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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.

This form serves as a substitute for Forms W-2, W-2c, and 1099-R and is completed by taxpayers or their representatives when:

  • Their employer or payer does not give them a Form W-2 or Form 1099-R, or
  • An employer or payer has issued an incorrect Form W-2 or Form 1099-R.

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Page Last Reviewed or Updated: 16-Jan-2015