PA W-2 RECONCILIATION WORKSHEET START PA-40 W-2 RW (EX) 12-22 HERE Name Social Security Number Ü Employer’s identification number from Box b FEDERAL WAGES FEDERAL WAGES MEDICARE WAGES (Box 1) (Box 1) (Box 5) SECTION I – Starting Point SECTION II – Additions COLUMN A COLUMN B COLUMN C 1. Company contribution to deferred compensation plan. 2. Elective deferrals to IRC Section 401(k) - Code “D” in Box 12. 3. Elective deferrals under IRC Section 403(b) salary reduction agreement - Code “E” in Box 12. 4. Elective deferrals under IRC Section 408(k)(6) salary reduction agreement (SEP) - Code “F” in Box 12. 5. Elective and non-elective deferrals under IRC Section 457(b) deferred compensation plan - Code “G” in Box 12. 6. Elective deferrals to a Section 501 (C)(18)(D) tax-exempt organization plan - Code “H” in Box 12. 7. Income from a nonqualified deferred compensation (NQDC) plan - Code “Z” in Box 12. 8. Deferrals to a NQDC plan qualifying under IRC Section 409A - Code “Y” in Box 12. 9. Other Additions (provide full descriptions) Fields 9a. through 9e. 9a. 9b. 9c. 9d. 9e. 10. TOTAL (add Lines 1 through 9e.) SECTION III – Subtractions COLUMN A COLUMN B COLUMN C 11. Company contribution to deferred compensation plan. 12. Cost of group-term life - Code “C” in Box 12. 13. Income from a NQDC plan - Code “Z” in Box 12. 14. Deferrals to a NQDC plan qualifying under IRC Section 409A - Code “Y” in Box 12. 15. Personal use of company vehicle. 16. Distributions from a NQDC plan. 17. Distributions from a NQDC plan previously taxed for Pennsylvania purposes. 18. Other Subtractions (provide full descriptions) Fields 18a. through 18e. 18a. 18b. 18c. 18d. 18e. 19. TOTAL (add Lines 11 through 18e.) SECTION IV – Finishing Point [Add Section I and Section II, Line 10 then subtract Section III, Line 19] MEDICARE WAGES PA WAGES PA WAGES (Box 5) (Box 16) (Box 16) RESET FORM TOP OF PAGE NEXT PAGE PRINT |
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Instructions for PA W-2 RW PA-40 W-2 RW IN (EX) 12-22 Interest Income GENERAL INFORMATION GENERAL INSTRUCTIONS PURPOSE OF SCHEDULE Column A reconciles the amount of federal wages in Box 1 Use the PA W-2 RW to provide supplemental information of the W-2 to the amount of Medicare wages reported in regarding amounts reported on federal Form W-2, Wage Box 5 of W-2. Include those items of compensation, such and Tax Statement, so that the department may reconcile as various types of retirement plan deferrals and any other items of compensation that are not included in federal the wages to determine if the proper amount of gross com- wages but are included Medicare wages in Section II of the pensation income is reported for Pennsylvania personal W-2 RW. Include those items of compensation included in income tax purposes. The W-2 RW may also be used to federal wages that are not included in Medicare wages in provide additional information regarding nonqualified Section III of the W-2 RW. deferred compensation distributions previously taxed. Column B reconciles federal wages in Box 1 of the W-2 to Pennsylvania wages in Box 16 or to what Pennsylvania RECORDING DOLLAR AMOUNTS wages should be (for wages earned by a Pennsylvania res- Show money amounts in whole-dollars only. Eliminate any ident outside the state or by nonresidents). Include those amount less than $0.50 and increase any amount that is items of compensation, such as various types of retirement $0.50 or more to the next highest dollar. plan deferrals and any other items of compensation that are not included in federal wages but are included Pennsylvania wages in Section II of the W-2 RW. Include WHO MUST COMPLETE those items of compensation included in federal wages that The W-2 RW must be completed by taxpayers when the are not included in Pennsylvania wages in Section III of the amount shown as Medicare wages in Box 5 of the W-2 are W-2 RW. greater than Pennsylvania wages shown in Box 16 and Column C reconciles Medicare wages in Box 5 of the W-2 there is insufficient information included on the W-2 to rec- to Pennsylvania wages in Box 16 or to what Pennsylvania oncile the wages without the additional information repre- wages should be (for wages earned by a Pennsylvania res- sented on the W-2 RW. The W-2 RW must also be complet- ident outside the state or by nonresidents). Include those ed when a PA resident taxpayer works in another state and items of compensation, that are not included in Medicare Pennsylvania tax is not withheld from the wages when wages but are included Pennsylvania wages in Section II of the W-2 RW. Include those items of compensation included insufficient information is included on the W-2 to adjust the in Medicare wages that are not included in Pennsylvania wages to the amount of world-wide wages a Pennsylvania wages in Section III of the W-2 RW. resident would be subject to using Pennsylvania personal income tax rules. NOTE: The most common differences between fed- eral, Medicare and Pennsylvania wages are included on Lines 1 thru 8 and Lines 10 thru 17. Other additions and SCHEDULE INSTRUCTIONS subtractions not listed may be reported on Lines 9 and 17, IDENTIFICATION INFORMATION respectively. NAME OF TAXPAYER ON W-2 IMPORTANT: If including the W-2 RW with a PA-40, Enter the name of the taxpayer shown on the W-2. Personal Income Tax Return, all three columns of the W-2 RW must be completed. SOCIAL SECURITY NUMBER Enter the Social Security number (SSN) of the taxpayer LINE INSTRUCTIONS shown on the W-2. EMPLOYER’S IDENTIFICATION NUMBER SECTION I Enter the federal employer identification number from Box STARTING POINT b of the W-2 for the employer whose wages are being rec- Enter the amount of federal wages from Box 1 of the W-2 onciled. in the space above the headings for Columns A and B. www.revenue.pa.gov PA-40 W-2 RW 1 PREVIOUS PAGE NEXT PAGE PRINT |
Enter the amount of Medicare wages from Box 5 of the W- Box 12 of the W-2, enter the amount from the last pay 2 in the space above the heading for Column C. statement of the year from the employer. SECTION II LINE 7 ADDITIONS COLUMN A Enter the amount of earnings on amounts deferred that are LINE 1 included in Box 1 when a nonqualified deferred compensa- COLUMN A tion (NQDC) plan fails to satisfy the requirements under Enter the amount of any company contributions to a IRC Section 409A plan shown as Code Z in Box 12 of the deferred compensation plan not included in federal wages W-2. that are included in Medicare wages. LINE 8 LINE 2 COLUMNS A AND B COLUMNS A AND B Enter the amount of any deferrals the taxpayer/employee Enter the amount of any elective deferrals the made to a nonqualified deferred compensation (NQDC) taxpayer/employee made to an IRC Section 401(k) cash or plan that are not required to be included in compensation deferred arrangement plan shown as Code D in Box 12 of under IRC Section 409A shown as Code Y in Box 12 of the the W-2. If contributions were made but are not shown in W-2. If contributions were made but are not shown in Box Box 12 of the W-2, enter the amount from the last pay 12 of the W-2, enter the amount from the last pay statement statement of the year from the employer. of the year from the employer. LINE 3 LINES 9a THROUGH 9e COLUMNS A AND B COLUMNS A AND B Enter the amount of any elective deferrals the Enter the amount of any items of compensation not shown taxpayer/employee made to an IRC Section 403(b) salary on Lines 1 thru 8 that are not included in federal wages that reduction agreement shown as Code E in Box 12 of the W- are included in Medicare or Pennsylvania wages. 2. If contributions were made but are not shown in Box 12 of the W-2, enter the amount from the last pay statement of COLUMN C the year from the employer. Enter the amount of any items of compensation not shown on Lines 1 thru 8 that are not included in Medicare wages LINE 4 that are included in Pennsylvania wages. COLUMNS A AND B Enter the amount of any elective deferrals the LINE 10 taxpayer/employee made to an IRC Section 408(k)(6) COLUMNS A AND B salary reduction agreement shown as Code F in Box 12 of Add the amounts on Lines 1 thru 9e and enter the total for the W-2. If contributions were made but are not shown in each column. Box 12 of the W-2, enter the amount from the last pay statement of the year from the employer. SECTION III SUBTRACTIONS LINE 5 COLUMNS A AND B LINE 11 Enter the amount of any elective and non-elective deferrals the taxpayer/ employee made to an IRC Section 457(b) COLUMN C deferred compensation plan shown as Code G in Box 12 of Enter the amount of any company contributions to a the W-2. If contributions were made but are not shown in deferred compensation plan not included in federal wages Box 12 of the W-2, enter the amount from the last pay that are included in Medicare wages. statement of the year from the employer. LINE 12 LINE 6 COLUMNS B AND C COLUMNS A AND B Enter the amount of the cost of group-term life insurance Enter the amount of any elective deferrals the payments shown as Code C in Box 12 of the W-2. If pay- taxpayer/employee made to an IRC Section 501(C)(18)(D) ments were made but are not shown in Box 12 of the W-2, tax-exempt organization plan shown as Code H in Box 12 enter the amount from the last pay statement of the year of the W-2. If contributions were made but are not shown in from the employer. 2 PA-40 W-2 RW www.revenue.pa.gov PREVIOUS PAGE NEXT PAGE PRINT |
LINE 13 LINES 18a THROUGH 18e COLUMN C COLUMNS A AND B Enter the amount of earnings on amounts deferred that are Enter the amount of any items of compensation not shown included in Box 1 when the NQDC plan fails to satisfy the on Lines 11 thru 16 that are included in federal wages that requirements under IRC Section 409A plan shown as Code are not included in Medicare or Pennsylvania wages. Z in Box 12 of the W-2. COLUMN C Enter the amount of any items of compensation not shown LINE 14 on Lines 11 thru 16 that are included in Medicare wages COLUMN C that are not included in Pennsylvania wages. Enter the amount of any deferrals the taxpayer/employee made to a NQDC plan that are not required to be included LINE 19 in compensation under IRC Section 409A shown as Code COLUMNS A, B AND C Y in Box 12 of the W-2. If contributions were made but are Add the amounts on Lines 11 thru 18e and enter the total not shown in Box 12 of the W-2, enter the amount from the for each column. last pay statement of the year from the employer. LINE 15 SECTION IV COLUMNS B AND C FINISHING POINT Enter the amount of any personal use of company vehicle COLUMNS A, B AND C included in federal wages. This amount is sometimes Add the amount from Section I and Section II, Line 10 and included in Box 14 of the W-2. If not included as a separate subtract the amount from Section III, Line 19 and enter the amount in Box 14 of the W-2, enter the amount from the result for each column. last pay statement of the year from the employer. IMPORTANT: The Finishing Point amounts from Columns B and C should be the same and equal the LINE 16 amount of Pennsylvania wages reported on Form W-2 pro- COLUMN A vided by an employer for a Pennsylvania resident working Enter the amount of any distributions from a NQDC plan in Pennsylvania. When the amounts do not match, include that were not previously included in Pennsylvania wages. the amount from Column C in the total as Gross Compensation on Line 1a of the PA-40 Return. LINE 17 COLUMN B Enter the amount of any distributions from a NQDC plan that were previously included in Pennsylvania wages. IMPORTANT: Proof that the amounts deferred for a NQDC plan were previously included in Pennsylvania wages is also required to be included with the return. www.revenue.pa.gov PA-40 W-2 RW 3 PREVIOUS PAGE RETURN TO FORM PRINT |