W-2C Transmittal of Corrected Wage and Tax Statements

Note: The draft you are looking for begins on the next page.

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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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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 the separate instructions.
Form

W-2c

(Rev. 8-2023)

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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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—For State, City, or Local Tax Department
Form

W-2c

(Rev. 8-2023)

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

a Employer’s name, address, and ZIP code

c Tax year/Form corrected

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

/ W-2

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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. 8-2023)

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

a Employer’s name, address, and ZIP code

Visit the IRS website
at www.irs.gov/efile.

c Tax year/Form corrected

d Employee’s correct SSN

/ W-2

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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. 8-2023)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

Notice to Employee
This is a corrected Form W-2 (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 1040-X 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.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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. Attach an original or
amended Form 8959 to Form 1040 or 1040-X, as
applicable.

For more information, contact your nearest Internal
Revenue Service office. Employees in American Samoa,
the Commonwealth of the Northern Mariana Islands,
Guam, or the U.S. Virgin Islands should contact their local
taxing authority for more information.
Future developments. For the latest information about
Form W-2c and its instructions, such as legislation
enacted after we release them, go to www.irs.gov/
FormW2c.

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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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. 8-2023)

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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

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

g Employee’s previously reported name

b Employer identification number (EIN)

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).

Previously reported

Last name

i Employee’s address and ZIP code

Previously reported

Correct information

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

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)

Suff.

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. 8-2023)

Corrected Wage and Tax Statement

Department of the Treasury
Internal Revenue Service

Employers, Please Note:
Specific information needed to complete Form W-2c is
available in a separate booklet titled the General
Instructions for Forms W-2 and W-3, under Specific
Instructions for Form W-2c. You can order these
instructions and additional forms at www.irs.gov/
OrderForms.

E-filing. See the General Instructions for Forms W-2 and
W-3 for information on when you’re required to file
Form(s) W-2c electronically. Even if you are not required
to file electronically, doing so can save you time and
effort. Employers may use the SSA’s W-2c Online service
to create, save, print, and electronically submit up to 25
Form(s) W-2c at a time. 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-2c Online service.
For information, visit the SSA’s Employer W-2 Filing
Instructions & Information website at
www.SSA.gov/employer.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
May 2, 2023
DO NOT FILE

Caution: Do not send the SSA any Forms W-2c or W-3c
that you have printed from IRS.gov. The SSA is unable to
process these forms. Instead, you can create and submit
them online. See E-filing, later.
Need help? If you have questions about reporting on
Form W-2c, call the Technical Services Operation (TSO)
toll free at 866-455-7438 or 304-263-8700 (not toll free).
Deaf or hard-of-hearing customers may call any of our
toll-free numbers using their choice of relay service.

Future developments. For the latest information about
Form W-2c and its instructions, such as legislation
enacted after we release them, go to www.irs.gov/
FormW2c.