
| 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 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:
This does not include:
|
| 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.
|
| 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:
|
| 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. |