Form W-2 Wage and Tax Statement 2009 Form W-2 Wage and Tax - PDF by xld14276

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									c Employer’s Name, Address, and ZIP Code
                                                                                                            Form W-2 Wage and Tax Statement
                                                                                                            COPY B To Be Filed with Employee’s FEDERAL Tax Return
                                                                                                                                                                       2009
                   120 University Services Building, Ste. 30                                                1 Wages, Tips, Other Comp.                      2 Federal Income Tax Withheld
                   Iowa City, Iowa 52242-1911

                   Human Resources - Payroll Office
                   PHONE: 319-335-2381                                a Employee’s Social Security Number   3 Social Security Wages                       4 Social Security Tax Withheld
                   FAX: 319-353-2234
                   EMAIL: payroll-web@uiowa.edu                       b Employer’s ID Number (EIN)          5 Medicare Wages                              6 Medicare Tax Withheld
                                                                           4     42-6004813
e Employee’s First Name and Initial            Last Name              13 Retirement Plan                    9 Advance EIC Payment                         10 Dependent Care Benefits




                                                                                                                                        y
                                                                      14 Other                              12 Taxable Benefits Included in Boxes 1, 3, and 5 (see instructions on back)




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                                                                                                            15 St Employer St ID           16 State Wages                    17 State Income Tax
f Employee’s Address and ZIP code
This information is being furnished to the internal Revenue Service                                                                                         Department of the Treasury - Internal Revenue Service




c Employer’s Name, Address, and ZIP Code



                   120 University Services Building, Ste. 30
                   Iowa City, Iowa 52242-1911

                   Human Resources - Payroll Office
                   PHONE: 319-335-2381
                   FAX: 319-353-2234
                   EMAIL: payroll-web@uiowa.edu
                                                                      eO
                                                                      a Employee’s Social Security Number


                                                                      b Employer’s ID Number (EIN)
                                                                                                            Form W-2 Wage and Tax Statement                            2009
                                                                                                            COPY 2 To Be Filed with Employee’s State, City, or Local Income Tax Return
                                                                                                            1 Wages, Tips, Other Comp.



                                                                                                            3 Social Security Wages


                                                                                                            5 Medicare Wages
                                                                                                                                                            2 Federal Income Tax Withheld



                                                                                                                                                          4 Social Security Tax Withheld


                                                                                                                                                          6 Medicare Tax Withheld
                                                                           4 42-6004813
                                               pl
e Employee’s First Name and Initial            Last Name              13 Retirement Plan                    9 Advance EIC Payment                         10 Dependent Care Benefits


                                                                      14 Other                              12 Taxable Benefits Included in Boxes 1, 3, and 5 (see instructions on back)
                   m

                                                                                                            15 St Employer St ID           16 State Wages                    17 State Income Tax
f Employee’s Address and ZIP code
This information is being furnished to the internal Revenue Service                                                                                         Department of the Treasury - Internal Revenue Service
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c Employer’s Name, Address, and ZIP Code
                                                                                                            Form W-2 Wage and Tax Statement
                                                                                                            COPY C for Employee’s Records
                                                                                                                                                                       2009
                   120 University Services Building, Ste. 30                                                1 Wages, Tips, Other Comp.                      2 Federal Income Tax Withheld
                   Iowa City, Iowa 52242-1911

                   Human Resources - Payroll Office
                   PHONE: 319-335-2381                                a Employee’s Social Security Number   3 Social Security Wages                       4 Social Security Tax Withheld
                   FAX: 319-353-2234
                   EMAIL: payroll-web@uiowa.edu                       b Employer’s ID Number (EIN)          5 Medicare Wages                              6 Medicare Tax Withheld
                                                                           4 42-6004813
e Employee’s First Name and Initial            Last Name              13 Retirement Plan                    9 Advance EIC Payment                         10 Dependent Care Benefits


                                                                      14 Other                              12 Taxable Benefits Included in Boxes 1, 3, and 5 (see instructions on back)




                                                                                                            15 St Employer St ID           16 State Wages                    17 State Income Tax
f Employee’s Address and ZIP code
This information is being furnished to the internal Revenue Service                                                                                         Department of the Treasury - Internal Revenue Service
                                                                                                                                                                y
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Notice to Employee:                                                                                                      C	–	Cost	of	group-term	life	insurance	coverage	over	$50,000

	       File	Copy	B	of	this	form	with	your	2009	Federal	income	tax	return.		Attach	Copy	2	to	your	state	or	local	        E—Elective	deferrals	under	Section	403(b)	Salary	Reduction	Agreement
return.		Keep	Copy	C	for	your	records.		If	your	name,	social	security	number,	or	address	is	incorrect,	correct		
Copies	B,	C,	and	2	and	tell	your	employer.	If	you	already	filed	a	return	and	the	information	from	this	W-2	was	not	          U
                                                                                                                         M	–		 ncollected	social	security	tax	on	cost	of	group-term	life	insurance	coverage	over		
included,	or	if	you	receive	a	Corrected	W-2	or	Form	W-2C,	amend	your	tax	return	by	filling	form	1040X.                       $50,000	(former	employees	only)

	       Refund	–	Even	if	you	do	not	have	to	file	a	tax	return,	you	should	file	to	get	a	refund	if	box	2	shows	Federal	       U
                                                                                                                         N	–		 ncollected	Medicare	tax	on	cost	of	group-term	life	insurance	coverage	over		
income	tax	withheld,	or	if	you	can	take	the	earned	income	credit.                                                            $50,000	(former	employees	only)
	
	       Earned income credit (EIC).	You	must	file	a	tax	return	if	any	amount	is	shown	in	box	9.		You	may	be	             P	–	Excludable	moving	expense	reimbursements	paid	directly	to	employee	(not	included	in	box	1,	3,	or	5)
able	to	take	the	EIC	for	2009	if	(a)	you	do	not	have	a	qualifying	child	and	you	earned	less	than	$13,440	($16,560	
if	married	filing	jointly),	(b)	you	have	one	qualifying	child	and	you	earned	less	than	$35,463	($38,583	if	married	      BB	-	Designated	Roth	contribution	under	section	403(b)	plan
filing	jointly),	or	(c)	you	have	more	than	one	qualifying	child	and	you	earned	less	than	$40,295	($43,415	if	
married	filing	jointly).	You	and	any	qualifying	children	must	have	valid	social	security	numbers	(SSNs).	You		           For	items	M	and	N,	see	your	Form	1040	instructions	for	how	to	pay	this	tax.
cannot	take	the	EIC	if	your	investment	income	is	more	than	$3,100.	Any EIC that is more than your tax
liability is refunded to you, but only if you file a tax return.	If	you	have	at	least	one	qualifying	child,	you	may	     Box 13 --		If	the	Retirement	Plan	coverage	says	YES,	special	limits	may	apply	to	the	amount	of	IRA	contributions	
get	as	much	as	$1,826	of	the	EIC	in	advance	by	completing	Form W-5,	Earned	Income	Credit	Advance	Payment	                you	may	deduct	on	your	return.		See	the	instructions	for	Forms	1040	and	1040A.
Certificate,	and	giving	it	to	your	employer.
                                                                                                                         Box 14 --		These	amounts	have	already	been	included	as	wages	in	box	1.		Do	not	add	these	amounts	to	box	1.		You	
	     Credit for Social Security Tax	–	If	more	than	one	employer	paid	you	wages	during	2009	and	more	than	               may	be	able	to	deduct	expenses	that	are	related	to	fringe	benefits;	see	the	instructions	for	your	income	tax	return.
the	maximum	social	security	tax,	or	railroad	retirement	(RRTA)	tax,	or	a	combination	of	these	taxes	was	withheld,	
you	may	claim	the	excess	as	a	credit	against	your	Federal	Income	tax.		See	your	income	tax	return	instructions.          Note	–	Keep	Copy	C	of	Form	W-2	for	at	least	3	years	after	the	due	date	for	filing	your	income	tax	return.		
                                                                                                                         However,	to	help	protect	your	social	security	benefits,	keep	Copy	C	until	you	begin	receiving	social	security	
Box 9 --	Enter	this	amount	on	the	advance	earned	income	credit	payments	line	of	your	Form	1040	and	1040A.                benefits,	just	in	case	there	is	a	question	about	your	work	record	and/or	earnings	in	a	particular	year.		Review		
                                                                                                                         the	information	shown	on	your	annual	(for	workers	over	25)	Social	Security	Statement.
Box 10 --		The	amount	in	this	box	is	the	total	amount	of	dependent	care	benefits	your	employer	paid	to	you	(or	
incurred	on	your	behalf).		Part	or	all	of	this	amount	may	be	taxable	unless	you	complete	Schedule	2	of	Form	             Note	–	If	you	are	required	to	file	a	tax	return,	you	may	be	assessed	a	negligence	penalty	or	other	sanctions	if	this	
1040A	or	Form	2441.		See	the	instructions	for	Forms	1040	and	1040A.                                                      income	is	taxable	and	you	fail	to	report	it.

Box 12 --		The	following	list	explains	the	codes	shown	in	box	12.	You	may	need	this	information	to	complete	your	
tax	return.	The	codes	are	as	follows:

								
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