Do any of the following apply to this employee? (Optional)
Field 14
State income tax
Local income tax
Local wages,tips etc
Locality name
Field 12a
Tax Code 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
Field 12b
Tax Code 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
Field 12c
Tax Code 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
Field 12d
Tax Code 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
