OMB No. 1545-0074
                                                 Uncollected Social Security and  
Form  8919                                             Medicare Tax on Wages
Department of the Treasury                    ▶  Go to www.irs.gov/Form8919 for the latest information.                                     2021
                                                                                                                                            Attachment   
Internal Revenue Service                                 ▶  Attach to your tax return.                                                      Sequence No.  61
Name of person who must file this form. If married, complete a separate Form 8919 for each spouse who must file this form.   Social security number

Who must file. You must file Form 8919 if all of the following apply.
               • You performed services for a firm.
               • You believe your pay from the firm wasn’t for services as an independent contractor.
               • The firm didn’t withhold your share of social security and Medicare taxes from your pay.
               • One of the reasons listed below under Reason codes applies to you.
Reason codes.  For each firm listed below, enter in column (c) the applicable reason code for filing this form. If none of the reason 
               codes apply to you, but you believe you should have been treated as an employee, enter reason code G, and file 
               Form SS-8 on or before the date you file your tax return.

      A        I filed Form SS-8 and received a determination letter stating that I am an employee of this firm.

      C        I received other correspondence from the IRS that states I am an employee.

      G        I filed Form SS-8 with the IRS and haven’t received a reply.

      H        I received a Form W-2 and a Form 1099-MISC and/or 1099-NEC from this firm for 2021. The amount on Form 
               1099-MISC and/or 1099-NEC should have been included as wages on Form W-2. (Don’t file Form SS-8 if you 
               select reason code H.)
                                                           (b) Firm’s federal                    (d) Date of IRS                 (e) Check  (f) Total wages 
                         (a) Name of firm                   identification       (c) Enter     determination or                   if Form          received with 
                                                               number            reason code   correspondence                  1099-MISC    no social security 
                                                           (see instructions)    from above.     (MM/DD/YYYY)                     and/or    or Medicare tax 
                                                                                               (see instructions)                1099-NEC   withholding and not 
                                                                                                                               was received. reported on Form W-2 

 1

 2

 3

 4

 5
 6    Total wages. Combine lines 1 through 5 in column (f). Enter here and include on Form 1040 or 1040-SR, 
      line 1; or Form 1040-NR, line 1a .        . . .  . .  .   . .   .      . . .    . .   .  . .   .    .                . . .  .      6
 7    Maximum amount of wages subject to social security tax  .              . . .    . .   .    7                           142,800
 8    Total social security wages and social security tips (total of boxes 3 and 7 on
      Form(s)  W-2),  railroad  retirement  (RRTA)  compensation  (subject  to  the  6.2%
      rate), and unreported tips subject to social security tax from Form 4137, line
      10. See instructions           .    . . . . . .  . .  .   . .   .      . . .    . .   .    8
 9    Subtract line 8 from line 7. If line 8 is more than line 7, enter -0- here and on line 10  .        .                . . .  .      9
 10   Wages subject to social security tax. Enter the smaller of line 6 or line 9  .        .  . .   .    .                . . .  .  10
 11   Multiply line 10 by 0.062 (social security tax rate)  .   . .   .      . . .    . .   .  . .   .    .                . . .  .  11
 12   Multiply line 6 by 0.0145 (Medicare tax rate)      .  .   . .   .      . . .    . .   .  . .   .    .                . . .  .  12
 13   Add lines 11 and 12. Enter here. Include as tax on your annual tax return (Schedule 2 (Form 1040), line 6; 
      Form 1040-PR, Part I, line 6; or Form 1040-SS, Part I, line 6). See the instructions there  .       .                . . .  ▶  13
For Paperwork Reduction Act Notice, see your tax return instructions.                          Cat. No. 37730B                              Form 8919 (2021)

Form 8919 (2021)                                                                                                               Page 2 
Future Developments                                                 Column (a). Enter the name of the firm for which you 
                                                                    worked. If you received a Form 1099-MISC and/or 1099-NEC 
For the latest information about developments related to Form       from the firm, enter the firm’s name exactly as it is entered on 
8919 and its instructions, such as legislation enacted after they   Form 1099-MISC and/or 1099-NEC.
were published, go to www.irs.gov/Form8919. 
                                                                    Column (b). The federal identification number for a firm 
What’s New                                                          can be an employer identification number (EIN) or a social 
                                                                    security number (SSN) (if the firm is an individual). An EIN is 
Increase in wage amount subject to social security tax. On          a nine-digit number assigned by the IRS to a business. Enter 
line 7, the maximum amount of wages subject to social security      an EIN like this: XX-XXXXXXX. Enter an SSN like this: XXX-XX-
tax has increased from $137,700 to $142,800 for 2021.               XXXX. If you received a Form 1099-MISC and/or 1099-NEC 
                                                                    from the firm, enter the firm’s federal identification number that 
General Instructions                                                is entered on Form 1099-MISC and/or 1099-NEC. If you don’t 
Purpose of form. Use Form 8919 to figure and report your            know the firm’s federal identification number, you can use Form 
share of the uncollected social security and Medicare taxes         W-9, Request for Taxpayer Identification Number and 
due on your compensation if you were an employee but were           Certification, to request it from the firm. If you are unable to 
treated as an independent contractor by your employer. By           obtain the number, enter “unknown.”
filing this form, your social security earnings will be credited to Column (c). Enter the reason code for why you are filing this 
your social security record. See https://www.irs.gov/businesses/    form. Enter only one reason code on each line. If none of the 
small-businesses-self-employed/independent-contractor-self-         reason codes apply to you, but you believe you should have 
employed-or-employee for more information.                          been treated as an employee, enter reason code G, and file 
                                                                    Form SS-8 on or before the date you file your tax return. 
            Don’t use this form:                                    Don’t attach Form SS-8 to your tax return. Form SS-8 must 
▲!          • For services you performed as an independent          be filed separately.
CAUTION     contractor. Instead, use Schedule C (Form 1040),        Enter reason code C if you were designated as a “section 530 
Profit or Loss From Business, to report the income. And use         employee” by the IRS. You are a section 530 employee, for 
Schedule SE (Form 1040), Self-Employment Tax, to figure the         these purposes, if you were determined to be an employee by 
tax on net earnings from self-employment.                           the IRS prior to January 1, 1997, but your employer was granted 
• To figure the social security and Medicare tax owed on tips       relief from payment of employment taxes under section 530 of 
you didn’t report to your employer, including any allocated tips    the Revenue Act of 1978. 
shown on your Form(s) W-2 that you must report as income.           Enter reason code H if you received both a Form W-2 and a 
Instead, use Form 4137, Social Security and Medicare Tax on         Form 1099-MISC and/or 1099-NEC from the firm and the 
Unreported Tip Income.                                              amount on the Form 1099-MISC and/or 1099-NEC should have 
Firm. For purposes of this form, the term “firm” means any          been included as wages on Form W-2 as an amount you 
individual, business enterprise, company, nonprofit                 received for services you provided as an employee. If reason 
organization, state, or other entity for which you performed        code H applies to your situation, don’t file Form SS-8. 
services. This firm may or may not have paid you directly for       Examples of amounts that are sometimes erroneously included 
these services.                                                     on Form 1099-MISC and/or 1099-NEC that should be reported 
Form SS-8, Determination of Worker Status for Purposes of           as wages on Form W-2 include employee bonuses, awards, 
Federal Employment Taxes and Income Tax Withholding.                travel expense reimbursements not paid under an accountable 
File Form SS-8 if you want the IRS to determine whether you are     plan, scholarships, and signing bonuses. Generally, amounts 
an independent contractor or an employee. See the form              paid by an employer to an employee aren’t reported on Form 
instructions for information on completing the form. If you         1099-MISC and/or 1099-NEC. Form 1099-MISC and/or 
select reason code G, you must file Form SS-8 on or before          1099-NEC is used for reporting nonemployee compensation, 
the date you file Form 8919. Don’t attach Form SS-8 to your         rents, royalties, and certain other payments. 
tax return. Form SS-8 must be filed separately.                              If you enter reason code G, you or the firm that paid 
Form 8959, Additional Medicare Tax. A 0.9% Additional                        you may be contacted for additional information. Use 
Medicare Tax applies to Medicare wages, Railroad Retirement         ▲!       of this reason code isn’t a guarantee that the IRS will 
                                                                    CAUTION
Tax Act compensation, and self-employment income over a                      agree with your worker status determination. If the  
threshold amount based on your filing status. Use Form 8959 to      IRS doesn’t agree that you are an employee, you may be billed 
figure this tax. See https://www.irs.gov/businesses/small-          for the additional tax, penalties, and interest resulting from the 
businesses-self-employed/questions-and-answers-for-the-             change to your worker status.
additional-medicare-tax for more information.                       Column (d).Complete only if reason code A or C is entered in 
                                                                    column (c).
Specific Instructions                                               Line 6. Also enter this amount on Form 8959, line 3, if you are 
Lines 1 through 5. Complete a separate line for each firm. If       required to file that form.
you worked as an employee for more than five firms in 2021,         Line 8. For railroad retirement (RRTA) compensation, don’t 
attach additional Form(s) 8919 with lines 1 through 5               include an amount greater than $142,800, which is the amount 
completed. Complete lines 6 through 13 on only one Form             subject to the 6.2% rate for 2021.
8919. The line 6 amount on that Form 8919 should be the 
combined totals of all lines 1 through 5 of all your Forms 8919.