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OMB No. 1545-0008                                                                                                               OMB No. 1545-0008
d Control Number                                 1 Wages, tips, other compensation         2 Federal income tax withheld        d Control Number                                    1 Wages, tips, other compensation        2 Federal income tax withheld

                                                                      61462.95                                      9655.82                                                                               61462.95                                     9655.82
b Employer identification number (EIN)           3 Social security wages                   4 Social security tax withheld       b Employer identification number (EIN)              3 Social security wages                  4 Social security tax withheld

               52-2166579                                             65697.35                                      2759.29                    52-2166579                                                 65697.35                                     2759.29
a Employee’s social security number              5 Medicare wages and tips                 6 Medicare tax withheld              a Employee’s social security number                 5 Medicare wages and tips                6 Medicare tax withheld

               125-50-0004                                            65697.35                                         952.61                  125-50-0004                                                65697.35                                       952.61
c Employer’s name, address and ZIP code                                                                                         c Employer’s name, address and ZIP code
       ALLY SERVICING LLC                                                                                                              ALLY SERVICING LLC
       2000 TOWN CENTER                                                                                                                2000 TOWN CENTER
       STE 2200                                                                                                                        STE 2200
       SOUTHFIELD MI 48075                                                                                                             SOUTHFIELD MI 48075

7 Social security tips                           8 Allocated tips                          9                                    7 Social security tips                              8 Allocated tips                         9


10 Dependent care benefits                       11 Nonqualified plans                     12a                                  10 Dependent care benefits                          11 Nonqualified plans                    12a




                                                                                         Code




                                                                                                                                                                                                                            Code
                                                                                                  C                    362.24                                                                                                       C                    362.24
12b                                              12c                                       12d                                  12b                                                 12c                                      12d
                                                 Code




                                                                                                                                                                                   Code
Code




                                                                                                                                Code
                                                                                         Code




                                                                                                                                                                                                                            Code
       D                 4234.40                        W              1500.00                                                         D                   4234.40                        W                1500.00
13 Statutory      Retirement      Third-party    14 Other                                                                       13 Statutory       Retirement       Third-party     14 Other
   employee          plan          sick pay                                                                                        employee           plan           sick pay
                                                   W2125                                                            2064.92                                                          W2125                                                             2064.92

                         X                                                                                                                               X
e Employee’s name, address and ZIP code                                                                                         e Employee’s name, address and ZIP code
       PATRICIA A MURPHY                                                                                                               PATRICIA A MURPHY
       41310 HAMILTON DRIVE                                                                                                            41310 HAMILTON DRIVE
       STERLING HEIGHTS MI 48313                                                                                                       STERLING HEIGHTS MI 48313



       2011                                                                                                                            2011
                             15 State    Employer’s state I.D. no.                              16 State wages, tips, etc.                                   15 State         Employer’s state I.D. no.                            16 State wages, tips, etc.

                             MI ME0258009                                                                         61462.95                                    MI ME0258009                                                                          61462.95
               W-2                                                                                                                             W-2
       Form




                                                                                                                                        Form
 Wage and Tax Statement                         17 State income tax                   18 Local wages, tips, etc.                 Wage and Tax Statement                           17 State income tax                   18 Local wages, tips, etc.

Copy C For EMPLOYEE’S                                                2351.71                                                     Copy B To Be Filed With                                               2351.71
RECORDS (See Notice to                                                                                                           Employee’s FEDERAL Tax
Employee on back of Copy B.)                                                                                                     Return.
This information is being furnished to the                                                                                       This information is being furnished to the
Internal Revenue Service. If you are required 19 Local income tax                     20 Locality name                           Internal Revenue Service.                        19 Local income tax                   20 Locality name
to file a tax return, a negligence penalty or
other sanction may be imposed on you if this
income is taxable and you fail to report it.

Department of the Treasury –                                                                                                    Department of the Treasury –
Internal Revenue Service                                                                                                        Internal Revenue Service


OMB No. 1545-0008                                                                                                               OMB No. 1545-0008
d Control Number                                  1 Wages, tips, other compensation        2 Federal income tax withheld        d Control Number                                   1 Wages, tips, other compensation         2 Federal income tax withheld

                                                                      61462.95                                      9655.82                                                                               61462.95                                     9655.82
b Employer identification number (EIN)            3 Social security wages                  4 Social security tax withheld       b Employer identification number (EIN)             3 Social security wages                   4 Social security tax withheld

               52-2166579                                             65697.35                                      2759.29                    52-2166579                                                 65697.35                                     2759.29
a Employee’s social security number               5 Medicare wages and tips                6 Medicare tax withheld              a Employee’s social security number                5 Medicare wages and tips                 6 Medicare tax withheld

               125-50-0004                                            65697.35                                         952.61                  125-50-0004                                                65697.35                                       952.61
c Employer’s name, address and ZIP code                                                                                         c Employer’s name, address and ZIP code
       ALLY SERVICING LLC                                                                                                              ALLY SERVICING LLC
       2000 TOWN CENTER                                                                                                                2000 TOWN CENTER
       STE 2200                                                                                                                        STE 2200
       SOUTHFIELD MI 48075                                                                                                             SOUTHFIELD MI 48075

7 Social security tips                            8 Allocated tips                         9                                    7 Social security tips                             8 Allocated tips                          9



10 Dependent care benefits                        11 Nonqualified plans                    12a                                  10 Dependent care benefits                         11 Nonqualified plans                     12a
                                                                                          Code




                                                                                                                                                                                                                           Code




                                                                                                  C                    362.24                                                                                                       C                    362.24
12b                                               12c                                      12d                                  12b                                                12c                                       12d
                                                 Code




                                                                                                                                                                                   Code
Code




                                                                                                                                Code
                                                                                          Code




                                                                                                                                                                                                                           Code




        D                4234.40                        W             1500.00                                                          D                   4234.40                        W               1500.00
13 Statutory      Retirement      Third-party     14 Other                                                                      13 Statutory       Retirement      Third-party     14 Other
   employee          plan          sick pay                                                                                        employee           plan          sick pay
                                                   W2125                                                            2064.92                                                          W2125                                                             2064.92

                         X                                                                                                                               X
e Employee’s name, address and ZIP code                                                                                         e Employee’s name, address and ZIP code
       PATRICIA A MURPHY                                                                                                               PATRICIA A MURPHY
       41310 HAMILTON DRIVE                                                                                                            41310 HAMILTON DRIVE
       STERLING HEIGHTS MI 48313                                                                                                       STERLING HEIGHTS MI 48313



       2011                                                                                                                            2011
                             15 State     Employer’s state I.D. no.                              16 State wages, tips, etc.                                  15 State         Employer’s state I.D. no.                           16 State wages, tips, etc.

                              MI ME0258009                                                                        61462.95                                    MI        ME0258009                                                                   61462.95
               W-2                                                                                                                             W-2
        Form




                                                                                                                                       Form




 Wage and Tax Statement                         17 State income tax                   18 Local wages, tips, etc.                 Wage and Tax Statement                           17 State income tax                   18 Local wages, tips, etc.

 Copy 2 To Be Filed With                                             2351.71                                                    Copy 2 To Be Filed With                                                2351.71
 Employee’s State, City, or                                                                                                     Employee’s State, City, or
 Local Income Tax Return.                                                                                                       Local Income Tax Return.

                                                19 Local income tax                   20 Locality name                                                                            19 Local income tax                   20 Locality name




 Department of the Treasury –                                                                                                   Department of the Treasury –
 Internal Revenue Service                                                                                                       Internal Revenue Service
Notice to Employee                                                                             Instructions for Employee (Also see Notice to Employee,           D—Elective deferrals to a section 401(k) cash or deferred
                                                                                               on the back of Copy B.)                                           arrangement. Also includes deferrals under a SIMPLE
                                                                                               Box 1. Enter this amount on the wages line of your tax            retirement account that is part of a section 401(k)
                                                 the employer to file Form W-2c, Corrected     return. Box 2. Enter this amount on the federal income tax        arrangement E—Elective deferrals under a section 403(b)
Refund. Even if you do not have to file a                                                      withheld line of your tax return. Box 8. This amount is not       salary reduction agreement F—Elective deferrals under a
tax return, you should file to get a refund if   Wage and Tax Statement, with the Social       included in boxes 1, 3, 5, or 7. For information on how to        section 408(k)(6) salary reduction SEP G—Elective
                                                                                               report tips on your tax return, see your Form 1040                deferrals and employer contributions (including nonelective
box 2 shows federal income tax withheld          Security Administration (SSA) to correct      instructions. Unless you have records that show you did not       deferrals) to a section 457(b) deferred compensation plan
or if you can take the earned income             any name, SSN, or money amount error          receive the amount reported in box 8 as allocated tips, you       H—Elective deferrals to a section 501(c)(18)(D) tax-exempt
                                                                                               must file Form 4137, Social Security and Medicare Tax on          organization plan. See “Adjusted Gross Income” in the
credit.                                          reported to the SSA on Form W-2. If your      Unreported Tip Income, with your income tax return to             Form 1040 instructions for how to deduct. J—Nontaxable
Earned income credit (EIC). You may be           name and SSN are correct but are not the      report the allocated tip amount. On Form 4137 you will            sick pay (information only, not included in boxes 1, 3 or 5)
                                                                                               figure the social security and Medicare tax owed on the           K—20% excise tax on excess golden parachute payments.
able to take the EIC for 2011 if (a) you do      same as shown on your social security         allocated tips shown on your Form(s) W-2 that you must            See “Total Tax” in the Form 1040 instructions. L—
                                                 card, you should ask for a new card that      report as income and on other tips you did not report to your     Substantiated employee business expense reimbursements
not have a qualifying child and you earned                                                     employer. By filing Form 4137, your social security tips will     (nontaxable) M—Uncollected social security or RRTA tax
less than $13,660 ($18,740 if married filing     displays your correct name at any SSA         be credited to your social security record (used to figure        on taxable cost of group-term life insurance over $50,000
                                                                                               your benefits). Box 10. This amount is the total dependent        (former employees only). See “Total Tax” in the Form 1040
jointly), (b) you have one qualifying child      office or by calling 1-800-772-1213. You      care benefits that your employer paid to you or incurred on       instructions. N—Uncollected Medicare tax on taxable cost
and you earned less than $36,052                 may also visit the SSA at                     your behalf (including amounts from a section 125                 of group-term life insurance over $50,000 (former
                                                                                               (cafeteria) plan). Any amount over $5,000 is also included        employees only). See “Total Tax” in the Form 1040
($41,132 if married filing jointly), (c) you     www.socialsecurity.gov.                       in box 1. Complete Form 2441, Child and Dependent Care            instructions. P—Excludable moving expense
have two qualifying children and you             Cost of employer-sponsored health             Expenses, to compute any taxable and nontaxable                   reimbursements paid directly to employee (not included in
                                                                                               amounts. Box 11. This amount is (a) reported in box 1 if it is    boxes 1, 3, or 5) Q—Nontaxable combat pay. See the
earned less than $40,964 ($46,044 if             coverage (if such cost is provided by         a distribution made to you from a nonqualified deferred           instructions for Form 1040 or Form 1040A for details on
married filing jointly), or (d) you have three   the employer). The reporting in Box 12,       compensation or nongovernmental section 457(b) plan or            reporting this amount. R—Employer contributions to your
                                                                                               (b) included in box 3 and/or 5 if it is a prior year deferral     Archer MSA. Report on form 8853, Archer MSAs and
or more qualifying children and you earned       using Code DD, of the cost of employer-       under a nonqualified or section 457(b) plan that became           Long-Term Care Insurance Contracts. S—Employee salary
                                                 sponsored health coverage is for your         taxable for social security and Medicare taxes this year          reduction contributions under a section 408(p) SIMPLE (not
less than $43,998 ($49,078 if married filing                                                   because there is no longer a substantial risk of forfeiture of    included in box 1) T—Adoption benefits (not included in box
jointly). You and any qualifying children        information only. The amount reported         your right to the deferred amount. Box 12. The following list     1). Complete Form 8839, Qualified Adoption Expenses, to
                                                                                               explains the codes shown in box 12. You may need this             compute any taxable and nontaxable amounts. V—Income
must have valid social security numbers          with Code DD is not taxable.                  information to complete your tax return. Elective deferrals       from exercise of nonstatutory stock option(s) (included in
(SSNs). You cannot take the EIC if your          Credit for excess taxes. If you had more      (codes D, E, F, and S) and designated Roth contributions          boxes 1, 3 (up to social security wage base), and 5) See
                                                                                               (codes AA, BB, and EE) under all plans are generally              Pub. 525 and instructions for Schedule D (Form 1040) for
investment income is more than $3,150.           than one employer in 2011 and more than       limited to a total of $16,500 ($11,500 if you only have           reporting requirements. W—Employer contributions
Any EIC that is more than your tax               $4,485.60 in social security and/or Tier I    SIMPLE plans; $19,500 for section 403(b) plans if you             (including amounts the employee elected to contribute using
                                                                                               qualify for the 15-year rule explained in Pub. 571).              a section 125 (cafeteria) plan) to your health savings
liability is refunded to you, but only if        railroad retirement (RRTA) taxes were         Deferrals under code G are limited to $16,500. Deferrals          account. Report on Form 8889, Health Savings Accounts
                                                 withheld, you may be able to claim a credit   under code H are limited to $7,000. However, if you were at       (HSAs). Y- Deferrals under a section 409A nonqualified
you file a tax return. Clergy and                                                              least age 50 in 2011, your employer may have allowed an           deferred compensation plan. Z- Income under section 409A
religious workers. If you are not subject        for the excess against your federal income    additional deferral of up to $5,500 ($2,500 for section           on a nonqualified deferred compensation plan. This amount
                                                                                               401(k)(11) and 408(p) SIMPLE plans). This additional              is also included in box 1. It is subject to an additional 20%
to social security and Medicare taxes, see       tax. If you had more than one railroad        deferral amount is not subject to the overall limit on elective   tax plus interest. See “Total Tax” in the Form 1040
Publication 517, Social Security and Other       employer and more than $3,088.80 in Tier      deferrals. For code G, the limit on elective deferrals may be     instructions. AA- Designated Roth contributions under a
                                                                                               higher for the last 3 years before you reach retirement age.      section 401(k) plan. BB- Designated Roth contributions
Information for Members of the Clergy and        II RRTA tax was withheld, you also may be     Contact your plan administrator for more information.             under a section 403(b) plan. DD—Cost of employer-
Religious Workers.                               able to claim a credit. See your Form 1040    Amounts in excess of the overall elective deferral limit must     sponsored health coverage. The amount reported with
                                                                                               be included in income. See the “Wages, Salaries, Tips, etc.”      Code DD is not taxable. EE—Designated Roth
Corrections. If your name, SSN, or               or Form 1040A instructions and Pub. 505,      line instructions for Form 1040. Note: If a year follows code     contributions under a governmental section 457(b) plan.
address is incorrect, correct Copies B, C,       Tax Withholding and Estimated Tax. (Also      D through H, S, Y, AA, BB, or EE you made a make-up               This amount does not apply to contributions under a tax-
                                                                                               pension contribution for a prior year(s) when you were in         exempt organization section 457(b) plan. Box 13. If the
and 2 and ask your employer to correct           see Instructions for Employee on the back     military service. To figure whether you made excess               “Retirement plan” box is checked, special limits may apply
                                                                                               deferrals, consider these amounts for the year shown, not         to the amount of traditional IRA contributions you may
your employment record. Be sure to ask           of copy C.)                                   the current year. If no year is shown, the contributions are      deduct.
                                                                                               for the current year. A—Uncollected social security or            Note: Keep Copy C of Form W-2 for at least 3 years after
                                                                                               RRTA tax on tips. Include this tax on Form 1040. See              the due date for filing your income tax return. However, to
                                                                                               “Total Tax” in the Form 1040 instructions. B—Uncollected          help protect your social security benefits, keep Copy C
                                                                                               Medicare tax on tips. Include this tax on Form 1040. See          until you begin receiving social security benefits, just in case
                                                                                               “Total Tax” in the Form 1040 instructions. C—Taxable cost         there is a question about your work record and/or earnings
                                                                                               of group-term life insurance over $50,000 (included in boxes      in a particular year. Compare the Social Security wages and
                                                                                               1, 3 (up to social security wage base), and 5)                    the Medicare wages to the information shown on your
                                                                                                                                                                 annual (for workers over 25) Social Security Statement.

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  • 1. OMB No. 1545-0008 OMB No. 1545-0008 d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld 61462.95 9655.82 61462.95 9655.82 b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld 52-2166579 65697.35 2759.29 52-2166579 65697.35 2759.29 a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld 125-50-0004 65697.35 952.61 125-50-0004 65697.35 952.61 c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code ALLY SERVICING LLC ALLY SERVICING LLC 2000 TOWN CENTER 2000 TOWN CENTER STE 2200 STE 2200 SOUTHFIELD MI 48075 SOUTHFIELD MI 48075 7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9 10 Dependent care benefits 11 Nonqualified plans 12a 10 Dependent care benefits 11 Nonqualified plans 12a Code Code C 362.24 C 362.24 12b 12c 12d 12b 12c 12d Code Code Code Code Code Code D 4234.40 W 1500.00 D 4234.40 W 1500.00 13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other employee plan sick pay employee plan sick pay W2125 2064.92 W2125 2064.92 X X e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code PATRICIA A MURPHY PATRICIA A MURPHY 41310 HAMILTON DRIVE 41310 HAMILTON DRIVE STERLING HEIGHTS MI 48313 STERLING HEIGHTS MI 48313 2011 2011 15 State Employer’s state I.D. no. 16 State wages, tips, etc. 15 State Employer’s state I.D. no. 16 State wages, tips, etc. MI ME0258009 61462.95 MI ME0258009 61462.95 W-2 W-2 Form Form Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc. Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc. Copy C For EMPLOYEE’S 2351.71 Copy B To Be Filed With 2351.71 RECORDS (See Notice to Employee’s FEDERAL Tax Employee on back of Copy B.) Return. This information is being furnished to the This information is being furnished to the Internal Revenue Service. If you are required 19 Local income tax 20 Locality name Internal Revenue Service. 19 Local income tax 20 Locality name to file a tax return, a negligence penalty or other sanction may be imposed on you if this income is taxable and you fail to report it. Department of the Treasury – Department of the Treasury – Internal Revenue Service Internal Revenue Service OMB No. 1545-0008 OMB No. 1545-0008 d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld d Control Number 1 Wages, tips, other compensation 2 Federal income tax withheld 61462.95 9655.82 61462.95 9655.82 b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld b Employer identification number (EIN) 3 Social security wages 4 Social security tax withheld 52-2166579 65697.35 2759.29 52-2166579 65697.35 2759.29 a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld a Employee’s social security number 5 Medicare wages and tips 6 Medicare tax withheld 125-50-0004 65697.35 952.61 125-50-0004 65697.35 952.61 c Employer’s name, address and ZIP code c Employer’s name, address and ZIP code ALLY SERVICING LLC ALLY SERVICING LLC 2000 TOWN CENTER 2000 TOWN CENTER STE 2200 STE 2200 SOUTHFIELD MI 48075 SOUTHFIELD MI 48075 7 Social security tips 8 Allocated tips 9 7 Social security tips 8 Allocated tips 9 10 Dependent care benefits 11 Nonqualified plans 12a 10 Dependent care benefits 11 Nonqualified plans 12a Code Code C 362.24 C 362.24 12b 12c 12d 12b 12c 12d Code Code Code Code Code Code D 4234.40 W 1500.00 D 4234.40 W 1500.00 13 Statutory Retirement Third-party 14 Other 13 Statutory Retirement Third-party 14 Other employee plan sick pay employee plan sick pay W2125 2064.92 W2125 2064.92 X X e Employee’s name, address and ZIP code e Employee’s name, address and ZIP code PATRICIA A MURPHY PATRICIA A MURPHY 41310 HAMILTON DRIVE 41310 HAMILTON DRIVE STERLING HEIGHTS MI 48313 STERLING HEIGHTS MI 48313 2011 2011 15 State Employer’s state I.D. no. 16 State wages, tips, etc. 15 State Employer’s state I.D. no. 16 State wages, tips, etc. MI ME0258009 61462.95 MI ME0258009 61462.95 W-2 W-2 Form Form Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc. Wage and Tax Statement 17 State income tax 18 Local wages, tips, etc. Copy 2 To Be Filed With 2351.71 Copy 2 To Be Filed With 2351.71 Employee’s State, City, or Employee’s State, City, or Local Income Tax Return. Local Income Tax Return. 19 Local income tax 20 Locality name 19 Local income tax 20 Locality name Department of the Treasury – Department of the Treasury – Internal Revenue Service Internal Revenue Service
  • 2. Notice to Employee Instructions for Employee (Also see Notice to Employee, D—Elective deferrals to a section 401(k) cash or deferred on the back of Copy B.) arrangement. Also includes deferrals under a SIMPLE Box 1. Enter this amount on the wages line of your tax retirement account that is part of a section 401(k) the employer to file Form W-2c, Corrected return. Box 2. Enter this amount on the federal income tax arrangement E—Elective deferrals under a section 403(b) Refund. Even if you do not have to file a withheld line of your tax return. Box 8. This amount is not salary reduction agreement F—Elective deferrals under a tax return, you should file to get a refund if Wage and Tax Statement, with the Social included in boxes 1, 3, 5, or 7. For information on how to section 408(k)(6) salary reduction SEP G—Elective report tips on your tax return, see your Form 1040 deferrals and employer contributions (including nonelective box 2 shows federal income tax withheld Security Administration (SSA) to correct instructions. Unless you have records that show you did not deferrals) to a section 457(b) deferred compensation plan or if you can take the earned income any name, SSN, or money amount error receive the amount reported in box 8 as allocated tips, you H—Elective deferrals to a section 501(c)(18)(D) tax-exempt must file Form 4137, Social Security and Medicare Tax on organization plan. See “Adjusted Gross Income” in the credit. reported to the SSA on Form W-2. If your Unreported Tip Income, with your income tax return to Form 1040 instructions for how to deduct. J—Nontaxable Earned income credit (EIC). You may be name and SSN are correct but are not the report the allocated tip amount. On Form 4137 you will sick pay (information only, not included in boxes 1, 3 or 5) figure the social security and Medicare tax owed on the K—20% excise tax on excess golden parachute payments. able to take the EIC for 2011 if (a) you do same as shown on your social security allocated tips shown on your Form(s) W-2 that you must See “Total Tax” in the Form 1040 instructions. L— card, you should ask for a new card that report as income and on other tips you did not report to your Substantiated employee business expense reimbursements not have a qualifying child and you earned employer. By filing Form 4137, your social security tips will (nontaxable) M—Uncollected social security or RRTA tax less than $13,660 ($18,740 if married filing displays your correct name at any SSA be credited to your social security record (used to figure on taxable cost of group-term life insurance over $50,000 your benefits). Box 10. This amount is the total dependent (former employees only). See “Total Tax” in the Form 1040 jointly), (b) you have one qualifying child office or by calling 1-800-772-1213. You care benefits that your employer paid to you or incurred on instructions. N—Uncollected Medicare tax on taxable cost and you earned less than $36,052 may also visit the SSA at your behalf (including amounts from a section 125 of group-term life insurance over $50,000 (former (cafeteria) plan). Any amount over $5,000 is also included employees only). See “Total Tax” in the Form 1040 ($41,132 if married filing jointly), (c) you www.socialsecurity.gov. in box 1. Complete Form 2441, Child and Dependent Care instructions. P—Excludable moving expense have two qualifying children and you Cost of employer-sponsored health Expenses, to compute any taxable and nontaxable reimbursements paid directly to employee (not included in amounts. Box 11. This amount is (a) reported in box 1 if it is boxes 1, 3, or 5) Q—Nontaxable combat pay. See the earned less than $40,964 ($46,044 if coverage (if such cost is provided by a distribution made to you from a nonqualified deferred instructions for Form 1040 or Form 1040A for details on married filing jointly), or (d) you have three the employer). The reporting in Box 12, compensation or nongovernmental section 457(b) plan or reporting this amount. R—Employer contributions to your (b) included in box 3 and/or 5 if it is a prior year deferral Archer MSA. Report on form 8853, Archer MSAs and or more qualifying children and you earned using Code DD, of the cost of employer- under a nonqualified or section 457(b) plan that became Long-Term Care Insurance Contracts. S—Employee salary sponsored health coverage is for your taxable for social security and Medicare taxes this year reduction contributions under a section 408(p) SIMPLE (not less than $43,998 ($49,078 if married filing because there is no longer a substantial risk of forfeiture of included in box 1) T—Adoption benefits (not included in box jointly). You and any qualifying children information only. The amount reported your right to the deferred amount. Box 12. The following list 1). Complete Form 8839, Qualified Adoption Expenses, to explains the codes shown in box 12. You may need this compute any taxable and nontaxable amounts. V—Income must have valid social security numbers with Code DD is not taxable. information to complete your tax return. Elective deferrals from exercise of nonstatutory stock option(s) (included in (SSNs). You cannot take the EIC if your Credit for excess taxes. If you had more (codes D, E, F, and S) and designated Roth contributions boxes 1, 3 (up to social security wage base), and 5) See (codes AA, BB, and EE) under all plans are generally Pub. 525 and instructions for Schedule D (Form 1040) for investment income is more than $3,150. than one employer in 2011 and more than limited to a total of $16,500 ($11,500 if you only have reporting requirements. W—Employer contributions Any EIC that is more than your tax $4,485.60 in social security and/or Tier I SIMPLE plans; $19,500 for section 403(b) plans if you (including amounts the employee elected to contribute using qualify for the 15-year rule explained in Pub. 571). a section 125 (cafeteria) plan) to your health savings liability is refunded to you, but only if railroad retirement (RRTA) taxes were Deferrals under code G are limited to $16,500. Deferrals account. Report on Form 8889, Health Savings Accounts withheld, you may be able to claim a credit under code H are limited to $7,000. However, if you were at (HSAs). Y- Deferrals under a section 409A nonqualified you file a tax return. Clergy and least age 50 in 2011, your employer may have allowed an deferred compensation plan. Z- Income under section 409A religious workers. If you are not subject for the excess against your federal income additional deferral of up to $5,500 ($2,500 for section on a nonqualified deferred compensation plan. This amount 401(k)(11) and 408(p) SIMPLE plans). This additional is also included in box 1. It is subject to an additional 20% to social security and Medicare taxes, see tax. If you had more than one railroad deferral amount is not subject to the overall limit on elective tax plus interest. See “Total Tax” in the Form 1040 Publication 517, Social Security and Other employer and more than $3,088.80 in Tier deferrals. For code G, the limit on elective deferrals may be instructions. AA- Designated Roth contributions under a higher for the last 3 years before you reach retirement age. section 401(k) plan. BB- Designated Roth contributions Information for Members of the Clergy and II RRTA tax was withheld, you also may be Contact your plan administrator for more information. under a section 403(b) plan. DD—Cost of employer- Religious Workers. able to claim a credit. See your Form 1040 Amounts in excess of the overall elective deferral limit must sponsored health coverage. The amount reported with be included in income. See the “Wages, Salaries, Tips, etc.” Code DD is not taxable. EE—Designated Roth Corrections. If your name, SSN, or or Form 1040A instructions and Pub. 505, line instructions for Form 1040. Note: If a year follows code contributions under a governmental section 457(b) plan. address is incorrect, correct Copies B, C, Tax Withholding and Estimated Tax. (Also D through H, S, Y, AA, BB, or EE you made a make-up This amount does not apply to contributions under a tax- pension contribution for a prior year(s) when you were in exempt organization section 457(b) plan. Box 13. If the and 2 and ask your employer to correct see Instructions for Employee on the back military service. To figure whether you made excess “Retirement plan” box is checked, special limits may apply deferrals, consider these amounts for the year shown, not to the amount of traditional IRA contributions you may your employment record. Be sure to ask of copy C.) the current year. If no year is shown, the contributions are deduct. for the current year. A—Uncollected social security or Note: Keep Copy C of Form W-2 for at least 3 years after RRTA tax on tips. Include this tax on Form 1040. See the due date for filing your income tax return. However, to “Total Tax” in the Form 1040 instructions. B—Uncollected help protect your social security benefits, keep Copy C Medicare tax on tips. Include this tax on Form 1040. See until you begin receiving social security benefits, just in case “Total Tax” in the Form 1040 instructions. C—Taxable cost there is a question about your work record and/or earnings of group-term life insurance over $50,000 (included in boxes in a particular year. Compare the Social Security wages and 1, 3 (up to social security wage base), and 5) the Medicare wages to the information shown on your annual (for workers over 25) Social Security Statement.