
Instructions for Employee
(See also Notice to Employee on the back of Copy B.)
Box 1. Enter this amount on the wages line of your tax return unless those
instructions direct you to report it elsewhere.
Box 2. Enter this amount on the federal income tax withheld line of your tax
return.
Box 5. You may be required to report this amount on Form 8959. See the
Form 1040 instructions to determine if you are required to complete Form
8959.
Box 6. This amount includes the 1.45% Medicare tax withheld on all
Medicare wages and tips shown in box 5, as well as the 0.9% Additional
Medicare Tax on any of those Medicare wages and tips above $200,000.
Box 8. This amount is not included in box 1, 3, 5, or 7. For information on
how to report tips on your tax return, see the Form 1040 instructions.
You must file Form 4137 with your income tax return to report at least the
allocated tip amount unless you can prove with adequate records that you
received a smaller amount. If you have records that show the actual amount
of tips you received, report that amount even if it is more or less than the
allocated tips. Use Form 4137 to figure the social security and Medicare tax
owed on tips you didn’t report to your employer. Enter this amount on the
wages line of your tax return. By filing Form 4137, your social security tips
will be credited to your social security record (used to figure your benefits).
Box 10. This amount includes the total dependent care benefits that your
employer paid to you or incurred on your behalf (including amounts from a
section 125 (cafeteria) plan). Any amount over your employer’s plan limit is
also included in box 1. See Form 2441.
Box 11. This amount is (a) reported in box 1 if it is a distribution made to you
from a nonqualified deferred compensation or nongovernmental section
457(b) plan, or (b) included in box 3 and/or box 5 if it is a prior year deferral
under a nonqualified or section 457(b) plan that became taxable for social
security and Medicare taxes this year because there is no longer a
substantial risk of forfeiture of your right to the deferred amount. This box
shouldn’t be used if you had a deferral and a distribution in the same
calendar year. If you made a deferral and received a distribution in the same
calendar year, and you are or will be age 62 by the end of the calendar year,
your employer should file Form SSA-131, Employer Report of Special Wage
Payments, with the Social Security Administration and give you a copy.
Box 12. The following list explains the codes shown in box 12. You may
need this information to complete your tax return. Elective deferrals (codes
D, E, F, and S) and designated Roth contributions (codes AA, BB, and EE)
under all plans are generally limited to a total of $24,500 (generally, $17,000
for SIMPLE plans; $27,500 for section 403(b) plans if you qualify for the
15-year rule explained in Pub. 571). Deferrals under code G are limited to
$24,500. Deferrals under code H are limited to $7,000.
However, if you were at least age 50 in 2026, your employer may have
allowed an additional elective deferral or designated Roth contribution
(catch-up contribution) to your plan. For information about the limits on these
catch-up contributions, including the higher limit if you were age 60 through
63 as of December 31, 2026, see Pub. 525. Contact your plan administrator
for more information. Amounts in excess of the overall elective deferral limit
must be included in income. See the Form 1040 instructions.
Note: If a year follows code D through H, S, Y, AA, BB, or EE, you made a
make-up pension contribution for a prior year(s) when you were in military
service. To figure whether you made excess deferrals, consider these
amounts for the year shown, not the current year. If no year is shown, the
contributions are for the current year.
A—Uncollected social security or RRTA tax on tips. Include this tax on Form
1040 or 1040-SR. See the Form 1040 instructions.
B—Uncollected Medicare tax on tips. Include this tax on Form 1040 or
1040-SR. See the Form 1040 instructions.
C—Taxable cost of group-term life insurance over $50,000 (included in
boxes 1, 3 (up to the social security wage base), and 5).
D—Elective deferrals to a section 401(k) cash or deferred arrangement. Also
includes deferrals under a SIMPLE retirement account that is part of a
section 401(k) arrangement.
E—Elective deferrals under a section 403(b) salary reduction agreement.
F—Elective deferrals under a section 408(k)(6) salary reduction SEP. (This
includes elective deferrals made to a Roth SEP IRA.)
G—Elective deferrals and employer contributions (including nonelective
deferrals) to a section 457(b) deferred compensation plan.
H—Elective deferrals to a section 501(c)(18)(D) tax-exempt organization plan.
See the Form 1040 instructions for how to deduct.
J—Nontaxable sick pay (information only, not included in box 1, 3, or 5).
K—20% excise tax on excess golden parachute payments. See the Form
1040 instructions.
L—Substantiated employee business expense reimbursements (nontaxable).
(continued on back of Copy 2)