New Jersey Employee's Substitute Wage and Tax Statement

Employee's Substitute Wage and Tax Statement
Employees Substitute Wage and Tax Statement (Form C-4267)State of New Jersey
Department of The Treasury
Division of Taxation
Name

Employee’s Substitute Wage and Tax Statement

Social Security Number

Address (Number, Street, City, State, ZIP Code)

I have been unable to obtain a Form W-2, Wage and Tax Statement, from my employer, named below, and have so notified the
Internal Revenue Service. The amounts shown below are my best estimates of the gross wages paid to me and the New Jersey
Gross Income Tax withheld by this employer during
.
Name and Address of Employer

Gross Wages, Tips, and
Other Compensation

New Jersey Gross Income
Tax Withheld

How did you estimate the above gross wages and New Jersey Gross Income Tax?

Give reason Form W-2 was not furnished by employer, if known, and explain your efforts to obtain it.

Under penalties of perjury, I declare that I have made reasonable attempts to obtain the Wage and Tax Statement or copy thereof and that I have examined this statement and, to the best of my knowledge and belief, it is true, correct, and complete.
Your Signature

Date

The Division of Taxation will contact your employer for verification of the information reported on this form and to determine the
reason no Wage and Tax Statement was issued.

THIS FORM IS TO BE USED ONLY IF A WAGE AND TAX STATEMENT
CANNOT BE SECURED FROM YOUR EMPLOYER
C-4267 (10-99)

Extracted from PDF file 2023-new-jersey-form-c-4267.pdf, last modified September 2019

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More about the New Jersey Form C-4267 Individual Income Tax TY 2023

We last updated the Employee's Substitute Wage and Tax Statement in February 2024, so this is the latest version of Form C-4267, fully updated for tax year 2023. You can download or print current or past-year PDFs of Form C-4267 directly from TaxFormFinder. You can print other New Jersey tax forms here.

Other New Jersey Individual Income Tax Forms:

TaxFormFinder has an additional 95 New Jersey income tax forms that you may need, plus all federal income tax forms.

Form Code	Form Name
Form NJ-1040-ES	Estimated Tax Voucher Estimated
Individual Tax Instructions	Form NJ-1040 Instructions
Form NJ-1040	Individual Income Tax Return Tax Return
Estimated Tax Instructions	Form NJ-1040-ES Instructions Estimated
Form NJ-630	Application for Extension of Time to File NJ GIT Return Extension

Download all NJ tax forms View all 96 New Jersey Income Tax Forms

Form Sources:

New Jersey usually releases forms for the current tax year between January and April. We last updated New Jersey Form C-4267 from the Division of Revenue in February 2024.

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About the Individual Income Tax

The IRS and most states collect a personal income tax, which is paid throughout the year via tax withholding or estimated income tax payments.

Most taxpayers are required to file a yearly income tax return in April to both the Internal Revenue Service and their state's revenue department, which will result in either a tax refund of excess withheld income or a tax payment if the withholding does not cover the taxpayer's entire liability. Every taxpayer's situation is different - please consult a CPA or licensed tax preparer to ensure that you are filing the correct tax forms!

Historical Past-Year Versions of New Jersey Form C-4267

We have a total of thirteen past-year versions of Form C-4267 in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:

2023 Form C-4267