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Field Name | Size | Type | Description | Notes |
---|---|---|---|---|
See Form Filer Common Fields | Filer fields common to all form types. | |||
See Recipient Common Fields | Recipient fields common to all form types. | |||
Employee payment type A checkbox | 1 | Checkbox | Services rendered by a qualified physician under act 14-2017 | |
Employee payment type B checkbox | 1 | Checkbox | Domestic services | |
Employee payment type C checkbox | 1 | Checkbox | Services rendered in agricultural labor | |
Employee payment type D checkbox | 1 | Checkbox | Services rendered by a minister of a church or by a member of a religious order | |
Employee payment type E checkbox | 1 | Checkbox | Other | |
Employee payment type E description | 15 | Text | Payment type description | |
Cease Ops Date | 8 | Date | Cease of operations date | MM/DD/YYYY or M/D/YYYY |
Box 5 Amount | 12 | Amount | Cost of employer health coverage | |
Box 6 Amount | 12 | Amount | Charitable contributions | |
Box 7 Amount | 12 | Amount | Wages | |
Box 8 Amount | 12 | Amount | Commissions | |
Box 9 Amount | 12 | Amount | Allowances | |
Box 10 Amount | 12 | Amount | Tips | |
Box 11 Amount | 12 | Amount | Total = 7+8+9+10 | |
Box 12 Amount | 12 | Amount | Reimb expenses and fringe benefits | |
Box 13 Amount | 12 | Amount | Tax withheld | |
Box 14 Amount | 12 | Amount | Governmental retirement fund | |
Box 15 Amount | 12 | Amount | Contributions to CODA plans | |
Box 16 Amount | 12 | Amount | Exempt salaries (see instructions) | |
Box 16 Code | 2 | Text | Exempt salaries code | |
Box 17 Amount | 12 | Amount | Exempt salaries (see instructions) | |
Box 17 Code | 2 | Text | Exempt salaries code | |
Box 18 Amount | 12 | Amount | Exempt salaries (see instructions) | |
Box 18 Code | 2 | Text | Exempt salaries code | |
Box 19 Amount | 12 | Amount | Contributions to save and double your money program | |
Box 20 Amount | 12 | Amount | Social security wages | |
Box 21 Amount | 12 | Amount | Social security tax withheld | |
Box 22 Amount | 12 | Amount | Medicare wages and tips | |
Box 23 Amount | 12 | Amount | Medicare tax withheld | |
Box 24 Amount | 12 | Amount | Social security tips | |
Box 25 Amount | 12 | Amount | Uncollected social security tax on tops | |
Box 26 Amount | 12 | Amount | Uncollected medicare tax on tips | |
See Form Common Fields | Form fields common to all form types. |
Form 499R-2:
Hacienda 499R-2 form and instructions: 499R-2 2019 Form & Instructions