Attention: 

This form is provided for informational purposes only. Copy A 

appears in red, similar to the official printed IRS form. But do 

not file Copy A downloaded from this website with the SSA. A 

penalty of $50 per information return may be imposed for filing 

such forms that cannot be scanned. 

To order official IRS forms, call 1-800-TAX-FORMS (1-800-829-

3676) or order online at Forms and Publications By U.S. Mail. 

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 the SSA. You may also print out copies for filing with state 

or local governments, distribution to your employees, and for your 

records. 

W-2 / W-3 Cover page 
Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

Copy A—For Social Security Administration

Department of the Treasury

Internal Revenue Service Form Cat. No. 61437D

a

b

W-2c Corrected Wage and Tax Statement

44444 OMB No. 1545-0008

For Official Use Only 

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

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

(Rev. 1-2006)

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

DO NOT CUT, FOLD, OR STAPLE THIS FORM

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

Suff.
Copy 1—State, City, or Local Tax Department

Department of the Treasury

Internal Revenue Service Form W-2c (Rev. 1-2006) Corrected Wage and Tax Statement

Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

a

b

44444 OMB No. 1545-0008

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

Suff.
Safe, accurate,

FAST! Use

Visit the IRS website

at www.irs.gov.

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

Department of the Treasury

Internal Revenue Service Form W-2c (Rev. 1-2006) Corrected Wage and Tax Statement

Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

a

b

OMB No. 1545-0008

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

Suff.
Safe, accurate,

FAST! Use

Visit the IRS website

at www.irs.gov.

Copy C—For EMPLOYEE’s RECORDS

Department of the Treasury

Internal Revenue Service Form W-2c (Rev. 1-2006) Corrected Wage and Tax Statement

Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

a

b

OMB No. 1545-0008

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

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

Department of the Treasury

Internal Revenue Service Form W-2c (Rev. 1-2006) Corrected Wage and Tax Statement

Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

a

b

OMB No. 1545-0008

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

Suff.
Copy D—For Employer

Department of the Treasury

Internal Revenue Service Form W-2c (Rev. 1-2006) Corrected Wage and Tax Statement

Tax year/Form corrected

Retirement

plan

Third-party

sick pay

Statutory

employee

Employee’s first name and initial

13

Employee’s correct SSN

a

b

OMB No. 1545-0008

/ W-2

1

6

2

7 8 Allocated tips

Wages, tips, other compensation Federal income tax withheld

3 Social security wages 4 Social security tax withheld

Medicare wages and tips

Social security tips

5 Medicare tax withheld

g Employer’s name, address, and ZIP code

d Employer’s Federal EIN

i Employee’s name (as incorrectly shown on previous form)

Retirement

plan

Third-party

sick pay

Statutory

employee

Previously reported Correct information Previously reported Correct information

Complete boxes h and/or i only

if incorrect on last form filed.

1

7

Wages, tips, other compensation

3 Social security wages

Medicare wages and tips

Social security tips

5 6

2

8 Allocated tips

Federal income tax withheld

4 Social security tax withheld

Medicare tax withheld

13

Note: Only complete money fields that are being corrected (except MQGE).

h Employee’s incorrect SSN

9 Advance EIC payment 9 Advance EIC payment Dependent care benefits 10 Dependent care benefits 10

11 Nonqualified plans 11 Nonqualified plans See instructions for box 12 12a See instructions for box 12 12a

C

o

d

e

C

o

d

e

12c 12c C

o

d

e

C

o

d

e

12b 12b C

o

d

e

C

o

d

e

12d 12d C

o

d

e

C

o

d

e

15

16 State wages, tips, etc. 16 State wages, tips, etc. State wages, tips, etc. 16 State wages, tips, etc. 16

17 State income tax 17 State income tax State income tax 17 State income tax 17

18 Local wages, tips, etc. 18 Local wages, tips, etc. Local wages, tips, etc. 18 Local wages, tips, etc. 18

19 Local income tax 19 Local income tax Local income tax 19 Local income tax 19

20 Locality name 20 Locality name 20 Locality name 20 Locality name

State 15 State 15 State 15 State

State Correction Information

Locality Correction Information

14 Other (see instructions) 14 Other (see instructions)



Employer’s state ID number Employer’s state ID number Employer’s state ID number Employer’s state ID number

c

e Last name

f Employee’s address and ZIP code

Previously reported Correct information Previously reported Correct information

Corrected SSN and/or

name (if checked, enter

incorrect SSN and/or name

in box h and/or box i)

Suff.
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.