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Fillable Printable 2005 Form W-2

Fillable Printable 2005 Form W-2

2005 Form W-2

2005 Form W-2

For Privacy Act and Paperwork Reduction
Act Notice, see back of Copy D.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy A For Social Security Administration Send this
entire page with Form W-3 to the Social Security
Administration; photocopies are not acceptable.
Department of the Treasury—Internal Revenue Service
Do Not Cut, Fold, or Staple Forms on This Page — Do Not Cut, Fold, or Staple Forms on This Page
Form
Dependent care benefits
See instructions for box 12
Cat. No. 10134D
a
b
c
d
e
f
Void
W-2
Wage and Tax
Statement
2
22222
Page 1 of 12 of Form W-2 (Page 2 Blank) 6 Part 3
The type and rule above prints on all proofs including departmental
reproduction proofs. MUST be removed before printing.
TLS, have you
transmitted all R
text files for this
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DateDate
Action
Revised proofs
requested
Date Signature
O.K. to print
T:FP:F
O.K. to print
Responsible
scan organization
005
Separation 1: prints red
Separation 2: prints black
Version A
OMB No. 1545-0008
For Official Use Only
Last name
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12b
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12c
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19
Local wages, tips, etc.
20
Local income tax
12d
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Page 3 of 12 of Form W-2 (Page 4 is blank) 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy 1—For State, City, or Local Tax Department
Department of the Treasury—Internal Revenue Service
Form
Dependent care benefits
a
b
c
d
e
f
W-2
Wage and Tax
Statement
2 005
OMB No. 1545-0008
Last name
C
o
d
e
12b
C
o
d
e
12c
C
o
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19
Local wages, tips, etc.
20
Local income tax
12d
C
o
d
e
22222
Page 5 of 12 of Form W-2 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy B—To Be Filed With Employee’s FEDERAL Tax Return.
This information is being furnished to the Internal Revenue Service.
Department of the Treasury—Internal Revenue Service
Form
Dependent care benefits
See instructions for box 12
a
b
c
d
e
f
W-2
Wage and Tax
Statement
2 005
OMB No. 1545-0008
Last name
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
19
Local wages, tips, etc.
20
Local income tax
12d
C
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Safe, accurate,
FAST! Use
Visit the IRS website
at www.irs.gov/efile.
Notice to Employee
Refund. Even if you do not have to file a tax return, you
should file to get a refund if box 2 shows federal income tax
withheld or if you can take the earned income credit.
Earned income credit (EIC). You must file a tax return if
any amount is shown in box 9.
You may be able to take the EIC for 2005 if: (a) you do not
have a qualifying child and you earned less than $11,750
($13,750 if married filing jointly), (b) you have one qualifying
child and you earned less than $31,030 ($33,030 if married
filing jointly), or (c) you have more than one qualifying child
and you earned less than $35,263 ($37,263 if married filing
jointly). You and any qualifying children must have valid
social security numbers (SSNs). You cannot take the EIC if
your investment income is more than $2,700. Any EIC that
is more than your tax liability is refunded to you, but only
if you file a tax return. If you have at least one qualifying
child, you may get as much as $1,597 of the EIC in advance
by completing Form W-5, Earned Income Credit Advance
Payment Certificate, and giving it to your employer.
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
Social Security Administration (SSA) to correct any name,
SSN, or money amount error reported to the SSA on Form
W-2. If your name and SSN are correct but are not the same
as shown on your social security card, you should ask for a
new card at any SSA office or call 1-800-772-1213.
Credit for excess taxes. If you had more than one
employer in 2005 and more than $5,580.00 in social security
and/or Tier I railroad retirement (RRTA) taxes were withheld,
you may be able to claim a credit for the excess against
your federal income tax. If you had more than one railroad
employer and more than $2,943.60 in Tier II RRTA tax was
withheld, you also may be able to claim a credit. See your
Form 1040 or Form 1040A instructions and Publication 505,
Tax Withholding and Estimated Tax.
Page 6 of 12 of Form W-2 (Back of Copy B) 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
Clergy and religious workers. If you are not subject to
social security and Medicare taxes, see Publication 517,
Social Security and Other Information for Members of the
Clergy and Religious Workers.
(Also see Instructions on back of Copy C.)
Page 7 of 12 of Form W-2 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy C—For EMPLOYEE’S RECORDS. (See Notice to
Employee on back of Copy B.)
Department of the Treasury—Internal Revenue Service
Form
Dependent care benefits
See instructions for box 12
a
b
c
d
e
f
W-2
Wage and Tax
Statement
2 005
OMB No. 1545-0008
Last name
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
19
Local wages, tips, etc.
20
Local income tax
12d
C
o
d
e
This information is being furnished to the Internal Revenue Service. 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.
Safe, accurate,
FAST! Use
Box 12. The following list explains the codes shown in box 12. You may need
this information to complete your tax return. Elective deferrals (codes D, E, F,
and S) under all plans are generally limited to a total of $14,000 ($17,000 for
section 403(b) plans if you qualify for the 15-year rule explained in Pub. 571).
Deferrals under code G are limited to $14,000. Deferrals under code H are
limited to $7,000. However, if you were at least age 50 in 2005, your employer
may have allowed an additional deferral of up to $4,000 ($2,000 for section
401(k)(11) and 408(p) SIMPLE plans). This additional deferral amount is not
subject to the overall limit on elective deferrals. For code G, the limit on elective
deferrals may be higher for the last three years before you reach retirement age.
Contact your plan administrator for more information. Amounts in excess of the
overall elective deferral limit must be included in income. See the “Wages,
Salaries, Tips, etc.” line instructions for Form 1040.
Box 13. If the “Retirement plan” box is checked, special limits may apply to the
amount of traditional IRA contributions that you may deduct.
Box 11. This amount is: (a) reported in box 1 if it is a distribution made to you
from a nonqualified deferred compensation or nongovernmental section 457(b)
plan or (b) included in box 3 and/or 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 no longer a substantial risk of
forfeiture of your right to the deferred amount.
Box 8. This amount is not included in boxes 1, 3, 5, or 7. For information on
how to report tips on your tax return, see your Form 1040 instructions.
Box 9. Enter this amount on the advance earned income credit payments line of
your Form 1040 or Form 1040A.
Box 2. Enter this amount on the federal income tax withheld line of your tax return.
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also
includes deferrals under a SIMPLE retirement account that is part of a section
401(k) arrangement.
E—Elective deferrals under a section 403(b) salary reduction agreement
F—Elective deferrals under a section 408(k)(6) salary reduction SEP
G—Elective deferrals and employer contributions (including nonelective deferrals)
to a section 457(b) deferred compensation plan
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan. See
“Adjusted Gross Income” in the Form 1040 instructions for how to deduct.
J—Nontaxable sick pay (information only, not included in boxes 1, 3, or 5)
K—20% excise tax on excess golden parachute payments. See “Total Tax” in
the Form 1040 instructions.
L—Substantiated employee business expense reimbursements (nontaxable)
M—Uncollected social security or RRTA tax on taxable cost of group-term life
insurance over $50,000 (former employees only). See “Total Tax” in the Form
1040 instructions.
N—Uncollected Medicare tax on taxable cost of group-term life insurance over
$50,000 (former employees only). See “Total Tax” in the Form 1040 instructions.
Box 1. Enter this amount on the wages line of your tax return.
Box 10. This amount is the total dependent care benefits that your employer
paid to you or incurred on your behalf (including amounts from a section 125
(cafeteria) plan). Any amount over $5,000 also is included in box 1. You must
complete Schedule 2 (Form 1040A) or Form 2441, Child and Dependent Care
Expenses, to compute any taxable and nontaxable amounts.
Page 8 of 12 of Form W-2 (Back of Copy C) 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
A—Uncollected social security or RRTA tax on tips. Include this tax on Form
1040. See “Total Tax” in the Form 1040 instructions.
C—Taxable cost of group-term life insurance over $50,000 (included in
boxes 1, 3 (up to social security wage base), and 5)
P—Excludable moving expense reimbursements paid directly to employee (not
included in boxes 1, 3, or 5)
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 protect your social security benefits,
keep Copy C until you begin receiving social security benefits, just in case there is a
question about your work record and/or earnings in a particular year. Review the
information shown on your annual (for workers over 25) Social Security Statement.
Instructions (Also see Notice to Employee, on back of Copy B.)
B—Uncollected Medicare tax on tips. Include this tax on Form 1040. See “Total
Tax” in the Form 1040 instructions.
R—Employer contributions to your Archer MSA. Report on Form 8853, Archer
MSAs and Long-Term Care Insurance Contracts.
S—Employee salary reduction contributions under a section 408(p) SIMPLE (not
included in box 1)
T—Adoption benefits (not included in box 1). You must complete Form 8839,
Qualified Adoption Expenses, to compute any taxable and nontaxable amounts.
Note. If a year follows code D, E, F, G, H, or S, you made a make-up pension
contribution for a prior year(s) when you were in military service. To figure whether you
made excess deferrals, consider these amounts for the year shown, not the current
year. If no year is shown, the contributions are for the current year.
V—Income from exercise of nonstatutory stock option(s) (included in boxes 1, 3
(up to social security wage base), and 5)
W—Employer contributions to your Health Savings Account. Report on
Form 8889, Health Savings Accounts (HSAs).
Q—Nontaxable combat pay. See the instructions for Form 1040 or Form 1040A
for details on reporting this amount.
Y—Deferrals under a section 409A nonqualified deferred compensation plan.
Z—Income under section 409A on a nonqualified deferred compensation plan.
This amount is also included in box 1. It is subject to an additional 20% tax plus
interest. See “Total Tax” in the Form 1040 instructions.
Page 9 of 12 of Form W-2 (Page 10 is blank) 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy 2—To Be Filed With Employee’s State, City, or Local
Income Tax Return.
Department of the Treasury—Internal Revenue Service
Form
Dependent care benefits
a
b
c
d
e
f
W-2
Wage and Tax
Statement
2 005
OMB No. 1545-0008
Last name
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
19
Local wages, tips, etc.
20
Local income tax
12d
C
o
d
e
Page 11 of 12 of Form W-2 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
1
Control number
Retirement
plan
Third-party
sick pay
Statutory
employee
6
2
Employer’s name, address, and ZIP code
Allocated tips7
Advance EIC payment
8
109
Wages, tips, other compensation
Federal income tax withheld
Social security tax withheldSocial security wages
12a11
Employer’s state ID number
43
Employer identification number (EIN)
Medicare wages and tips
Social security tips
13
5
Employee’s social security number
Employee’s first name and initial Nonqualified plans
Medicare tax withheld
15
14
1716
Other
18
Employee’s address and ZIP code
State income tax
State
State wages, tips, etc.
Locality name
Copy D—For Employer.
Department of the Treasury—Internal Revenue Service
Form
Dependent care benefits
See instructions for box 12
a
b
c
d
e
f
W-2
Wage and Tax
Statement
2 005
OMB No. 1545-0008
Last name
C
o
d
e
12b
C
o
d
e
12c
C
o
d
e
19
Local wages, tips, etc.
20
Local income tax
12d
C
o
d
e
For Privacy Act and Paperwork Reduction
Act Notice, see back of Copy D.
Void
Page 12 of 12 of Form W-2 (Back of Copy D) 6 Part
3
The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.
Employers, Please Note—
Specific information needed to complete Form W-2 is given
in a separate booklet titled 2005 Instructions for Forms W-2
and W-3. You can order those instructions and additional
forms by calling 1-800-TAX-FORM (1-800-829-3676). You
can also get forms and instructions from the IRS website at
www.irs.gov.
Due dates. Furnish Copies B, C, and 2 to the employee
generally by January 31, 2006.
File Copy A with the SSA generally by February 28, 2006.
Send all Copies A with Form W-3, Transmittal of Wage and
Tax Statements. However, if you file electronically (not by
magnetic media), the due date is March 31, 2006.
Caution. Because the SSA processes paper forms by
machine, you cannot file with the SSA Forms W-2 and W-3
that you print from the IRS website. Instead, you can use the
SSA website at www.socialsecurity.gov/employer to create
and file electronically “fill-in” versions of Forms W-2 and
W-3.
Privacy Act and Paperwork Reduction Act Notice. We ask
for the information on Forms W-2 and W-3 to carry out the
Internal Revenue laws of the United States. We need it to
figure and collect the right amount of tax. Section 6051 and
its regulations require you to furnish wage and tax
statements to employees and to the Social Security
Administration. Section 6109 requires you to provide your
employer identification number (EIN). If you fail to provide
this information in a timely manner, you may be subject to
penalties.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in
the administration of any Internal Revenue law.
Generally, tax returns and return information are
confidential, as required by section 6103. However,
section 6103 allows or requires the Internal Revenue
Service to disclose or give the information shown on your
return to others as described in the Code. For example, we
may disclose your tax information to the Department of
Justice for civil and/or criminal litigation, and to cities,
states, and the District of Columbia for use in administering
their tax laws. We may also disclose this information to
other countries under a tax treaty, to federal and state
agencies to enforce federal nontax criminal laws, or to
federal law enforcement and intelligence agencies to combat
terrorism.
The time needed to complete and file these forms will vary
depending on individual circumstances. The estimated
average times are: Form W-2—30 minutes, and Form
W-3—28 minutes. If you have comments concerning the
accuracy of these time estimates or suggestions for making
these forms simpler, we would be happy to hear from you.
You can write to the Internal Revenue Service, Tax Products
Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111
Constitution Ave. NW, IR-6406, Washington, DC 20224. Do
not send Forms W-2 and W-3 to this address. Instead, see
Where to file in the Instructions for Forms W-2 and W-3.
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