Exhibit C Form W-2c — Internal Revenue Bulletin 2026-41

44444	For Official Use Only OMB No. 1545-0029
aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	cTax year/Form corrected /W-2	dEmployee’s correct SSN	dEmployee’s correct SSN
aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	eCorrected SSN and/or name. (Check this box and complete boxes f and/or g if incorrect on form previously fled.)	eCorrected SSN and/or name. (Check this box and complete boxes f and/or g if incorrect on form previously fled.)	eCorrected SSN and/or name. (Check this box and complete boxes f and/or g if incorrect on form previously fled.)
aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	Complete boxes f and/or g only if incorrect on formpreviously ﬁled:	Complete boxes f and/or g only if incorrect on formpreviously ﬁled:	Complete boxes f and/or g only if incorrect on formpreviously ﬁled:
aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	aEmployer’s name, address, and ZIP code	fEmployee’spreviously reportedSSN	fEmployee’spreviously reportedSSN	fEmployee’spreviously reportedSSN
bEmployer identifcation number (EIN)	bEmployer identifcation number (EIN)	bEmployer identifcation number (EIN)	gEmployee’spreviously reportedname	gEmployee’spreviously reportedname	gEmployee’spreviously reportedname
			hEmployee’s frst name and initial	Last name	Suff.
			iEmployee’s address and ZIP code
Note:Only complete money felds that are being corrected. (Exception: For corrections involving MQGE, see_Boxes 5 and 6_ under_Speciﬁc Instructions_ for Form W-2c in the General Instructions for Forms W-2 and W-3.)
Previously reported	Previously reported	Correct information	Previously reported	Correct information	Correct information
1Wages, tips, other compensation	1Wages, tips, other compensation	1Wages, tips, other compensation	2Federal income tax withheld	2Federal income tax withheld	2Federal income tax withheld
3Social security wages	3Social security wages	3Social security wages	4Social security tax withheld	4Social security tax withheld	4Social security tax withheld
5Medicare wages and tips	5Medicare wages and tips	5Medicare wages and tips	6Medicare tax withheld	6Medicare tax withheld	6Medicare tax withheld
7Social security tips	7Social security tips	7Social security tips	8Allocated tips	8Allocated tips	8Allocated tips
9	9	9 0.17 in	10Dependent care benefts	10Dependent care benefts	10Dependent care benefts
11Nonqualifed plans	11Nonqualifed plans	11Nonqualifed plans	11Nonqualifed plans	11Nonqualifed plans	11Nonqualifed plans
11Nonqualifed plans	11Nonqualifed plans	11Nonqualifed plans	12aSee instructions for box 12	12aSee instructions for box 12	12aSee instructions for box 12
13 Statutory employee Retirement plan Third-party sick pay 0.36 in 0.20 in 0.44 in 0.48 in	13 Statutory employee Retirement plan Third-party sick pay 0.36 in 0.20 in 0.44 in 0.48 in	13 Statutory employee Retirement plan Third-party sick pay	13 Statutory employee Retirement plan Third-party sick pay	13 Statutory employee Retirement plan Third-party sick pay	13 Statutory employee Retirement plan Third-party sick pay
13 Statutory employee Retirement plan Third-party sick pay 0.36 in 0.20 in 0.44 in 0.48 in	13 Statutory employee Retirement plan Third-party sick pay 0.36 in 0.20 in 0.44 in 0.48 in	13 Statutory employee Retirement plan Third-party sick pay	12b	12b	12b
14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)
14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)	12c	12c	12c
14aOther (see instructions)	14aOther (see instructions)	14aOther (see instructions)	12d	12d	12d
14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in	14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in	14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in	14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in	14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in	14bTreasury Tipped Occupation Code(s) 1. 2. 0.95 in
State Correction Information
Previously reported	Previously reported	Correct information	Previously reported	Correct information	Correct information
15State	15State	15State	15State	15State	15State
Employer’s state ID number	Employer’s state ID number	Employer’s state ID number	Employer’s state ID number	Employer’s state ID number	Employer’s state ID number
16State wages, tips, etc.	16State wages, tips, etc.	16State wages, tips, etc.	16State wages, tips, etc.	16State wages, tips, etc.	16State wages, tips, etc.
17State income tax	17State income tax	17State income tax	17State income tax	17State income tax	17State income tax
Locality Correction Information
Previously reported	Previously reported	Correct information	Previously reported	Correct information	Correct information
18Local wages, tips, etc.	18Local wages, tips, etc.	18Local wages, tips, etc.	18Local wages, tips, etc.	18Local wages, tips, etc.	18Local wages, tips, etc.
19Local income tax	19Local income tax	19Local income tax	19Local income tax	19Local income tax	19Local income tax
20Locality name	20Locality name	20Locality name	20Locality name	20Locality name	20Locality name

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Copy A—For Social Security Administration

Form W-2c (Rev. 1-2026) Corrected Wage and Tax Statement

0000/

Department of the Treasury

Internal Revenue Service

October 5, 2026 486 Bulletin No. 2026–41