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الاستمارة 941-X

Instructions for Form 941-X, Adjusted Employerly Federal Tax Return or Claim for Refund

Rev. April 2023

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  • الاستمارة 941-X - صاحب العمل المعدل رد الضرائب الاتحادية أو المطالبة باستردادها
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Department of the Treasury  
Internal Revenue Service  
Instructions for Form 941-X  
(Rev. April 2023)  
Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund  
Section references are to the Internal Revenue Code  
unless otherwise noted.  
Contents  
the information included in the Instructions for Form 941.  
For example, these instructions don't discuss who is  
eligible to claim the credit for qualified sick and family  
leave wages, the employee retention credit, or the  
COBRA premium assistance credit. Prior revisions of the  
Instructions for Form 941 are available at IRS.gov/  
Form941 (select the link for “All Form 941 Revisions”  
under “Other Items You May Find Useful”).  
Page  
General Instructions: Understanding Form 941-X . . . . 4  
What Is the Purpose of Form 941-X? . . . . . . . . . . 4  
Where Can You Get Help? . . . . . . . . . . . . . . . . . 5  
When Should You File Form 941-X? . . . . . . . . . . 5  
Is There a Deadline for Filing Form 941-X? . . . . . . 6  
Where Should You File Form 941-X? . . . . . . . . . . 6  
How Should You Complete Form 941-X? . . . . . . . 6  
Overview of the Process . . . . . . . . . . . . . . . . . . . 7  
Specific Instructions: . . . . . . . . . . . . . . . . . . . . . . . . . 8  
Part 1: Select ONLY One Process . . . . . . . . . . . . 8  
Part 2: Complete the Certifications . . . . . . . . . . . . 8  
Part 3: Enter the Corrections for This Quarter . . . 10  
What's New  
Qualified small business payroll tax credit for in-  
creasing research activities. For tax years beginning  
before January 1, 2023, a qualified small business may  
elect to claim up to $250,000 of its credit for increasing  
research activities as a payroll tax credit. The Inflation  
Reduction Act of 2022 (the IRA) increases the election  
amount to $500,000 for tax years beginning after  
Part 4: Explain Your Corrections for This  
Quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25  
December 31, 2022. The payroll tax credit election must  
be made on or before the due date of the originally filed  
income tax return (including extensions). The portion of  
the credit used against payroll taxes is allowed in the first  
calendar quarter beginning after the date that the qualified  
small business filed its income tax return. The election  
and determination of the credit amount that will be used  
against the employer's payroll taxes are made on Form  
6765, Credit for Increasing Research Activities. The  
amount from Form 6765, line 44, must then be reported  
on Form 8974, Qualified Small Business Payroll Tax  
Credit for Increasing Research Activities.  
Part 5: Sign Here . . . . . . . . . . . . . . . . . . . . . . . 26  
Worksheet 1. Adjusted Credit for Qualified Sick  
and Family Leave Wages for Leave Taken  
After March 31, 2020, and Before April 1,  
2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27  
Worksheet 2. Adjusted Employee Retention Credit  
for Qualified Wages Paid After March 12, 2020,  
and Before July 1, 2021 . . . . . . . . . . . . . . . . . . 28  
Worksheet 3. Adjusted Credit for Qualified Sick  
and Family Leave Wages for Leave Taken  
After March 31, 2021, and Before October 1,  
2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29  
For quarters beginning before January 1, 2023, the  
payroll tax credit can be used only against the employer  
share of social security tax for the quarter and any  
remaining credit is carried forward to the next quarter.  
Starting in the first quarter of 2023, the payroll tax credit is  
first used to reduce the employer share of social security  
tax up to $250,000 per quarter and any remaining credit  
reduces the employer share of Medicare tax for the  
quarter. Any remaining credit, after reducing the employer  
share of social security tax and the employer share of  
Medicare tax, is then carried forward to the next quarter.  
Form 8974 is used to determine the amount of the credit  
that can be used in the current quarter. Corrections to this  
credit are made on Form 941-X, line 16. If you make a  
correction to Form 941-X, line 16, you must attach a  
corrected Form 8974. For more information, see the  
Instructions for Form 8974 and go to IRS.gov/  
Worksheet 4. Adjusted Employee Retention Credit  
for Qualified Wages Paid After June 30, 2021,  
and Before January 1, 2022 . . . . . . . . . . . . . . . . 30  
Worksheet 5. Adjusted COBRA Premium  
Assistance Credit . . . . . . . . . . . . . . . . . . . . . . . 31  
How Can You Get Forms, Instructions, and  
Publications From the IRS? . . . . . . . . . . . . . . . . 31  
Future Developments  
For the latest information about developments related to  
Form 941-X and its instructions, such as legislation  
enacted after they were published, go to IRS.gov/  
These instructions have been updated for  
changes to the qualified small business payroll tax  
credit for increasing research activities reported  
TIP  
Reminders  
on Form 8974. You may use these instructions and the  
April 2023 revision of Form 941-X for all years for which  
the statute of limitations on corrections hasn't expired.  
Before you proceed with these instructions and  
If a line on Form 941-X doesn't apply to you, leave  
it blank. If you're correcting a quarter that began  
before April 1, 2020, you must leave blank lines 9,  
TIP  
completing Form 941-X, you'll need a copy of the  
Instructions for Form 941 for the quarter that you're  
correcting because these instructions don't repeat all of  
10, 17, 18a, 24, 25, 26a, 28, 29, 30, 31a, 32, 33a, and 34.  
If you're correcting a quarter that began before July 1,  
May 18, 2023  
Cat. No. 20331U  
2020, you must leave blank line 33b. If you're correcting a  
quarter that began before April 1, 2021, you must leave  
blank lines 18b, 18c, 18d, 26b, 26c, 35, 36, 37, 38, 39,  
and 40. If you're correcting a quarter that began before  
July 1, 2021, you must leave blank line 31b. If you're  
correcting a quarter that began after December 31, 2021,  
you must leave blank lines 18a, 26a, 30, 31a, and 31b.  
employee retention credit solely because your business is  
a recovery startup business.  
Credit for COBRA premium assistance payments is  
limited to periods of coverage beginning on or after  
April 1, 2021, through periods of coverage beginning  
on or before September 30, 2021. Section 9501 of the  
ARP provides for COBRA premium assistance in the form  
of a full reduction in the premium otherwise payable by  
certain individuals and their families who elect COBRA  
continuation coverage due to a loss of coverage as the  
result of a reduction in hours or an involuntary termination  
of employment (assistance eligible individuals). This  
COBRA premium assistance was available for periods of  
coverage beginning on or after April 1, 2021, through  
periods of coverage beginning on or before September  
30, 2021. A premium payee was entitled to the COBRA  
premium assistance credit at the time an eligible individual  
elects coverage. Therefore, other than in rare  
The COVID-19 related credit for qualified sick and  
family leave wages is limited to leave taken after  
March 31, 2020, and before October 1, 2021. The  
credit for qualified sick and family leave wages, as  
enacted under the Families First Coronavirus Response  
Act (FFCRA) and amended and extended by the  
COVID-related Tax Relief Act of 2020, is for leave taken  
after March 31, 2020, and before April 1, 2021, and the  
credit for qualified sick and family leave wages under  
sections 3131, 3132, and 3133 of the Internal Revenue  
Code, as enacted under the American Rescue Plan Act of  
2021 (the ARP), is for leave taken after March 31, 2021,  
and before October 1, 2021. For more information about  
the credit for qualified sick and family leave wages, go to  
circumstances, due to the COBRA notice and election  
period requirements (generally, employers have 60 days  
to provide notice and assistance eligible individuals have  
60 days to elect coverage), the first quarter of 2022 was  
the last quarter in which employers may have been  
eligible to claim the COBRA premium assistance credit on  
Form 941. Employers eligible to claim the COBRA  
premium assistance credit after March 31, 2022, must file  
Form 941-X to claim the credit.  
Corrections to amounts reported on Form 941, lines  
5a(i), 5a(ii), 11b, 13c, 19, and 20, for the credit for  
qualified sick and family leave wages for leave taken after  
March 31, 2020, and before April 1, 2021, are reported on  
Form 941-X, lines 9, 10, 17, 25, 28, and 29, respectively.  
For more information on COBRA premium assistance  
payments and the credit, see Notice 2021-31, 2021-23  
I.R.B. 1173, available at IRS.gov/irb/  
Corrections to amounts reported on Form 941, lines  
11d, 13e, 23, 24, 25, 26, 27, and 28, for the credit for  
qualified sick and family leave wages for leave taken after  
March 31, 2021, and before October 1, 2021, are reported  
on Form 941-X, lines 18b, 26b, 35, 36, 37, 38, 39, and 40,  
respectively.  
2021-23_IRB#NOT-2021-31; and Notice 2021-46,  
2021-33 I.R.B. 303, available at IRS.gov/irb/  
Corrections to amounts reported on Form 941, lines  
11e, 11f, and 13f, for the COBRA premium assistance  
credit are reported on Form 941-X, lines 18c, 18d, and  
26c, respectively.  
The COVID-19 related employee retention credit has  
expired. The employee retention credit enacted under  
the Coronavirus Aid, Relief, and Economic Security  
(CARES) Act and amended and extended by the  
Taxpayer Certainty and Disaster Tax Relief Act of 2020  
was limited to qualified wages paid after March 12, 2020,  
and before July 1, 2021. The employee retention credit  
under section 3134 of the Internal Revenue Code, as  
enacted by the ARP and amended by the Infrastructure  
Investment and Jobs Act, was limited to qualified wages  
paid after June 30, 2021, and before October 1, 2021,  
unless the employer was a recovery startup business. An  
employer that was a recovery startup business could also  
claim the employee retention credit for qualified wages  
paid after September 30, 2021, and before January 1,  
2022. For more information about the employee retention  
credit, including the dates for which the credit may be  
claimed, go to IRS.gov/ERC.  
Corrections to amounts reported on Form 941, lines  
11c, 13d, 21, and 22, for the employee retention credit are  
reported on Form 941-X, lines 18a, 26a, 30, and 31a,  
respectively. However, how you figure the employee  
retention credit for qualified wages paid after March 12,  
2020, and before July 1, 2021, is different from how you  
figure the credit for qualified wages paid after June 30,  
2021, and before January 1, 2022. Also, for corrections to  
qualified wages paid after June 30, 2021, you may need  
to complete line 31b to tell us if you're eligible for the  
If you claimed the credit for qualified sick and  
family leave wages for leave taken after March 31,  
!
CAUTION  
2020, and before April 1, 2021, and you make any  
corrections on Form 941X to amounts used to figure this  
credit, you'll need to refigure the amount of this credit  
using Worksheet 1. You'll also use this worksheet to figure  
this credit if you’re claiming it for the first time on Form  
941-X. If you claimed the credit for qualified sick and  
family leave wages for leave taken after March 31, 2021,  
and before October 1, 2021, and you make any  
corrections on Form 941X to amounts used to figure this  
credit, you'll need to refigure the amount of this credit  
using Worksheet 3. You'll also use this worksheet to figure  
this credit if you’re claiming it for the first time on Form  
941-X. If you claimed the employee retention credit for  
wages paid after March 12, 2020, and before July 1,  
2021, and you make any corrections on Form 941X to  
amounts used to figure this credit, you'll need to refigure  
the amount of this credit using Worksheet 2. You'll also  
use this worksheet to figure this credit if you’re claiming it  
for the first time on Form 941-X. If you claimed the  
employee retention credit for wages paid after June 30,  
2021, and before January 1, 2022, and you make any  
corrections on Form 941X to amounts used to figure this  
credit, you'll need to refigure the amount of this credit  
-2-  
Instructions for Form 941-X (Rev. 4-2023)  
 
using Worksheet 4. You'll also use this worksheet to figure  
this credit if you’re claiming it for the first time on Form  
941-X. If you claimed the COBRA premium assistance  
credit and you make any corrections on Form 941X to  
amounts used to figure this credit, you'll need to refigure  
the amount of this credit using Worksheet 5. You'll also  
use this worksheet to figure this credit if you’re claiming it  
for the first time on Form 941-X.  
13 of Pub. 15, Employer’s Tax Guide, for more information  
about corrections during the calendar year and about  
administrative errors. See section 2 of Pub. 15 for more  
information about section 3509. If section 3509 rates  
apply, see the instructions for lines 19–22, later.  
Only transposition or math errors involving the  
inaccurate reporting of the amount withheld are  
!
CAUTION  
administrative errors.  
Form 941-X is filed to correct Form 941 or Form  
941-SS. References to Form 941 on Form 941-X and in  
these instructions also apply to Form 941-SS, Employer's  
QUARTERLY Federal Tax Return (American Samoa,  
Guam, the Commonwealth of the Northern Mariana  
Islands, and the U.S. Virgin Islands), unless otherwise  
noted.  
Payroll tax credit for certain tax-exempt organiza-  
tions affected by qualified disasters. Section 303(d) of  
the Taxpayer Certainty and Disaster Tax Relief Act of  
2020 allows for a payroll tax credit for certain tax-exempt  
organizations affected by certain qualified disasters not  
related to COVID-19. This credit is claimed on Form  
5884-D. Form 5884-D is filed after the Form 941 for the  
quarter for which the credit is being claimed has been  
filed. If applicable to the quarter that you're correcting,  
you'll enter the credit claimed on Form 5884-D on  
Worksheet 1 to figure your credit for qualified sick and  
family leave wages for leave taken before April 1, 2021, or  
Worksheet 2 to figure the employee retention credit for  
wages paid after March 12, 2020, and before July 1,  
2021. For more information about this credit, go to  
You can’t file a Form 941-X to correct federal income  
tax withholding for prior years for nonadministrative errors.  
In other words, you can’t correct federal income tax  
actually withheld from an employee in a prior year if you  
discover that you didn’t withhold the right amount. For  
example, you can’t correct federal income tax withheld in  
a prior year because you used the wrong income tax  
withholding table or you didn’t treat a payment correctly as  
taxable or nontaxable. Similarly, if you paid federal  
income tax in a prior year on behalf of your employee,  
rather than deducting it from the employee’s pay (which  
resulted in additional wages subject to tax), and in a  
subsequent year you determine that you incorrectly  
calculated the amount of tax, you can’t correct the federal  
income tax withholding. However, you must still correct  
the amount of wages you reported on Form 941 and Form  
W-2, Wage and Tax Statement, for a prior year by filing  
Form 941-X and Form W-2c, Corrected Wage and Tax  
Statement, respectively. You'll report the correct wages  
on Form 941-X, line 6, column 1.  
The amount actually withheld is reflected on  
payroll information or on Form W-2, which can be  
used by the employee to claim a credit for  
TIP  
withholding for individual income tax return purposes.  
Employee consents to support a claim for refund.  
Rev. Proc. 2017-28, 2017-14 I.R.B. 1061, available at  
guidance to employers on the requirements for employee  
consents used by an employer to support a claim for  
refund of overcollected social security tax and Medicare  
tax. The revenue procedure clarifies the basic  
Correcting Additional Medicare Tax withholding and  
wages and tips subject to Additional Medicare Tax  
withholding. Wages and tips subject to Additional  
Medicare Tax withholding are reported on Form 941,  
line 5d. Certain errors discovered on a previously filed  
Form 941 are corrected on Form 941-X, line 13. However,  
you can’t file a Form 941-X to correct the wrong amount of  
Additional Medicare Tax actually withheld from an  
employee in a prior year, including any amount you paid  
on behalf of your employee rather than deducting it from  
the employee’s pay (which resulted in additional wages  
subject to tax). See the instructions for line 13, later, for  
more information on the types of errors that can be  
corrected and how the correction is reported on Form  
941-X. For more information about Additional Medicare  
Tax withholding, see the Instructions for Form 941 or go to  
You may need to attach Schedule R (Form 941) to  
your Form 941-X. If you were required to file Schedule R  
(Form 941), Allocation Schedule for Aggregate Form 941  
Filers, when you filed Form 941, you must complete  
Schedule R (Form 941) when correcting an aggregate  
Form 941. Schedule R (Form 941) is completed only for  
those clients and customers who have corrections  
reported on Form 941-X. Schedule R (Form 941) is filed  
as an attachment to Form 941-X.  
requirements for both a request for employee consent and  
for the employee consent, and permits a consent to be  
requested, furnished, and retained in an electronic format  
as an alternative to a paper format. The revenue  
procedure also contains guidance concerning when an  
employer may claim a refund of only the employer share  
of overcollected social security tax and Medicare tax. The  
revenue procedure requires that any request for consent  
include an Additional Medicare Tax notice indicating that  
any claim on the employee’s behalf won’t include a claim  
for overpaid Additional Medicare Tax.  
Correcting federal income tax withheld. Generally,  
you may correct federal income tax withholding errors  
only if you discovered the errors in the same calendar  
year you paid the wages. In addition, for an overcollection,  
you may correct federal income tax withholding only if you  
also repaid or reimbursed the employees in the same  
year.  
For prior years, you may only correct administrative  
errors to federal income tax withholding (that is, errors in  
which the amount reported on Form 941, line 3, isn't the  
amount you actually withheld from an employee’s wages)  
and errors for which section 3509 rates apply. See section  
Approved section 3504 agents and certified  
professional employer organizations (CPEOs) must  
Instructions for Form 941-X (Rev. 4-2023)  
-3-  
complete and file Schedule R (Form 941) when filing an  
aggregate Form 941. Aggregate Forms 941 are filed by  
agents approved by the IRS under section 3504. To  
request approval to act as an agent for an employer, the  
agent files Form 2678 with the IRS. Aggregate Forms 941  
are also filed by CPEOs approved by the IRS under  
section 7705. To become a CPEO, the organization must  
apply through the IRS Online Registration System at  
IRS.gov/CPEO. CPEOs file Form 8973, Certified  
Professional Employer Organization/Customer Reporting  
Agreement, to notify the IRS that they started or ended a  
service contract with a customer.  
adjustments to Form 941, lines 11d, 13e, 23, 24, 25, 26,  
27, and 28;  
Amounts reported on Form 941 for the employee  
retention credit, including adjustments to Form 941, lines  
11c, 13d, 21, and 22, (for the second quarter of 2020, also  
Form 941, lines 24 and 25); and  
Amounts reported on Form 941 for the COBRA  
premium assistance credit, for periods of coverage  
beginning on or after April 1, 2021, through periods of  
coverage beginning on or before September 30, 2021,  
including adjustments to Form 941, lines 11e, 11f, and  
13f.  
Other third-party payers that file aggregate Forms 941,  
such as non-certified PEOs, must complete and file  
Schedule R (Form 941) if they have clients that are  
claiming the qualified small business payroll tax credit for  
increasing research activities, the credit for qualified sick  
and family leave wages, the employee retention credit,  
and/or the COBRA premium assistance credit, or clients  
deferring the employer or the employee share of social  
security tax. If you're an other third-party payer that didn't  
file Schedule R (Form 941) with Form 941 because you  
didn't meet these requirements, but are now filing Form  
941-X to report these credits or the deferral of the  
employer or the employee share of social security tax for  
your clients, then you must now file Schedule R (Form  
941) and attach it to Form 941-X.  
Use Form 843, Claim for Refund and Request for  
Abatement, to request a refund or abatement of assessed  
interest or penalties. Don’t request a refund or abatement  
of assessed interest or penalties on Form 941 or Form  
941-X.  
We use the terms “correct” and “corrections” on  
Form 941-X and in these instructions to include  
interest-free adjustments under sections 6205 and  
TIP  
6413 and claims for refund and abatement under sections  
6402, 6414, and 6404. See Rev. Rul. 2009-39 for  
examples of how the interest-free adjustment and claim  
for refund rules apply in 10 different situations. You can  
find Rev. Rul. 2009-39, 2009-52 I.R.B. 951, at IRS.gov/irb/  
See the March 2022 revision of the Instructions for  
Form 941 for information about when a third party is  
considered the person to whom COBRA premium  
assistance payments are payable.  
When you discover an error on a previously filed Form  
941, you must:  
Correct that error using Form 941-X;  
File a separate Form 941-X for each Form 941 that  
you’re correcting; and  
General Instructions:  
Generally, file Form 941-X separately. Don't file Form  
941-X with Form 941. However, if you didn't previously file  
Form 941 because you mistakenly treated your  
employees as nonemployees, you may have to file Form  
941-X with Form 941. See the instructions for line 42,  
later.  
Understanding Form 941-X  
What Is the Purpose of Form 941-X?  
Use Form 941-X to correct errors on a Form 941 that you  
previously filed. Use Form 941-X to correct:  
Wages, tips, and other compensation;  
If you didn’t file a Form 941 for one or more quarters,  
don’t use Form 941-X. Instead, file Form 941 for each of  
those quarters. Also, see When Should You File Form  
941-X, later. However, if you didn’t file Forms 941  
Income tax withheld from wages, tips, and other  
compensation;  
Taxable social security wages;  
Taxable social security tips;  
because you improperly treated workers as independent  
contractors or nonemployees and are now reclassifying  
them as employees, see the instructions for line 42, later.  
Taxable Medicare wages and tips;  
Taxable wages and tips subject to Additional Medicare  
Tax withholding;  
Unless otherwise specified in these instructions,  
Deferred amount of the employer share of social  
an underreported employment tax credit or social  
security tax deferral should be treated like an  
TIP  
security tax;  
Deferred amount of the employee share of social  
overreported tax amount. An overreported employment  
tax credit or social security tax deferral should be treated  
like an underreported tax amount. For more information,  
including which process to select on lines 1 and 2, see  
deferral, later.  
security tax;  
Qualified small business payroll tax credit for increasing  
research activities;  
Amounts reported on Form 941 for the credit for  
qualified sick and family leave wages for leave taken after  
March 31, 2020, and before April 1, 2021, including  
adjustments to Form 941, lines 5a(i), 5a(ii), 11b, 13c, 19,  
and 20;  
Report the correction of underreported and  
overreported tax amounts for the same tax period on a  
single Form 941-X, unless you’re requesting a refund or  
abatement. If you’re requesting a refund or abatement and  
are correcting both underreported and overreported tax  
amounts, file one Form 941-X correcting the  
Amounts reported on Form 941 for the credit for  
qualified sick and family leave wages for leave taken after  
March 31, 2021, and before October 1, 2021, including  
-4-  
Instructions for Form 941-X (Rev. 4-2023)  
   
underreported tax amounts only and a second Form  
941-X correcting the overreported tax amounts.  
federal tax liabilities reported on Form 941, Part 2, or on  
Schedule B (Form 941), see the Instructions for  
Schedule B (Form 941).  
You’ll use the adjustment process if you underreported  
employment taxes and are making a payment, or if you  
overreported employment taxes and will be applying the  
credit to Form 941 for the period during which you file  
Form 941-X. However, see the Caution under Is There a  
Deadline for Filing Form 941-X, later, if you’re correcting  
overreported tax amounts during the last 90 days of a  
period of limitations. You’ll use the claim process if you  
overreported employment taxes and are requesting a  
refund or abatement of the overreported tax amount.  
Follow the chart on page 6 of Form 941-X for help in  
choosing whether to use the adjustment process or the  
claim process. Be sure to give us a detailed explanation  
on line 43 for each correction that you show on Form  
941-X.  
Due dates. The due date for filing Form 941-X depends  
on when you discover an error and if you underreported or  
overreported tax. If you underreported tax, see  
Underreported tax, later. For overreported tax amounts,  
you may choose to either make an interest-free  
adjustment or file a claim for refund or abatement. If you’re  
correcting overreported tax amounts, see Overreported  
process, later.  
If any due date falls on a Saturday, Sunday, or legal  
holiday, you may file Form 941-X on the next business  
day. If we receive Form 941-X after the due date, we will  
treat Form 941-X as filed on time if the envelope  
containing Form 941-X is properly addressed, contains  
sufficient postage, and is postmarked by the U.S. Postal  
Service on or before the due date, or sent by an  
Continue to report current quarter fractions of cents,  
third-party sick pay, tips, and group-term life insurance on  
Form 941, lines 7–9.  
IRS-designated private delivery service (PDS) on or  
before the due date. If you don’t follow these guidelines,  
we will consider Form 941-X filed when it is actually  
received. See Pub. 15 or Pub. 80 for more information on  
legal holidays. For more information about PDSs, see  
You have additional requirements to complete when  
filing Form 941-X, such as certifying that you filed (or will  
file) all applicable Forms W-2 and Forms W-2c with the  
Social Security Administration (SSA). For corrections of  
overreported federal income tax, social security tax,  
Medicare tax, or Additional Medicare Tax, you must make  
any certifications that apply to your situation.  
Underreported tax. If you’re correcting underreported  
tax, you must file Form 941-X by the due date of the return  
for the return period in which you discovered the error and  
pay the amount you owe by the time you file. Doing so  
will generally ensure that your correction is interest free  
and not subject to failure-to-pay (FTP) or failure-to-deposit  
(FTD) penalties. See What About Penalties and Interest,  
later. For details on how to make a payment, see the  
instructions for line 27, later.  
Don’t use Form 941-X to correct Form CT-1, 943,  
944, or 945. Instead, use the “X” form that  
!
CAUTION  
corresponds to those forms (Form CT-1 X, 943-X,  
944-X, or 945-X).  
Where Can You Get Help?  
If Form 941-X is filed late (after the due date of the  
return for the return period in which you discovered the  
error), you must attach an amended Schedule B (Form  
941) to Form 941-X. Otherwise, the IRS may assess an  
“averaged” FTD penalty. See “Averaged” FTD penalty in  
section 11 of Pub. 15 or section 8 of Pub. 80 for more  
information about “averaged” FTD penalties. The total tax  
reported on the “Total liability for the quarter” line of  
Schedule B (Form 941) must match the corrected tax  
(Form 941, line 12, combined with any correction entered  
on Form 941-X, line 23) for the quarter, less any previous  
abatements and interest-free tax assessments.  
For help filing Form 941-X or for questions about federal  
employment taxes and tax corrections, you can:  
See Pub. 15 for correcting Form 941, or Pub. 80,  
Federal Tax Guide for Employers in the U.S. Virgin  
Islands, Guam, American Samoa, and the Commonwealth  
of the Northern Mariana Islands, for correcting Form  
941-SS; or  
Call the IRS Business and Specialty Tax Line at  
800-829-4933 or 800-829-4059 (TDD/TTY for persons  
who are deaf, hard of hearing, or have a speech  
disability), Monday–Friday from 7:00 a.m. to 7:00 p.m.  
local time (Alaska and Hawaii follow Pacific time).  
If you discover an error in . . .  
Form 941-X is due . . .  
1. January, February, March  
2. April, May, June  
3. July, August, September  
April 30  
July 31  
October 31  
January 31  
4. October, November,  
When Should You File Form 941-X?  
December  
File Form 941-X when you discover an error on a  
The dates shown in the table above apply only to corrections of  
underreported amounts. If any due date falls on a Saturday,  
Sunday, or legal holiday, you may file Form 941-X on the next  
business day.  
previously filed Form 941.  
However, if your only errors on Form 941 relate to the  
number of employees who received wages (Form 941,  
line 1) or to federal tax liabilities reported on Form 941,  
Part 2, or on Schedule B (Form 941), Report of Tax  
Liability for Semiweekly Schedule Depositors, don’t file  
Form 941-X. For more information about correcting  
Example—You owe tax. On July 7, 2023, you  
discover that you underreported $10,000 of social security  
Instructions for Form 941-X (Rev. 4-2023)  
-5-  
     
and Medicare wages on your 2023 first quarter Form 941.  
File Form 941-X and pay the amount you owe by October  
31, 2023, because you discovered the error in the third  
quarter of 2023, and October 31, 2023, is the due date for  
that quarter. If you file Form 941-X before October 31,  
2023, pay the amount you owe by the time you file.  
If you file Form 941-X to correct overreported tax  
amounts in the last 90 days of a period of  
!
CAUTION  
limitations, you must use the claim process. You  
can’t use the adjustment process. If you’re also correcting  
underreported tax amounts, you must file another Form  
941-X to correct the underreported tax amounts using the  
adjustment process and pay any tax due.  
The due date for filing the adjusted return is  
determined by the type of return (Form 941 or  
Form 944) being corrected, without regard to your  
TIP  
Where Should You File Form 941-X?  
Send your completed Form 941-X to the address shown  
current filing requirements. Therefore, if you're currently  
filing Form 941 and you're correcting a previously filed  
Form 944, you must file Form 944-X by January 31 of the  
year following the year you discover the error.  
next.  
IF you’re in . . .  
THEN use this address . . .  
Connecticut, Delaware, District of  
Columbia, Florida, Georgia,  
Illinois, Indiana, Kentucky, Maine,  
Maryland, Massachusetts,  
Michigan, New Hampshire, New  
Jersey, New York, North Carolina,  
Ohio, Pennsylvania, Rhode  
Island, South Carolina,  
Tennessee, Vermont, Virginia,  
West Virginia, Wisconsin  
Overreported tax—Adjustment process. If you  
overreported tax on Form 941 and choose to apply the  
credit to Form 941 or Form 944, file an adjusted return on  
Form 941-X soon after you discover the error but more  
than 90 days before the period of limitations on the credit  
or refund for Form 941 expires. See Is There a Deadline  
Overreported tax—Claim process. If you overreported  
tax on Form 941, you may choose to file a claim for refund  
or abatement on Form 941-X any time before the period of  
limitations on credit or refund expires on Form 941. If you  
also need to correct any underreported tax amounts, you  
must file another Form 941-X reporting only corrections to  
the underreported amounts. See Is There a Deadline for  
Department of the Treasury  
Internal Revenue Service  
Cincinnati, OH 45999-0005  
Alabama, Alaska, Arizona,  
Arkansas, California, Colorado,  
Hawaii, Idaho, Iowa, Kansas,  
Louisiana, Minnesota,  
Mississippi, Missouri, Montana,  
Nebraska, Nevada, New Mexico,  
North Dakota, Oklahoma,  
Oregon, South Dakota, Texas,  
Utah, Washington, Wyoming  
Department of the Treasury  
Internal Revenue Service  
Ogden, UT 84201-0005  
You may not file a refund claim to correct federal  
income tax or Additional Medicare Tax actually  
!
No legal residence or principal  
place of business in any state  
Internal Revenue Service  
P.O. Box 409101  
Ogden, UT 84409  
CAUTION  
withheld from employees.  
Is There a Deadline for Filing Form  
941-X?  
Special filing address for  
exempt organizations; federal,  
state, and local governmental  
entities; and Indian tribal  
governmental entities, regardless  
of location  
Department of the Treasury  
Internal Revenue Service  
Ogden, UT 84201-0005  
Generally, you may correct overreported taxes on a  
previously filed Form 941 if you file Form 941-X within 3  
years of the date Form 941 was filed or 2 years from the  
date you paid the tax reported on Form 941, whichever is  
later. You may correct underreported taxes on a  
previously filed Form 941 if you file Form 941-X within 3  
years of the date the Form 941 was filed. We call each of  
these time frames a period of limitations. For purposes of  
the period of limitations, Forms 941 for a calendar year  
are considered filed on April 15 of the succeeding year if  
filed before that date.  
Example. You filed your 2020 fourth quarter Form 941  
on January 26, 2021, and payments were timely made.  
The IRS treats the return as if it were filed on April 15,  
2021. On January 24, 2024, you discover that you  
overreported social security and Medicare wages on that  
form by $350. To correct the error, you must file Form  
941-X by April 15, 2024, which is the end of the period of  
limitations for Form 941, and use the claim process.  
PDSs can't deliver to P.O. boxes. You must use the  
U.S. Postal Service to mail an item to a P.O. box address.  
Go to IRS.gov/PDS for the current list of PDSs. If you file  
Form 941-X using a PDS, send it to the following address.  
Ogden - Internal Revenue Submission Processing  
Center  
1973 Rulon White Blvd.  
Ogden, UT 84201  
Use this address even if your business is located in a  
state that files in Cincinnati.  
How Should You Complete Form  
941-X?  
Use a Separate Form 941-X for Each Quarter  
You’re Correcting  
Use a separate Form 941-X for each Form 941 that you’re  
correcting. For example, if you found errors on your Forms  
-6-  
Instructions for Form 941-X (Rev. 4-2023)  
           
941 for the third and fourth quarters of 2022, file one Form  
941-X to correct the 2022 third quarter Form 941 and file a  
second Form 941-X to correct the 2022 fourth quarter  
Form 941.  
Complete all five pages and sign Form 941-X on  
page 5.  
Staple multiple sheets in the upper-left corner.  
What About Penalties and Interest?  
Employer Identification Number (EIN), Name,  
and Address  
Generally, your correction of an underreported tax amount  
won’t be subject to an FTP penalty, an FTD penalty, or  
interest if you:  
Enter your EIN, name, and address in the spaces  
provided. Also enter your name and EIN on the top of  
pages 2, 3, 4, and 5, and on any attachments. If your  
address has changed since you filed your Form 941, enter  
the corrected information and the IRS will update your  
address of record. Be sure to write your name, EIN, “Form  
941-X,” the calendar quarter you’re correcting (for  
example, “Quarter 2”), and the calendar year of the  
quarter you’re correcting on the top of any attachments.  
File on time (by the due date of Form 941 for the quarter  
in which you discover the error),  
Pay the amount shown on line 27 by the time you file  
Form 941-X,  
Enter the date you discovered the error, and  
Explain in detail the grounds and facts relied on to  
support the correction.  
No correction will be eligible for interest-free treatment  
if any of the following apply.  
Return You’re Correcting  
The amounts underreported relate to an issue that was  
In the box at the top of page 1, check the type of return  
(Form 941 or Form 941-SS) you’re correcting. Check the  
appropriate box for the one quarter you’re correcting.  
Enter the calendar year of the Form 941 you’re correcting.  
Enter the quarter and calendar year on pages 2, 3, 4, and  
5.  
raised in an examination of a prior period.  
You knowingly underreported your employment tax  
liability.  
You received a notice and demand for payment.  
You received a notice of determination under section  
7436.  
Enter the Date You Discovered Errors  
If you receive a notice about a penalty after you file this  
You must enter the date you discovered errors. You  
discover an error when you have enough information to be  
able to correct it. If you’re reporting several errors that you  
discovered at different times, enter the earliest date you  
discovered them here. Report any subsequent dates and  
related errors on line 43.  
return, reply to the notice with an explanation and we will  
determine if you meet the reasonable-cause criteria. Don’t  
attach an explanation when you file your return.  
Overview of the Process  
To correct a previously filed Form 941, use Form 941-X to  
file either an adjusted employment tax return or a claim for  
refund or abatement. The adjustment process and the  
claim process are outlined below.  
If you underreported the tax. If you underreported  
the tax on a previously filed Form 941, check the box on  
line 1 and pay any additional amount you owe by the  
time you file Form 941-X. For details on how to make a  
payment, see the instructions for line 27, later.  
Must You Make an Entry on Each Line?  
You must provide all of the information requested at the  
top of page 1 of Form 941-X. You must check one box  
(but not both) in Part 1. In Part 2, you must check the box  
on line 3 and any applicable boxes on lines 4 and 5. In  
Part 3, if any line doesn’t apply, leave it blank. Complete  
Parts 4 and 5 as instructed.  
How Should You Report Negative Amounts?  
Example—You underreported employment taxes.  
On July 7, 2023, you discover an error that results in  
additional tax on your 2022 third quarter Form 941. File  
Form 941-X by October 31, 2023, and pay the amount  
you owe by the time you file. See When Should You File  
Form 941-X, earlier. Don’t attach Form 941-X to your 2023  
third quarter Form 941.  
Form 941-X uses negative numbers to show reductions in  
tax (credits) and positive numbers to show additional tax  
(amounts you owe).  
When reporting a negative amount in columns 3 and 4,  
use a minus sign instead of parentheses. For example,  
enter “-10.59” instead of “(10.59).” However, if you’re  
completing the return on your computer and your software  
only allows you to use parentheses to report negative  
amounts, you may use them.  
If you overreported the tax. If you overreported the  
tax on a previously filed Form 941, you may choose one  
of the following options.  
Use the adjustment process. Check the box on line 1 to  
apply any credit (negative amount) from line 27 to Form  
941 for the quarter during which you file Form 941-X.  
How Should You Make Entries on Form 941-X?  
You can help the IRS process Form 941-X timely and  
accurately if you follow these guidelines.  
Use the claim process. Check the box on line 2 to file a  
claim on Form 941-X requesting a refund or abatement of  
the amount shown on line 27.  
Type or print your entries.  
Use Courier font (if possible) for all typed or  
computer-generated entries.  
To ensure that the IRS has enough time to  
Omit dollar signs. You may use commas and decimal  
process a credit for an overreporting tax  
TIP  
points, if desired. Enter dollar amounts to the left of any  
preprinted decimal point and cents to the right of it.  
adjustment in the quarter during which you file  
Form 941-X, you’re encouraged to file Form 941-X  
correcting the overreported tax amount in the first 2  
months of a quarter. For example, if you discover an  
Always show an amount for cents, even if it is zero.  
Don’t round entries to whole dollars.  
Instructions for Form 941-X (Rev. 4-2023)  
-7-  
   
overreported tax amount in March, June, September, or  
December, you may want to file Form 941-X in the first 2  
months of the next quarter. However, there must be 90  
days remaining on the period of limitations when you file  
Form 941-X. See the Caution under Is There a Deadline  
for Filing Form 941-X, earlier. This should ensure that the  
IRS will have enough time to process Form 941-X so the  
credit will be posted before you file Form 941, thus  
avoiding an erroneous balance due notice from the IRS.  
See the example below.  
date you discovered the error, and explain the correction  
on line 43.  
If you have a credit. You overreported employment  
taxes (you have a negative amount on line 27) and want  
the IRS to apply the credit to Form 941 or Form 944 for the  
period during which you filed Form 941-X. The IRS will  
apply your credit on the first day of the Form 941 or Form  
944 period during which you filed Form 941-X. However,  
the credit you show on Form 941-X, line 27, may not be  
fully available on your Form 941 or Form 944 if the IRS  
corrects it during processing or you owe other taxes,  
penalties, or interest. The IRS will notify you if your  
claimed credit changes or if the amount available as a  
credit on Form 941 or Form 944 was reduced because of  
unpaid taxes, penalties, or interest.  
Example—You want your overreported tax applied  
as a credit to Form 941. On September 18, 2023, you  
discover you overreported your tax on your 2022 fourth  
quarter Form 941 and want to choose the adjustment  
process. To allow the IRS enough time to process the  
credit, you file Form 941-X on October 2, 2023, and take  
the credit on your fourth quarter 2023 Form 941.  
Don’t check the box on line 1 if you’re correcting  
overreported tax amounts and the period of  
!
CAUTION  
limitations on credit or refund for Form 941 will  
If you currently file Form 944 and you’re making a  
expire within 90 days of the date you file Form 941-X. See  
correction to a previously filed Form 941 that will  
be claimed as a credit on Form 944, file Form  
TIP  
941-X before December in any year before the expiration  
of the period of limitations for the previously filed Form  
941. In the year that the period of limitations for the  
previously filed Form 941 expires, file Form 941-X at least  
90 days before the expiration date.  
2. Claim  
Check the box on line 2 to use the claim process if you’re  
correcting overreported tax amounts only and you’re  
claiming a refund or abatement for the negative amount  
(credit) shown on line 27. Don’t check this box if you’re  
correcting any underreported tax amounts on this form.  
Specific Instructions:  
You must check the box on line 2 if you have a credit (a  
negative amount on line 27) and the period of limitations  
on credit or refund for Form 941 will expire within 90 days  
of the date you file Form 941-X. See Is There a Deadline  
The IRS usually processes claims shortly after they are  
filed. The IRS will notify you if your claim is denied,  
accepted as filed, or selected to be examined. See Pub.  
556, Examination of Returns, Appeal Rights, and Claims  
for Refund, for more information.  
Unless the IRS corrects Form 941-X during processing  
or you owe other taxes, penalties, or interest, the IRS will  
refund the amount shown on line 27, plus any interest that  
applies.  
Part 1: Select ONLY One Process  
Because Form 941-X may be used to file either an  
adjusted employment tax return or a claim for refund or  
abatement, you must check one box on either line 1 or  
line 2. Don’t check both boxes.  
Correcting an employment tax credit or social securi-  
ty tax deferral. For lines 1 and 2, if you underreported an  
employment tax credit or the amount of social security tax  
deferred, treat it like you overreported a tax amount. If you  
overreported an employment tax credit or the amount of  
social security tax deferred, treat it like you underreported  
a tax amount. If you're filing Form 941-X to adjust only an  
employment tax credit and/or the amount of social  
security tax deferred and you're not correcting any  
overreported taxes on Form 941-X, lines 6–13, skip lines 4  
and 5.  
You may not file a refund claim to correct federal  
income tax or Additional Medicare Tax actually  
!
CAUTION  
withheld from employees.  
Part 2: Complete the Certifications  
1. Adjusted Employment Tax Return  
Check the box on line 1 if you’re correcting underreported  
tax amounts or overreported tax amounts and you would  
like to use the adjustment process to correct the errors.  
You must complete all certifications that apply by  
checking the appropriate boxes. If all of your corrections  
relate to underreported tax amounts, complete line 3 only;  
skip lines 4 and 5 and go to Part 3. If your corrections  
relate to overreported tax amounts, other than corrections  
related to underreported employment tax credits and  
social security tax deferrals, you have a duty to ensure  
that your employees' rights to recover overpaid employee  
social security and Medicare taxes that you withheld are  
protected. The certifications on lines 4 and 5 address the  
requirement to:  
If you’re correcting both underreported tax amounts  
and overreported tax amounts on this form, you must  
check this box. If you check this box, any negative amount  
shown on line 27 will be applied as a credit (tax deposit) to  
your Form 941 or Form 944 for the period in which you’re  
filing this form. See Example—You want your  
If you owe tax. Pay the amount shown on line 27 by the  
time you file Form 941-X. Generally, you won’t be  
charged interest if you file on time, pay on time, enter the  
Repay or reimburse your employees for the  
overcollection of employee social security and Medicare  
taxes, or  
-8-  
Instructions for Form 941-X (Rev. 4-2023)  
         
Obtain consents from your employees to file a claim on  
security tax, Medicare tax, or Additional Medicare Tax that  
you didn’t withhold from your employees.  
their behalf. See Rev. Proc. 2017-28 for guidance on the  
requirements for both a request for employee consent and  
for the employee consent.  
5. Certifying Claims  
If you’re filing a claim for refund or abatement of  
3. Filing Forms W-2 or Forms W-2c  
overreported federal income tax, social security tax,  
Medicare tax, or Additional Medicare Tax and checked  
the box on line 2, check the appropriate box on line 5. You  
may need to check more than one box. If you obtained  
written statements or consents from some employees but  
you couldn’t locate employees or secure the statements  
or consents of the remaining employees, check all  
applicable boxes. Provide a summary on line 43 of the  
amount of the corrections for both the employees who  
provided statements or consents and for those who didn’t.  
Check the box on line 3 to certify that you filed or will file  
Forms W-2 or Forms W-2c with the SSA, as required,  
showing your employees' correct wage and tax amounts.  
See the General Instructions for Forms W-2 and W-3 for  
detailed information about filing requirements. References  
to Form W-2 on Form 941-X and in these instructions also  
apply to Forms W-2AS, W-2CM, W-2GU, and W-2VI,  
unless otherwise noted.  
You must check the box on line 3 to certify that you filed  
Forms W-2 or Forms W-2c even if your corrections on  
Form 941-X don’t change amounts shown on those forms.  
For example, if your only correction to Form 941 involves  
misstated tax adjustments, which don't impact the  
amounts reported on your employees’ Forms W-2 (see  
the instructions for line 15, later), check the box on line 3  
to certify that you already filed all required Forms W-2 and  
W-2c with the SSA. In this situation, you're certifying that  
you don't need to file Form W-2c because you already  
filed a correct Form W-2.  
You can’t file a refund claim to correct the  
incorrect amount of federal income tax or  
!
CAUTION  
Additional Medicare Tax actually withheld from  
employees in a prior year. If you request their consent to  
file a claim for social security tax or Medicare tax, you  
must tell your employees that you can’t claim a refund of  
any Additional Medicare Tax on their behalf. See Rev.  
Proc. 2017-28 for sample language to use in your request.  
5a. Check the box on line 5a if your overreported tax  
includes each affected employee share of social security  
and Medicare taxes. You’re certifying that you repaid or  
reimbursed to the employees their share of social security  
and Medicare taxes. For refunds of employee social  
security and Medicare taxes overcollected in prior years,  
you’re certifying that you received written statements from  
those employees stating that they didn’t and won’t receive  
a refund or credit for the prior year taxes. Don’t send these  
statements to the IRS. Keep them for your records.  
Generally, all employment tax records must be kept for at  
least 4 years. Records related to qualified sick leave  
wages and qualified family leave wages for leave taken  
after March 31, 2021, and before October 1, 2021, and  
records related to qualified wages for the employee  
retention credit paid after June 30, 2021, should be kept  
for at least 6 years. Copies must be submitted to the IRS if  
requested.  
5b. Check the box on line 5b if your overreported tax  
includes each affected employee share of social security  
and Medicare taxes and you haven’t yet repaid or  
reimbursed the employee share of taxes. You’re certifying  
that you received consent from each affected employee to  
file a claim on the employee share of those taxes and you  
received written statements from those employees stating  
that they didn’t and won’t receive a refund or credit for the  
prior year taxes.  
4. Certifying Overreporting Adjustments  
If you overreported federal income tax, social security tax,  
Medicare tax, or Additional Medicare Tax and checked  
the box on line 1, check the appropriate box on line 4. You  
may need to check more than one box. If you obtained  
written statements from some employees but you couldn’t  
locate employees or secure the statements of the  
remaining employees, check all applicable boxes. Provide  
a summary on line 43 of the amount of the corrections  
both for the employees who provided written statements  
and for those who didn’t.  
4a. Check the box on line 4a if your overreported amount  
includes each affected employee share of overcollected  
taxes. You’re certifying that you repaid or reimbursed the  
employee share of current and prior year taxes and you  
received written statements from the employees stating  
that they didn’t and won’t receive a refund or credit for the  
prior year taxes. You’re certifying that you adjusted federal  
income tax or Additional Medicare Tax withheld from  
employees for the current calendar year only. Don’t send  
these statements to the IRS. Keep them for your records.  
Generally, all employment tax records must be kept for at  
least 4 years. Records related to qualified sick leave  
wages and qualified family leave wages for leave taken  
after March 31, 2021, and before October 1, 2021, and  
records related to qualified wages for the employee  
retention credit paid after June 30, 2021, should be kept  
for at least 6 years. Copies must be submitted to the IRS if  
requested.  
An employee consent must:  
Contain the name, address, and social security number  
(or truncated taxpayer identification number, when  
appropriate) of the employee;  
Contain the name, address, and EIN of the employer;  
Contain the tax period(s), the type of tax, and the  
4b. Check the box on line 4b to certify that your  
overreported amount is only for the employer share of  
taxes on those employees who you were unable to find or  
those who didn’t give you a statement described on  
line 4a.  
amount of tax for which the consent is provided;  
Affirmatively state that the employee authorizes the  
employer to claim a refund for the overpayment of the  
employee share of tax;  
4c. Check the box on line 4c to certify that your  
overreported amount is only for federal income tax, social  
Instructions for Form 941-X (Rev. 4-2023)  
-9-  
For amounts collected in a prior year, include the  
If you previously adjusted or amended Form 941  
by using Form 941-X or because of an IRS  
examination change, show amounts in column 2  
employee’s written statement certifying that the employee  
hasn’t made any previous claims (or the claims were  
rejected) and won’t make any future claims for refund or  
credit of the amount of the overcollection;  
!
CAUTION  
that include those previously reported corrections.  
Identify the basis of the claim; and  
6. Wages, Tips, and Other Compensation  
Be dated and contain the employee’s signature under  
If you’re correcting the wages, tips, and other  
compensation you reported on Form 941, line 2, enter the  
total corrected amount for all employees in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2. This line doesn’t apply to Form  
941-SS.  
penalties of perjury. The penalties of perjury statement  
should be located immediately above the required  
signature.  
Don’t send these statements and consents to the IRS.  
Keep them for your records. Generally, all employment  
tax records must be kept for at least 4 years. Records  
related to qualified sick leave wages and qualified family  
leave wages for leave taken after March 31, 2021, and  
before October 1, 2021, and records related to qualified  
wages for the employee retention credit paid after June  
30, 2021, should be kept for at least 6 years. Copies must  
be submitted to the IRS if requested.  
If you or the IRS previously corrected the amount  
reported on Form 941, line 2, enter in column 2 the  
amount after any previous corrections.  
line 6 (column 1)  
- line 6 (column 2)  
In certain situations, you may not have repaid or  
reimbursed your employees or obtained their consents  
prior to filing a claim, such as in cases where the period of  
limitations on credit or refund is about to expire. In those  
situations, file Form 941-X, but don’t check a box on  
line 5. Tell us on line 43 that you haven’t repaid or  
reimbursed employees or obtained consents at the time  
you file the claim. However, you must repay or reimburse  
your employees and certify that you’ve done so before the  
IRS can allow the claim.  
5c. Check the box on line 5c to certify that your  
overreported tax is only for the employer share of social  
security and Medicare taxes. This applies when affected  
employees didn’t give you consent to file a claim for  
refund for the employee share of social security and  
Medicare taxes, they couldn’t be found, or they didn’t give  
you a statement described on line 5b.  
line 6 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Example—Wages, tips, and other compensation  
increased. You reported $9,000 as total wages, tips, and  
other compensation on line 2 of your 2023 first quarter  
Form 941. In May of 2023, you discovered that you had  
overlooked $1,000 in tips for one of your employees. To  
correct the error, figure the difference on Form 941-X as  
shown.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 2)  
Column 3 (difference)  
10,000.00  
- 9,000.00  
1,000.00  
5d. Check the box on line 5d to certify that your  
overreported amount is only for federal income tax, social  
security tax, Medicare tax, or Additional Medicare Tax that  
you didn’t withhold from your employees.  
Example—Wages, tips, and other compensation  
decreased. You reported $9,000 as wages, tips, and  
other compensation on line 2 of your 2023 first quarter  
Form 941. In May of 2023, you discovered that you  
included $2,000 in wages for one of your employees  
twice. To correct the error, figure the difference on Form  
941-X as shown.  
Part 3: Enter the Corrections for This  
Quarter  
What Amounts Should You Report in Part 3?  
Column 1 (corrected amount)  
Column 2 (Form 941, line 2)  
Column 3 (difference)  
7,000.00  
- 9,000.00  
-2,000.00  
On lines 6–13, columns 1 and 2, for each line you're  
correcting, show amounts for all of your employees, not  
just for those employees whose amounts you’re  
correcting.  
If a correction that you report in column 4 includes both  
underreported and overreported amounts (see the  
instructions for line 41, later), give us details for each error  
on line 43.  
Example—Auto allowance; wages, tips, and other  
compensation increased. You paid one of your  
employees a $500 monthly auto allowance from October  
through December 2022, and didn’t treat the payments as  
taxable wages. In February 2023, you realized that the  
payments were wages because they weren’t  
Because special circumstances apply for lines 14–22,  
24–26c, and 28–40, read the instructions for each line  
carefully before entering amounts in the columns.  
reimbursements of deductible business expenses that  
were substantiated and paid under an accountable plan.  
You correct the error by treating the auto allowance as  
wages subject to income, social security, and Medicare  
taxes. Report the additional $1,500 of wages on Form  
941-X, lines 6, 8, 12, and, if applicable, 13.  
If any line doesn't apply to you, leave it blank.  
-10-  
Instructions for Form 941-X (Rev. 4-2023)  
     
Be sure to explain the reasons for the corrections on  
line 43.  
Example—Prior year nonadministrative error  
(failure to withhold federal income tax when  
required). You were required to withhold $400 of federal  
income tax from an employee's bonus that was paid in  
December of 2022 but you withheld nothing. You  
discovered the error on March 13, 2023. You can’t file  
Form 941-X to correct federal income tax withheld  
reported on your 2022 fourth quarter Form 941 because  
the error involves a previous year and the amount  
previously reported for the employee represents the  
actual amount withheld from the employee during 2022.  
Example—Prior year administrative error  
(incorrectly reported amount of federal income tax  
actually withheld). You had three employees. In the  
fourth quarter of 2022, you withheld $1,000 of federal  
income tax from Xavier Black, $2,000 from Sophie Rose,  
and $6,000 from Leo Wood. The total amount of federal  
income tax you withheld was $9,000. You mistakenly  
reported $6,000 on line 3 of your 2022 fourth quarter Form  
941. You discovered the error on March 10, 2023. This is  
an example of an administrative error that may be  
corrected in a later calendar year because the amount  
actually withheld from the employees' wages isn’t the  
amount reported on Form 941. Use Form 941-X to correct  
the error. Enter $9,000 in column 1 and $6,000 in column  
2. Subtract the amount in column 2 from the amount in  
column 1.  
The quarterly amount on line 6, column 1, should  
be used to figure the annual amount to report on  
your Forms W-2 or Forms W-2c. This amount  
TIP  
should also generally be used for any business expense  
deduction on your income tax return (or amended return)  
for wages paid.  
7. Federal Income Tax Withheld From Wages,  
Tips, and Other Compensation  
If you’re correcting the federal income tax withheld from  
wages, tips, and other compensation you reported on  
Form 941, line 3, enter the total corrected amount in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. This line doesn’t  
apply to Form 941-SS.  
line 7 (column 1)  
- line 7 (column 2)  
line 7 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Copy the amount in column 3 to column 4. Include any  
minus sign shown in column 3.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 3)  
9,000.00  
- 6,000.00  
Generally, you may correct federal income tax  
withholding errors only if you discovered the  
!
Column 3 (difference)  
3,000.00  
CAUTION  
errors in the same calendar year you paid the  
wages. In addition, for an overcollection, you may correct  
federal income tax withholding only if you also repaid or  
reimbursed the employees in the same year. For prior  
years, you may only correct administrative errors to  
federal income tax withholding (that is, errors in which the  
amount reported on Form 941, line 3, isn't the amount you  
actually withheld from an employee’s wages) and errors  
for which section 3509 rates apply. Only transposition or  
math errors involving the inaccurate reporting of the  
amount withheld are administrative errors. See section 13  
of Pub. 15 for more information about corrections during  
the calendar year and about administrative errors. See  
section 2 of Pub. 15 for more information about section  
3509. If section 3509 rates apply, see the instructions for  
lines 19–22, later.  
Report the $3,000 as a tax correction in column 4.  
Be sure to explain the reasons for this correction on  
line 43.  
Example—Nonadministrative error reporting  
federal income tax because of repayment of wages  
paid in prior year. You prepaid Jack Brown $4,000 of  
wages for 2 months of work in September 2022. You  
withheld $400 of federal income tax at the time you paid  
Jack. These amounts were reported on your 2022 third  
quarter Form 941. Jack left employment in October 2022  
(after only 1 month of service). In January 2023, Jack  
repaid $2,000 to you for the 1 month Jack didn't work. You  
can’t file Form 941-X to reduce the federal income tax  
withheld because you actually withheld the federal income  
tax from wages. You also can’t file Form 941-X to reduce  
wages because the wages were income to Jack for the  
prior year. These amounts were correctly reported on  
Form 941.  
You can’t file a Form 941-X to correct federal income  
tax withholding for prior years for nonadministrative errors.  
In other words, you can’t correct federal income tax  
actually withheld from an employee in a prior year if you  
discover that you didn’t withhold the right amount. For  
example, you can’t correct federal income tax withheld in  
a prior year because you used the wrong income tax  
withholding table or you didn’t treat a payment correctly as  
taxable or nontaxable. Similarly, if you paid federal  
income tax in a prior year on behalf of your employee,  
rather than deducting it from the employee’s pay (which  
resulted in additional wages subject to tax), and in a  
subsequent year you determine that you incorrectly  
calculated the amount of tax, you can’t correct the federal  
income tax withholding.  
8. Taxable Social Security Wages  
Qualified sick leave wages and qualified family  
leave wages for leave taken after March 31, 2021,  
and before October 1, 2021, were included on  
TIP  
Form 941, line 5a, column 1, and can be adjusted only on  
Form 941-X, line 8.  
If you’re correcting the taxable social security wages  
you reported on Form 941, line 5a, column 1, enter the  
total corrected amount in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
Instructions for Form 941-X (Rev. 4-2023)  
-11-  
In column 3, enter the difference between columns 1 and  
2.  
reported on Form 941X, line 25. Adjustments to qualified  
health plan expenses allocable to qualified sick leave  
wages and to qualified family leave wages for leave taken  
after March 31, 2020, and before April 1, 2021, are  
reported on Form 941X, lines 28 and 29, respectively. If  
you claimed the credit for qualified sick and family leave  
wages for leave taken after March 31, 2020, and before  
April 1, 2021, on your original Form 941 for the quarter,  
and you make any corrections on Form 941X for the  
quarter to amounts used to figure this credit, you'll need to  
refigure the amount of this credit using Worksheet 1. You'll  
also use this worksheet to figure this credit if you’re  
claiming the credit for the first time on Form 941-X. For  
more information about the credit for qualified sick and  
family leave wages, go to IRS.gov/PLC.  
line 8 (column 1)  
- line 8 (column 2)  
line 8 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Multiply the amount in column 3 by 0.124 and enter that  
result in column 4.  
line 8 (column 3)  
x 0.124  
Qualified sick leave wages paid with respect to leave  
taken after March 31, 2020, and before April 1, 2021,  
aren't subject to the employer share of social security tax;  
therefore, the tax rate on these wages is 6.2% (0.062). For  
more information about qualified sick leave wages, see  
2021, later, and go to IRS.gov/PLC. If you’re correcting  
the qualified sick leave wages you reported on Form 941,  
line 5a(i), column 1, enter the total corrected amount in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2.  
line 8 (column 4)  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
Note. If you checked the box on Form 941-X, line 4b or  
line 5c, because you’re correcting only the employer  
share of tax on a decrease to social security wages, use  
0.062 (6.2%) when multiplying the amount shown in  
column 3. If you’re correcting both shares of tax for some  
employees and only the employer share for other  
employees, enter the properly calculated amount in  
column 4. Be sure to show your calculations on line 43.  
Example—Social security wages decreased.  
compensation decreased in the instructions for line 6, the  
wages that you counted twice were also taxable social  
security wages. To correct the error, figure the difference  
on Form 941-X as shown.  
line 9 (column 1)  
- line 9 (column 2)  
line 9 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5a, column 1)  
7,000.00  
- 9,000.00  
Multiply the amount in column 3 by 0.062 and enter that  
result in column 4.  
Column 3 (difference)  
-2,000.00  
line 9 (column 3)  
x 0.062  
line 9 (column 4)  
Use the difference in column 3 to determine your tax  
correction.  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
Column 3 (difference)  
Tax rate (12.4%)  
-2,000.00  
x 0.124  
Column 4 (tax correction)  
-248.00  
Note. If you erroneously reported qualified sick leave  
wages for leave taken after March 31, 2020, and before  
April 1, 2021, on Form 941, line 5a, instead of on  
line 5a(i), you'll need to make a correction on Form 941-X,  
lines 8 and 9, and enter the properly calculated amount in  
column 4 for each line.  
Example—Qualified sick leave wages increased.  
You paid $2,000 of qualified sick leave wages to only one  
of your employees in the second quarter of 2020. In  
March 2023, you discovered that you only reported  
$1,000 of qualified sick leave wages on Form 941 for the  
second quarter. To correct the error, figure the difference  
on Form 941X as shown.  
Be sure to explain the reasons for this correction on  
line 43.  
9. Qualified Sick Leave Wages (For Leave Taken  
After March 31, 2020, and Before April 1, 2021)  
Adjustments to the social security tax on qualified  
sick leave wages and qualified family leave wages  
for leave taken after March 31, 2020, and before  
TIP  
April 1, 2021, are reported on Form 941X, lines 9 and 10,  
respectively. Adjustments to the nonrefundable portion of  
the credit for qualified sick and family leave wages for  
leave taken after March 31, 2020, and before April 1,  
2021, are reported on Form 941X, line 17, and  
adjustments to the refundable portion of the credit are  
-12-  
Instructions for Form 941-X (Rev. 4-2023)  
 
wages on Form 941 for the second quarter. To correct the  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5a(i), column 1)  
2,000.00  
- 1,000.00  
error, figure the difference on Form 941X as shown.  
Column 3 (difference)  
1,000.00  
Column 1 (corrected amount)  
1,000.00  
Column 2 (Form 941, line 5a(ii), column 1)  
- 3,000.00  
Column 3 (difference)  
-2,000.00  
Use the difference in column 3 to determine your tax  
correction.  
Use the difference in column 3 to determine your tax  
correction.  
Column 3 (difference)  
Tax rate (6.2%)  
1,000.00  
x 0.062  
Column 4 (tax correction)  
62.00  
Column 3 (difference)  
Tax rate (6.2%)  
-2,000.00  
x 0.062  
Column 4 (tax correction)  
-124.00  
Be sure to explain the reasons for this correction on  
line 43.  
Be sure to explain the reasons for this correction on  
line 43.  
10. Qualified Family Leave Wages (For Leave  
Taken After March 31, 2020, and Before April 1,  
2021)  
11. Taxable Social Security Tips  
Qualified family leave wages paid with respect to leave  
taken after March 31, 2020, and before April 1, 2021,  
aren't subject to the employer share of social security tax;  
therefore, the tax rate on these wages is 6.2% (0.062). For  
more information about qualified family leave wages, see  
2021, later, and go to IRS.gov/PLC. If you’re correcting  
the qualified family leave wages you reported on Form  
941, line 5a(ii), column 1, enter the total corrected amount  
in column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2.  
If you’re correcting the taxable social security tips you  
reported on Form 941, line 5b, column 1, enter the total  
corrected amount in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
In column 3, enter the difference between columns 1 and  
2.  
line 11 (column 1)  
- line 11 (column 2)  
line 11 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
line 10 (column 1)  
- line 10 (column 2)  
line 10 (column 3)  
Multiply the amount in column 3 by 0.124 and report  
that result in column 4.  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
line 11 (column 3)  
x 0.124  
line 11 (column 4)  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
Multiply the amount in column 3 by 0.062 and enter that  
result in column 4.  
Note. If you checked the box on Form 941-X, line 4b or  
line 5c, because you’re correcting only the employer  
share of tax on a decrease to social security tips, use  
0.062 (6.2%) when multiplying the amount shown in  
column 3. If you’re correcting both shares of tax for some  
employees and only the employer share for other  
employees, report the properly calculated amount in  
column 4. Be sure to show your calculations on line 43.  
Example—Social security tips increased.  
compensation increased in the instructions for line 6, the  
tips that you overlooked were also taxable social security  
tips. To correct the error, figure the difference on Form  
941-X as shown.  
line 10 (column 3)  
x 0.062  
line 10 (column 4)  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
Note. If you erroneously reported qualified family leave  
wages for leave taken after March 31, 2020, and before  
April 1, 2021, on Form 941, line 5a, instead of on  
line 5a(ii), you'll need to make a correction on Form  
941-X, lines 8 and 10, and enter the properly calculated  
amount in column 4 for each line.  
Example—Qualified family leave wages  
decreased. You paid $1,000 of qualified family leave  
wages to only one of your employees in the second  
quarter of 2020. In March 2023, you discovered that you  
erroneously reported $3,000 of qualified family leave  
Instructions for Form 941-X (Rev. 4-2023)  
-13-  
Use the difference in column 3 to determine your tax  
correction.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5b, column 1)  
10,000.00  
- 9,000.00  
Column 3 (difference)  
1,000.00  
Column 3 (difference)  
Tax rate (2.9%)  
-2,000.00  
x 0.029  
Column 4 (tax correction)  
-58.00  
Use the difference in column 3 to determine your tax  
correction.  
Be sure to explain the reasons for this correction on  
line 43.  
Column 3 (difference)  
Tax rate (12.4%)  
1,000.00  
x 0.124  
Column 4 (tax correction)  
124.00  
13. Taxable Wages & Tips Subject to Additional  
Medicare Tax Withholding  
Generally, you may correct errors to Additional Medicare  
Tax withholding only if you discovered the errors in the  
same calendar year the wages and tips were paid to  
employees. However, you may correct errors to Additional  
Medicare Tax withholding for prior years if the amount  
reported on Form 941, line 5d, column 2, isn’t the amount  
you actually withheld, including any amount you paid on  
behalf of your employee rather than deducting it from the  
employee’s pay (which resulted in additional wages  
subject to tax). This type of error is an administrative error.  
The administrative error adjustment corrects the amount  
reported on Form 941 to agree with the amount actually  
withheld from employees.  
Be sure to explain the reasons for this correction on  
line 43.  
12. Taxable Medicare Wages & Tips  
If you’re correcting the taxable Medicare wages and tips  
you reported on Form 941, line 5c, column 1, enter the  
total corrected amount in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
In column 3, enter the difference between columns 1 and  
2.  
line 12 (column 1)  
- line 12 (column 2)  
You may also correct errors to Additional Medicare Tax  
withholding for prior years if section 3509 rates apply. If  
section 3509 rates apply, see the instructions for lines 19–  
22, later.  
line 12 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
If a prior year error was a nonadministrative error, you  
may correct only the wages and tips subject to  
Additional Medicare Tax withholding that were originally  
reported on Form 941, line 5d, column 1, or previously  
corrected on Form 941-X. You can’t correct the tax  
reported on Form 941, line 5d, column 2.  
Errors discovered in the same calendar year or prior  
year administrative errors. If you’re correcting the  
taxable wages and tips subject to Additional Medicare Tax  
withholding that you reported on Form 941, line 5d,  
column 1, enter the total corrected amount in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2.  
Multiply the amount in column 3 by 0.029 (2.9% tax  
rate) and enter that result in column 4.  
line 12 (column 3)  
x 0.029  
line 12 (column 4)  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
Note. If you checked the box on Form 941-X, line 4b or  
line 5c, because you’re correcting only the employer  
share of tax on a decrease to Medicare wages and tips,  
use 0.0145 (1.45%) when multiplying the amount in  
column 3. If you’re correcting both shares of tax for some  
employees and only the employer share for other  
employees, enter the properly calculated amount in  
column 4. Be sure to explain your calculations on line 43.  
line 13 (column 1)  
- line 13 (column 2)  
line 13 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Example—Medicare wages and tips decreased.  
compensation decreased in the instructions for line 6, the  
wages that you counted twice were also taxable Medicare  
wages and tips. To correct the error, figure the difference  
on Form 941-X as shown.  
Multiply the amount in column 3 by 0.009 (0.9% tax  
rate) and enter that result in column 4.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5c, column 1)  
7,000.00  
- 9,000.00  
line 13 (column 3)  
x 0.009  
Column 3 (difference)  
-2,000.00  
line 13 (column 4)  
If the amount in column 3 used a minus sign,  
also use a minus sign in column 4.  
-14-  
Instructions for Form 941-X (Rev. 4-2023)  
 
Example—Prior year administrative error  
(incorrectly reported amount of Additional Medicare  
Tax actually withheld). Xavier Black's wages exceeded  
the $200,000 withholding threshold for Additional  
Medicare Tax in November 2022. The total wages paid to  
Xavier for 2022 were $230,000. You withheld $270  
($30,000 x 0.009) from Xavier's wages. However, on your  
fourth quarter 2022 Form 941, you mistakenly reported  
$3,000 on line 5d, column 1, and Additional Medicare Tax  
withheld of $27 on line 5d, column 2. You discover the  
error on March 13, 2023. This is an example of an  
administrative error that may be corrected in a later  
calendar year because the amount actually withheld isn’t  
the amount reported on your fourth quarter 2022 Form  
941. Use Form 941-X, line 13, to correct the error as  
shown below.  
Medicare Tax withheld (column 4) because the error  
involves a previous year and the amount previously  
reported for Sophie represents the actual amount withheld  
from Sophie during 2022.  
Combination of prior year administrative and nonad-  
ministrative errors. If you’re reporting both  
administrative errors and nonadministrative errors for the  
same quarter of a prior year, enter the total corrected  
amount in column 1. In column 2, enter the amount you  
originally reported or as previously corrected. In column 3,  
enter the difference between columns 1 and 2. However,  
multiply only the amount of wages and tips reported in  
column 3 that are related to administrative errors by 0.009  
(0.9% tax rate). Don’t multiply any wages and tips  
reported in column 3 that are related to nonadministrative  
errors by 0.009 (0.9% tax rate). Use line 43 to explain in  
detail your corrections. The explanation must include the  
reasons for the corrections and a breakdown of the  
amount reported in column 3 into the amounts related to  
administrative errors and nonadministrative errors.  
Example—Combination of prior year administrative  
and nonadministrative errors. Xavier Black’s wages  
exceeded the $200,000 withholding threshold for  
Additional Medicare Tax in November 2022. The total  
wages paid to Xavier for 2022 were $230,000. You  
withheld $270 ($30,000 x 0.009) from Xavier's wages.  
However, on your fourth quarter 2022 Form 941, you  
mistakenly reported $3,000 on line 5d, column 1, and  
Additional Medicare Tax withheld of $27 on line 5d,  
column 2. The difference in wages subject to Additional  
Medicare Tax related to this administrative error is  
$27,000 ($30,000 - $3,000).  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5d, column 1)  
30,000.00  
- 3,000.00  
Column 3 (difference)  
27,000.00  
Use the difference in column 3 to determine your tax  
correction.  
Column 3 (difference)  
Tax rate (0.9%)  
27,000.00  
x 0.009  
Column 4 (tax correction)  
243.00  
Be sure to explain the reasons for this correction on  
line 43.  
Sophie Rose’s wages exceeded the $200,000  
withholding threshold for Additional Medicare Tax in  
December 2022. The total wages paid to Sophie for 2022  
were $220,000. You were required to withhold $180  
($20,000 x 0.009) but you withheld nothing and didn’t  
report Sophie's $20,000 in wages subject to Additional  
Medicare Tax withholding on line 5d of your fourth quarter  
2022 Form 941.  
Prior year nonadministrative errors. You may correct  
only the taxable wages and tips subject to Additional  
Medicare Tax withholding that you reported on Form 941,  
line 5d, column 1. Enter the total corrected amount in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2.  
You discover both errors on March 13, 2023. Use Form  
line 13 (column 1)  
- line 13 (column 2)  
941-X, line 13, to correct the errors as shown below.  
line 13 (column 3)  
If the amount in column 2 is larger than the  
amount in column 1, use a minus sign in  
column 3.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 5d, column 1)  
50,000.00  
- 3,000.00  
Column 3 (difference)  
47,000.00  
Don’t multiply the amount in column 3 by 0.009 (0.9%  
tax rate). Leave column 4 blank and explain the reasons  
for this correction on line 43.  
Determine the portion of wages and tips reported in  
column 3 that is related to the administrative error  
($47,000 - $20,000 (nonadministrative error) = $27,000  
(administrative error)). Multiply this portion of column 3 by  
0.009 (0.9% tax rate) to determine your tax correction.  
Example—Prior year nonadministrative error  
(failure to withhold Additional Medicare Tax when  
required). Sophie Rose’s wages exceeded the $200,000  
withholding threshold for Additional Medicare Tax in  
December 2022. The total wages paid to Sophie for 2022  
were $220,000. You were required to withhold $180  
($20,000 x 0.009) but you withheld nothing and didn’t  
report an amount on line 5d of your fourth quarter 2022  
Form 941. You discover the error on March 13, 2023. File  
Form 941-X to correct wages and tips subject to  
Additional Medicare Tax withholding for your 2022 fourth  
quarter Form 941, but you may not correct the Additional  
Difference related to administrative error  
Tax rate (0.9%)  
27,000.00  
x 0.009  
Column 4 (tax correction)  
243.00  
Be sure to explain the reasons for these corrections on  
line 43. You must also report that $20,000 of the amount  
shown in column 3 was related to the correction of a prior  
Instructions for Form 941-X (Rev. 4-2023)  
-15-  
year nonadministrative error and $27,000 of the amount  
shown in column 3 was related to the correction of an  
administrative error.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 8)  
Column 3 (difference)  
-9,600.00  
- (6,900.00)  
-2,700.00  
14. Section 3121(q) Notice and Demand—Tax  
on Unreported Tips  
Here is how you would enter the numbers on Form  
941-X.  
Enter on line 14 any corrections to amounts reported on  
Form 941, line 5f, for the tax due from a Section 3121(q)  
Notice and Demand. The IRS issues a Section 3121(q)  
Notice and Demand to advise an employer of the amount  
of tips received by employees who failed to report or  
underreported tips to the employer. An employer isn’t  
liable for the employer share of the social security and  
Medicare taxes on unreported tips until a Section 3121(q)  
Notice and Demand for the taxes is made to the employer  
by the IRS.  
Column 1  
(corrected  
amount)  
Column 2  
(Form 941, line 8)  
Column 3  
(difference)  
-9,600.00  
-6,900.00  
-2,700.00  
Report “-2,700.00” as your correction in column 4.  
In this example, you’re claiming a credit for $2,700 in  
overreported tax for your 2022 second quarter Form 941.  
Always enter the same amount in column 4 (including any  
minus sign) that you enter in column 3.  
Be sure to explain the reasons for any corrections on  
line 43.  
15. Tax Adjustments  
Be sure to explain the reasons for this correction on  
line 43.  
For purposes of these instructions, all references  
to “sick pay” mean ordinary sick pay, not “qualified  
sick leave wages.”  
TIP  
16. Qualified Small Business Payroll Tax Credit  
for Increasing Research Activities  
Use line 15 to correct any adjustments reported on  
Form 941, lines 7–9. Enter in column 1 the total corrected  
amount for Form 941, lines 7–9.  
The payroll tax credit election must be made on or  
before the due date of the originally filed income  
!
CAUTION  
tax return (including extensions). Any election to  
Enter in column 2 the total originally reported or  
take the payroll tax credit may be revoked only with the  
consent of the IRS.  
previously corrected amounts from Form 941, lines 7–9. In  
column 3, enter the difference between columns 1 and 2.  
If you’re correcting the qualified small business payroll  
tax credit for increasing research activities that you  
reported on Form 941, line 11a (line 11 for quarters  
beginning before April 1, 2020), enter the total corrected  
amount in column 1. In column 2, enter the amount you  
originally reported or as previously corrected. In column 3,  
enter the difference between columns 1 and 2.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4.  
line 15 (column 1)  
-line 15 (column 2)  
line 15 (column 3)  
You may need to report negative numbers in any  
column. Make sure that the difference you enter in  
column 3 accurately represents the change to  
TIP  
adjustments originally reported or previously corrected on  
Form 941, lines 7–9.  
Copy the amount in column 3 to column 4. Include any  
minus sign shown in column 3.  
You must attach a corrected Form 8974 and explain  
the reasons for this correction on line 43.  
On line 43, describe what you misreported on Form  
941. Tell us if your adjustment is for fractions of cents,  
third-party sick pay, tips, or group-term life insurance.  
17. Nonrefundable Portion of Credit for  
Qualified Sick and Family Leave Wages for  
Leave Taken After March 31, 2020, and Before  
April 1, 2021  
Example—Current quarter's third-party sick pay  
underreported. You reported $6,900 (shown as  
“-6,900.00”) as a third-party sick pay adjustment  
(reduction to tax) on line 8 of your 2022 second quarter  
Form 941. You didn’t report any amounts on lines 7 and 9.  
Your third-party sick pay adjustment should’ve been  
$9,600 (shown as “-9,600.00”) because your third-party  
sick pay payer withheld that amount of social security and  
Medicare taxes from your employees. You discovered the  
error in April of 2023. To correct the error, figure the  
difference on Form 941-X as shown.  
Form 941-X and these instructions use the terms  
“nonrefundable” and “refundable” when  
TIP  
discussing credits. The term “nonrefundable”  
means the portion of the credit which is limited by law to  
certain taxes. The term “refundable” means the portion of  
the credit which is in excess of those taxes.  
For corrections to Form 941, line 11b, the credit for  
qualified sick and family leave wages is only available for  
wages paid with respect to leave taken after March 31,  
2020, and before April 1, 2021. Don't enter an amount on  
line 17 if you're correcting a quarter that began before  
April 1, 2020.  
-16-  
Instructions for Form 941-X (Rev. 4-2023)  
   
If you’re correcting the nonrefundable portion of the  
credit for qualified sick and family leave wages for leave  
taken after March 31, 2020, and before April 1, 2021, that  
you reported on Form 941, line 11b, enter the total  
corrected amount from Worksheet 1, Step 2, line 2j, in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. For more  
increased in the instructions for line 9, you originally  
reported a $1,000 nonrefundable portion of the credit for  
qualified sick and family leave wages on Form 941,  
line 11b, for the second quarter of 2020. You use  
Worksheet 1 to refigure the correct nonrefundable portion  
of the credit for qualified sick and family leave wages and  
you determine that the correct credit is now $2,000. To  
correct the error, figure the difference on Form 941X as  
shown.  
information about the credit for qualified sick and family  
leave wages, go to IRS.gov/PLC.  
Column 1 (corrected amount)  
Column 2 (Form 941, line 11b)  
2,000.00  
- 1,000.00  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4.  
Definition of qualified sick and family leave wages  
for leave taken after March 31, 2020, and before April  
1, 2021. For purposes of the credit for qualified sick and  
family leave wages, qualified sick and family leave wages  
are wages for social security and Medicare tax purposes,  
determined without regard to the exclusions from the  
definition of employment under sections 3121(b)(1)–(22),  
that an employer pays that otherwise meet the  
Column 3 (difference)  
1,000.00  
To properly show the credit increase as a reduction to  
your tax balance, enter the positive number in column 3 as  
a negative number in column 4. Here is how you would  
enter the numbers on Form 941X, line 17.  
Column 1  
(corrected  
amount)  
Column 2  
(Form 941,  
line 11b)  
Column 3  
(difference)  
Column 4  
(tax correction)  
2,000.00  
1,000.00  
1,000.00  
-1,000.00  
requirements of the Emergency Paid Sick Leave Act  
(EPSLA) or the Emergency Family and Medical Leave  
Expansion Act (Expanded FMLA), as enacted under the  
FFCRA and amended by the COVID-related Tax Relief  
Act of 2020. However, don't include any wages otherwise  
excluded under sections 3121(b)(1)–(22) when reporting  
qualified sick and family leave wages on your employment  
tax return and when figuring the credit on Worksheet 1,  
Step 2, lines 2a and 2a(i), and on Step 2, lines 2e and  
2e(i). Instead, include qualified sick leave wages and  
qualified family leave wages excluded from the definition  
of employment under sections 3121(b)(1)–(22) separately  
in Step 2, line 2a(iii) and/or line 2e(iii), respectively, before  
you figure your total credit in Step 2, line 2d (credit for  
qualified sick leave wages), or Step 2, line 2h (credit for  
qualified family leave wages).  
The April 2020 revision and July 2020 revision of the  
Instructions for Form 941 were released before the  
COVID-related Tax Relief Act of 2020 was enacted on  
December 27, 2020; therefore, Worksheet 1, in those  
Instructions for Form 941, didn't include lines to add the  
wages that meet an exclusion under sections 3121(b)(1)–  
(22) when figuring the credits for qualified sick and family  
leave wages. If your Form 941 for the second, third, or  
fourth quarter of 2020 didn't claim the correct amount of  
the credit for qualified sick and family leave wages  
because you paid qualified sick leave wages and/or  
qualified family leave wages that meet an exclusion under  
sections 3121(b)(1)–(22), you may file Form 941-X and  
complete Worksheet 1 to claim the correct amount of the  
credit. You'll also include on Form 941-X, lines 28 and 29,  
and on Worksheet 1 any qualified health plan expenses  
allocable to those wages. The appropriate lines related to  
the exclusions under sections 3121(b)(1)–(22) were  
added to Worksheet 1 in the first quarter 2021 Instructions  
for Form 941 (Revised March 2021).  
Be sure to explain the reasons for this correction on  
line 43.  
18a. Nonrefundable Portion of Employee  
Retention Credit  
Use line 18a only for corrections to quarters beginning  
after March 31, 2020, and before January 1, 2022.  
Section 206(c) of the Taxpayer Certainty and  
Disaster Tax Relief Act of 2020 removed the  
restriction on an employer who has received a  
TIP  
Small Business Interruption Loan under the Paycheck  
Protection Program (PPP) from claiming the employee  
retention credit. The eligible employer can claim the  
employee retention credit on any qualified wages that  
aren't counted as payroll costs in obtaining PPP loan  
forgiveness. Any wages that could count toward eligibility  
for the employee retention credit or PPP loan forgiveness  
can be applied to either of these two programs, but not  
both. If your Form 941 didn't claim the correct amount for  
the employee retention credit because you received a  
Small Business Interruption Loan under the PPP, you may  
file Form 941-X and complete Worksheet 2 to claim the  
correct amount of the credit. For more information, see  
Notice 2021-20, 2021-11 I.R.B. 922, available at  
2021-33, 2021-34 I.R.B. 327, available at IRS.gov/irb/  
Instructions for Qualified Wages Paid After March  
12, 2020, and Before July 1, 2021  
If you’re correcting the nonrefundable portion of the  
employee retention credit for qualified wages paid after  
March 12, 2020, and before July 1, 2021, that you  
reported on Form 941, line 11c, enter the total corrected  
amount from Worksheet 2, Step 2, line 2j, in column 1. In  
Example—Nonrefundable portion of credit for  
qualified sick and family leave wages increased.  
Instructions for Form 941-X (Rev. 4-2023)  
-17-  
 
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2.  
quarter of 2021 to employers that are recovery startup  
businesses, as defined in section 3134(c)(5). Thus, for  
wages paid after September 30, 2021, and before  
January 1, 2022, only the wages paid by recovery startup  
businesses can be qualified wages. See the December  
2021 revision of the Instructions for Form 941 for more  
information about a recovery startup business.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
If you're correcting the nonrefundable portion of the  
employee retention credit for qualified wages paid after  
June 30, 2021, and before January 1, 2022, that you  
reported on Form 941, line 11c, enter the total corrected  
amount from Worksheet 4, Step 2, line 2h, in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2.  
For more information about the employee retention  
credit for qualified wages paid after March 12, 2020, and  
before January 1, 2021, see Notice 2021-20. See Notice  
2021-23, 2021-16 I.R.B. 1113, available at IRS.gov/irb/  
2021-16_IRB#NOT-2021-23, for more information about  
the employee retention credit for qualified wages paid  
after December 31, 2020, and before July 1, 2021. Also  
see section IV of Notice 2021-49, 2021-34 I.R.B. 316,  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Be sure to explain the reasons for this correction on  
line 43.  
Adjustments to the nonrefundable portion of the  
For more information about the employee retention  
credit for qualified wages paid after June 30, 2021, and  
before January 1, 2022, see Notice 2021-49 and Rev.  
Proc. 2021-33. See Notice 2021-65, 2021-51 I.R.B. 880,  
modifications to Notice 2021-49.  
employee retention credit for qualified wages paid  
after March 12, 2020, and before July 1, 2021, are  
TIP  
reported on Form 941-X, line 18a, and adjustments to the  
refundable portion of the credit are reported on Form  
941-X, line 26a. Adjustments to qualified wages for the  
employee retention credit are reported on Form 941-X,  
line 30. Adjustments to qualified health plan expenses  
allocable to the employee retention credit are reported on  
Form 941-X, line 31a. Adjustments to qualified wages  
paid March 13, 2020, through March 31, 2020, for the  
employee retention credit are reported on Form 941-X,  
line 33a, and adjustments to qualified health plan  
Be sure to explain the reasons for this correction on  
line 43.  
Adjustments to the nonrefundable portion of the  
employee retention credit for qualified wages paid  
after June 30, 2021, and before January 1, 2022,  
TIP  
are reported on Form 941-X, line 18a, and adjustments to  
the refundable portion of the credit are reported on Form  
941-X, line 26a. Adjustments to qualified wages for the  
employee retention credit are reported on Form 941-X,  
line 30. Adjustments to qualified health plan expenses  
allocable to the employee retention credit are reported on  
Form 941-X, line 31a. If you claimed the employee  
retention credit on your original Form 941 for the quarter,  
and you make any corrections on Form 941-X for the  
quarter to amounts used to figure this credit, you'll need to  
refigure the amount of the credit using Worksheet 4. You'll  
also use this worksheet to figure this credit if you’re  
claiming the credit for the first time on Form 941-X.  
expenses allocable to these wages are reported on Form  
941-X, line 34. The employee retention credit may only be  
claimed on Form 941 filed for quarters beginning after  
March 31, 2020. The employee retention credit for wages  
paid March 13, 2020, through March 31, 2020, is claimed  
on Form 941 for the second quarter of 2020; therefore,  
any corrections to the employee retention credit for the  
period from March 13, 2020, through March 31, 2020,  
should be reported on Form 941X filed for the second  
quarter of 2020. Don’t file Form 941X for the first quarter  
of 2020 to report these amounts. If you claimed the  
employee retention credit on your original Form 941 for  
the quarter, and you make any corrections on Form 941X  
for the quarter to amounts used to figure this credit, you'll  
need to refigure the amount of the credit using Worksheet  
2. You'll also use this worksheet to figure this credit if  
you’re claiming the credit for the first time on Form 941-X.  
18b. Nonrefundable Portion of Credit for  
Qualified Sick and Family Leave Wages for  
Leave Taken After March 31, 2021, and Before  
October 1, 2021  
For corrections to Form 941, line 11d, the credit for  
qualified sick and family leave wages is only available for  
wages paid with respect to leave taken after March 31,  
2021, and before October 1, 2021. Don't enter an amount  
on line 18b if you're correcting a quarter that began before  
April 1, 2021.  
Instructions for Qualified Wages Paid After June  
30, 2021, and Before January 1, 2022  
The Infrastructure Investment and Jobs Act  
amends section 3134 of the Internal Revenue  
!
CAUTION  
Code, as enacted under the ARP, to limit the  
availability of the employee retention credit in the fourth  
-18-  
Instructions for Form 941-X (Rev. 4-2023)  
If you’re correcting the nonrefundable portion of the  
credit for qualified sick and family leave wages for leave  
taken after March 31, 2021, and before October 1, 2021,  
that you reported on Form 941, line 11d, enter the total  
corrected amount from Worksheet 3, Step 2, line 2r, in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. For more  
If you’re correcting the nonrefundable portion of the  
COBRA premium assistance credit that you reported on  
Form 941, line 11e, enter the total corrected amount from  
Worksheet 5, Step 2, line 2g, in column 1. In column 2,  
enter the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
information about the credit for qualified sick and family  
leave wages, go to IRS.gov/PLC.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Be sure to explain the reasons for this correction on  
line 43.  
18d. Number of Individuals Provided COBRA  
Premium Assistance  
Definition of qualified sick and family leave wages  
for leave taken after March 31, 2021, and before Oc-  
tober 1, 2021. For purposes of this credit, qualified sick  
leave wages and qualified family leave wages are wages  
for social security and Medicare tax purposes, determined  
without regard to the exclusions from the definition of  
employment under sections 3121(b)(1)–(22), that an  
employer pays that otherwise meet the requirements of  
the EPSLA or Expanded FMLA, as enacted under the  
FFCRA and amended for purposes of the ARP. Taxable  
qualified sick leave wages and qualified family leave  
wages for leave taken after March 31, 2021, and before  
October 1, 2021, were included on Form 941, line 5a,  
column 1, and can be adjusted only on Form 941-X,  
line 8. Total qualified sick and family leave wages for  
leave taken after March 31, 2021, and before October 1,  
2021, including any qualified leave wages that were  
above the social security wage base and any qualified  
leave wages excluded from the definition of employment  
under sections 3121(b)(1)–(22), were included on Form  
941, lines 23 and 26, respectively, and can be adjusted  
only on Form 941-X, lines 35 and 38, respectively. Use  
Worksheet 3 to figure your credit.  
Use line 18d only for corrections to quarters beginning  
after March 31, 2021.  
If you’re correcting the number of individuals provided  
COBRA premium assistance that you reported on Form  
941, line 11f, enter the total corrected amount in column 1.  
In column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2.  
Be sure to explain the reasons for this correction on  
line 43.  
19–22. Special Additions to Wages for Federal  
Income Tax, Social Security Taxes, Medicare  
Taxes, and Additional Medicare Tax  
Section 3509 provides special rates for the employee  
share of federal income tax, social security tax, Medicare  
tax, and Additional Medicare Tax withholding when  
workers are reclassified as employees in certain  
circumstances. The applicable rate depends on whether  
you filed required information returns. An employer can’t  
recover any tax paid under this provision from the  
employees. The full employer share of social security tax  
and Medicare tax is due for all reclassifications.  
Be sure to explain the reasons for this correction on  
line 43.  
18c. Nonrefundable Portion of COBRA Premium  
Assistance Credit  
Note. Section 3509 rates aren’t available if you  
intentionally disregarded the requirements to withhold  
taxes from the employee, or if you withheld federal income  
tax but didn’t withhold social security and Medicare taxes.  
Section 3509 rates are also not available for certain  
statutory employees.  
The COBRA premium assistance was available for  
periods of coverage beginning on or after April 1, 2021,  
through periods of coverage beginning on or before  
September 30, 2021. For more information, see Credit for  
September 30, 2021 under Reminders, earlier. Use  
line 18c only for corrections to quarters beginning after  
March 31, 2021.  
On lines 19–22, enter only corrections to wages  
resulting from reclassifying certain workers as employees  
when section 3509 rates are used to calculate the taxes.  
If the employer issued the required information returns,  
use the section 3509 rates as follows.  
Premium payees that receive an election from an  
For social security taxes, use the employer rate of 6.2%  
assistance eligible individual are entitled to the  
COBRA premium assistance credit for premiums  
TIP  
plus 20% of the employee rate of 6.2%, for a total rate of  
7.44% of wages.  
not paid during the quarter in which the election is  
received. See Notice 2021-31 for more information.  
For Medicare taxes, use the employer rate of 1.45%  
plus 20% of the employee rate of 1.45%, for a total rate of  
1.74% of wages.  
Instructions for Form 941-X (Rev. 4-2023)  
-19-  
 
For Additional Medicare Tax, 0.18% (20% of the  
defers the payment due, to properly show the amount as a  
deferral of payment, enter a positive number in column 3  
as a negative number in column 4. A decrease to the  
deferred amount of the employer and/or the employee  
share of social security tax decreases the payment you  
can defer and must be shown as a balance due item;  
therefore, to properly show the amount as a balance due  
item, enter a negative number in column 3 as a positive  
number in column 4. If you make any corrections to the  
deferred amount of the employee share of social security  
tax on Form 941-X, line 24, you may also need to make a  
correction on Form 941-X, line 33b.  
employee rate of 0.9%) of wages subject to Additional  
Medicare Tax.  
For federal income tax withholding, the rate is 1.5% of  
wages.  
If the employer didn’t issue the required information  
returns, use the section 3509 rates as follows.  
For social security taxes, use the employer rate of 6.2%  
plus 40% of the employee rate of 6.2%, for a total rate of  
8.68% of wages.  
For Medicare taxes, use the employer rate of 1.45%  
plus 40% of the employee rate of 1.45%, for a total rate of  
2.03% of wages.  
Be sure to explain the reasons for any corrections on  
line 43.  
For Additional Medicare Tax, 0.36% (40% of the  
employee rate of 0.9%) of wages subject to Additional  
Medicare Tax.  
Deferred amount of the employer share of social se-  
curity tax. If you’re filing Form 941-X to increase the  
amount of social security wages paid on or after March  
27, 2020, and before January 1, 2021, so that there is an  
additional amount of social security tax that hasn’t yet  
been paid, and hasn’t yet been deferred, then you may  
use Form 941-X to increase the amount of the deferred  
employer share of social security tax originally reported on  
Form 941, line 13b. If you’re filing Form 941-X to decrease  
the amount of social security wages paid on or after  
March 27, 2020, and before January 1, 2021, so that there  
is a decrease in the amount of social security tax that is  
eligible for deferral, then you must use Form 941-X to  
decrease the amount of the deferred employer share of  
social security tax originally reported on Form 941,  
line 13b, if the decrease in wages causes the amount you  
originally deferred to exceed the amount that is now  
eligible for deferral. Otherwise, you may only correct the  
amount of the deferred employer share of social security  
tax if the amount originally reported on Form 941, line 13b,  
isn’t the amount you actually deferred (for example, you  
incorrectly reported the amount that you actually  
For federal income tax withholding, the rate is 3.0% of  
wages.  
Unlike some other lines on Form 941-X, enter in  
column 1 only the corrected wages for workers being  
reclassified, not the amount paid to all employees. Enter  
in column 2 previously reported wages (if any) to  
reclassified employees. To get the amount for column 4,  
use the applicable section 3509 rates. If you filed the  
required information returns for some employees but  
didn’t file them for other employees, be sure to use the  
applicable rates for each employee when calculating the  
amounts in column 4 and show your calculations on  
line 43. The tax correction in column 4 will be a positive  
number if you increased the amount of wages you  
previously reported. See the instructions for line 42, later,  
for more information.  
23. Subtotal  
Combine the amounts from column 4 on lines 7–22 and  
enter the result on line 23.  
deferred). If you already paid the correct amount of the  
employer’s share of social security tax for a calendar  
quarter during the payroll tax deferral period, you may not  
subsequently defer the payment by filing Form 941-X. See  
IRS.gov/ETD for more information about the interaction of  
credits and the deferral of employment tax deposits and  
payments.  
Example. You entered “1,400.00” in column 4 on  
line 7, “-500.00” in column 4 on line 8, and “-100.00” in  
column 4 on line 12. Combine these amounts and enter  
“800.00” in column 4 on line 23.  
Line 7  
Line 8  
Line 12  
1,400.00  
(500.00)  
+ (100.00)  
The deferred amount of the employer share of social  
security tax was only available for deposits and payments  
due on or after March 27, 2020, and before January 1,  
2021, as well as deposits and payments due after January  
1, 2021, that were required for wages paid during the  
quarter ending on December 31, 2020. One-half of the  
deferred amount of the employer share of social security  
tax was due by December 31, 2021, and the remainder  
was due by December 31, 2022. Because both December  
31, 2021, and December 31, 2022, were nonbusiness  
days, payments made on the next business day were  
considered timely. Any payments or deposits you made  
before December 31, 2021, were first applied against your  
payment due on December 31, 2021, and then applied  
against your payment due on December 31, 2022. For  
more information about the deferral of employment tax  
deposits, go to IRS.gov/ETD and see the Instructions for  
Form 941, available at IRS.gov/Form941.  
Line 23  
800.00  
24. Deferred Amount of Social Security Tax  
Use Form 941-X, line 24, if you need to correct the  
deferred amount of the employer share of social security  
tax for the second, third, or fourth quarter of 2020, and/or  
the deferred amount of the employee share of social  
security tax for the third or fourth quarter of 2020, that you  
reported on Form 941, line 13b. Enter the total corrected  
amount in column 1. In column 2, enter the amount you  
originally reported or as previously corrected by you or the  
IRS. In column 3, enter the difference between columns 1  
and 2.  
Copy the amount in column 3 to column 4. However,  
because an increase to the deferred amount of the  
employer and/or the employee share of social security tax  
-20-  
Instructions for Form 941-X (Rev. 4-2023)  
26a. Refundable Portion of Employee Retention  
Credit  
Deferred amount of the employee share of social se-  
curity tax. You may only correct the amount of the  
deferred employee share of social security tax if the  
amount originally reported on Form 941, line 13b, isn’t the  
amount you actually deferred (for example, you incorrectly  
reported the amount that you actually deferred). If you  
already paid the correct amount of the employee’s share  
of social security tax, you may not subsequently defer the  
payment by filing Form 941-X.  
Use line 26a only for corrections to quarters beginning  
after March 31, 2020, and before January 1, 2022.  
Instructions for Qualified Wages Paid After March  
12, 2020, and Before July 1, 2021  
If you’re correcting the refundable portion of the employee  
retention credit that you reported on Form 941, line 13d,  
for qualified wages paid after March 12, 2020, and before  
July 1, 2021, enter the total corrected amount from  
Worksheet 2, Step 2, line 2k, in column 1. In column 2,  
enter the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2. For more information about the  
employee retention credit for qualified wages paid after  
March 12, 2020, and before January 1, 2021, see Notice  
2021-20. See Notice 2021-23 for more information about  
the employee retention credit for qualified wages paid  
after December 31, 2020, and before July 1, 2021. Also  
see section IV of Notice 2021-49, and Rev. Proc.  
The deferred amount of the employee share of social  
security tax was only available for social security wages of  
less than $4,000 paid to an employee in any biweekly pay  
period (or the equivalent threshold amount for other pay  
periods) paid on a pay date during the period beginning  
on September 1, 2020, and ending on December 31,  
2020. The due date for withholding and payment of the  
deferred employee share of social security tax was  
postponed until the period beginning on January 1, 2021,  
and ending on December 31, 2021. The employer was  
liable to pay the deferred employee share of social  
security tax to the IRS and was required to do so before  
January 1, 2022, to avoid interest, penalties, and  
additions to tax on those amounts. Because January 1,  
2022, was a nonbusiness day, payments made on  
January 3, 2022, were considered timely. For more  
information about the deferral of the employee share of  
social security tax, see Notice 2020-65, 2020-38 I.R.B.  
and Notice 2021-11, 2021-06 I.R.B. 827, available at  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
25. Refundable Portion of Credit for Qualified  
Sick and Family Leave Wages for Leave Taken  
After March 31, 2020, and Before April 1, 2021  
For corrections to Form 941, line 13c, the credit for  
qualified sick and family leave wages is only available for  
wages paid with respect to leave taken after March 31,  
2020, and before April 1, 2021. Don't enter an amount on  
line 25 if you're correcting a quarter that began before  
April 1, 2020.  
Be sure to explain the reasons for this correction on  
line 43.  
Instructions for Qualified Wages Paid After June  
30, 2021, and Before January 1, 2022  
If you're correcting the refundable portion of the employee  
retention credit that you reported on Form 941, line 13d,  
for qualified wages paid after June 30, 2021, and before  
January 1, 2022, enter the total corrected amount from  
Worksheet 4, Step 2, line 2i, in column 1. In column 2,  
enter the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2. For more information about the  
employee retention credit for qualified wages paid after  
June 30, 2021, and before January 1, 2022, see Notice  
modifications to Notice 2021-49.  
If you’re correcting the refundable portion of the credit  
for qualified sick and family leave wages for leave taken  
after March 31, 2020, and before April 1, 2021, that you  
reported on Form 941, line 13c, enter the total corrected  
amount from Worksheet 1, Step 2, line 2k, in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2. For more information about the  
credit for qualified sick and family leave wages, go to  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Be sure to explain the reasons for this correction on  
line 43.  
Be sure to explain the reasons for this correction on  
line 43.  
Instructions for Form 941-X (Rev. 4-2023)  
-21-  
September 30, 2021 under Reminders, earlier. Use  
line 26c only for corrections to quarters beginning after  
March 31, 2021.  
Corrections to Form 941, Line 13f (For Quarters  
Beginning After March 31, 2020, and Ending  
Before April 1, 2021) or Line 13h (For Quarters  
Beginning After March 31, 2021, and Ending  
Before January 1, 2022)  
Form 941-X doesn't include a line to correct amounts  
reported on Form 941, line 13f (13h), for the total  
If you’re correcting the refundable portion of the  
COBRA premium assistance credit that you reported on  
Form 941, line 13f, enter the total corrected amount from  
Worksheet 5, Step 2, line 2h, in column 1. In column 2,  
enter the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2.  
advances received from filing Form(s) 7200 for the  
quarter. If a discrepancy exists between the amount  
reported on Form 941 and the amount of advance  
payments issued, the IRS will generally correct the  
amount reported on Form 941, line 13f (13h), to match the  
amount of advance payments issued. However,  
aggregate filers may need to correct the amount reported  
on Form 941, line 13f (13h), to reflect the correct advance  
payments received by their clients or customers. If you’re  
an aggregate filer that needs to correct the amount  
reported on Form 941, line 13f (13h), include any increase  
or decrease to the amount in the “Total” reported on Form  
941-X, line 27; write “Correction to line 13f” or "Correction  
to line 13h," as applicable, on the dotted line to the left of  
the entry box on line 27; explain your correction on line 43;  
and attach Schedule R (Form 941) to Form 941-X to show  
corrections for your clients or customers.  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Be sure to explain the reasons for this correction on  
line 43.  
27. Total  
26b. Refundable Portion of Credit for Qualified  
Sick and Family Leave Wages for Leave Taken  
After March 31, 2021, and Before October 1,  
2021  
For corrections to Form 941, line 13e, the credit for  
qualified sick and family leave wages is only available for  
wages paid with respect to leave taken after March 31,  
2021, and before October 1, 2021. Don't enter an amount  
on line 26b if you're correcting a quarter that began before  
April 1, 2021.  
Combine the amounts from column 4 on lines 23–26c and  
enter the result on line 27.  
Your credit. If the amount entered on line 27 is less than  
zero, for example, “-115.00,” you have a credit because  
you overreported your federal employment taxes.  
If you checked the box on line 1, include this amount on  
the "Total deposits" line of Form 941 for the quarter during  
which you filed Form 941-X. If you currently file Form 944  
because your filing requirement changed, include this  
amount on the "Total deposits" line of Form 944 for the  
year during which you filed Form 941-X. Don’t make any  
changes to your record of federal tax liability reported on  
Form 941, line 16, or Schedule B (Form 941) if your Form  
941-X is filed timely. The amounts reported on the record  
should reflect your actual tax liability for the period.  
If you’re correcting the refundable portion of the credit  
for qualified sick and family leave wages for leave taken  
after March 31, 2021, and before October 1, 2021, that  
you reported on Form 941, line 13e, enter the total  
corrected amount from Worksheet 3, Step 2, line 2s, in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. For more  
If you checked the box on line 2, you’re filing a claim for  
refund or abatement of the amount shown.  
If your credit is less than $1, we will send a refund or  
apply it only if you ask us in writing to do so.  
information about the credit for qualified sick and family  
leave wages, go to IRS.gov/PLC.  
Amount you owe. If the amount on line 27 is a positive  
number, you must pay the amount you owe by the time  
you file Form 941-X. You may not use any credit that you  
show on another Form 941-X to pay the amount you owe,  
even if you filed for the amount you owe and the credit at  
the same time.  
If you owe tax and are filing a timely Form 941-X, don’t  
file an amended Schedule B (Form 941) unless you were  
assessed an FTD penalty caused by an incorrect,  
incomplete, or missing Schedule B (Form 941). Don’t  
include the tax increase reported on Form 941-X on any  
amended Schedule B (Form 941) you file.  
If you owe tax and are filing a late Form 941-X, that is,  
after the due date for Form 941 for the quarter in which  
you discovered the error, you must file an amended  
Schedule B (Form 941) with the Form 941-X. Otherwise,  
the IRS may assess an “averaged” FTD penalty. The total  
Copy the amount in column 3 to column 4. However, to  
properly show the amount as a credit or balance due item,  
enter a positive number in column 3 as a negative number  
in column 4 or a negative number in column 3 as a  
positive number in column 4. For an example of how to  
report amounts in columns 1–4 for an employment tax  
credit, see the instructions for line 17, earlier.  
Be sure to explain the reasons for this correction on  
line 43.  
26c. Refundable Portion of COBRA Premium  
Assistance Credit  
The COBRA premium assistance was available for  
periods of coverage beginning on or after April 1, 2021,  
through periods of coverage beginning on or before  
September 30, 2021. For more information, see Credit for  
-22-  
Instructions for Form 941-X (Rev. 4-2023)  
 
tax reported on the “Total liability for the quarter” line of  
Schedule B (Form 941) must match the corrected tax  
(Form 941, line 12, combined with any correction reported  
on Form 941-X, line 23) for the quarter, less any previous  
abatements and interest-free tax assessments.  
Payment methods. You may pay the amount you owe  
on line 27 electronically using the Electronic Federal Tax  
Payment System (EFTPS), by credit or debit card, or by a  
check or money order.  
29. Qualified Health Plan Expenses Allocable to  
Qualified Family Leave Wages for Leave Taken  
After March 31, 2020, and Before April 1, 2021  
If you’re correcting the qualified health plan expenses  
allocable to qualified family leave wages for leave taken  
after March 31, 2020, and before April 1, 2021, that you  
reported on Form 941, line 20, enter the total corrected  
amount for all employees in column 1. In column 2, enter  
the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2. Enter the corrected amount from column  
1 on Worksheet 1, Step 2, line 2f.  
The preferred method of payment is EFTPS. For more  
information, go to EFTPS.gov or call 800-555-4477. To  
contact EFTPS using Telecommunications Relay  
Services (TRS) for people who are deaf, hard of hearing,  
or have a speech disability, dial 711 and then provide the  
TRS assistant the 800-555-4477 number above or  
800-733-4829. Additional information about EFTPS is  
also available in Pub. 966.  
30. Qualified Wages for the Employee Retention  
Credit  
Use line 30 only for corrections to quarters beginning after  
March 31, 2020, and before January 1, 2022.  
To pay by credit or debit card, go to IRS.gov/  
PayByCard. Your payment will be processed by a  
If you’re correcting the qualified wages for the  
payment processor who will charge a processing fee.  
employee retention credit that you reported on Form 941,  
line 21, enter the total corrected amount for all employees  
in column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. Enter the corrected  
amount from column 1 on Worksheet 2, Step 2, line 2a, for  
qualified wages paid after March 12, 2020, and before  
July 1, 2021. Enter the corrected amount from column 1  
on Worksheet 4, Step 2, line 2a, for qualified wages paid  
after June 30, 2021, and before January 1, 2022.  
If you pay by check or money order, make it payable to  
“United States Treasury.” On your check or money order,  
be sure to write your EIN, “Form 941-X,” the calendar  
quarter you corrected (for example, “Quarter 2”), and the  
calendar year of the quarter you corrected.  
You don’t have to pay if the amount you owe is less  
than $1.  
Previously assessed FTD penalty. If line 27 reflects  
overreported tax and the IRS previously assessed an FTD  
penalty, you may be able to reduce the penalty. For more  
information, see the Instructions for Schedule B (Form  
941).  
31a. Qualified Health Plan Expenses for the  
Employee Retention Credit  
Use line 31a only for corrections to quarters beginning  
after March 31, 2020, and before January 1, 2022.  
Lines 28–40  
For lines 28–31a and lines 32–40, you'll only enter  
amounts in columns 1, 2, and 3. These lines don’t have an  
entry space for column 4 because these adjustments  
don’t directly result in an increase or decrease to your tax.  
The amounts entered on lines 28–31a and lines 32–40 are  
amounts that you use in Worksheets 1–5, as applicable, to  
figure your credits. If you reported an incorrect amount on  
lines 19–28 on your original Form 941, then you'll use  
lines 28–31a and lines 32–40 of Form 941X to report the  
correction. Use Worksheets 1–5, as applicable, to refigure  
your credits based on the corrected amounts reported in  
column 1. For details on how to complete line 31b, see the  
instructions for line 31b, later. Be sure to explain the  
reasons for your corrections on line 43.  
If you’re correcting the qualified health plan expenses  
allocable to wages reported on Form 941, line 21, that you  
reported on Form 941, line 22, enter the total corrected  
amount for all employees in column 1. In column 2, enter  
the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2. Enter the corrected amount from column  
1 on Worksheet 2, Step 2, line 2b, for qualified health plan  
expenses allocable to qualified wages paid after March  
12, 2020, and before July 1, 2021. Enter the corrected  
amount from column 1 on Worksheet 4, Step 2, line 2b, for  
qualified health plan expenses allocable to qualified  
wages paid after June 30, 2021, and before January 1,  
2022.  
28. Qualified Health Plan Expenses Allocable to  
Qualified Sick Leave Wages for Leave Taken  
After March 31, 2020, and Before April 1, 2021  
If you’re correcting the qualified health plan expenses  
allocable to qualified sick leave wages for leave taken  
after March 31, 2020, and before April 1, 2021, that you  
reported on Form 941, line 19, enter the total corrected  
amount for all employees in column 1. In column 2, enter  
the amount you originally reported or as previously  
corrected. In column 3, enter the difference between  
columns 1 and 2. Enter the corrected amount from column  
1 on Worksheet 1, Step 2, line 2b.  
31b. Recovery Startup Business Checkbox  
For the fourth quarter of 2021, only a recovery  
startup business may claim the employee  
!
CAUTION  
retention credit.  
Whether you check the box on line 31b to tell us if  
you're eligible for the employee retention credit in the third  
or fourth quarter of 2021 solely because your business is  
a recovery startup business depends on its applicability  
and how you originally answered the question on Form  
941, line 18b.  
If you checked the box on line 18b on your originally  
filed Form 941 and you still qualify for the employee  
-23-  
Instructions for Form 941-X (Rev. 4-2023)  
 
retention credit solely because your business is a  
recovery startup business, check the box on line 31b.  
for qualified wages paid after March 12, 2020, and before  
July 1, 2021, enter the corrected amount from column 1  
on Worksheet 2, Step 1, line 1k, unless you also  
If you checked the box on line 18b on your originally  
filed Form 941 but that response is no longer accurate,  
don't check the box on line 31b. However, explain in detail  
on line 43 why you no longer think that you're a recovery  
startup business and, if correcting the third quarter of  
2021, the reasons that you still qualify for the employee  
retention credit.  
completed Worksheet 1 and you're bringing the amount  
from Worksheet 1, Step 1, line 1l, forward to Worksheet 2,  
Step 1, line 1a. Reporting a correction on this line doesn't  
correct the credit claimed on Form 5884-C.  
33a. Qualified Wages Paid March 13 Through  
March 31, 2020, for the Employee Retention  
Credit  
Use line 33a only for corrections to the second quarter of  
2020.  
If you didn't check the box on line 18b on your originally  
filed Form 941 and this question still doesn't apply, don't  
check the box on line 31b.  
If you didn't check the box on line 18b on your originally  
filed Form 941 but you're now claiming the employee  
retention credit as a recovery startup business, check the  
box on line 31b.  
If you’re correcting the qualified wages paid March 13,  
2020, through March 31, 2020, for the employee retention  
credit that you reported on Form 941, line 24, for the  
second quarter of 2020, enter the total corrected amount  
for all employees in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
In column 3, enter the difference between columns 1 and  
2. Enter the corrected amount from column 1 on  
Worksheet 2, Step 2, line 2c.  
Recovery startup business. For the third quarter of  
2021, a recovery startup business is an employer that:  
Began carrying on a trade or business after February  
15, 2020;  
Had average annual gross receipts of $1 million or less  
for the 3 tax years ending with the tax year before the  
calendar quarter in which the employee retention credit is  
claimed; and  
33b. Deferred Amount of the Employee Share of  
Social Security Tax Included on Form 941,  
Line 13b  
Use line 33b only for corrections to the third and fourth  
quarters of 2020.  
Isn't otherwise eligible for the employee retention credit  
because business operations aren't fully or partially  
suspended due to a governmental order or because gross  
receipts (within the meaning of section 448(c) or, if you're  
a tax-exempt organization, section 6033) aren't less than  
80% of the gross receipts for the same calendar quarter in  
calendar year 2019. The employee retention credit isn't  
available in the second quarter of 2021 on the basis of  
being a recovery startup business.  
If you're correcting the deferred amount of the  
employee share of social security tax (for the third and  
fourth quarters of 2020) that you reported on Form 941,  
line 24, enter the total corrected amount for all employees  
in column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2.  
For the fourth quarter of 2021, a recovery startup  
business is an employer that began carrying on a trade or  
business after February 15, 2020, and had average  
annual gross receipts of $1 million or less for the 3 tax  
years ending with the tax year before the calendar quarter  
in which the employee retention credit is claimed.  
34. Qualified Health Plan Expenses Allocable to  
Wages Reported on Form 941, Line 24  
Use line 34 only for corrections to the second quarter of  
2020.  
Recovery startup businesses are limited to a  
maximum employee retention credit of $50,000  
!
CAUTION  
per quarter. If you check the box on line 31b, don't  
enter more than $50,000 per quarter in total on lines 18a  
and 26a.  
If you’re correcting the qualified health plan expenses  
allocable to wages reported on Form 941, line 24, that you  
reported on Form 941, line 25, for the second quarter of  
2020, enter the total corrected amount for all employees in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. Enter the corrected  
amount from column 1 on Worksheet 2, Step 2, line 2d.  
32. Credit From Form 5884C, Line 11, for This  
Quarter  
Use line 32 only for corrections to quarters beginning after  
March 31, 2020, and before April 1, 2021.  
If you’re correcting the credit from Form 5884C,  
line 11, for the second, third, or fourth quarter of 2020, or  
the first quarter of 2021, that you reported on Form 941,  
line 23, enter the total corrected amount in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2. Enter the corrected amount  
from column 1 on Worksheet 1, Step 1, line 1j. Entering an  
amount here is strictly for purposes of figuring the credit  
for qualified sick and family wages for leave taken after  
March 31, 2020, and before April 1, 2021, on Worksheet  
1. For purposes of figuring the employee retention credit  
35. Qualified Sick Leave Wages for Leave Taken  
After March 31, 2021, and Before October 1,  
2021  
If you’re correcting the qualified sick leave wages for leave  
taken after March 31, 2021, and before October 1, 2021,  
that you reported on Form 941, line 23, enter the total  
corrected amount in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
In column 3, enter the difference between columns 1 and  
2. Enter the corrected amount from column 1 on  
Worksheet 3, Step 2, line 2a.  
-24-  
Instructions for Form 941-X (Rev. 4-2023)  
 
Be sure to explain the reasons for this correction on  
line 43.  
between columns 1 and 2. Enter the corrected amount  
from column 1 on Worksheet 3, Step 2, line 2h.  
Be sure to explain the reasons for this correction on  
line 43.  
36. Qualified Health Plan Expenses Allocable to  
Qualified Sick Leave Wages for Leave Taken  
After March 31, 2021, and Before October 1,  
2021  
If you’re correcting the qualified health plan expenses  
allocable to qualified sick leave wages for leave taken  
after March 31, 2021, and before October 1, 2021, that  
you reported on Form 941, line 24, enter the total  
corrected amount for all employees in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
between columns 1 and 2. Enter the corrected amount  
from column 1 on Worksheet 3, Step 2, line 2b.  
40. Amounts Under Certain Collectively  
Bargained Agreements Allocable to Qualified  
Family Leave Wages for Leave Taken After  
March 31, 2021, and Before October 1, 2021  
If you’re correcting the amounts under certain collectively  
bargained agreements allocable to qualified family leave  
wages for leave taken after March 31, 2021, and before  
October 1, 2021, that you reported on Form 941, line 28,  
enter the total corrected amount for all employees in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. Enter the corrected  
amount from column 1 on Worksheet 3, Step 2, line 2i.  
Be sure to explain the reasons for this correction on  
line 43.  
Be sure to explain the reasons for this correction on  
line 43.  
37. Amounts Under Certain Collectively  
Bargained Agreements Allocable to Qualified  
Sick Leave Wages for Leave Taken After March  
31, 2021, and Before October 1, 2021  
If you’re correcting the amounts under certain collectively  
bargained agreements allocable to qualified sick leave  
wages for leave taken after March 31, 2021, and before  
October 1, 2021, that you reported on Form 941, line 25,  
enter the total corrected amount for all employees in  
column 1. In column 2, enter the amount you originally  
reported or as previously corrected. In column 3, enter the  
difference between columns 1 and 2. Enter the corrected  
amount from column 1 on Worksheet 3, Step 2, line 2c.  
Part 4: Explain Your Corrections for  
This Quarter  
41. Corrections of Both Underreported and  
Overreported Amounts  
Check the box on line 41 if any corrections you entered on  
lines 7–26c, or lines 28–31a, or lines 32–40, column 3,  
reflect both underreported and overreported amounts.  
Example. If you had an increase to social security  
wages of $15,000 for Xavier Black and a decrease to  
social security wages of $5,000 for Sophie Rose, you  
would enter $10,000 on line 8, column 3. That $10,000  
represents the net change from corrections.  
Be sure to explain the reasons for this correction on  
line 43.  
On line 43, you must explain the reason for both the  
38. Qualified Family Leave Wages for Leave  
Taken After March 31, 2021, and Before October  
1, 2021  
$15,000 increase and the $5,000 decrease.  
42. Did You Reclassify Any Workers?  
If you’re correcting the qualified family leave wages for  
leave taken after March 31, 2021, and before October 1,  
2021, that you reported on Form 941, line 26, enter the  
total corrected amount in column 1. In column 2, enter the  
amount you originally reported or as previously corrected.  
In column 3, enter the difference between columns 1 and  
2. Enter the corrected amount from column 1 on  
Worksheet 3, Step 2, line 2g.  
Check the box on line 42 if you reclassified any workers to  
be independent contractors or nonemployees. Also check  
this box if the IRS (or you) determined that workers you  
treated as independent contractors or nonemployees  
should be classified as employees. On line 43, give us a  
detailed reason why any worker was reclassified and, if  
you used section 3509 rates on lines 19–22 for any worker  
reclassified as an employee, explain why section 3509  
rates apply and what rates you used.  
Return not filed because you didn’t treat any workers  
as employees. If you didn’t previously file Form 941  
because you mistakenly treated all workers as  
independent contractors or as nonemployees, file a Form  
941 for each delinquent quarter.  
Be sure to explain the reasons for this correction on  
line 43.  
39. Qualified Health Plan Expenses Allocable to  
Qualified Family Leave Wages for Leave Taken  
After March 31, 2021, and Before October 1,  
2021  
If you’re correcting the qualified health plan expenses  
allocable to qualified family leave wages for leave taken  
after March 31, 2021, and before October 1, 2021, that  
you reported on Form 941, line 27, enter the total  
corrected amount for all employees in column 1. In  
column 2, enter the amount you originally reported or as  
previously corrected. In column 3, enter the difference  
On each Form 941 for which you’re entitled to use  
section 3509 rates, complete the following steps.  
Write “Misclassified Employees” in bold letters  
across the top margin of page 1.  
Enter a zero on line 12.  
Complete the signature area.  
Attach a completed Form 941-X (see instructions next).  
On each Form 941-X, complete the following steps.  
Instructions for Form 941-X (Rev. 4-2023)  
-25-  
     
Complete the top of Form 941-X, including the date you  
Who must sign the Form 941-X? The following persons  
are authorized to sign the return for each type of business  
entity.  
discovered the error.  
Enter the wage amounts on lines 19–22, column 1.  
Enter zeros on lines 19–22, column 2.  
Complete columns 3 and 4 as instructed in Part 3.  
Provide a detailed statement on line 43.  
Complete the signature area.  
Sole proprietorship—The individual who owns the  
business.  
Corporation (including a limited liability company  
(LLC) treated as a corporation)—The president, vice  
president, or other principal officer duly authorized to sign.  
If you can’t use section 3509 rates (for example,  
Partnership (including an LLC treated as a  
because the workers you treated as  
!
partnership) or unincorporated organization—A  
responsible and duly authorized member, partner, or  
officer having knowledge of its affairs.  
CAUTION  
nonemployees were certain statutory employees),  
file a Form 941 for each delinquent quarter. Write  
Misclassified Employees” in bold letters across the top  
margin of page 1 of each Form 941. Complete Form 941  
using the Instructions for Form 941. Attach a Form 941-X  
to each Form 941. Complete the top of Form 941-X,  
including the date you discovered the error, and provide a  
detailed explanation on line 43.  
Single-member LLC treated as a disregarded entity  
for federal income tax purposes—The owner of the  
LLC or a principal officer duly authorized to sign.  
Trust or estate—The fiduciary.  
Form 941-X may also be signed by a duly authorized  
agent of the taxpayer if a valid power of attorney has been  
filed.  
43. Explain Your Corrections  
Treasury regulations require you to explain in detail the  
grounds and facts relied upon to support each correction.  
On line 43, describe in detail each correction you entered  
in column 4 on lines 7–22, and lines 24–26c. Also use  
line 43 to describe corrections made on line 6 and lines  
28–40. If you need more space, attach additional sheets,  
but be sure to write your name, EIN, “Form 941-X,” the  
quarter you’re correcting (for example, “Quarter 2”), and  
the calendar year of the quarter you’re correcting on the  
top of each sheet.  
You must describe the events that caused the  
underreported or overreported amounts. Explanations  
such as “social security and Medicare wages were  
overstated” or “administrative/payroll errors were  
discovered” or “taxes were not withheld” are insufficient  
and may delay processing your Form 941-X because the  
IRS may need to ask for a more complete explanation.  
Alternative signature method. Corporate officers or  
duly authorized agents may sign Form 941-X by rubber  
stamp, mechanical device, or computer software  
program. For details and required documentation, see  
Rev. Proc. 2005-39. You can find Rev. Proc. 2005-39,  
2005-28 I.R.B. 82, at IRS.gov/irb/  
Paid Preparer Use Only  
A paid preparer must sign Form 941-X and provide the  
information in the Paid Preparer Use Only section of Part  
5 if the preparer was paid to prepare Form 941-X and isn’t  
an employee of the filing entity. Paid preparers must sign  
paper returns with a manual signature. The preparer must  
give you a copy of the return in addition to the copy to be  
filed with the IRS.  
If you’re a paid preparer, enter your Preparer Tax  
Identification Number (PTIN) in the space provided.  
Include your complete address. If you work for a firm,  
enter the firm's name and the EIN of the firm. You can  
apply for a PTIN online or by filing Form W-12. For more  
information about applying for a PTIN online, go to the IRS  
website at IRS.gov/PTIN. You can’t use your PTIN in  
place of the EIN of the tax preparation firm.  
Provide the following information in your explanation for  
each correction.  
Form 941-X line number(s) affected.  
Date you discovered the error.  
Difference (amount of the error).  
Cause of the error.  
You may report the information in paragraph form. The  
following paragraph is an example.  
Generally, you’re not required to complete this section  
if you’re filing the return as a reporting agent and have a  
valid Form 8655 on file with the IRS. However, a reporting  
agent must complete this section if the reporting agent  
offered legal advice, for example, advising the client on  
determining whether its workers are employees or  
independent contractors for federal tax purposes.  
“The $1,000 difference shown in column 3 on lines 6, 8,  
and 12 was discovered on May 15, 2023, during an  
internal payroll audit. We discovered that we included  
$1,000 of wages for one of our employees twice. This  
correction removes the reported wages that were never  
paid.”  
For corrections shown on lines 19–22, explain why the  
correction was necessary and attach any notice you  
received from the IRS.  
Part 5: Sign Here  
You must complete all five pages of Form 941-X and sign  
it on page 5. If you don’t sign, processing of Form 941-X  
will be delayed.  
-26-  
Instructions for Form 941-X (Rev. 4-2023)  
 
Worksheet 1. Adjusted Credit for Qualified Sick and Family Leave  
Wages for Leave Taken After March 31, 2020, and Before April 1,  
2021  
Keep for Your Records  
You must use this worksheet if you claimed the credit for qualified sick and family leave wages for leave taken after March 31, 2020, and  
before April 1, 2021, on your original Form 941 and you correct any amounts used to figure the credit for qualified sick and family leave  
wages for leave taken after March 31, 2020, and before April 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it  
for the first time on Form 941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a  
client-by-client basis.  
Step 1.  
Determine the corrected employer share of social security tax this quarter after it is reduced by any credit  
claimed on Form 8974, Form 5884-C, and/or Form 5884-D  
1a  
1b  
Enter the amount of social security wages from Form 941, Part 1, line 5a, column 1,  
or, if corrected, the amount from Form 941-X, line 8, column 1 . . . . . . . . . . . . . . . . . 1a  
Enter the amount of social security tips from Form 941, Part 1, line 5b, column 1, or,  
if corrected, the amount from Form 941-X, line 11, column 1 . . . . . . . . . . . . . . . . . . . 1b  
1c  
1d  
1e  
Add lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1c  
Multiply line 1c by 6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1d  
If you're a third-party payer of sick pay that isn't an agent and you're claiming credits  
for amounts paid to your employees, enter the employer share of social security tax  
included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer  
share of social security tax on sick pay that you included on Form 941-X, line 15,  
column 1 (enter as a negative number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e  
1f  
Employer share of social security tax included on Form 941-X, line 20,  
column 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1f  
1g  
If you received a Section 3121(q) Notice and Demand during the quarter, enter the  
amount of the employer share of social security tax from the notice . . . . . . . . . . . . . 1g  
1h  
1i  
Employer share of social security tax. Combine lines 1d, 1e, 1f, and 1g . . . . . . .  
1h  
Enter the amount from Form 8974, line 12 (including any amended Form 8974  
attached to Form 941-X) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1i  
1j  
Enter the amount from Form 5884-C, line 11, for this quarter (for quarters ending  
before April 1, 2021, this amount was also included on Form 941, Part 3, line 23, or,  
if corrected, the amount from Form 941-X, line 32, column 1) . . . . . . . . . . . . . . . . . . 1j  
1j(i) Enter the amount from Form 5884-D, line 12, for this quarter . . . . . . . . . . . . . . . . . .  
1j(i)  
1k  
Total nonrefundable credits already used against the employer share of  
social security tax. Add lines 1i, 1j, and 1j(i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1k  
1l  
1l  
Employer share of social security tax remaining. Subtract line 1k  
from line 1h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Step 2.  
Figure the sick and family leave credit  
2a  
Qualified sick leave wages reported on Form 941, Part 1, line 5a(i), column 1, or, if  
corrected, the amount from Form 941-X, line 9, column 1 . . . . . . . . . . . . . . . . . . . . . 2a  
2a(i) Qualified sick leave wages included on Form 941, Part 1, line 5c, or, if corrected, the  
amount from Form 941-X, line 12, column 1, but not included on Form 941, Part 1,  
line 5a(i), column 1, or Form 941-X, line 9, column 1, because the wages reported  
on that line were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . . 2a(i)  
2a(ii) Total qualified sick leave wages. Add lines 2a and 2a(i) . . . . . . . . . . . . . . . . . . . . . .  
2a(iii) Qualified sick leave wages excluded from the definition of employment under  
2a(ii)  
sections 3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(iii)  
2b  
2c  
Qualified health plan expenses allocable to qualified sick leave wages (Form 941,  
Part 3, line 19, or, if corrected, Form 941-X, line 28, column 1) . . . . . . . . . . . . . . . . . 2b  
Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by  
1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c  
2d  
2e  
Credit for qualified sick leave wages. Add lines 2a(ii), 2a(iii), 2b, and 2c . . . . . . .  
2d  
Qualified family leave wages reported on Form 941, Part 1, line 5a(ii), column 1, or,  
if corrected, the amount from Form 941-X, line 10, column 1 . . . . . . . . . . . . . . . . . . . 2e  
2e(i) Qualified family leave wages included on Form 941, Part 1, line 5c, or, if corrected,  
the amount from Form 941-X, line 12, column 1, but not included on Form 941, Part  
1, line 5a(ii), column 1, or Form 941-X, line 10, column 1, because the wages  
reported on that line were limited by the social security wage base . . . . . . . . . . . . . . 2e(i)  
2e(ii) Total qualified family leave wages. Add lines 2e and 2e(i) . . . . . . . . . . . . . . . . . . . . .  
2e(iii) Qualified family leave wages excluded from the definition of employment under  
2e(ii)  
sections 3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e(iii)  
2f  
Qualified health plan expenses allocable to qualified family leave wages (Form 941,  
Part 3, line 20, or, if corrected, Form 941-X, line 29, column 1) . . . . . . . . . . . . . . . . . 2f  
2g  
Employer share of Medicare tax on qualified family leave wages. Multiply line 2e(ii)  
by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g  
2h  
2i  
Credit for qualified family leave wages. Add lines 2e(ii), 2e(iii), 2f, and 2g . . . . .  
Credit for qualified sick and family leave wages. Add lines 2d and 2h . . . . . . . .  
2h  
2i  
2j  
Nonrefundable portion of credit for qualified sick and family leave wages for  
leave taken after March 31, 2020, and before April 1, 2021. Enter the smaller of  
line 1l or line 2i. Enter this amount on Form 941-X, line 17, column 1 . . . . . . . . . . . .  
2j  
2k  
Refundable portion of credit for qualified sick and family leave wages for  
leave taken after March 31, 2020, and before April 1, 2021. Subtract line 2j from  
line 2i and enter this amount on Form 941-X, line 25, column 1 . . . . . . . . . . . . . . . . .  
2k  
Instructions for Form 941-X (Rev. 4-2023)  
-27-  
 
Worksheet 2. Adjusted Employee Retention Credit for Qualified  
Wages Paid After March 12, 2020, and Before July 1, 2021  
Keep for Your Records  
You must use this worksheet if you claimed the employee retention credit for qualified wages paid after March 12, 2020, and before July 1,  
2021, on your original Form 941 and you correct any amounts used to figure the employee retention credit for qualified wages paid after  
March 12, 2020, and before July 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form  
941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis.  
Step 1.  
Determine the corrected employer share of social security tax this quarter after it is reduced by any credit  
claimed on Form 8974, Form 5884-C, and/or Form 5884-D  
1a  
If you completed Worksheet 1 to claim a credit for qualified sick and family leave  
wages for leave taken after March 31, 2020, and before April 1, 2021, for a quarter  
in which you're also claiming the employee retention credit, enter the amount from  
Worksheet 1, Step 1, line 1l, and go to Step 2. Otherwise, complete lines 1b–1n  
below and then go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1a  
1b  
1c  
Enter the amount of social security wages from Form 941, Part 1, line 5a, column 1,  
or, if corrected, the amount from Form 941-X, line 8, column 1 . . . . . . . . . . . . . . . . . 1b  
Enter the amount of social security tips from Form 941, Part 1, line 5b, column 1, or,  
if corrected, the amount from Form 941-X, line 11, column 1 . . . . . . . . . . . . . . . . . . . 1c  
1d  
1e  
1f  
Add lines 1b and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1d  
Multiply line 1d by 6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e  
If you're a third-party payer of sick pay that isn't an agent and you're claiming credits  
for amounts paid to your employees, enter the employer share of social security tax  
included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer  
share of social security tax on sick pay that you included on Form 941-X, line 15,  
column 1 (enter as a negative number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1f  
1g  
1h  
Employer share of social security tax included on Form 941-X, line 20,  
column 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1g  
If you received a Section 3121(q) Notice and Demand during the quarter, enter the  
amount of the employer share of social security tax from the notice . . . . . . . . . . . . . 1h  
1i  
1j  
Employer share of social security tax. Combine lines 1e, 1f, 1g, and 1h . . . . . . .  
1i  
Enter the amount from Form 941, Part 1, line 11a, or, if corrected, the amount from  
Form 941-X, line 16, column 1 (credit from Form 8974) . . . . . . . . . . . . . . . . . . . . . . . 1j  
1k  
Enter the amount from Form 5884-C, line 11, for this quarter (for quarters ending  
before April 1, 2021, this amount was also included on Form 941, Part 3, line 23, or,  
if corrected, the amount from Form 941-X, line 32, column 1) . . . . . . . . . . . . . . . . . . 1k  
1l  
1m  
Enter the amount from Form 5884-D, line 12, for this quarter . . . . . . . . . . . . . . . . . .  
1l  
Total nonrefundable credits already used against the employer share of  
social security tax. Add lines 1j, 1k, and 1l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1m  
1n  
1n  
Employer share of social security tax remaining. Subtract line 1m  
from line 1i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
Step 2.  
Figure the employee retention credit  
Caution: For qualified wages paid before January 1, 2021, the cumulative total for  
all quarters of 2020 that can be claimed on lines 2a, 2b, 2c, and 2d can't exceed  
$10,000 per employee. For qualified wages paid after December 31, 2020, the total  
amount included on lines 2a and 2b can't exceed $10,000 per employee each  
quarter.  
2a  
2b  
2c  
Qualified wages (excluding qualified health plan expenses) for the employee  
retention credit (Form 941, Part 3, line 21, or, if corrected, Form 941-X, line 30,  
column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a  
Qualified health plan expenses allocable to qualified wages for the employee  
retention credit (Form 941, Part 3, line 22, or, if corrected, Form 941-X, line 31a,  
column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b  
Qualified wages (excluding qualified health plan expenses) paid March 13, 2020,  
through March 31, 2020, for the employee retention credit (Form 941, Part 3,  
line 24, or, if corrected, Form 941-X, line 33a, column 1). Enter an amount here only  
if filing a Form 941-X to correct the second quarter of 2020 . . . . . . . . . . . . . . . . . . . . 2c  
2d  
Qualified health plan expenses allocable to qualified wages paid March 13, 2020,  
through March 31, 2020, for the employee retention credit (Form 941, Part 3,  
line 25, or, if corrected, Form 941-X, line 34, column 1). Enter an amount here only if  
filing a Form 941-X to correct the second quarter of 2020 . . . . . . . . . . . . . . . . . . . . . 2d  
2e  
2f  
Add lines 2a, 2b, 2c, and 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2e  
Retention credit. If you're correcting the second, third, or fourth quarter of 2020,  
multiply line 2e by 50% (0.50). If you're correcting the first or second quarter of  
2021, multiply line 2e by 70% (0.70) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2f  
2g  
2h  
Enter the amount of the employer share of social security tax from Step 1, line 1a,  
or, if applicable, Step 1, line 1n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g  
Enter the amount of the nonrefundable portion of the credit for qualified sick and  
family leave wages for leave taken after March 31, 2020, and before April 1, 2021  
(this amount may come from Worksheet 1, Step 2, line 2j, in these instructions if  
you're correcting that credit for the quarter or you may need to enter the credit  
claimed on your original Form 941 for the quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . 2h  
2i  
2j  
Subtract line 2h from line 2g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2i  
Nonrefundable portion of employee retention credit. Enter the smaller of line 2f  
or line 2i. Enter this amount on Form 941-X, line 18a, column 1 . . . . . . . . . . . . . . . .  
2j  
2k  
Refundable portion of employee retention credit. Subtract line 2j from line 2f  
and enter this amount on Form 941-X, line 26a, column 1 . . . . . . . . . . . . . . . . . . . . .  
2k  
-28-  
Instructions for Form 941-X (Rev. 4-2023)  
 
Worksheet 3. Adjusted Credit for Qualified Sick and Family Leave  
Wages for Leave Taken After March 31, 2021, and Before October 1,  
2021  
Keep for Your Records  
You must use this worksheet if you claimed the credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before October 1, 2021, on  
your original Form 941 and you correct any amounts used to figure the credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before  
October 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 941-X. If you're a third-party payer, you must complete  
this worksheet for each client for which it is applicable, on a client-by-client basis.  
Step 1.  
Determine the corrected employer share of Medicare tax  
1a  
Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if corrected, the  
amount from Form 941-X, line 12, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a  
1b  
1c  
Multiply line 1a by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1b  
If you're a third-party payer of sick pay that isn't an agent and you're claiming credits for amounts  
paid to your employees, enter the employer share of Medicare tax included on Form 941, Part 1,  
line 8, or, if corrected, the amount of the employer share of Medicare tax on sick pay that you  
included on Form 941-X, line 15, column 1 (enter as a negative number) . . . . . . . . . . . . . . . . . . 1c  
1d  
1e  
Employer share of Medicare tax included on Form 941-X, line 21, column 4 . . . . . . . . . . . . . . . . 1d  
If you received a Section 3121(q) Notice and Demand during the quarter, enter the amount of the  
employer share of Medicare tax from the notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1e  
1f  
Employer share of Medicare tax. Combine lines 1b, 1c, 1d, and 1e . . . . . . . . . . . . . . . . . . . .  
1f  
1g  
For corrections to quarters beginning after December 31, 2022, only, enter the amount from Form  
8974, line 16 (including any amended Form 8974 attached to Form 941-X) . . . . . . . . . . . . . . . . . 1g  
1h  
Employer share of Medicare tax remaining. Subtract line 1g from line 1f . . . . . . . . . . . . . . . .  
1h  
Step 2.  
Figure the sick and family leave credit  
2a  
Qualified sick leave wages for leave taken after March 31, 2021, and before October 1, 2021,  
reported on Form 941, Part 3, line 23, or, if corrected, the amount from Form 941-X, line 35,  
column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a  
2a(i)  
Qualified sick leave wages included on Form 941, Part 3, line 23, or, if corrected, the amount from  
Form 941-X, line 35, column 1, that were not included as wages reported on Form 941, Part 1, lines  
5a and 5c, or, if corrected, the amount from Form 941-X, lines 8 and 12, column 1, because the  
qualified sick leave wages were excluded from the definition of employment under sections 3121(b)  
(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(i)  
2a(ii) Subtract line 2a(i) from line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2a(ii)  
2a(iii) Qualified sick leave wages included on Form 941, Part 3, line 23, or, if corrected, the amount from  
Form 941-X, line 35, column 1, that were not included as wages reported on Form 941, Part 1,  
line 5a, or, if corrected, the amount from Form 941-X, line 8, column 1, because the qualified sick  
leave wages were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(iii)  
2a(iv) Subtract line 2a(iii) from line 2a(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2a(iv)  
2b  
Qualified health plan expenses allocable to qualified sick leave wages for leave taken after March 31,  
2021, and before October 1, 2021, reported on Form 941, Part 3, line 24, or, if corrected, the amount  
from Form 941-X, line 36, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b  
2c  
Amounts under certain collectively bargained agreements allocable to qualified sick leave wages for  
leave taken after March 31, 2021, and before October 1, 2021, reported on Form 941, Part 3, line 25,  
or, if corrected, the amount from Form 941-X, line 37, column 1 . . . . . . . . . . . . . . . . . . . . . . . . 2c  
2d  
2e  
Employer share of social security tax on qualified sick leave wages. Multiply line 2a(iv) by 6.2%  
(0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d  
Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 1.45%  
(0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e  
2f  
Credit for qualified sick leave wages. Add lines 2a, 2b, 2c, 2d, and 2e . . . . . . . . . . . . . . . . . .  
2f  
2g  
Qualified family leave wages for leave taken after March 31, 2021, and before October 1, 2021,  
reported on Form 941, Part 3, line 26, or, if corrected, the amount from Form 941-X, line 38,  
column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g  
2g(i)  
Qualified family leave wages included on Form 941, Part 3, line 26, or, if corrected, the amount from  
Form 941-X, line 38, column 1, that were not included as wages reported on Form 941, Part 1, lines  
5a and 5c, or, if corrected, the amount from Form 941-X, lines 8 and 12, column 1, because the  
qualified family leave wages were excluded from the definition of employment under sections 3121(b)  
(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g(i)  
2g(ii) Subtract line 2g(i) from line 2g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2g(iii) Qualified family leave wages included on Form 941, Part 3, line 26, or, if corrected, the amount from  
Form 941-X, line 38, column 1, that were not included as wages reported on Form 941, Part 1,  
line 5a, or, if corrected, the amount from Form 941-X, line 8, column 1, because the qualified family  
2g(ii)  
leave wages were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g(iii)  
2g(iv) Subtract line 2g(iii) from line 2g(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2h  
2g(iv)  
Qualified health plan expenses allocable to qualified family leave wages for leave taken after March  
31, 2021, and before October 1, 2021, reported on Form 941, Part 3, line 27, or, if corrected, the  
amount from Form 941-X, line 39, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2h  
2i  
Amounts under certain collectively bargained agreements allocable to qualified family leave wages  
for leave taken after March 31, 2021, and before October 1, 2021, reported on Form 941, Part 3,  
line 28, or, if corrected, the amount from Form 941-X, line 40, column 1 . . . . . . . . . . . . . . . . . . . 2i  
2j  
Employer share of social security tax on qualified family leave wages. Multiply line 2g(iv) by 6.2%  
(0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2j  
2k  
Employer share of Medicare tax on qualified family leave wages. Multiply line 2g(ii) by 1.45%  
(0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2k  
2l  
2m  
2n  
Credit for qualified family leave wages. Add lines 2g, 2h, 2i, 2j, and 2k . . . . . . . . . . . . . . . . .  
Credit for qualified sick and family leave wages. Add lines 2f and 2l . . . . . . . . . . . . . . . . . .  
2l  
2m  
For second quarter of 2021 only, enter any employee retention credit claimed under section 2301  
of the CARES Act (this amount may come from Worksheet 2, Step 2, line 2f, in these instructions if  
you're correcting that credit for the second quarter of 2021 or you may need to enter the credit  
claimed on your original Form 941 for the second quarter of 2021) with respect to any wages taken  
into account for the credit for qualified sick and family leave wages for the quarter . . . . . . . . . . . . 2n  
2o  
Enter any credit claimed under section 41 for increasing research activities with respect to any  
wages taken into account for the credit for qualified sick and family leave wages . . . . . . . . . . . . . 2o  
2p  
2q  
Add lines 2n and 2o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2p  
Credit for qualified sick and family leave wages after adjusting for other credits. Subtract  
line 2p from line 2m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2q  
2r  
2r  
Nonrefundable portion of credit for qualified sick and family leave wages for leave taken  
after March 31, 2021, and before October 1, 2021. Enter the smaller of line 1h or line 2q. Enter  
this amount on Form 941-X, line 18b, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2s  
Refundable portion of credit for qualified sick and family leave wages for leave taken after  
March 31, 2021, and before October 1, 2021. Subtract line 2r from line 2q and enter this amount  
on Form 941-X, line 26b, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2s  
Instructions for Form 941-X (Rev. 4-2023)  
-29-  
 
Worksheet 4. Adjusted Employee Retention Credit for Qualified  
Wages Paid After June 30, 2021, and Before January 1, 2022  
Keep for Your Records  
You must use this worksheet if you claimed the employee retention credit for qualified wages paid after June 30, 2021, and before January  
1, 2022, on your original Form 941 and you correct any amounts used to figure the employee retention credit for qualified wages paid after  
June 30, 2021, and before January 1, 2022. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form  
941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis.  
Step 1.  
Determine the corrected employer share of Medicare tax  
1a  
If you completed Worksheet 3 to claim a credit for qualified sick and family leave  
wages for leave taken after March 31, 2021, and before October 1, 2021, for a  
quarter in which you're also claiming the employee retention credit, enter the  
amount from Worksheet 3, Step 1, line 1h, and go to Step 2. Otherwise, complete  
lines 1b–1g below and then go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1a  
1b  
Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if  
corrected, the amount from Form 941-X, line 12, column 1 . . . . . . . . . . . . . . . . . . . 1b  
1c  
1d  
Multiply line 1b by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1c  
If you're a third-party payer of sick pay that isn't an agent and you're claiming credits  
for amounts paid to your employees, enter the employer share of Medicare tax  
included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer  
share of Medicare tax on sick pay that you included on Form 941-X, line 15, column  
1 (enter as a negative number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1d  
1e  
1f  
Employer share of Medicare tax included on Form 941-X, line 21, column 4 . . . . . 1e  
If you received a Section 3121(q) Notice and Demand during the quarter, enter the  
amount of the employer share of Medicare tax from the notice . . . . . . . . . . . . . . . . 1f  
1g  
Employer share of Medicare tax. Combine lines 1c, 1d, 1e, and 1f . . . . . . . . . . .  
1g  
Step 2.  
Figure the employee retention credit  
Caution: You must be a recovery startup business to claim the employee retention  
credit for qualified wages paid after September 30, 2021, and before January 1,  
2022 (fourth quarter 2021). The total amount included on lines 2a and 2b can't  
exceed $10,000 per employee each quarter.  
2a  
2b  
Qualified wages (excluding qualified health plan expenses) for the employee  
retention credit (Form 941, Part 3, line 21, or, if corrected, Form 941-X, line 30,  
column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a  
Qualified health plan expenses allocable to qualified wages for the employee  
retention credit (Form 941, Part 3, line 22, or, if corrected, Form 941-X, line 31a,  
column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b  
2c  
2d  
Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2c  
Retention credit. Multiply line 2c by 70% (0.70). If you qualify for the employee  
retention credit solely because your business is a recovery startup business, don't  
enter more than $50,000 per quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2d  
2e  
2f  
Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if  
applicable, Step 1, line 1g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e  
Enter the amount of the nonrefundable portion of the credit for qualified sick and  
family leave wages for leave taken after March 31, 2021, and before October 1,  
2021 (this amount may come from Worksheet 3, Step 2, line 2r, in these instructions  
if you're correcting that credit or you may need to enter the credit claimed on your  
original Form 941) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f  
2g  
2h  
Subtract line 2f from line 2e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2g  
Nonrefundable portion of employee retention credit. Enter the smaller of  
line 2d or line 2g. Enter this amount on Form 941-X, line 18a, column 1 . . . . . . . . .  
2h  
2i  
2i  
Refundable portion of employee retention credit. Subtract line 2h from line 2d  
and enter this amount on Form 941-X, line 26a, column 1 . . . . . . . . . . . . . . . . . . . .  
-30-  
Instructions for Form 941-X (Rev. 4-2023)  
 
Keep for Your Records  
Worksheet 5. Adjusted COBRA Premium Assistance Credit  
You must use this worksheet if you claimed the COBRA premium assistance credit on your original Form 941 and you correct any amounts used to figure  
the COBRA premium assistance credit. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 941-X. If you're a  
third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis.  
Step 1.  
Determine the corrected employer share of Medicare tax  
1a  
If you completed Worksheet 3 or Worksheet 4 for a quarter in which you're also claiming the  
COBRA premium assistance credit, enter the amount listed on Worksheet 3, line 1h, or  
Worksheet 4, line 1a or 1g (as applicable). Otherwise, complete lines 1b–1g below and then  
go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1a  
1b  
Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if corrected,  
the amount from Form 941-X, line 12, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b  
1c  
1d  
Multiply line 1b by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
1c  
If you're a third-party payer of sick pay that isn't an agent and you're claiming credits for  
amounts paid to your employees, enter the employer share of Medicare tax included on Form  
941, Part 1, line 8, or, if corrected, the amount of the employer share of Medicare tax on sick  
pay that you included on Form 941-X, line 15, column 1 (enter as a negative  
number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1d  
Employer share of Medicare tax included on Form 941-X, line 21, column 4 . . . . . . . . . . . . 1e  
1e  
1f  
If you received a Section 3121(q) Notice and Demand during the quarter, enter the amount of  
the employer share of Medicare tax from the notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1f  
1g  
Employer share of Medicare tax. Combine lines 1c, 1d, 1e, and 1f . . . . . . . . . . . . . . . .  
1g  
Step 2.  
Figure the COBRA premium assistance credit  
2a  
2b  
Enter the COBRA premium assistance that you provided this quarter . . . . . . . . . . . . . . . .  
Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if applicable,  
2a  
Step 1, line 1g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b  
2c  
Enter the amount of the nonrefundable portion of the credit for qualified sick and family leave  
wages for leave taken after March 31, 2021, and before October 1, 2021 (this amount may  
come from Worksheet 3, Step 2, line 2r, in these instructions if you're correcting that credit for  
the quarter or you may need to enter the credit claimed on your original Form 941 for the  
quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c  
2d  
2e  
Enter the amount of the nonrefundable portion of the employee retention credit (this amount  
may come from Worksheet 4, Step 2, line 2h, in these instructions if you're correcting that  
credit for the quarter or you may need to enter the credit claimed on your original Form 941 for  
the quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d  
Other nonrefundable credits used against the employer share of Medicare tax. Add  
lines 2c and 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e  
2f  
2g  
Subtract line 2e from line 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  
2f  
Nonrefundable portion of the COBRA premium assistance credit. Enter the smaller of  
line 2a or line 2f. Enter this amount on Form 941-X, line 18c, column 1 . . . . . . . . . . . . . . .  
2g  
2h  
2h  
Refundable portion of the COBRA premium assistance credit. Subtract line 2g from  
line 2a and enter this amount on Form 941-X, line 26c, column 1 . . . . . . . . . . . . . . . . . . .  
Reduction Act unless the form displays a valid OMB  
control number. Books and records relating to a form or  
instructions must be retained as long as their contents  
may become material in the administration of any Internal  
Revenue law.  
How Can You Get Forms,  
Instructions, and Publications From  
the IRS?  
You can view, download, or print most of the  
forms, instructions, and publications you may  
need at IRS.gov/Forms. Otherwise, you can go to  
IRS.gov/OrderForms to place an order and have them  
mailed to you. The IRS will process your order for forms  
and publications as soon as possible. Don't resubmit  
requests you've already sent us. You can get forms and  
publications faster online.  
The time needed to complete and file Form 941-X will  
vary depending on individual circumstances. The  
estimated average time is:  
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . 31 hr., 19 min.  
Learning about the law or the form . . . . . . . .  
Preparing and sending the form to the IRS . .  
35 min.  
1 hr., 8 min.  
If you have comments concerning the accuracy of  
these time estimates or suggestions for making Form  
941-X simpler, we would be happy to hear from you. You  
can send us comments from IRS.gov/FormComments. Or  
you can send your comments to: Internal Revenue  
Service, Tax Forms and Publications Division, 1111  
Constitution Ave. NW, IR-6526, Washington, DC 20224.  
Don’t send Form 941-X to this address. Instead, see  
Paperwork Reduction Act Notice. We ask for the  
information on Form 941-X to carry out the Internal  
Revenue laws of the United States. We need it to figure  
and collect the right amount of tax. Subtitle C,  
Employment Taxes, of the Internal Revenue Code  
imposes employment taxes, including federal income tax  
withholding, on wages. This form is used to determine the  
amount of taxes that you owe. Section 6011 requires you  
to provide the requested information if the tax is  
applicable to you.  
You’re not required to provide the information  
requested on a form that is subject to the Paperwork  
Instructions for Form 941-X (Rev. 4-2023)  
-31-