W-2 Wage and Tax Statement

Tax Year 2026 - Complete all sections below

Section 1: Employee Information

Social Security Number *

Telephone Number

Driver License Number

License Issue State

License Issue Date

License Expiry Date

First Name *

Last Name *

Address *

Employer Identification Number (EIN)

Control Number

Employer Name

Employer Address

Box 1: Wages, tips, other compensation

Box 2: Federal income tax withheld

Box 3: Social security wages

Box 4: Social security tax withheld

Box 5: Medicare wages and tips

Box 6: Medicare tax withheld

Box 7: Social security tips

Box 8: Allocated tips

Box 10: Dependent care benefits

Box 11: Nonqualified plans

Box 12a

Box 12b

Box 12c

Box 12d

Statutory employeeRetirement planThird-party sick pay

Box 14: Other

Box 15: State

Employer's State ID Number

Box 16: State wages, tips, etc.

Box 17: State income tax

Box 18: Local wages, tips, etc.

Box 19: Local income tax

Box 20: Locality name

Form W-2 - Wage and Tax Statement 2026

Department of the Treasury - Internal Revenue Service