Form 4137, Social Security and Medicare Tax on Unreported Tip Income Instructions
This form contains 34 fields organized into 6 sections. Below is a complete list of every field, its type, and what information is expected.
| Field Name | Type | Description |
|---|---|---|
| Personal Information | ||
| Name of person who received tips. If married, complete a separate Form 4137 for each spouse with unreported tips | Text |
Enter the name of the person who received the tips. If you are married, each spouse with unreported tips must complete a separate Form 4137.
|
| topmostSubform[0].Page1[0].f1_02[0 | Text |
Enter your Social Security Number (SSN). This field has a maximum length of 11 characters.
|
| Tax Calculation | ||
| Subtract line 3 from line 2. You must include this amount on line 1c of Form 1040, 1040-SR, or 1040-NR. See Allocated tips on page 2. 4 4 | Text |
Subtract the amount on line 3 from the amount on line 2. This amount must be included on line 1c of Form 1040, 1040-SR, or 1040-NR.
|
| Unreported tips subject to social security tax. Enter the smaller of line 6 or line 9. If you received tips as a federal, state, or local government employee, see instructions. 10 10 | Text |
Enter the smaller of line 6 or line 9. This is the amount of unreported tips subject to social security tax. If you received tips as a federal, state, or local government employee, see instructions.
|
| Multiply line 10 by 0.062 (social security tax rate). 11 11 | Text |
Multiply the amount on line 10 by 0.062 to calculate the social security tax owed.
|
| Add lines 11 and 12. Enter here and include as tax on Schedule 2 (Form 1040), line 5; Form 1040-SS (sp), Part I, line 6; or Form 1040-SS, Part I, line 6. See your tax return instructions 13 13 | Text |
This field requires you to add the amounts from lines 11 and 12 and enter the total here. This total should also be included as tax on Schedule 2 (Form 1040), line 5; Form 1040-SS (sp), Part I, line 6; or Form 1040-SS, Part I, line 6. Refer to your tax return instructions for more details.
|
| Tip Income | ||
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow1[0].f1_03[0 | Text |
Enter the total amount of tips you received in the first month being reported.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow1[0].f1_04[0 | Text |
Enter the total amount of tips you reported to your employer in the first month being reported. This field has a maximum length of 10 characters.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow1[0].f1_05[0 | Text |
Enter the total amount of unreported tips for the first month being reported.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow1[0].f1_06[0 | Text |
Enter the total amount of tips you received in the second month being reported.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow2[0].f1_07[0 | Text |
Enter the total amount of tips you reported to your employer in the second month being reported.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow2[0].f1_08[0 | Text |
Enter the total amount of unreported tips for the second month being reported. This field has a maximum length of 10 characters.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow2[0].f1_09[0 | Text |
Enter the total amount of tips you received in the third month being reported.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow2[0].f1_10[0 | Text |
Enter the total amount of tips you reported to your employer in the third month being reported.
|
| Tips Received | ||
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow3[0].f1_11[0 | Text |
Enter the total amount of cash tips you received in the first month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow3[0].f1_12[0 | Text |
Enter the total amount of charge tips you received in the first month. Maximum length is 10 characters.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow3[0].f1_13[0 | Text |
Enter the total amount of cash tips you received in the second month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow3[0].f1_14[0 | Text |
Enter the total amount of charge tips you received in the second month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow4[0].f1_15[0 | Text |
Enter the total amount of cash tips you received in the third month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow4[0].f1_16[0 | Text |
Enter the total amount of charge tips you received in the third month. Maximum length is 10 characters.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow4[0].f1_17[0 | Text |
Enter the total amount of cash tips you received in the fourth month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow4[0].f1_18[0 | Text |
Enter the total amount of charge tips you received in the fourth month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow5[0].f1_19[0 | Text |
Enter the total amount of cash tips you received in the fifth month.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow5[0].f1_20[0 | Text |
Enter the total amount of charge tips you received in the fifth month. Maximum length is 10 characters.
|
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow5[0].f1_21[0 | Text |
Enter the total amount of cash and charge tips you received in 2023.
|
| 2 Total cash and charge tips you received in 2023. Add the amounts from line 1, 2 column (c) | Text |
Enter the total cash and charge tips you received in 2023. This is the sum of the amounts from line 1, column (c).
|
| Tips Reported | ||
| topmostSubform[0].Page1[0].Table_Line1[0].BodyRow5[0].f1_22[0 | Text |
Enter the total amount of cash and charge tips you reported to your employer in 2023.
|
| 3 | Text |
Enter the total amount of tips you reported to your employer in 2023.
|
| Unreported Tips | ||
| 5 5 Cash and charge tips you received but didn't report to your employer because the total was less than $20 in a calendar month (see instructions) | Text |
Enter the amount of cash and charge tips you received but did not report to your employer because the total was less than $20 in a calendar month.
|
| 6 | Text |
Enter the total amount of tips you received but did not report to your employer.
|
| topmostSubform[0].Page1[0].f1_28[0 | Text |
Enter the total amount of tips you received but did not report to your employer.
|
| 8 | Text |
Enter the total amount of tips you received but did not report to your employer.
|
| topmostSubform[0].Page1[0].f1_30[0 | Text |
Enter the total amount of tips you received but did not report to your employer.
|
| topmostSubform[0].Page1[0].f1_33[0 | Text |
Enter the total amount of tips you received but did not report to your employer.
|