Document asset

About Form 4852, Substitute for Form W-2, Wage and Tax Statement, or Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc. | Internal Revenue Service

Information about Form 4852, Substitute for Form W-2 or Form 1099-R, including recent updates, related forms, and instructions on how to file. Form 4852 is a substitute for Forms W-2, W-2c, and 1099-R.

Document viewer

PDF preview is unavailable in this browser. Open the PDF directly.

Actions
Reader view

About Form 4852, Substitute for Form W-2, Wage and Tax Statement, or Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc. | Internal Revenue Service

Summary: Form 4852 is a substitute for Form W-2, W-2c, or 1099-R used by taxpayers when they have not received these forms from their employer or payer, or have received an incorrect version.

Form 4852 (Rev. September 2020) is an official IRS document used as a substitute for Form W-2, W-2c, or 1099-R. Taxpayers must attempt to obtain the original or corrected form from their employer or payer before filing this substitute. If the missing form is not received by the end of February, taxpayers may contact the IRS for assistance. The form requires detailed information about the taxpayer, the employer/payer, and estimated wage or distribution amounts. It must be attached to the taxpayer's income tax return (Form 1040, 1040-SR, or 1040-X). Improper use of this form may result in accuracy-related, civil fraud, or frivolous return penalties.

Document outline

1. Steps to take before filing Form 4852 2. Contacting the IRS for assistance 3. Form 4852 fields (Taxpayer info, Employer/Payer info) 4. Form W-2 reporting section 5. Form 1099-R reporting section 6. Determining amounts and explaining efforts to obtain original forms 7. General Instructions 8. Penalties for improper use 9. Specific instructions for lines 1-10 10. Paperwork Reduction Act Notice
Metadata
Asset ID2316
Typedownload
Source hostirs.gov
Original filenamef4852.pdf
Source URLhttps://irs.gov/pub/irs-pdf/f4852.pdf
Source pagehttps://irs.gov/forms-pubs/about-form-4852
MIMEapplication/pdf
File size79.5 KB
SHA-256810e5e4df3022cf5421094b1d19dcf47eee020c751c47585b72d3249309cd066
Legacy seedNo
Source page capturedYes
Fetch statuscomplete
Convert statuscomplete
AI statuscomplete

7 days: 14,015

Technical metadata
File typePDF
MIME typeapplication/pdf
Created2020:09:09 14:37-05:00
Modified2020:09:09 14:37-05:00
TitleForm 4852 (Rev. September 2020)
AuthorSE:W:CAR:MP
SubjectFillable
KeywordsFillable
Raw extracted metadata
Accessibility: structured; tagged
AnnotationUsageRights: Create
AnnotationUsageRights: Delete
AnnotationUsageRights: Modify
AnnotationUsageRights: Copy
AnnotationUsageRights: Import
AnnotationUsageRights: Export
AnnotationUsageRights: Online
Author: SE:W:CAR:MP
CreateDate: 2020:09:09 14:37-05:00
Creator: SE:W:CAR:MP
CreatorTool: Adobe LiveCycle Designer ES 9.0
Description: Substitute for Form W-2, Wage and Tax Statement, or Form 1099-R, Distributions From Pensions, Annuities, Retirement or Profit-Sharing Plans, IRAs, Insurance Contracts, etc.
Directory: /var/www/omb.report/_data/catalog/assets/810e5e4df3022cf5421094b1d19dcf47eee020c751c47585b72d3249309cd066
DocumentID: uuid:7fcd6b97-1ab8-4245-8782-741169c0260d
DocumentUsageRights: FullSave
EmbeddedFileUsageRights: Create
EmbeddedFileUsageRights: Delete
EmbeddedFileUsageRights: Import
EmbeddedFileUsageRights: Modify
ExifToolVersion: 12.76
FileAccessDate: 2026:04:23 11:06:25+00:00
FileInodeChangeDate: 2026:04:23 11:06:25+00:00
FileModifyDate: 2026:04:23 11:06:25+00:00
FileName: original.pdf
FilePermissions: -rw-r--r--
FileSize: 81 kB
FileType: PDF
FileTypeExtension: pdf
Form0020fields: fillable
FormFields: fillable
FormUsageRights: FillIn
FormUsageRights: Import
FormUsageRights: Export
FormUsageRights: SubmitStandalone
FormUsageRights: Online
FormUsageRights: Add
FormUsageRights: Delete
FormUsageRights: SpawnTemplate
Format: application/pdf
HasXFA: Yes
InstanceID: uuid:3a87ea36-2642-4763-a92f-d3ba36e2b81e
Keywords: Fillable
Linearized: No
MIMEType: application/pdf
MetadataDate: 2020:09:09 14:37-05:00
ModifyDate: 2020:09:09 14:37-05:00
PDFVersion: 1.7
PageCount: 2
Producer: Adobe LiveCycle Designer ES 9.0
SPDF: 1112
SignatureUsageRights: Modify
SigningAuthority: ARE Production V6.1 P16 ID9423
SigningDate: 2020:09:09 16:25:53-04:00
Spdf: 1112
Subject: Fillable
TaggedPDF: Yes
Title: Form 4852 (Rev. September 2020)
UsageRightsMessage: This form has document rights applied to it. These rights allow anyone completing this form, with the free Adobe Reader, to save their filled-in form locally.
XMPToolkit: Adobe XMP Core 4.2.1-c043 52.398682, 2009/08/10-13:00:47