US Internal Revenue Service: fw2--2001

8/14/2019 US Internal Revenue Service: fw2--2001

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For Privacy Act and Paperwork ReduAct Notice, see separate instruct

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Control number

Retirementplan

Third-partysick pay

Statutoryemployee

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Employers name, address, and ZIP code

Allocated t ips7

Advance EIC payment

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Wages, tips, other compensation Federal income tax withheld

Social security tax withheldSocial security wages

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Employers state ID number

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Employer identification number

Medicare wages and tips

Social security tips

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Employees social security number

Employees first name and initial Nonqualified plans

Medicare tax withheld

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Other

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Employees address and ZIP code

State income taxState State wages, tips, etc. Locality na

opy A For Social Security AdministrationSend this entireage with Form W-3 to the Social Security Administration;hotocopies are not acceptable.

Department of the TreasuryInternal Revenue S

Do Not Cut, Fold, or Staple Forms on This Page Do Not Cut, Fold, or Staple Forms on This Page

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Dependent care benefits

See instructions for box 12

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W-2Wage and TaxStatement 2

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19Local wages, tips, etc. 20Local income tax

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Allocated t ips7

Advance EIC payment

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opy 1 For State, City, or Local Tax Department


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opy B To Be Filed with Employees FEDERAL Tax Return.his information is being furnished to the Internal Revenue Service.


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OMB No. 1545-0008

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Safe, accurate,

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Visit the IRS Web Site

at www.irs.gov.


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Notice to Employee

efund. Even if you do not have to file a tax return, youhould file to get a refund if box 2 shows Federal incomeax withheld, or if you can take the earned income credit.

arned income credit (EIC). You must file a tax return ifny amount is shown in box 9.

You may be able to take the EIC for 2001 if (a) you do notave a qualifying child and you earned less than $10,710,b) you have one qualifying child and you earned less than28,281, or (c) you have more than one qualifying child andou earned less than $32,121. You and any qualifyinghildren must have valid social security numbers (SSNs).ou cannot claim the EIC if your investment income is morean $2,450. Any EIC that is more than your tax liability is

efunded to you, but only if you file a tax return. If youave at least one qualifying child, you may get as much as1,457 of the EIC in advance by completing Form W-5,arned Income Credit Advance Payment Certificate.

Corrections. If your name, SSN, or address is incorrect,correct Copies B, C, and 2 and ask your employer to coryour employment record. Be sure to ask the employer to Form W-2c, Corrected Wage and Tax Statement, with thSocial Security Administration (SSA) to correct any nameSSN, or money amount error reported to the SSA on ForW-2. If your name and SSN are correct but are not the saas shown on your social security card, you should ask fonew card at any SSA office or call 1-800-772-1213.

Credit for excess taxes. If you had more than one

employer in 2001 and more than $4,984.80 in social secuand/or Tier 1 railroad retirement (RRTA) taxes were withheyou may be able to claim a credit for the excess againstyour Federal income tax. If you had more than one railroaemployer and more than $2,925.30 in Tier 2 RRTA tax wawithheld, you also may be able to claim a credit. See youForm 1040 or 1040A instructions and Pub. 505, TaxWithholding and Estimated Tax.

lergy and religious workers. If you are not subject toocial security and Medicare taxes, see Pub. 517, Socialecurity and Other Information for Members of the Clergynd Religious Workers.

(Also see Instructions on back of Copy


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Control number

Retirementplan

Third-partysick pay

Statutoryemployee

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Allocated t ips7

Advance EIC payment

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12a11


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opy C For EMPLOYEES RECORDS. (See Notice tomployee on back of Copy B).


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OMB No. 1545-0008

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This information is being furnished to the Internal Revenue Service. If youare required to file a tax return, a negligence penalty or other sanction mabe imposed on you if this income is taxable and you fail to report it.

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FAST! Use


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ox 12. The following list explains the codes shown in box 12. You may needs information to complete your tax return.

Box 13. If the Retirement plan box is checked, special limits may apply toamount of traditional IRA contributions you may deduct. Also, the electivedeferrals in box 12 (codes D, E, F, G, H, and S) (for all employers, and for al

such plans to which you belong) are generally limited to $10,500. Electivedeferrals for section 403(b) contracts are limited to $10,500 ($13,500 in somcases; see Pub. 571). The limit for section 457(b) plans is $8,500. Amounts othese limits must be included in income. See Wages, Salaries, Tips, etc. inForm 1040 instructions.

ox 11. This amount is (a) reported in box 1 if it is a distribution made to youom a nonqualified deferred compensation or section 457 plan or (b) included inox 3 and/or 5 if it is a prior year deferral under a nonqualified or section 457an that became taxable for social security and Medicare taxes this yearecause there is no longer a substantial risk of forfeiture of your right to theeferred amount.

ox 8. This amount is not included in boxes 1, 3, 5, or 7. For information onow to report tips on your tax return, see your Form 1040 instructions.

ox 9. Enter this amount on the advance earned income credit payments line ofour Form 1040 or 1040A.

ox 2. Enter this amount on the Federal income tax withheld line of your taxturn.

Elective deferrals to a section 401(k) cash or deferred arrangement. Alsocludes deferrals under a SIMPLE retirement account that is part of a section01(k) arrangement.

Elective deferrals under a section 403(b) salary reduction agreement

Elective deferrals under a section 408(k)(6) salary reduction SEP

GElective deferrals and employer contributions (including nonelective defeto a section 457(b) deferred compensation plan

HElective deferrals to a section 501(c)(18)(D) tax-exempt organization planAdjusted Gross Income in the Form 1040 instructions for how to deduct)

JNontaxable sick pay (not included in boxes 1, 3, or 5)

K20% excise tax on excess golden parachute payments (see Total Taxthe Form 1040 instructions)

LSubstantiated employee business expense reimbursements (nontaxable)

MUncollected social security or RRTA tax on cost of group-term life insuraover $50,000 (former employees only) (see Total Tax in the Form 1040instructions)

NUncollected Medicare tax on cost of group-term life insurance over $50,

(former employees only) (see Total Tax in the Form 1040 instructions)

ox 1. Enter this amount on the wages line of your tax return.

ox 10. This amount is the total dependent care benefits your employer paid toou or incurred on your behalf (including amounts from a section 125 (cafeteria)an). Any amount over $5,000 also is included in box 1. You must completechedule 2 (Form 1040A) or Form 2441, Child and Dependent Care Expenses,compute any taxable and nontaxable amounts.

Uncollected social security or RRTA tax on tips (Include this tax on Form040. See Total Tax in the Form 1040 instructions.)

Cost of group-term life insurance over $50,000 (included inoxes 1, 3 (up to social security wage base), and 5)

PExcludable moving expense reimbursements paid directly to employee (nincluded in boxes 1, 3, or 5)

QMilitary employee basic housing, subsistence, and combat zonecompensation (use this amount if you qualify for EIC)

Note: Keep Copy C of Form W-2 for at least 3 years after the due date for fiyour income tax return. However, to helpprotect your social security benekeep Copy C until you begin receiving social security benefits, just in case this a question about your work record and/or earnings in a particular year. Rethe information shown on your annual (for workers over 25) Social SecurityStatement.

nstructions (Also see Notice to Employee on back of Copy B.)

Uncollected Medicare tax on tips (Include this tax on Form 1040. See Totalax in the Form 1040 instructions.)

REmployer contributions to your medical savings account (MSA) (see Form8853, Medical Savings Accounts and Long-Term Care Insurance Contracts)

SEmployee salary reduction contributions under a section 408(p) SIMPLE included in box 1)

TAdoption benefits (not included in box 1). You must complete Form 883Qualified Adoption Expenses, to compute any taxable and nontaxable amou

ote: If a year follows code D, E, F, G, H, or S, you made a make-up pensionontribution for a prior year(s) when you were in military service. To figurehether you made excess deferrals, consider these amounts for the year shown,ot the current year. If no year is shown, the contributions are for the currentear.

VIncome from exercise of nonstatutory stock option(s) (included in boxes (up to social security wage base), and 5)


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Control number

Retirementplan

Third-partysick pay

Statutoryemployee

6

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Allocated t ips7

Advance EIC payment

8

109



12a11


43




13

5




5

14

1716

Other

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opy 2 To Be Filed With Employees State, City, or Localcome Tax Return.


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opy D For Employer.


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For Privacy Act and Paperwork ReductionAct Notice, see separate instructions.

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Employers, Please Note

pecific information needed to complete FormW-2 is given in a separate booklet titled 2001nstructions for Forms W-2 and W-3. You canrder those instructions and additional forms byalling 1-800-TAX-FORM (1-800-829-3676). Youan also get forms and instructions from the IRS

Web Site at www.irs.gov.

Due dates. Furnish Copies B, C, and 2 to theemployee generally by January 31, 2002.

File Copy A with the SSA generally by Februa28, 2002. Send all Copies A with Form W-3,Transmittal of Wage and Tax Statements.However, if you file electronically (not by magne

media), the due date is April 1, 2002.Caution: Because the SSA processes paper forms

y machine, you cannot file with the SSA FormsW-2 and W-3 that you print from the IRS Web Site.

Documents

US Internal Revenue Service: fw2--2001