This form contains 40 fields organized into 14 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Add lines 11 and 12 (Line 13)
topmostSubform[0].Page1[0].f1_35[0 Text
Fifth Firm Info (Row 5)
Fifth Firm — Name of firm Text
Enter the legal name of the firm that paid you for services (this is the fifth firm listed).
Fifth Firm — Federal employer identification number (EIN) Number
Enter the firm's federal employer identification number (EIN) for this fifth firm.
Max length: 11 characters
Fifth Firm — Reason code Text
Enter the applicable reason code (for example A, C, G, or H) that explains why you believe you should have been treated as an employee of this fifth firm.
Max length: 1 characters
Fifth Firm — Date of IRS determination or correspondence Date
Enter the date the IRS sent the determination or other correspondence related to this fifth firm. Fill only if 'Fifth Firm — Reason code' is 'A' or 'C' (any).
Max length: 10 characters
Depends on: Fifth Firm — Reason code
Row 5 – Check if Form 1099‑MISC and/or 1099‑NEC was received Checkbox
Check this box if, for the firm listed on line 5, you received a Form 1099‑MISC and/or Form 1099‑NEC.
Fifth Firm — Total wages not reported on Form W-2 Number
Enter the total wages you received from this fifth firm that had no social security or Medicare tax withheld and were not reported on Form W-2.
Filer name and Social Security number
Filer's name Text
Enter the full name of the person who must file this Form 8919 (first name, middle initial if used, and last name).
Social security number Text
Enter the filer’s nine-digit Social Security number exactly as assigned (include leading zeros if any).
Max length: 11 characters
First Firm Info (Row 1)
First firm — Name of firm Text
Enter the legal name of the first firm that paid you for which you are reporting uncollected Social Security and Medicare tax.
First firm — Federal employer identification number (EIN) Text
Enter the first firm’s federal employer identification number (EIN) exactly as issued by the IRS.
Max length: 11 characters
First firm — Reason code Text
Enter the applicable reason code (A, C, G, or H) that best explains why the firm did not withhold Social Security and Medicare tax.
Max length: 1 characters
First firm — Date of IRS determination or correspondence Date
Enter the date the IRS sent the determination or any correspondence related to this firm. Fill only if 'First firm — Reason code' is 'A' or 'C' (any).
Max length: 10 characters
Depends on: First firm — Reason code
First firm (Row 1) — Check if Form 1099-MISC and/or 1099-NEC was received Checkbox
Check this box when the first firm you listed (row 1) issued you a Form 1099-MISC and/or Form 1099-NEC for the tax year.
First firm — Total wages with no Social Security or Medicare tax withheld Number
Enter the total amount of wages you received from the first firm on which no Social Security or Medicare tax was withheld.
Fourth Firm Info (Row 4)
4th Firm — Name of firm Text
Enter the full legal name of the firm that paid you for the services listed on row 4 exactly as it appears on their records or tax documents.
4th Firm — Federal employer identification number (EIN) Text
Enter the firm's nine-digit federal employer identification number (EIN) as shown on tax documents, including any leading zeros and without dashes.
Max length: 11 characters
4th Firm — Reason code Text
Enter the single-letter reason code (for example A, C, G, or H) that applies to why you are filing for this firm on row 4.
Max length: 1 characters
4th Firm — Date of IRS determination or correspondence Date
Enter the date of the IRS determination letter or other IRS correspondence related to this firm's classification for row 4. Fill only if '4th Firm — Reason code' is 'A' or 'C' (any).
Max length: 10 characters
Depends on: 4th Firm — Reason code
Fourth firm — Check if Form 1099‑MISC and/or 1099‑NEC was received Checkbox
Check this box if you received a Form 1099‑MISC and/or Form 1099‑NEC from the fourth firm listed (i.e., for the firm on row 4).
4th Firm — Total wages not subject to Social Security/Medicare tax Number
Enter the total wages you received from this firm that had no Social Security or Medicare tax withheld and were not reported on a Form W-2 for row 4.
Maximum amount subject to social security tax (Line 7)
topmostSubform[0].Page1[0].f1_29[0 Text
Multiply line 10 by 0.062 (Line 11)
topmostSubform[0].Page1[0].f1_33[0 Text
Multiply line 6 by 0.0145 (Line 12)
topmostSubform[0].Page1[0].f1_34[0 Text
Second Firm Info (Row 2)
Second Firm Name Text
Enter the full name of the second firm for which you performed services.
Second Firm EIN Number
Enter the federal employer identification number assigned to the second firm.
Max length: 11 characters
Second Reason Code Text
Enter the applicable reason code (for example A, C, G, or H) that explains why you are filing for the second firm.
Max length: 1 characters
Second IRS Determination/Correspondence Date Date
Enter the date of the IRS determination or correspondence related to the second firm. Fill only if 'Second Reason Code' is 'A' or 'C' (any).
Max length: 10 characters
Depends on: Second Reason Code
Second - Check if Form 1099-MISC and/or 1099-NEC was received Checkbox
Check this box if, for the second firm listed on the form, you received a Form 1099-MISC and/or Form 1099-NEC for the tax year.
Second Total Wages Not Subject to SS/Medicare Number
Enter the total wages received from the second firm for which no Social Security or Medicare tax was withheld and that were not reported on Form W-2.
Subtract line 8 from line 7 (Line 9)
Line 9 — Subtract line 8 from line 7 Number
Enter the result of subtracting line 8 from line 7; if line 8 is greater than line 7, enter 0. Fill only if 'topmostSubform[0].Page1[0].f1_29[0', 'Line 8 — Total social security wages' 35 is less than or equal to 34 (all).
Depends on: topmostSubform[0].Page1[0].f1_29[0, Line 8 — Total social security wages
Third Firm Info (Row 3)
Third firm — Name of firm Text
Enter the full name of the third firm that paid you for services during the tax year.
Third firm — Federal identification number (EIN) Text
Enter the firm's federal employer identification number (EIN) as shown on the firm's tax documents.
Max length: 11 characters
Third firm — Reason code Text
Enter the applicable reason code (A, C, G, or H) that explains why you are filing Form 8919 for this firm.
Max length: 1 characters
Third firm — Date of IRS determination/correspondence Date
Enter the date of the IRS determination or correspondence related to this firm's worker classification. Fill only if 'Third firm — Reason code' is 'A' or 'C' (any).
Max length: 10 characters
Depends on: Third firm — Reason code
Third firm — Check if Form 1099‑MISC and/or 1099‑NEC was received Checkbox
Check this box if, for the third firm listed on line 3, you received a Form 1099‑MISC and/or Form 1099‑NEC from that firm.
Third firm — Total wages not reported on Form W-2 Number
Enter the total wages you received from this firm that had no Social Security or Medicare tax withheld and were not reported on a Form W-2.
Total social security wages (Line 8)
Line 8 — Total social security wages Number
Enter the total social security wages and social security tips (total of boxes 3 and 7 on Form(s) W-2), plus railroad retirement (RRTA) compensation subject to the 6.2% rate and any unreported tips subject to social security tax.
Total wages (Line 6)
Total wages — Line 6 Number
Enter the combined total of wages from lines 1 through 5 in column (f); this is the Line 6 total wages amount to report here and on your Form 1040, 1040-SR, or 1040-NR (line 1g). Fill only if 'First firm — Total wages with no Social Security or Medicare tax withheld', 'Second Total Wages Not Subject to SS/Medicare', 'Third firm — Total wages not reported on Form W-2', '4th Firm — Total wages not subject to Social Security/Medicare tax', 'Fifth Firm — Total wages not reported on Form W-2' is filled (any).
Depends on: First firm — Total wages with no Social Security or Medicare tax withheld, Second Total Wages Not Subject to SS/Medicare, Third firm — Total wages not reported on Form W-2, 4th Firm — Total wages not subject to Social Security/Medicare tax, Fifth Firm — Total wages not reported on Form W-2
Wages subject to social security tax (Line 10)
Line 10 — Wages subject to social security tax Number
Enter the dollar amount of wages subject to social security tax (the smaller of line 6 or line 9) as reported on this form. Fill only if 'Total wages — Line 6', 'Line 9 — Subtract line 8 from line 7' is the smaller of 33 and 36 (all).
Depends on: Total wages — Line 6, Line 9 — Subtract line 8 from line 7