To ask your employer to withhold an additional amount each pay period, complete lines 3, 4, and 5 on Form IT-2104, as applicable. You can complete the W4S with your estimated adjusted gross income and any income tax withheld to date to determine if withholdings are recommended.Your W-2 is a record of your earnings and tax withheld for the year. You use information found on your W-2 to file your federal, state, and local tax returns. Fill out the table using your gross wages from your last employer prior to disability. You can pay the IRS directly or withhold taxes from your payment. To the extent the benefits are taxable, any benefits paid during a member's first complete six months of Disability are subject to FICA tax. Your employer will report employee contributions on Form W-2 using Box 14 – state disability insurance taxes withheld. The amount in the IRC 125 Box is subject to New York State and City taxes. To figure out how much tax to withhold, employees on the payroll who work in the state, but live elsewhere, complete Form IT2104.