| Box |
Description |
| A |
Employee’s Social Security Number: Your social security number. |
| B |
Employer Identification Number: UC Berkeley’s federal tax identification number. |
| C |
Employer’s name, address, and ZIP code: The address of UC Berkeley’s Central Payroll office. |
| D |
Control Number: Optional field for employer use. |
| E/F |
Employee’s name, suffix AND employee’s address and ZIP code: Your employee identification number, full name (as shown on your Social Security Card), and address (as listed in the HCM system). |
| 1 |
Wages, tips, other compensation: Your total federal taxable gross pay.
This can include :
- Wages, bonuses, and other cash compensation (including prizes or awards)
- Non-cash fringe benefits
- Executive life insurance
- Imputed income
- Non-qualified moving expenses
- Taxable employee business expense reimbursements
This does not include :
- 403(b) contributions
- DCP contributions
- Medical contributions
- Health care (HCRA) and Dependent care (DepCare) contributions
- All other pre-tax contributions
|
| 2 |
Federal income tax withheld: The total amount of federal income tax that was withheld from your wages, tips, and other compensation. |
| 3 |
Social security wages: Total wages that are subject to social security tax. |
| 4 |
Social security tax withheld: The amount of social security tax withheld from all OASDI taxable wages. This amount should be equal to 6.2% of the wages listed in Box 3 up to the maximum allowed. |
| 5 |
Medicare wages and tips: The total wages, tips and other compensation that are subject to Medicare taxes. There is no limit on the amount of wages that are subject to Medicare taxes. |
| 6 |
Medicare tax withheld: The amount of Medicare tax withheld from your Medicare taxable wages, tips and other compensation. This amount should be equal to 1.45% of the wages listed in Box 5. |
| 9 |
Advance EIC payment: The total amount of any EIC (earned income credit) payments you have received during the year. |
| 10 |
Dependent care benefits: The total amount of any dependent care you had deducted for the year. |
| 11 |
Nonqualified plans: Amounts distributed to you from nonqualified deferred compensation plans or non-government Section 457 pension plan. The amount in Box 11 is already included as taxable wages in Box 1. |
| 12 |
See inst. for box 12: The total amount of executive life insurance, 403(b) or 457(b) contributions, and excludable moving expenses.
- Code C: Executive life insurance
- Code E: 403(b) contribution
- Code G: 457(b) contribution
- Code P: Excludable moving expenses
- Code W: Employer Contributions (including amounts the employee lected to contribute using a section 125 (cafeteria plan) to your health savings account. Report on Form 8889, Health Savings Accounts (HSAs).
- Code Y: Deferrals under a section 409A nonqualified deferred compensation plan.
- Code Z: Income under a nonqualified deferred compensation plan that fails to satisfy section 409A. This amount is laso included in box 1. It is subject to and additional 20% tax plus interest. See “Other Taxes” in teh Form 1040 instructions.
- Code DD: Cost of employer-sponsored health coverage. The amount reported with code DD is not taxable.
|
| 13 |
Retirement plan: This box is checked if you are a member of the UC retirement plan. |
| 14 |
Other: This box is used by the University to report other information to you. This box may contain one or more of the following:
- Defined contribution plan (DCP) casual (CAS) or regular (REG) contributions
- Imputed income
- Travel reimbursement
- Taxable relocation expenses
- Union dues withheld
- Uniform payment deductions
- Non-excludable moving expenses
- Auto allowance
- Social club membership
|
| 15 |
State code and employer’s state I.D. number: Usually CA for California and the California employer identification number for California. If you live and/or work outside of California and withholding was required for that state, the corresponding state code and identification number will be listed as well. |
| 16 |
State wages, tips, etc: The total state taxable gross pay you received. |
| 17 |
State income tax: The total state income taxes that were withheld from your compensation. |
| 18 |
Local wages, tips, etc: The total local taxable gross pay you received. |
| 19 |
Local income tax: The total local income tax withheld from your compensation. |
| 20 |
Locality: If you live and/or work outside of California and the locality that you reside in requires withholding, the locality name will be displayed. |
