Form 4070
Employee’s Report
of Tips to Employer
(Rev. August 2005)
OMB No. 1545-0074
Cat. No. 41320P
Department of the Treasury
Internal Revenue Service
For Paperwork Reduction Act Notice, see the instructions on the
back of this form.
Employee’s name and address Social security number
Employer’s name and address (include establishment name, if different)
Month or shorter period in which tips were received
from
, , to ,
1
Cash tips received
2
Credit and debit card tips received
3 Tips paid out
4
Net tips (lines 1 + 2 - 3)
Signature
Date
Form 4070 (Rev. 8-2005)
Purpose. Use this form to report tips you receive to
your employer. This includes cash tips, tips you
receive from other employees, and debit and credit
card tips. You must report tips every month
regardless of your total wages and tips for the year.
However, you do not have to report tips to your
employer for any month you received less than $20 in
tips while working for that employer.
Report tips by the 10th day of the month following
the month that you receive them. If the 10th day is a
Saturday, Sunday, or legal holiday, report tips by the
next day that is not a Saturday, Sunday, or legal
holiday.
See Pub. 531, Reporting Tip Income, for more
details.
You can get additional copies of Pub. 1244,
Employee’s Daily Record of Tips and Report to
Employer, which contains both Forms 4070A and
4070, by calling 1-800-TAX-FORM (1-800-829-3676)
or by downloading the pub from the IRS website at
www.irs.gov.
Paperwork Reduction Act Notice. We ask for the
information on these forms to carry out the Internal
Revenue laws of the United States. You are required
to give us the information. We need it to ensure that
you are complying with these laws and to allow us to
figure and collect the right amount of tax.
You are 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. Generally, tax returns and
return information are confidential, as required by
Code section 6103.
The average time and expenses required to
complete and file this form will vary depending on
individual circumstances. For the estimated averages,
see the instructions for your income tax return.
If you have suggestions for making this form
simpler, we would be happy to hear from you. See
the instructions for your income tax return.