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Federal Free Printable 2023 Form 8922 for 2024 Federal Third-Party Sick Pay Recap

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Third-Party Sick Pay Recap
2023 Form 8922

CORRECTED 8888 FILER’S name, street address, city or town, province or state, country, ZIP or foreign postal code, and telephone no. Filer is an (check one): OMB No. 1545-0123 Employer 2023 Insurer/Agent Third-Party Sick Pay Recap Form 8922 FILER’S employer identification number 1 Sick pay subject to federal income tax 2 Federal income tax withheld from sick pay $ $ 3 Sick pay subject to social security tax 4 Social security tax withheld from sick pay $ $ 5 Sick pay subject to Medicare tax 6 Medicare tax withheld from sick pay $ $ OTHER PARTY’S name (see instructions before entering) OTHER PARTY’S employer identification number (see instructions before entering) Instructions for Form 8922 Section references are to the Internal Revenue Code unless otherwise noted. Future Developments For the latest information about developments related to Form 8922 and its instructions, such as legislation enacted after they were published, go to www.irs.gov/Form8922. General Instructions ! ▲ Don’t send this form to the Social Security Administration. This form is processed solely by the IRS for third-party sick pay reporting. CAUTION Purpose of Form Form 8922 is filed to reconcile employment tax returns (for example, Form 941) with Forms W-2 when third-party sick pay is paid. For more information, see Sick Pay Reporting in Pub. 15-A. For purposes of these instructions, all references to “sick pay” mean ordinary sick pay, not qualified sick leave wages. See the instructions for your employment tax return for more information about qualified sick leave wages. Who Must File Generally, if the liability for the employer’s share of social security tax and Medicare tax is reported on the employer’s employment tax return, Form 8922 must be filed by: • The employer, if sick pay is reported on Forms W-2 under the name and employer identification number (EIN) of the insurer or agent; or • The insurer or agent, if sick pay is reported on Forms W-2 under the name and EIN of the employer. For more information on who must file Form 8922, see Pub. 15-A. When To File File Form 8922 by February 29, 2024. Where To File Send Form 8922 to the following address. If your principal business, office, or agency is located in Use the following address Alabama, Alaska, Arizona, Arkansas, Colorado, Florida, Georgia, Hawaii, Kansas, Louisiana, Mississippi, Missouri, Nevada, New Mexico, Oklahoma, Tennessee, Texas, Utah, Washington Internal Revenue Service Memphis Service Center P.O. Box 87 Mail Stop 814 D6 Memphis, TN 38101-0087 California, Connecticut, Delaware, District of Columbia, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, New Hampshire, New Jersey, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Rhode Island, South Carolina, South Dakota, Vermont, Virginia, West Virginia, Wisconsin, Wyoming Internal Revenue Service IRS SSA CAWR Philadelphia, PA 19255-0533 Form 8922 Cat. No. 37734T If your principal place of business is outside the United States, file with the Internal Revenue Service, IRS SSA CAWR, Philadelphia, PA 19255-0533. Private delivery services. Private delivery services can’t deliver to the addresses shown above. If you choose to use a private delivery service, send Form 8922 to the address shown below based on the location of your principal business, office, or agency. Internal Revenue Service 5333 Getwell Rd Stop 814 D6 Memphis, TN 38118 Internal Revenue Service Mail Stop 4-G08 151 2970 Market St Philadelphia, PA 19104 Go to www.irs.gov/PDS for the current list of designated services. Substitute Forms The IRS accepts quality substitute tax forms that are consistent with the official forms and have no adverse impact on our processing. The official Form 8922 is the standard for substitute forms. Because a substitute form is a variation from the official form, you should know the requirements of the official form for the year of use before you create a substitute version. For details on the requirements for substitute forms, see Pub. 1167. Specific Instructions Check box for employer or insurer/agent. Check the appropriate box to state whether you’re the employer or the insurer/agent filing Form 8922. Filer’s name. If the Employer box is checked, the employer for whom the sick pay was paid by the insurer or agent will complete the information with the employer’s name, address, and phone number. If the Insurer/Agent box is checked, the insurer or agent who paid the sick pay will complete the information with the insurer/agent’s name, address, and phone number. Filer’s EIN. If the Employer box is checked, enter the EIN of the employer. If the Insurer/Agent box is checked, enter the EIN of the insurer or agent. Other party’s name and EIN. If the Employer box is checked, the employer must provide the name and EIN of the insurer or agent. If the employer has contracts with more than one insurer or agent, the employer must file a separate Form 8922 for the wages and taxes related to each contract. If the Insurer/Agent box is checked, the insurer or agent may, but isn’t required to, provide the name and EIN of the employer. If it is providing this information, and if it has contracts with more than one employer, it must file a separate Form 8922 for the wages and taxes related to each employer. Alternatively, it may file a separate Form 8922 for the wages and taxes related to each employer for which it is www.irs.gov/Form8922 Department of the Treasury - Internal Revenue Service Form 8922 (2023) supplying the name and EIN, and then file one Form 8922 for the wages and taxes related to the employers for which it isn’t supplying the name and EIN. Box 1. Enter the total amount of sick pay subject to federal income tax. Box 2. Enter the total amount of federal income tax withheld from the sick pay. Box 3. Enter the total amount of sick pay subject to social security tax. If a third-party payer of sick pay is also paying qualified sick leave wages on behalf of an employer, the third party would be making the payments as an agent of the employer. The employer is required to do the reporting and payment of employment taxes with respect to the qualified sick leave wages, unless the employer has an agency agreement with the third-party payer that requires the third-party payer to do the collecting, reporting, and/or paying or depositing employment taxes on the qualified sick leave wages. If the employer has that type of agency agreement with the third-party payer, the third-party payer includes the qualified sick leave wages in box 3. The third-party payer must also attach a statement to Form 8922 that specifies the amount of qualified sick leave wages included in box 3. See the instructions for your employment tax return for more information about qualified sick leave wages. Box 4. Enter the total amount of social security tax withheld from the sick pay. Box 5. Enter the total amount of sick pay subject to Medicare tax. Box 6. Enter the total amount of the Medicare tax (including Additional Medicare Tax) withheld from the sick pay. Corrected Form 8922. If you filed Form 8922 with the IRS and later discover that you made an error on it, you must correct it as soon as possible. Complete all entries on Form 8922 when making a correction. Enter an “X” in the “CORRECTED” checkbox only when correcting a Form 8922 previously filed with the IRS. Recordkeeping. Keep all records of employment taxes for at least 6 years. These should be available for IRS review. Page 2 Privacy Act and Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of the United States. We need it to figure and collect the right amount of tax. Section 6051 and its regulations require you to furnish wage and tax statements to employees, the Social Security Administration, and the Internal Revenue Service. Section 6109 requires you to provide your identification number. Failure to provide this information in a timely manner or providing false or fraudulent information may subject you to penalties. Generally, tax returns and return information are confidential, as required by section 6103. However, section 6103 allows or requires the Internal Revenue Service to disclose or give the information shown on your return to others as described in the Code. For example, we may disclose your tax information to the Department of Justice for civil and/or criminal litigation, and to cities, states, the District of Columbia, and U.S. commonwealths and territories for use in administering their tax laws. We may also disclose this information to other countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and intelligence agencies to combat terrorism. You’re not required to provide the information requested on a form that is subject to the Paperwork Reduction Act unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law. The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for business taxpayers filing this form is approved under OMB control number 1545-0123 and is included in the estimates shown in the instructions for their business income tax return. If you have comments concerning the accuracy of these time estimates or suggestions for making Form 8922 simpler, we would be happy to hear from you. You can send us comments from www.irs.gov/FormComments. Or you can send your comments to Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Don’t send Form 8922 to this address. Instead, see Where To File, earlier.
Extracted from PDF file 2023-federal-form-8922.pdf, last modified October 2023

More about the Federal Form 8922 Other TY 2023

We last updated the Third-Party Sick Pay Recap in January 2024, so this is the latest version of Form 8922, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form 8922 directly from TaxFormFinder. You can print other Federal tax forms here.

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Form Sources:

The Internal Revenue Service usually releases income tax forms for the current tax year between October and January, although changes to some forms can come even later. We last updated Federal Form 8922 from the Internal Revenue Service in January 2024.

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Historical Past-Year Versions of Federal Form 8922

We have a total of ten past-year versions of Form 8922 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2023 Form 8922

2023 Form 8922

2022 Form 8922

2022 Form 8922

2021 Form 8922

2021 Form 8922

2020 Form 8922

2020 Form 8922

2019 Form 8922

2019 Form 8922

2018 Form 8922

2018 Form 8922

2017 Form 8922

2017 Form 8922

2016 Form 8922

2016 Form 8922

Third-Party Sick Pay Recap 2015 Form 8922

2015 Form 8922

Third-Party Sick Pay Recap 2014 Form 8922

2014 Form 8922


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