is part of a section 401(k)
also included in box 1. It is subject to an additional 20%
(used to figure your benefits).
Administration (SSA).
EE, you made a make-up pension contribution for a prior
contributions under a tax-exempt organization section
benefits that your employer paid to you or incurred on
instructions.
(cafeteria) plan). Any amount over your employer’s plan
arrangement.
457(b) plan.
Clergy and religious workers. If you aren’t subject to
limit is also included in box 1. See Form 2441.
year(s) when you were in military service. To figure
FF—Permitted benefits under a qualified small employer
your behalf (including amounts from a section 125
(cafeteria) plan). Any amount over your employer’s plan
only if you file a tax return.
tax plus interest. See the Form 1040 instructions.
Employee’s social security number (SSN). For your
Box 11. This amount is (a) reported in box 1 if it is a
health reimbursement arrangement
social security and Medicare taxes, see Pub. 517.
protection, this form may show only the last four digits of
whether you made excess deferrals, consider these
E—Elective deferrals under a section 403(b) salary
AA—Designated Roth contributions under a section
limit is also included in box 1. See Form 2441.
reduction agreement
amounts for the year shown, not the current year. If no
distribution made to you from a nonqualified deferred
Box 11. This amount is (a) reported in box 1 if it is a
your SSN. However, your employer has reported your
year is shown, the contributions are for the current year.
BB—Designated Roth contributions under a section
Corrections. If your name, SSN, or address is incorrect,
GG—Income from qualified equity grants under section
F—Elective deferrals under a section 408(k)(6) salary
compensation or nongovernmental section 457(b) plan, or
83(i)
complete SSN to the IRS and the Social Security
distribution made to you from a nonqualified deferred
correct Copies B, C, and 2 and ask your employer to
reduction SEP (this includes elective deferrals made to a
A—Uncollected social security or RRTA tax on tips.
Include this tax on Form 1040 or 1040-SR. See the Form
(b) included in box 3 and/or box 5 if it is a prior year
DD—Cost of employer-sponsored health coverage. The
HH—Aggregate deferrals under section 83(i) elections as
compensation or nongovernmental section 457(b) plan, or
deferral under a nonqualified or section 457(b) plan that
correct your employment record. Be sure to ask the
401(k) plan
Roth SEP IRA)
of the close of the calendar year
G—Elective deferrals and employer contributions
employer to file Form W-2c, Corrected Wage and Tax
amount reported with code DD is not taxable.
became taxable for social security and Medicare taxes this
Administration (SSA).
Statement, with the SSA to correct any name, SSN, or
deferral under a nonqualified or section 457(b) plan that
EE—Designated Roth contributions under a governmen-
II—Medicaid waiver payments excluded from gross
B—Uncollected Medicare tax on tips. Include this tax on
(including nonelective deferrals) to a section 457(b)
became taxable for social security and Medicare taxes this
social security and Medicare taxes, see Pub. 517.
Form 1040 or 1040-SR. See the Form 1040 instructions.
tal section 457(b) plan. This amount does not apply to
Corrections. If your name, SSN, or address is incorrect,
C—Taxable cost of group-term life insurance over $50,000
forfeiture of your right to the deferred amount. This box
Box 13. If the “Retirement plan” box is checked, special
Be sure to get your copies of Form W-2c from your
limits may apply to the amount of traditional IRA contri-
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt
year because there is no longer a substantial risk of
shouldn’t be used if you had a deferral and a distribution in
employer for all corrections made so you may file them
forfeiture of your right to the deferred amount. This box
organization plan. See the Form 1040 instructions for how
(included in boxes 1, 3 (up to the social security wage
correct Copies B, C, and 2 and ask your employer to
FOLD, CREASE AND TEAR ALONG PERFORATION
correct your employment record. Be sure to ask the
butions you may deduct. See Pub. 590-A.
the same calendar year. If you made a deferral and
shouldn’t be used if you had a deferral and a distribution in
to deduct.
FF—Permitted benefits under a qualified small employer
D—Elective deferrals to a section 401(k) cash or deferred
employer to file Form W-2c, Corrected Wage and Tax
Box 14. Employers may use this box to report informa-
J—Nontaxable sick pay (information only, not included in
received a distribution in the same calendar year, and you
with your tax return. If your name and SSN are correct but
457(b) plan.
the same calendar year. If you made a deferral and
are or will be age 62 by the end of the calendar year, your
received a distribution in the same calendar year, and you
GG—Income from qualified equity grants under section
aren’t the same as shown on your social security card,
Statement, with the SSA to correct any name, SSN, or
tion such as state disability insurance taxes withheld,
arrangement. Also includes deferrals under a SIMPLE
union dues, uniform payments, health insurance premi-
employer should file Form SSA-131, Employer Report of
are or will be age 62 by the end of the calendar year, your
base), and 5)
health reimbursement arrangement
you should ask for a new card that displays your correct
box 1, 3, or 5)
K—20% excise tax on excess golden parachute
retirement account that is part of a section 401(k)
money amount error reported to the SSA on Form W-2.
employer should file Form SSA-131, Employer Report of
name at any SSA office or by calling 800-772-1213. You
payments. See the Form 1040 instructions.
HH—Aggregate deferrals under section 83(i) elections as
ums deducted, nontaxable income, educational assis-
Be sure to get your copies of Form W-2c from your
Special Wage Payments, with the Social Security
2-WIDE
tance payments, or a member of the clergy’s parsonage
Administration and give you a copy.
may also visit the SSA website at www.SSA.gov.
REMOVE THESE EDGES FIRST 1040 instructions. organization plan. See the Form 1040 instructions for how 403(b) plan contributions under a tax-exempt organization section Clergy and religious workers. If you aren’t subject to (b) included in box 3 and/or box 5 if it is a prior year COPY B COPY C E deferred compensation plan income under Notice 2014-7. money amount error reported to the SSA on Form W-2. year because there is no longer a substantial risk of PSE-Z-BLANK-POP 17X14 TXE Z-BLANK-POP-2W - 17” x 11”
E—Elective deferrals under a section 403(b) salary
L—Substantiated employee business expense
employer for all corrections made so you may file them
Box 12. The following list explains the codes shown in box
with your tax return. If your name and SSN are correct but
Special Wage Payments, with the Social Security
allowance and utilities. Railroad employers use this box
Cost of employer-sponsored health coverage (if such
Box 12. The following list explains the codes shown in box
12. You may need this information to complete your tax
of the close of the calendar year
to report railroad retirement (RRTA) compensation, Tier 1
arrangement.
reimbursements (nontaxable)
83(i)
II—Medicaid waiver payments excluded from gross
M—Uncollected social security or RRTA tax on taxable
cost is provided by the employer). The reporting in box
Administration and give you a copy.
aren’t the same as shown on your social security card,
F—Elective deferrals under a section 408(k)(6) salary
reduction SEP (this includes elective deferrals made to a
12. You may need this information to complete your tax
tax, Tier 2 tax, Medicare tax, and Additional Medicare
Box 13. If the “Retirement plan” box is checked, special
you should ask for a new card that displays your correct
return. Elective deferrals (codes D, E, F, and S) and
12, using code DD, of the cost of employer-sponsored
reduction agreement
cost of group-term life insurance over $50,000 (former
employees only). See the Form 1040 instructions.
designated Roth contributions (codes AA, BB, and EE)
name at any SSA office or by calling 800-772-1213. You
Tax. Include tips reported by the employee to the
limits may apply to the amount of traditional IRA contri-
income under Notice 2014-7.
health coverage is for your information only. The amount
under all plans are generally limited to a total of $23,500
G—Elective deferrals and employer contributions
return. Elective deferrals (codes D, E, F, and S) and
employer in railroad retirement (RRTA) compensation.
reported with code DD is not taxable.
Box 14. Employers may use this box to report informa-
designated Roth contributions (codes AA, BB, and EE)
N—Uncollected Medicare tax on taxable cost of group-
butions you may deduct. See Pub. 590-A.
may also visit the SSA website at www.SSA.gov.
Note: Keep Copy C of Form W-2 for at least 3 years
(Generally, $16,500 for SIMPLE plans; $26,500 for
Cost of employer-sponsored health coverage (if such
after the due date for filing your income tax return.
(including nonelective deferrals) to a section 457(b)
term life insurance over $50,000 (former employees only).
Roth SEP IRA)
under all plans are generally limited to a total of $23,500
Credit for excess taxes. If you had more than one
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt
tion such as state disability insurance taxes withheld,
See the Form 1040 instructions.
(Generally, $16,500 for SIMPLE plans; $26,500 for
section 403(b) plans if you qualify for the 15-year rule
explained in Pub. 571). Deferrals under code G are limited
employer in 2025 and more than $10,918.20 in social
section 403(b) plans if you qualify for the 15-year rule
However, to help protect your social security benefits,
union dues, uniform payments, health insurance premi-
cost is provided by the employer). The reporting in box
P—Excludable moving expense reimbursements paid
directly to a member of the U.S. Armed Forces (not
12, using code DD, of the cost of employer-sponsored
to $23,500. Deferrals under code H are limited to $7,000.
ums deducted, nontaxable income, educational assis-
keep Copy C until you begin receiving social security
explained in Pub. 571). Deferrals under code G are limited
deferred compensation plan
benefits, just in case there is a question about your work
health coverage is for your information only. The amount
to $23,500. Deferrals under code H are limited to $7,000.
security and/or Tier 1 railroad retirement (RRTA) taxes
tance payments, or a member of the clergy’s parsonage
J—Nontaxable sick pay (information only, not included in
included in box 1, 3, or 5)
allowance and utilities. Railroad employers use this box
were withheld, you may be able to claim a credit for the
record and/or earnings in a particular year.
excess against your federal income tax. See the Form
Q—Nontaxable combat pay. See the Form 1040
to report railroad retirement (RRTA) compensation, Tier 1
1040 instructions. If you had more than one railroad
instructions for details on reporting this amount.
reported with code DD is not taxable.
tax, Tier 2 tax, Medicare tax, and Additional Medicare
K—20% excise tax on excess golden parachute
Credit for excess taxes. If you had more than one
to deduct.
R—Employer contributions to your Archer MSA. Report on
employer in 2025 and more than $10,918.20 in social
employer and more than $6,409.20 in Tier 2 RRTA tax was
(See also Instructions for Employee
payments. See the Form 1040 instructions.
box 1, 3, or 5)
Form 8853.
Tax. Include tips reported by the employee to the
employer in railroad retirement (RRTA) compensation.
security and/or Tier 1 railroad retirement (RRTA) taxes
withheld, you may be able to claim a refund on Form 843.
See the Instructions for Form 843.
(See also Notice to Employee on back of Copy B)
were withheld, you may be able to claim a credit for the
on the back of Copy C.)
L—Substantiated employee business expense
Note: Keep Copy C of Form W-2 for at least 3 years
(See also Instructions for Employee
However, to help protect your social security benefits,
cost of group-term life insurance over $50,000 (former
reimbursements (nontaxable)
1040 instructions. If you had more than one railroad
keep Copy C until you begin receiving social security
employer and more than $6,409.20 in Tier 2 RRTA tax was
employees only). See the Form 1040 instructions.
withheld, you may be able to claim a refund on Form 843.
benefits, just in case there is a question about your work
N—Uncollected Medicare tax on taxable cost of group-
term life insurance over $50,000 (former employees only).
record and/or earnings in a particular year.
P—Excludable moving expense reimbursements paid
See the Instructions for Form 843.
Copy C - For EMPLOYEE’S RECORDS.
(See Notice to Employee on the back of Copy B.)
See the Form 1040 instructions.
directly to a member of the U.S. Armed Forces (not
(See also Notice to Employee on back of Copy B)
Q—Nontaxable combat pay. See the Form 1040
included in box 1, 3, or 5)
instructions for details on reporting this amount.
E M—Uncollected social security or RRTA tax on taxable after the due date for filing your income tax return. excess against your federal income tax. See the Form THEN FOLD AND TEAR THIS STUB ALONG PERFORATION on the back of Copy C.) 2 3 1 2025 2025 REMOVE SIDE EDGES FIRST THEN FOLD AND TEAR THIS STUB ALONG PERFORATION 2 3 1 OPENING INSTRUCTIONS SEE OTHER SIDE FOR
R—Employer contributions to your Archer MSA. Report on
Copy B - To Be Filed With
Employee’s FEDERAL Tax Return.
Form 8853.
REMOVE SIDE EDGES FIRST
SEE OTHER SIDE FOR OPENING INSTRUCTIONS
TXE W2-CNB TXE W2-CNP
11” Blank V Fold 11” Printed V Fold
4 Corner Printed Backer 4 Corner Copies B,C,2,2
w/Instructions - Duplex w/Instructions - Duplex
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SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN
2025 OMB No. 1545-0029
Copy B - To Be Filed With Employee’s FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
Instructions for Employee (See also Notice to Employee on the back of Copy B.)
REMOVE SIDE EDGES FIRST
REMOVE SIDE EDGES FIRST
SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN
Box 2. Enter this amount on the federal income tax withheld line of your tax return.
Future developments. For the latest information about developments related to Form W-2, such as legislation Instructions for Employee (See also Notice to Employee on the back of Copy B.) SLIDE FINGER BETWEEN FRONT & MIDDLE PANEL TO OPEN REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST
Box 1. Enter this amount on the wages line of your tax return.
enacted after it was published, go to www.irs.gov/FormW2. Box 1. Enter this amount on the wages line of your tax return.
Notice to Employee Box 2. Enter this amount on the federal income tax withheld line of your tax return. Box 5. You may be required to report this amount on Form 8959. See the Form 1040 instructions to determine if you are
Box 5. You may be required to report this amount on Form 8959. See the Form 1040 instructions to determine if you are
Do you have to file? Refer to the Form 1040 instructions to determine if you are required to file a tax return. Even if you Box 6. This amount includes the 1.45% Medicare tax withheld on all Medicare wages and tips shown in box 5, as well as
don’t have to file a tax return, you may be eligible for a refund if box 2 shows an amount or if you are eligible for any credit. required to complete Form 8959. L
required to complete Form 8959.
received, report that amount even if it is more or less than the allocated tips. Use Form 4137 to figure the social security
Earned income tax credit (EITC). You may be able to take the EITC for 2025 if your adjusted gross income (AGI) is Box 6. This amount includes the 1.45% Medicare tax withheld on all Medicare wages and tips shown in box 5, as well as the 0.9% Additional Medicare Tax on any of those Medicare wages and tips above $200,000.
less than a certain amount. The amount of the credit is based on income and family size. Workers without children the 0.9% Additional Medicare Tax on any of those Medicare wages and tips above $200,000. Box 8. This amount is not included in box 1, 3, 5, or 7. For information on how to report tips on your tax return, see the
C
Do you have to file? Refer to the Form 1040 instructions to determine if you are required to file a tax return. Even if you
could qualify for a smaller credit. You and any qualifying children must have valid social security numbers (SSNs). You Box 8. This amount is not included in box 1, 3, 5, or 7. For information on how to report tips on your tax return, see the Future developments. For the latest information about developments related to Form W-2, such as legislation You must file Form 4137 with your income tax return to report at least the allocated tip amount unless you can prove
Box 10. This amount includes the total dependent care benefits that your employer paid to you or incurred on your
Form 1040 instructions.
can’t take the EITC if your investment income is more than the specified amount for 2025 or if income is earned for with adequate records that you received a smaller amount. If you have records that show the actual amount of tips you
Earned income tax credit (EITC). You may be able to take the EITC for 2025 if your adjusted gross income (AGI) is
services provided while you were an inmate at a penal institution. For 2025 income limits and more information, visit You must file Form 4137 with your income tax return to report at least the allocated tip amount unless you can prove
could qualify for a smaller credit. You and any qualifying children must have valid social security numbers (SSNs). You
www.irs.gov/EITC. See also Pub. 596. Any EITC that is more than your tax liability is refunded to you, but only if with adequate records that you received a smaller amount. If you have records that show the actual amount of tips you Form 1040 instructions.
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from a nonqualified deferred compensation
can’t take the EITC if your investment income is more than the specified amount for 2025 or if income is earned for
you file a tax return. received, report that amount even if it is more or less than the allocated tips. Use Form 4137 to figure the social security enacted after it was published, go to www.irs.gov/FormW2. and Medicare tax owed on tips you didn’t report to your employer. Enter this amount on the wages line of your tax return. 62506
Employee’s social security number (SSN). For your protection, this form may show only the last four digits of your and Medicare tax owed on tips you didn’t report to your employer. Enter this amount on the wages line of your tax return. don’t have to file a tax return, you may be eligible for a refund if box 2 shows an amount or if you are eligible for any credit. By filing Form 4137, your social security tips will be credited to your social security record (used to figure your benefits).
services provided while you were an inmate at a penal institution. For 2025 income limits and more information, visit
By filing Form 4137, your social security tips will be credited to your social security record (used to figure your benefits).
or nongovernmental section 457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior year deferral under a
nonqualified or section 457(b) plan that became taxable for social security and Medicare taxes this year because there is
www.irs.gov/EITC. See also Pub. 596. Any EITC that is more than your tax liability is refunded to you, but only if
SSN. However, your employer has reported your complete SSN to the IRS and the Social Security Administration Notice to Employee
no longer a substantial risk of forfeiture of your right to the deferred amount. This box shouldn’t be used if you had a
(SSA). Clergy and religious workers. If you aren’t subject to social security and Medicare taxes, see Pub. 517. Box 10. This amount includes the total dependent care benefits that your employer paid to you or incurred on your less than a certain amount. The amount of the credit is based on income and family size. Workers without children behalf (including amounts from a section 125 (cafeteria) plan). Any amount over your employer’s plan limit is also
Employee’s social security number (SSN). For your protection, this form may show only the last four digits of your
deferral and a distribution in the same calendar year. If you made a deferral and received a distribution in the same
behalf (including amounts from a section 125 (cafeteria) plan). Any amount over your employer’s plan limit is also
included in box 1. See Form 2441.
calendar year, and you are or will be age 62 by the end of the calendar year, your employer should file Form SSA-131,
included in box 1. See Form 2441.
SSN. However, your employer has reported your complete SSN to the IRS and the Social Security Administration
Corrections. If your name, SSN, or address is incorrect, correct Copies B, C, and 2 and ask your employer to correct
your employment record. Be sure to ask the employer to file Form W-2c, Corrected Wage and Tax Statement, with the
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you from a nonqualified deferred compensation
Box 12. The following list explains the codes shown in box 12. You may need this information to complete your tax return.
or nongovernmental section 457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior year deferral under a
SSA to correct any name, SSN, or money amount error reported to the SSA on Form W-2. Be sure to get your copies
Corrections. If your name, SSN, or address is incorrect, correct Copies B, C, and 2 and ask your employer to correct
Clergy and religious workers. If you aren’t subject to social security and Medicare taxes, see Pub. 517.
Elective deferrals (codes D, E, F, and S) and designated Roth contributions (codes AA, BB, and EE) under all plans are
of Form W-2c from your employer for all corrections made so you may file them with your tax return. If your name and
nonqualified or section 457(b) plan that became taxable for social security and Medicare taxes this year because there is
generally limited to a total of $23,500 (Generally, $16,500 for SIMPLE plans; $26,500 for section 403(b) plans if you qualify
no longer a substantial risk of forfeiture of your right to the deferred amount. This box shouldn’t be used if you had a
SSN are correct but aren’t the same as shown on your social security card, you should ask for a new card that
your employment record. Be sure to ask the employer to file Form W-2c, Corrected Wage and Tax Statement, with the
for the 15-year rule explained in Pub. 571). Deferrals under code G are limited to $23,500. Deferrals under code H are lim-
SSA to correct any name, SSN, or money amount error reported to the SSA on Form W-2. Be sure to get your copies
displays your correct name at any SSA office or by calling 800-772-1213. You may also visit the SSA website at
deferral and a distribution in the same calendar year. If you made a deferral and received a distribution in the same
REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION www.SSA.gov. calendar year, and you are or will be age 62 by the end of the calendar year, your employer should file Form SSA-131, FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST you file a tax return. Employer Report of Special Wage Payments, with the Social Security Administration and give you a copy. Employee FOLD, CREASE AND TEAR ALONG PERFORATION REMOVE THESE EDGES FIRST 2025 OMB No. 1545-0029 OPENING INSTRUCTIONS SEE OTHER SIDE FOR
of Form W-2c from your employer for all corrections made so you may file them with your tax return. If your name and
Employer Report of Special Wage Payments, with the Social Security Administration and give you a copy.
Cost of employer-sponsored health coverage (if such cost is provided by the employer). The reporting in box 12,
SSN are correct but aren’t the same as shown on your social security card, you should ask for a new card that
(See also Instructions for Employee on the back of Copy C.)
displays your correct name at any SSA office or by calling 800-772-1213. You may also visit the SSA website at
using code DD, of the cost of employer-sponsored health coverage is for your information only. The amount reported
Box 12. The following list explains the codes shown in box 12. You may need this information to complete your tax return.
with code DD is not taxable.
(SSA).
Elective deferrals (codes D, E, F, and S) and designated Roth contributions (codes AA, BB, and EE) under all plans are
generally limited to a total of $23,500 (Generally, $16,500 for SIMPLE plans; $26,500 for section 403(b) plans if you qualify
Cost of employer-sponsored health coverage (if such cost is provided by the employer). The reporting in box 12,
Credit for excess taxes. If you had more than one employer in 2025 and more than $10,918.20 in social security
for the 15-year rule explained in Pub. 571). Deferrals under code G are limited to $23,500. Deferrals under code H are lim-
and/or Tier 1 railroad retirement (RRTA) taxes were withheld, you may be able to claim a credit for the excess against
using code DD, of the cost of employer-sponsored health coverage is for your information only. The amount reported
Q—Nontaxable combat pay. See the Form 1040 instructions for details on reporting this amount. Copy C -For EMPLOYEE’S RECORDS. (See Notice to
ited to $7,000.
your federal income tax. See the Form 1040 instructions. If you had more than one railroad employer and more than
$6,409.20 in Tier 2 RRTA tax was withheld, you may be able to claim a refund on Form 843. See the Instructions for
S—Employee salary reduction contributions under a section 408(p) SIMPLE plan (this includes salary reduction on the back of Copy B.)
and/or Tier 1 railroad retirement (RRTA) taxes were withheld, you may be able to claim a credit for the excess against
ited to $7,000.
Credit for excess taxes. If you had more than one employer in 2025 and more than $10,918.20 in social security
Form 843.
(See also Instructions for Employee on the back of Copy C.)
V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3 (up to the social security wage base), and
R—Employer contributions to your Archer MSA. Report on Form 8853.
your federal income tax. See the Form 1040 instructions. If you had more than one railroad employer and more than
T—Adoption benefits (not included in box 1). Complete Form 8839 to figure any taxable and nontaxable amounts.
$6,409.20 in Tier 2 RRTA tax was withheld, you may be able to claim a refund on Form 843. See the Instructions for
Q—Nontaxable combat pay. See the Form 1040 instructions for details on reporting this amount.
8686375
Instructions for Employee (continued from back of Copy B)
www.SSA.gov.
Box 12 (continued)
R—Employer contributions to your Archer MSA. Report on Form 8853.
with code DD is not taxable.
contributions made to a Roth SIMPLE IRA)
S—Employee salary reduction contributions under a section 408(p) SIMPLE plan (this includes salary reduction
However, if you were at least age 50 in 2025, your employer may have allowed an additional elective deferral or designated
8686367
contributions made to a Roth SIMPLE IRA)
Roth contribution (catch-up contribution) to your plan. For information about the limits on these catch-up contributions,
including the higher limit if you were age 60 through 63 as of December 31, 2025, see Pub. 525. Contact your plan
T—Adoption benefits (not included in box 1). Complete Form 8839 to figure any taxable and nontaxable amounts.
Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A. This amount is also
5). See Pub. 525 for reporting requirements.
However, if you were at least age 50 in 2025, your employer may have allowed an additional elective deferral or designated
Y—Deferrals under a section 409A nonqualified deferred compensation plan
administrator for more information. Amounts in excess of the overall elective deferral limit must be included in income.
included in box 1. It is subject to an additional 20% tax plus interest. See the Form 1040 instructions.
Roth contribution (catch-up contribution) to your plan. For information about the limits on these catch-up contributions,
See the Form 1040 instructions.
your health savings account. Report on Form 8889.
5). See Pub. 525 for reporting requirements.
Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made a make-up pension contribution for a prior year(s)
W—Employer contributions (including amounts the employee elected to contribute using a section 125 (cafeteria) plan) to
including the higher limit if you were age 60 through 63 as of December 31, 2025, see Pub. 525. Contact your plan
your health savings account. Report on Form 8889.
DD—Cost of employer-sponsored health coverage. The amount reported with code DD is not taxable.
when you were in military service. To figure whether you made excess deferrals, consider these amounts for the year
EE—Designated Roth contributions under a governmental section 457(b) plan. This amount does not apply to
Y—Deferrals under a section 409A nonqualified deferred compensation plan
shown, not the current year. If no year is shown, the contributions are for the current year.
Z—Income under a nonqualified deferred compensation plan that fails to satisfy section 409A. This amount is also
A—Uncollected social security or RRTA tax on tips. Include this tax on Form 1040 or 1040-SR. See the Form 1040
instructions. V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3 (up to the social security wage base), and REMOVE THESE EDGES FIRST FOLD, CREASE AND TEAR ALONG PERFORATION Form 843. Instructions for Employee (continued from back of Copy B) W—Employer contributions (including amounts the employee elected to contribute using a section 125 (cafeteria) plan) to
included in box 1. It is subject to an additional 20% tax plus interest. See the Form 1040 instructions.
B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or 1040-SR. See the Form 1040 instructions. AA—Designated Roth contributions under a section 401(k) plan Box 12 (continued) AA—Designated Roth contributions under a section 401(k) plan
C—Taxable cost of group-term life insurance over $50,000 (included in boxes 1, 3 (up to the social security wage base), BB—Designated Roth contributions under a section 403(b) plan administrator for more information. Amounts in excess of the overall elective deferral limit must be included in income. BB—Designated Roth contributions under a section 403(b) plan
contributions under a tax-exempt organization section 457(b) plan.
and 5) DD—Cost of employer-sponsored health coverage. The amount reported with code DD is not taxable. Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made a make-up pension contribution for a prior year(s)
EE—Designated Roth contributions under a governmental section 457(b) plan. This amount does not apply to
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also includes deferrals under a SIMPLE retirement when you were in military service. To figure whether you made excess deferrals, consider these amounts for the year FF—Permitted benefits under a qualified small employer health reimbursement arrangement This information is being furnished to the Internal Revenue Service. If you are
II—Medicaid waiver payments excluded from gross income under Notice 2014-7.
account that is part of a section 401(k) arrangement. contributions under a tax-exempt organization section 457(b) plan. See the Form 1040 instructions. required to file a tax return, a negligence penalty or other sanction may be SEE OTHER SIDE FOR OPENING INSTRUCTIONS
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also includes deferrals under a SIMPLE retirement
E—Elective deferrals under a section 403(b) salary reduction agreement FF—Permitted benefits under a qualified small employer health reimbursement arrangement shown, not the current year. If no year is shown, the contributions are for the current year. HH—Aggregate deferrals under section 83(i) elections as of the close of the calendar year imposed on you if this income is taxable and you fail to report it.
member of the clergy’s parsonage allowance and utilities. Railroad employers use this box to report railroad retirement
F—Elective deferrals under a section 408(k)(6) salary reduction SEP (this includes elective deferrals made to a Roth SEP GG—Income from qualified equity grants under section 83(i) A—Uncollected social security or RRTA tax on tips. Include this tax on Form 1040 or 1040-SR. See the Form 1040 GG—Income from qualified equity grants under section 83(i)
IRA) HH—Aggregate deferrals under section 83(i) elections as of the close of the calendar year B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or 1040-SR. See the Form 1040 instructions. Box 13. If the “Retirement plan” box is checked, special limits may apply to the amount of traditional IRA contributions
II—Medicaid waiver payments excluded from gross income under Notice 2014-7.
F—Elective deferrals under a section 408(k)(6) salary reduction SEP (this includes elective deferrals made to a Roth SEP
G—Elective deferrals and employer contributions (including nonelective deferrals) to a section 457(b) deferred C—Taxable cost of group-term life insurance over $50,000 (included in boxes 1, 3 (up to the social security wage base), Box 14. Employers may use this box to report information such as state disability insurance taxes withheld, union dues,
protect your social security benefits, keep Copy C until you begin receiving social security benefits, just in case there is
compensation plan Box 13. If the “Retirement plan” box is checked, special limits may apply to the amount of traditional IRA contributions
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See the Form 1040 instructions for how to you may deduct. See Pub. 590-A. instructions. uniform payments, health insurance premiums deducted, nontaxable income, educational assistance payments, or a
deduct. Box 14. Employers may use this box to report information such as state disability insurance taxes withheld, union dues, you may deduct. See Pub. 590-A.
J—Nontaxable sick pay (information only, not included in box 1, 3, or 5) uniform payments, health insurance premiums deducted, nontaxable income, educational assistance payments, or a and 5) (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax, and Additional Medicare Tax. Include tips reported by the
member of the clergy’s parsonage allowance and utilities. Railroad employers use this box to report railroad retirement
K—20% excise tax on excess golden parachute payments. See the Form 1040 instructions. (RRTA) compensation, Tier 1 tax, Tier 2 tax, Medicare tax, and Additional Medicare Tax. Include tips reported by the account that is part of a section 401(k) arrangement. Note: Keep Copy C of Form W-2 for at least 3 years after the due date for filing your income tax return. However, to help
L—Substantiated employee business expense reimbursements (nontaxable) E—Elective deferrals under a section 403(b) salary reduction agreement employee to the employer in railroad retirement (RRTA) compensation.
M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (former employees employee to the employer in railroad retirement (RRTA) compensation. G—Elective deferrals and employer contributions (including nonelective deferrals) to a section 457(b) deferred 2025
only). See the Form 1040 instructions. Note: Keep Copy C of Form W-2 for at least 3 years after the due date for filing your income tax return. However, to help (See also Notice to Employee on back of Copy B) OMB No. 1545-0029
N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (former employees only). See the protect your social security benefits, keep Copy C until you begin receiving social security benefits, just in case there is IRA) H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See the Form 1040 instructions for how to a question about your work record and/or earnings in a particular year. Copy 2 - To Be Filed With Employee’s State, City, or Local
M—Uncollected social security or RRTA tax on taxable cost of group-term life insurance over $50,000 (former employees
a question about your work record and/or earnings in a particular year.
K—20% excise tax on excess golden parachute payments. See the Form 1040 instructions.
J—Nontaxable sick pay (information only, not included in box 1, 3, or 5)
Form 1040 instructions.
P—Excludable moving expense reimbursements paid directly to a member of the U.S. Armed Forces (not included in box (See also Notice to Employee on back of Copy B) Income Tax Return.
L—Substantiated employee business expense reimbursements (nontaxable)
N—Uncollected Medicare tax on taxable cost of group-term life insurance over $50,000 (former employees only). See the
1, 3, or 5) compensation plan
deduct.
only). See the Form 1040 instructions.
Form 1040 instructions.
1, 3, or 5) P—Excludable moving expense reimbursements paid directly to a member of the U.S. Armed Forces (not included in box 62982 PSE4CN-BLANK

2025 OMB No. 1545-0029
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Income Tax Return.
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FROM: SEE OTHER SIDE FOR OPENING INSTRUCTIONS K
SEE REVERSE SIDE FOR OPENING INSTRUCTIONS Important Tax Document Enclosed First-Class Mail SEE REVERSE SIDE FOR OPENING INSTRUCTIONS Important Tax Document Enclosed First-Class Mail OPENING INSTRUCTIONS SEE OTHER SIDE FOR REMOVE SIDE EDGES FIRST THEN FOLD AND TEAR THIS STUB ALONG PERFORATION 2 3 1
TXF W2-ARB TXE Z-BLANK-FB-POP TXE 4CN-BLANK
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4 Around 4 Around Copies - B,C, 2, 2 Blank Blank Back - Duplex
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Tax Form Type TX F W2-CN P Form Description:
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