W-2C Corrected Wage and Tax Statement

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

fw-2_c--2014-08-00

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

OMB: 1545-0008

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Download: pdf | pdf
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.

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

44444

▶

OMB No. 1545-0008

a Employer’s name, address, and ZIP code

c Tax year/Form corrected

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

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

Last name

Suff.

i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Correct information
15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

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

W-2c

(Rev. 8-2014)

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

▶

OMB No. 1545-0008

a Employer’s name, address, and ZIP code

c Tax year/Form corrected

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

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

Last name

Suff.

i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Correct information
15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

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

W-2c

(Rev. 8-2014)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

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

Last name

Suff.

i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Correct information
15 State

Employer’s state ID number

Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

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

W-2c

(Rev. 8-2014)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

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

Last name

Suff.

i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Employer’s state ID number

Correct information
15 State
Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

Copy C—For EMPLOYEE’s RECORDS
Form

W-2c

(Rev. 8-2014)

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 there is a correction in box 5, Medicare wages and
tips, use the corrected amount to determine if you need
to file or amend Form 8959, Additional Medicare Tax. If
you need to file Form 8959 or an amended Form 8959,
attach it to Form 1040 or Form 1040X, as applicable.

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

▶

OMB No. 1545-0008

a Employer’s name, address, and ZIP code

c Tax year/Form corrected

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

Last name

Suff.

Note. Only complete money fields that are being corrected (exception: for
corrections involving MQGE, see the General Instructions for W-2 and W-3,
under Specific Instructions for Form W-2c, boxes 5 and 6).
i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Employer’s state ID number

Correct information
15 State
Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

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

W-2c

(Rev. 8-2014)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

For Official Use Only

44444

▶

OMB No. 1545-0008

a Employer’s name, address, and ZIP code

c Tax year/Form corrected

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

▶

f Employee’s previously reported SSN
b Employer's Federal EIN

g Employee’s previously reported name
h Employee’s first name and initial

Last name

Suff.

Note. Only complete money fields that are being corrected (exception: for
corrections involving MQGE, see the General Instructions for W-2 and W-3,
under Specific Instructions for Form W-2c, boxes 5 and 6).
i Employee’s address and ZIP code

Previously reported

Correct information

1 Wages, tips, other compensation

1 Wages, tips, other compensation

2 Federal income tax withheld

2 Federal income tax withheld

3 Social security wages

3 Social security wages

4 Social security tax withheld

4 Social security tax withheld

5 Medicare wages and tips

5 Medicare wages and tips

6 Medicare tax withheld

6 Medicare tax withheld

7 Social security tips

7 Social security tips

8 Allocated tips

8 Allocated tips

9

9

11 Nonqualified plans
13

Statutory
employee

Retirement
plan

11 Nonqualified plans
Third-party
sick pay

14 Other (see instructions)

13

Statutory
employee

Retirement
plan

Previously reported

10 Dependent care benefits

10 Dependent care benefits

12a See instructions for box 12

12a See instructions for box 12

12b

12b

12c

12c

12d

12d

C
o
d
e

Third-party
sick pay

14 Other (see instructions)

Correct information

C
o
d
e

C
o
d
e
C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

C
o
d
e

State Correction Information
Previously reported
15 State

Correct information
15 State

Employer’s state ID number

Previously reported
15 State

Employer’s state ID number

Employer’s state ID number

Correct information
15 State
Employer’s state ID number

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

16 State wages, tips, etc.

17 State income tax

17 State income tax

17 State income tax

17 State income tax

Locality Correction Information
Previously reported

Correct information

Previously reported

Correct information

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

18 Local wages, tips, etc.

19 Local income tax

19 Local income tax

19 Local income tax

19 Local income tax

20 Locality name

20 Locality name

20 Locality name

20 Locality name

Copy D—For Employer
Form

W-2c

(Rev. 8-2014)

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 General Instructions for Forms W-2
and W-3, under Specific Instructions for Form W-2c. 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.

E-filing. If you file 250 or more Form(s) W-2c, you must
file electronically. Even if you are not required to file
electronically, doing so can save you time and effort.
Employers may now use the SSA's W-2 Online service to
create, save, print and submit up to 50 Form(s) W-2c at a
time over the Internet. When you e-file with the SSA, no
separate Form W-3c filing is required. An electronic Form
W-3c will be created for you by the W-2 Online service.
For information, visit the SSA's Employer W-2 Filing
Instructions & Information website at
www.socialsecurity.gov/employer.


File Typeapplication/pdf
File TitleForm W-2c (Rev. August 2014)
SubjectCorrected Wage and Tax Statement
AuthorSE:W:CAR:MP
File Modified2014-10-20
File Created2014-10-20

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