Notice To Employee: WWW - Irs.gov/efile
Notice To Employee: WWW - Irs.gov/efile
Notice To Employee: WWW - Irs.gov/efile
e Employee’s name, address, and ZIP code Suff. e Employee’s name, address, and ZIP code Suff.
13 Statutory employee 14 Other 12b Code 13 Statutory employee 14 Other 12b Code
Third-party sick pay 12d Code Third-party sick pay 12d Code
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 15 State Employer’s state I.D. number 16 State wages, tips, etc. 17 State income tax
18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
Form W-2 Wage and Tax Statement 2022 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement
2022 Dept. of the Treasury -- IRS
This information is being furnished to the Internal Revenue Service.
www.irs.gov/efile
Copy C – For EMPLOYEE’S RECORDS (See 41-0852411 Copy 2 – To Be Filed With Employee’s State, 41-0852411
OMB No. 1545-0008 OMB No. 1545-0008
Notice to Employee on the back of Copy B.) City, or Local Income Tax Return.
a Employee’s soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld a Employee’s soc. sec. no. 1 Wages, tips, other comp. 2 Federal income tax withheld
15721.76 1679.82 15721.76 1679.82
631-02-3674 631-02-3674
3 Social security wages 4 Social security tax withheld 3 Social security wages 4 Social security tax withheld
b Employer ID number (EIN) 15721.76 974.75 b Employer ID number (EIN) 15721.76 974.75
5 Medicare wages and tips 6 Medicare tax withheld 5 Medicare wages and tips 6 Medicare tax withheld
72-1332889 72-1332889
15721.76 227.97 15721.76 227.97
c Employer’s name, address, and ZIP code c Employer’s name, address, and ZIP code
e Employee’s name, address, and ZIP code Suff. e Employee’s name, address, and ZIP code Suff.
13 Statutory employee 14 Other 12b Code 13 Statutory employee 14 Other 12b Code
Third-party sick pay 12d Code Third-party sick pay 12d Code
15 State Employer’s state I.D. number 16 State wages, tips, etc. 17 State income tax 15 State Employer’s state I.D. number 16 State wages, tips, etc. 17 State income tax
18 Local wages, tips, etc. 19 Local income tax 20 Locality name 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
Form W-2 Wage and Tax Statement 2022 Dept. of the Treasury -- IRS Form W-2 Wage and Tax Statement 2022 Dept. of the Treasury -- IRS
This information is being furnished to the IRS. If you are required to file a tax return, a negligence
penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. L4UP 5205
Notice to Employee
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 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.
Earned income credit (EIC). You may be able to take the EIC for 2022 if your adjusted gross income (AGI) is less than a
certain amount. The amount of the credit is based on income and family size. Workers without children could qualify for a
smaller credit. You and any qualifying children must have valid social security numbers (SSNs). You can’t take the EIC if your
investment income is more than the specified amount for 2022 or if income is earned for services provided while you were an
inmate at a penal institution. For 2022 income limits and more information, visit www.irs.gov/EITC. See also Pub. 596, Earned
Income Credit. Any EIC that is more than your tax liability is refunded to you, but only if you file a tax return.
Employee's social security number (SSN). For your protection, this form may show only the last four digits of your SSN.
However, your employer has reported your complete SSN to the IRS and the Social Security Administration (SSA).
Clergy and religious workers. If you aren’t subject to social security and Medicare taxes, see Pub. 517, Social Security and
Other Information for Members of the Clergy and Religious Workers.
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 SSA to
correct any name, SSN, or money amount error reported to the SSA on Form W-2. Be sure to get your copies of Form W-2c
from your employer for all corrections made so you may file them with your tax return. If your name and SSN are correct but
aren’t the same as shown on your social security card, you should ask for a new card that displays your correct name at any
SSA office or by calling 800-772-1213. You also may visit the SSA website at www.SSA.gov.
Cost of employer-sponsored health coverage (if such cost is provided by the employer). The reporting in box 12, using
code DD, of the cost of employer-sponsored health coverage is for your information only. The amount reported with code DD
is not taxable.
Credit for excess taxes. If you had more than one employer in 2022 and more than $9,114 in social security and/or Tier 1
railroad retirement (RRTA) taxes were withheld, you may be able to claim a credit for the excess against your federal income
tax. See the Form 1040 instructions. If you had more than one railroad employer and more than $5,350.80 in Tier 2 RRTA tax
was withheld, you may be able to claim a refund on Form 843. See the Instructions for Form 843.