Form W-2C Corrected Wage and Tax Statement

Wage and Tax Statements W-2/W-3 series

W-2c

Wage and Tax Statements W-2/W-3 series

OMB: 1545-0008

⚠️ Notice: This form may be outdated. More recent filings and information on OMB 1545-0008 can be found here:

Document [pdf]

Download: pdf | pdf

Attention:
This form is provided for informational purposes only. Copy A
appears in red, similar to the official printed IRS form. But do
not file Copy A downloaded from this website with the SSA. A
penalty of $50 per information return may be imposed for filing
such forms that cannot be scanned.
To order official IRS forms, call 1-800-TAX-FORMS (1-800-8293676) or order online at Forms and Publications By U.S. Mail.
You may file Forms W-2 and W-3 electronically on the SSA’s
website at Employer Reporting Instructions & Information.
You can create fill-in versions of Forms W-2 and W-3 for filing
with the SSA. You may also print out copies for filing with state
or local governments, distribution to your employees, and for your
records.

W-2 / W-3 Cover page

3
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 FW-2c, PAGE 1 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK & OCR Red
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Separation 1: Black

Action

Date

Signature

O.K. to print
Revised proofs
requested

Separation 2: Red

DO NOT CUT, FOLD, OR STAPLE THIS FORM
a Tax year/Form corrected

For Official Use Only

44444

/ W-2

䊳

OMB No. 1545-0008
c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Copy A—For Social Security Administration
Cat. No. 61437D

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 3 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

a Tax year/Form corrected

OMB No. 1545-0008

44444

/ W-2

c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

Copy 1—State, City, or Local Tax Department
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 5 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

a Tax year/Form corrected

OMB No. 1545-0008

Safe, accurate,
FAST! Use

/ W-2
c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

Visit the IRS website
at www.irs.gov.

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

Copy B—To Be Filed with Employee’s FEDERAL Tax Return
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 7 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

a Tax year/Form corrected

OMB No. 1545-0008

Safe, accurate,
FAST! Use

/ W-2
c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

Visit the IRS website
at www.irs.gov.

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

Copy C—For EMPLOYEE’s RECORDS
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 8 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Notice to Employee
This is a corrected Form W-2, Wage and Tax Statement,
(or Form W-2AS, W-2CM, W-2GU, W-2VI or W-2c) for
the tax year shown in box a. If you have filed an income
tax return for the year shown, you may have to file an
amended return. Compare amounts on this form with
those reported on your income tax return. If the
corrected amounts change your U.S. income tax, file
Form 1040X, Amended U.S. Individual Income Tax
Return, with Copy B of this Form W-2c to amend the
return you already filed.

If you have not filed your return for the year shown in
box a, attach Copy B of the original Form W-2 you
received from your employer and Copy B of this Form
W-2c to your return when you file it.
For more information, contact your nearest Internal
Revenue Service office. Employees in American Samoa,
Commonwealth of the Northern Mariana Islands, Guam,
or the U.S. Virgin Islands should contact their local
taxing authority for more information.

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 9 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

a Tax year/Form corrected

OMB No. 1545-0008

/ W-2
c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

Copy 2—To Be Filed with Employee’s State, City, or Local Income Tax Return
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 11 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

a Tax year/Form corrected

OMB No. 1545-0008

/ W-2
c Corrected SSN and/or
name (if checked, enter
incorrect SSN and/or name
in box h and/or box i)

b Employee’s correct SSN

e Employee’s first name and initial

Last name

d Employer’s Federal EIN

g Employer’s name, address, and ZIP code

Suff.

f Employee’s address and ZIP code

Complete boxes h and/or i only
if incorrect on last form filed. 䊳

h Employee’s incorrect SSN

Employee’s name (as incorrectly shown on previous form)

Note: Only complete money fields that are being corrected (except MQGE).
Previously reported

Correct information

Previously reported

Correct information

Wages, tips, other compensation

Federal income tax withheld

Social security wages

Social security tax withheld

Medicare wages and tips

Medicare tax withheld

Social security tips

Allocated tips

Advance EIC payment

Nonqualified plans

12a See instructions for box 12

C
o
d
e

12b

C
o
d
e

12c

C
o
d
e

12d

C
o
d
e

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11
Third-party
sick pay

14 Other (see instructions)

Retirement
plan

Third-party
sick pay

Other (see instructions)

State Correction Information
Previously reported

Previously reported
15 State

Statutory
employee

Dependent care benefits

Correct information

Correct information
15 State

Employer’s state ID number

15 State

Employer’s state ID number

Dependent care benefits

15 State

Employer’s state ID number

16 State wages, tips, etc.

State wages, tips, etc.

17 State income tax

State income tax

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Locality Correction Information

Copy D—For Employer
Form

W-2c

(Rev. 1-2006)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

3
I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM FW-2c, PAGE 12 OF 12
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20.
INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Employers, Please Note:
Specific information needed to complete Form W-2c is
given in the separate Instructions for Forms W-2c and
W-3c. 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.

File Type	application/pdf
File Title	Form W-2c (Rev. January 2006)
Subject	Corrected Wage and Tax Statement
Author	SE:W:CAR:MP
File Modified	2006-02-01
File Created	2006-02-01