8900 Qualified Railroad Track Maintenance Credit

Caution: DRAFT FORM
This is an advance proof copy of an IRS tax form.
It is subject to change and OMB approval before it
is officially released. You can check the scheduled
release date on our web site (www.irs.gov).
If you have any comments on this draft form, you can
submit them to us on our web site. Include the word
DRAFT in your response. You may make comments
anonymously, or you may include your name and
e-mail address or phone number. We will be unable
to respond to all comments due to the high volume
we receive. However, we will carefully consider
each suggestion. So that we can properly consider
your comments, please send them to us within 30
days from the date the draft was posted.

1
TLS, have you
transmitted all R
text files for this
cycle update?

Date

I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
FORM 4137, PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄ 2 "), CENTER SIDES.
PAPER: WHITE WRITING, SUB. 20.
FLAT SIZE: 203 mm (8") 3 279 mm (11")
PERFORATE: HORIZONTALLY 4" FROM BOTTOM.

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form

4137

Action

Date

Signature

O.K. to print
Revised proofs
requested

OMB No. 1545-0074

Social Security and Medicare Tax
on Unreported Tip Income

2006

f
o
s
a
6
t
0
f
0
a
2
r
/
D /29
8
0
©

Department of the Treasury
Internal Revenue Service (99)

See instructions on back.
© Attach to Form 1040.

Attachment
Sequence No.

Name of person who received tips (as shown on Form 1040). If married, complete a separate Form 4137 for each spouse with unreported tips.

24

Social security number

Name(s) of employer(s) to whom you were required to, but did not, report your tips:

1

Total cash and charge tips you received in 2006 (see instructions)

1

2
3

Total cash and charge tips you reported to your employer in 2006
Subtract line 2 from line 1. This amount is income you must include in the total on Form 1040,
line 7
Cash and charge tips you received but did not report to your employer because the total was
less than $20 in a calendar month (see instructions)
Unreported tips subject to Medicare tax. Subtract line 4 from line 3. Enter here and on line 2
of Schedule U below
6
94,200 00
Maximum amount of wages (including tips) subject to social security tax
Total social security wages and social security tips (total of boxes 3
7
and 7 on Form(s) W-2) or railroad retirement (tier 1) compensation

2

8

Subtract line 7 from line 6. If line 7 is more than line 6, enter -0- here and on line 9 and go to line 11

8

9

Unreported tips subject to social security tax. Enter the smaller of line 5 or line 8 here and on
line 1 of Schedule U below. If you received tips as a federal, state, or local government
employee, see instructions

9

4
5
6
7

3
4
5

10

Multiply line 9 by .062

10

11

Multiply line 5 by .0145

11

12

Add lines 10 and 11. Enter the result here and on Form 1040, line 59

©

12

For Paperwork Reduction Act Notice, see instructions on back.

Form

4137

(2006)

Do Not Detach

SCHEDULE U
(Form 1040)

U.S. Schedule of Unreported Tip Income

Department of the Treasury
Internal Revenue Service

2006

For crediting to your social security record

Note: The amounts you report below are for your social security record. This record is used to figure any benefits, based on your
earnings, payable to you and your dependents or your survivors. Fill in each item accurately and completely.
Print or type name of person who received tip income (as shown on Form 1040)
Address (number, street, and apt. no., or P.O. box if mail is not delivered to your home)

Social security number
Occupation

City, town or post office, state, and ZIP code

1 Unreported tips subject to social security tax. Enter the amount from line 9 (Form 4137) above
2 Unreported tips subject to Medicare tax. Enter the amount from line 5 (Form 4137) above

©
©

1
2

Please do not write in this space

DLN—
Cat. No. 12626C

Schedule U (Form 1040) 2006