W-2C Corrected Wage and Tax Statement

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

W-2 C

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⚠️ Notice: This form may be outdated.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:

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Attention:
This form is provided for informational purposes only. Copy A appears in red, similar to the
official IRS form. Do not file copy A downloaded from this website with the SSA. The official
printed version of this IRS form is scannable, but the online version of it, printed from this
website, is not. A penalty may be imposed for filing forms that can’t be scanned. See the
penalties section in the current General Instructions for Forms W-2 and W-3 for more
information.
To order official IRS forms, call 1-800-TAX-FORM (1-800-829-3676) or Order Information
Returns and Employer Returns Online, and we’ll mail you the scannable forms and other
products.
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 SSA. You may also print out copies for filing with state or local governments,
distribution to your employees, and for your records.
See IRS Publications 1141, 1167, 1179 and other IRS resources for information about
printing these tax forms.

Comp Specialist: This form needs to have a 2/3" head margin when the PDF is cropped.

DO NOT CUT, FOLD, OR STAPLE THIS FORM
For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructions
for Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
Correct information

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

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

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

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

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

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

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

Safe, accurate,
FAST! Use

OMB No. 1545-0008

c Tax year/Form corrected

a Employer’s name, address, and ZIP code

Visit the IRS website
at www.irs.gov.
d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

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

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

Safe, accurate,
FAST! Use

OMB No. 1545-0008

Visit the IRS website
at www.irs.gov.

c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Copy C—For EMPLOYEE’s RECORDS
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

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 c. 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 c, 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.

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

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

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

䊳

OMB No. 1545-0008
c Tax year/Form corrected

a Employer’s name, address, and ZIP code

d Employee’s correct SSN

/ W-2
e Corrected SSN and/or name (Check this box and complete boxes f and/or

g if incorrect on form previously filed.)
Complete boxes f and/or g only if incorrect on form previously filed

䊳

f Employee’s previously reported SSN

g Employee’s previously reported name

b Employer’s Federal EIN

h Employee’s first name and initial

Last name

Suff.

Employee’s address and ZIP code

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

Locality Correction Information
Previously reported

Previously reported

Correct information

18 Local wages, tips, etc.

Local wages, tips, etc.

19 Local income tax

Local income tax

20 Locality name

Locality name

Copy D—For Employer
Form

W-2c

(Rev. 2-2009)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

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. Electronic filing of Form W-2c is
preferred. For information on how to file electronically,
go to the Social Security Administration website at
www.socialsecurity.gov/employer.

File Type	application/pdf
File Title	Form W-2c (Rev. February 2009)
Subject	Corrected Wage and Tax Statement
Author	SE:W:CAR:MP
File Modified	2013-09-04
File Created	2009-03-19