a Employee’s social security number

22222
415-13-2679 OMB No. 1545-0008
b Employer identification number (EIN) 1 Wages, tips, other compensation 2 Federal income tax withheld
47-1892990 115,107 19,811
c Employer’s name, address, and ZIP code 3 Social security wages 4 Social security tax withheld
CLYCrafts LLC 11,844 784
6212 S 106th Street (302) 416-6554 5 Medicare wages and tips 6 Medicare tax withheld
13,890 184
7 Social security tips 8 Allocated tips
Omaha NE 68127 United States

d Control number 9 10 Dependent care benefits

2,980
e Employee’s first name and initial Last name Suff. 11 Nonqualified plans 12a
C
o
Victoria Clines d
e DD 2,810
13 Statutory Retirement Third-party 12b
339 Knighthood Trail (302) 416-6554 employee plan sick pay C
o
d
D 2,540
Northwest
e

14 Other 12c
C
Cleveland TN 37312 United States o
d
e C 2,120
12d
C
o
d
e

f Employee’s address and ZIP code

15 State Employer’s state ID number 16 State wages, tips, etc. 17 State income tax 18 Local wages, tips, etc. 19 Local income tax 20 Locality name
TN 47-1892990 39,440 3,210 17,050 1,265 TN

W-2
2022
Department of the Treasury—Internal Revenue Service
Form
Wage and Tax Statement
Copy 1—For State, City, or Local Tax Department
Future developments. For the latest information about Corrections. If your name, SSN, or address is incorrect, correct
developments related to Form W-2, such as legislation enacted Copies B, C, and 2 and ask your employer to correct your
after it was published, go to www.irs.gov/FormW2. employment record. Be sure to ask the employer to file Form
W-2c, Corrected Wage and Tax Statement, with the SSA to
Notice to Employee correct any name, SSN, or money amount error reported to the
SSA on Form W-2. Be sure to get your copies of Form W-2c
Do you have to file? Refer to the Form 1040 instructions to
from your employer for all corrections made so you may file
determine if you are required to file a tax return. Even if you
them with your tax return. If your name and SSN are correct but
don’t have to file a tax return, you may be eligible for a refund if
aren’t the same as shown on your social security card, you
box 2 shows an amount or if you are eligible for any credit.
should ask for a new card that displays your correct name at
Earned income tax credit (EITC). You may be able to take the any SSA office or by calling 800-772-1213. You may also visit
EITC for 2024 if your adjusted gross income (AGI) is less than a the SSA website at www.SSA.gov.
certain amount. The amount of the credit is based on income
Cost of employer-sponsored health coverage (if such cost is
and family size. Workers without children could qualify for a
provided by the employer). The reporting in box 12, using
smaller credit. You and any qualifying children must have valid
code DD, of the cost of employer-sponsored health coverage is
social security numbers (SSNs). You can’t take the EITC if your
for your information only. The amount reported with code DD
investment income is more than the specified amount for 2024
is not taxable.
or if income is earned for services provided while you were an
inmate at a penal institution. For 2024 income limits and more Credit for excess taxes. If you had more than one employer in
information, visit www.irs.gov/EITC. See also Pub. 596. Any 2024 and more than $10,453.20 in social security and/or Tier 1
EITC that is more than your tax liability is refunded to you, railroad retirement (RRTA) taxes were withheld, you may be able
but only if you file a tax return. to claim a credit for the excess against your federal income tax.
See the Form 1040 instructions. If you had more than one
Employee’s social security number (SSN). For your
railroad employer and more than $6,129.90 in Tier 2 RRTA tax
protection, this form may show only the last four digits of your
was withheld, you may be able to claim a refund on Form 843.
SSN. However, your employer has reported your complete SSN
See the Instructions for Form 843.
to the IRS and the Social Security Administration (SSA).
(See also Instructions for Employee on the back of Copy C.)
Clergy and religious workers. If you aren’t subject to social
security and Medicare taxes, see Pub. 517.