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b Employer identification number (EIN) 12a See instructions for box 12 1 Wages, tips, other compensation 2 Federal income

for box 12 1 Wages, tips, other compensation 2 Federal income tax withheld
36-1253600
c Employer’s name, address, and ZIP code C
C 24.00 71685.16 7363.43
o
d
e $
ILLINOIS BELL TELEPHONE COMPANY 12b 3 Social security wages 4 Social security tax withheld
C
o
d
e
D $ 2400.00 74085.16 3111.58
12c 5 Medicare wages and tips 6 Medicare tax withheld
909 CHESTNUT ST, 28K07
C
o
d
e
DD $ 15170.04 74085.16 1074.23
12d 7 Social security tips 8 Allocated tips
ST. LOUIS, MO 63101-3002 C
o
d
e
L $ 60.00
e Employee’s first name and initial Last name Suff. 12e
00200470 1 of 1 ID:10535000000000000153188048 C 9 Advance EIC payment 10 Dependent care benefits
$
o
d
e

KEITH WOODS 0.00


This information is being furnished to the
Internal Revenue Service. 11 Nonqualified plans 13 Statutory Retirement
plan
Third-party
sick pay
employee
X
14608 S.STATE.ST. Copy B To Be Filed With 14 Other
DOLTON, IL 60419 Employee’s FEDERAL
Tax Return
a Employee’s social security number
f Employee’s address and ZIP code 341-72-4070
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
IL 361253600 71685.16 3025.38

Form W-2 Wage and Tax Statement 2012 Department of the Treasury-Internal Revenue Service OMB # 1545-0008 Copy B To Be Filed With Employee's FEDERAL Tax Return

b Employer identification number (EIN) 12a 1 Wages, tips, other compensation 2 Federal income tax withheld
36-1253600
c Employer’s name, address, and ZIP code C
o
C 71685.16 7363.43
d
e $ 24.00
ILLINOIS BELL TELEPHONE COMPANY 12b 3 Social security wages 4 Social security tax withheld
C
o
d
e
D $ 2400.00 74085.16 3111.58
12c 5 Medicare wages and tips 6 Medicare tax withheld
C

909 CHESTNUT ST, 28K07


o
d
e
DD $ 15170.04 74085.16 1074.23
12d 7 Social security tips 8 Allocated tips
ST. LOUIS, MO 63101-3002 C
o
L 60.00
d
e $
e Employee’s first name and initial Last name Suff.
12e
00200470 1 of 1 ID:10535000000000000153188048 C
o 9 Advance EIC payment 10 Dependent care benefits
d
e $
KEITH WOODS 0.00
11 Nonqualified plans 13 Statutory Retirement
plan
Third-party
sick pay
employee
X
14608 S.STATE.ST. Copy 2 To Be Filed With 14 Other
DOLTON, IL 60419 Employee’s STATE, CITY or
LOCAL Income Tax Return
a Employee’s social security number
f Employee’s address and ZIP code 341-72-4070
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
IL 361253600 71685.16 3025.38

Form W-2 Wage and Tax Statement 2012 Department of the Treasury-Internal Revenue Service OMB # 1545-0008 Copy 2 To Be Filed With Employee's State, CITY or Local Tax Departments

b Employer identification number (EIN) 12a 1 Wages, tips, other compensation 2 Federal income tax withheld
36-1253600
c Employer’s name, address, and ZIP code C
C 71685.16 7363.43
o
d
e $ 24.00
ILLINOIS BELL TELEPHONE COMPANY 12b 3 Social security wages 4 Social security tax withheld
C
o
d
e
D $ 2400.00 74085.16 3111.58
12c 5 Medicare wages and tips 6 Medicare tax withheld
909 CHESTNUT ST, 28K07
C
o
d
e
DD $ 15170.04 74085.16 1074.23
12d 7 Social security tips 8 Allocated tips
ST. LOUIS, MO 63101-3002 C
L 60.00
$
o
d
e
e Employee’s first name and initial Last name Suff.
12e
00200470 1 of 1 ID:10535000000000000153188048 C 9 Advance EIC payment 10 Dependent care benefits
$
o
d
e

KEITH WOODS 0.00


11 Nonqualified plans 13 Statutory Retirement
plan
Third-party
sick pay
employee
X
14608 S.STATE.ST. Copy 2 To Be Filed With 14 Other
DOLTON, IL 60419 Employee’s STATE, CITY or
LOCAL Income Tax Return
a Employee’s social security number
f Employee’s address and ZIP code 341-72-4070
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
IL 361253600 71685.16 3025.38

Form W-2 Wage and Tax Statement 2012 Department of the Treasury-Internal Revenue Service OMB # 1545-0008 Copy 2 To Be Filed With Employee's State, CITY or Local Tax Departments

b Employer identification number (EIN) 12a See instructions for box 12 1 Wages, tips, other compensation 2 Federal income tax withheld
c Employer’s name, address, and ZIP code
36-1253600 C
o
d
e
C $ 24.00 71685.16 7363.43
ILLINOIS BELL TELEPHONE COMPANY 12b 3 Social security wages 4 Social security tax withheld
C
o
d
e
D $ 2400.00 74085.16 3111.58
12c 5 Medicare wages and tips 6 Medicare tax withheld
909 CHESTNUT ST, 28K07
C
o
d
e
DD $ 15170.04 74085.16 1074.23
12d 8 Allocated tips
ST. LOUIS, MO 63101-3002 C
7 Social security tips
o
d
e
L $ 60.00
e Employee’s first name and initial Last name Suff.
12e
00200470 1 of 1 ID:10535000000000000153188048 C 9 Advance EIC payment 10 Dependent care benefits
o
d
e $
KEITH WOODS This information is being furnished to the Internal 0.00
Revenue Service. If you are required to file a tax
return, a negligence penalty or other sanction may 11 Nonqualified plans 13 Statutory Retirement
plan
Third-party
sick pay
employee
be imposed on you if this income is taxable and you
fail to report it. X
14608 S.STATE.ST.
Copy C For EMPLOYEE’S 14 Other
DOLTON, IL 60419
RECORDS. (See Notice to
Employee on back.)
a Employee’s social security number
f Employee’s address and ZIP code 341-72-4070
15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
IL 361253600 71685.16 3025.38

Form W-2 Wage and Tax Statement 2012 Department of the Treasury-Internal Revenue Service OMB # 1545-0008 Copy C for Employee's Records

673307 1A-w 1B-w


Notice to Employee
Refund. Even if you do not have to file a tax return, you should file to get a ask the employer to file Form W-2c, Corrected Wage and Tax Statement, with
refund if box 2 shows federal income tax withheld or if you can take the the Social Security Administration (SSA) to correct any name, SSN, or money
earned income credit. amount error reported to the SSA on Form W-2. If your name and SSN are
Earned income credit (EIC). You may be able to take the EIC for 2012 if (a) correct but are not the same as shown on your social security card, you
you do not have a qualifying child and you earned less than $13,980 ($19,190 if should ask for a new card that displays your correct name at any SSA office
married filing jointly), (b) you have one qualifying child and you earned less than or by calling 1-800-772-1213. You also may visit the SSA at
$36,920 ($42,130 if married filing jointly), (c) you have two qualifying children www.socialsecurity.gov.
and you earned less than $41,952 ($47,162 if married filing jointly), or (d) you Cost of employer-sponsored health coverage (if such cost is provided by
have three or more qualifying children and you earned less than $45,060 the employer). The reporting in Box 12, using Code DD, of the cost of
($50,270 if married filing jointly). You and any qualifying children must have employer-sponsored health coverage is for your information only. The amount
valid social security numbers (SSNs). You cannot take the EIC if your reported with Code DD is not taxable.
investment income is more than $3,200,or if income is earned for services
provided while you were an inmate at a penal institution.Any EIC that is more Credit for excess taxes. If you had more than one employer in 2012 and
than your tax liability is refunded to you,but only if you file a tax return. more than $4,624.20 in social security and/or Tier I railroad retirement (RRTA)
Clergy and religious workers. If you are not subject to social security and taxes were withheld, you may be able to claim a credit for the excess against
Medicare taxes, see Pub. 517, Social Security and Other Information for your federal income tax. If you had more than one railroad employer and more
Members of the Clergy and Religious Workers. than $3,192.90 in Tier II RRTA tax was withheld, you also may be able to
Corrections. If your name, SSN, or address is incorrect, correct Copies B, C, claim a credit. See your Form 1040 or Form 1040A instructions and Pub. 505,
and 2 and ask your employer to correct your employment record. Be sure to Tax Withholding and Estimated Tax

Instructions for Employee return. Elective deferrals (codes D, E, account that is part of a section 401(k) nonstatutory stock option(s) (included
Box 1. Enter this amount on the F, and S) and designated Roth arrangement. in boxes 1, 3 (up to social security
contributions (codes AA, BB, and EE) E—Elective deferrals under a section wage base), and 5). See Pub. 525 and
wages line of your tax return.
under all plans are generally limited to 403(b) salary reduction agreement instructions for Schedule D (Form
Box 2. Enter this amount on the a total of $17,000 ($11,500 if you only 1040) for reporting requirements.
F—Elective deferrals under a section
federal income tax withheld line of your have SIMPLE plans; $20,000 for 408(k)(6) salary reduction SEP W—Employer contributions (including
tax return. Box 8. This amount is not section 403(b) plans if you qualify for G—Elective deferrals and employer amounts the employee elected to
included in boxes 1, 3, 5, or 7. For the 15-year rule explained in Pub. contributions (including nonelective contribute using a section 125
information on how to report tips on 571). Deferrals under code G are deferrals) to a section 457(b) deferred (cafeteria) plan) to your health savings
limited to $17,000. Deferrals under compensation plan account. Report on Form 8889, Health
your tax return, see your Form 1040
code H are limited to $7,000. H—Elective deferrals to a section Savings Accounts (HSAs).
instructions. However, if you were at least age Y—Deferrals under a section 409A
Unless you have records that show 501(c)(18)(D) tax-exempt organization
50 in 2012, your employer may have plan. See “Adjusted Gross Income” in nonqualified deferred compensation
you did not receive the amount allowed an additional deferral of up to plan
reported in box 8 as allocated tips, you the Form 1040 instructions for how to
$5,500 ($2,500 for section 401(k)(11) deduct. Z—Income under section 409A on a
must file Form 4137, Social Security and 408(p) SIMPLE plans). This nonqualified deferred compensation
and Medicare Tax on Unreported Tip J—Nontaxable sick pay (information
additional deferral amount is not only, not included in boxes 1, 3, or 5) plan. This amount is also included in
Income, with your income tax return to subject to the overall limit on elective box 1. It is subject to an additional
report the allocated tip amount. On K—20% excise tax on excess golden
deferrals. For code G, the limit on parachute payments. See “Total Tax” 20% tax plus interest. See “Total Tax”
Form 4137 you will figure the social elective deferrals may be higher for the in the Form 1040 instructions.
security and Medicare tax owed on the in the Form 1040 instructions.
last 3 years before you reach L—Substantiated employee business AA—Designated Roth contributions
allocated tips shown on your Form(s) retirement age. Contact your plan under a section 401(k) plan
W-2 that you must report as income expense reimbursements (nontaxable)
administrator for more information. M—Uncollected social security or BB—Designated Roth contributions
and on other tips you did not report to Amounts in excess of the overall under a section 403(b) plan
your employer. By filing Form 4137, RRTA tax on taxable cost of group-
elective deferral limit must be included term life insurance over $50,000 DD—Cost of employer-sponsored
your social security tips will be credited in income. See the “Wages, Salaries, health coverage. The amount
to your social security record (used to (former employees only). See “Total
Tips, etc.” line instructions for Form Tax” in the Form 1040 instructions. reported with Code DD is not
figure your benefits). 1040. taxable.
Box 10. This amount is the total N—Uncollected Medicare tax on
Note. If a year follows code D through EE—Designated Roth contributions
dependent care benefits that your taxable cost of group-term life
H, S, Y, AA, BB, or EE, you made a insurance over $50,000 (former under a governmental section 457(b)
employer paid to you or incurred on make-up pension contribution for a plan. This amount does not apply to
your behalf (including amounts from a employees only). See “Total Tax” in
prior year(s) when you were in military the Form 1040 instructions. contributions under a tax-exempt
section 125 (cafeteria) plan). Any organization section 457(b) plan.
service. To figure whether you made P—Excludable moving expense
amount over $5,000 is also included in Box 13. If the “Retirement plan” box is
excess deferrals, consider these reimbursements paid directly to
box 1. Complete Form 2441, Child and checked, special limits may apply to
amounts for the year shown, not the employee (not included in boxes 1, 3,
Dependent Care Expenses, to the amount of traditional IRA
current year. If no year is shown, the or 5)
compute any taxable and nontaxable contributions you may deduct.
contributions are for the current year. Q—Nontaxable combat pay. See the
amounts. Note. Keep Copy C of Form W-2 for at
A—Uncollected social security or instructions for Form 1040 or Form
Box 11. This amount is (a) reported in least 3 years after the due date for
RRTA tax on tips. Include this tax on 1040A for details on reporting this
box 1 if it is a distribution made to you filing your income tax return. However,
Form 1040. See “Total Tax” in the amount.
from a nonqualified deferred to help protect your social security
Form 1040 instructions. R—Employer contributions to your
compensation or nongovernmental benefits, keep Copy C until you begin
B—Uncollected Medicare tax on tips. Archer MSA. Report on Form 8853,
section 457(b) plan or (b) included in receiving social security benefits, just
Include this tax on Form 1040. See Archer MSAs and Long-Term Care
box 3 and/or 5 if it is a prior year in case there is a question about your
“Total Tax” in the Form 1040 Insurance Contracts.
deferral under a nonqualified or work record and/or earnings in a
instructions. S—Employee salary reduction
section 457(b) plan that became particular year. Compare the Social
C—Taxable cost of group-term life contributions under a section 408(p)
taxable for social security and Security wages and the Medicare
insurance over $50,000 (included SIMPLE (not ncluded in box 1) T—
Medicare taxes this year because wages to the information shown on
there is no longer a substantial risk of in boxes 1, 3 (up to social security Adoption benefits (not included in box
wage base), and 5) D—Elective your annual (for workers over 25)
forfeiture of your right to the deferred 1). Complete Form 8839, Qualified Social Security Statement.
amount. deferrals to a section 401(k) cash or Adoption Expenses, to compute any
Box 12. The following list explains the deferred arrangement. Also includes taxable and nontaxable amounts.
codes shown in box 12. You may need deferrals under a SIMPLE retirement V—Income from exercise of
this information to complete your tax
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