941-X ohjeet
941-X-muodon, korjatun työnantajan neljännesvuosittaisen liittovaltion veroilmoituksen tai palautusvaatimuksen
Rev. huhtikuuta 2023
Liittyvät lomakkeet
- Muoto 941-X - Sopeutettu työnantajan QUARTERLY Liittovaltion veroilmoitus tai palautusvaatimukset
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
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
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.
Worksheet 1. Adjusted Credit for Qualified Sick
and Family Leave Wages for Leave Taken
After March 31, 2020, and Before April 1,
Worksheet 2. Adjusted Employee Retention Credit
for Qualified Wages Paid After March 12, 2020,
Worksheet 3. Adjusted Credit for Qualified Sick
and Family Leave Wages for Leave Taken
After March 31, 2021, and Before October 1,
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,
Worksheet 5. Adjusted COBRA Premium
How Can You Get Forms, Instructions, and
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
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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
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 941‐X to amounts used to figure this
credit, you'll need to refigure the amount of this credit
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 941‐X to amounts used to figure this
credit, you'll need to refigure the amount of this credit
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 941‐X to
amounts used to figure this credit, you'll need to refigure
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 941‐X to amounts used to figure this
credit, you'll need to refigure the amount of this credit
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Instructions for Form 941-X (Rev. 4-2023)
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 941‐X to
amounts used to figure this credit, you'll need to refigure
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
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
IRS.gov/irb/2017-14_IRB#RP-2017-28, provides
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
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
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
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
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
Where Should You File Form 941-X, later.
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
later. For details on how to make a payment, see the
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
Publications From the IRS, later.
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
for Filing Form 941-X, later.
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
Filing Form 941-X? next.
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.
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
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
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
for Filing Form 941-X, earlier.
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.
•
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
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
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 941‐X, 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 941‐X, 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 941‐X for the
quarter to amounts used to figure this credit, you'll need to
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
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
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.
Following Example—Wages, tips, and other
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 941‐X 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 941‐X, 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 941‐X, 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 941‐X 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
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.
Following Example—Wages, tips, and other
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.
Following Example—Wages, tips, and other
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
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 941‐X as
shown.
information about the credit for qualified sick and family
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 941‐X, 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
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
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
correct amount of the credit. For more information, see
Notice 2021-20, 2021-11 I.R.B. 922, available at
IRS.gov/irb/2021-11_IRB#NOT-2021-20; and Rev. Proc.
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
Example—Nonrefundable portion of credit for
qualified sick and family leave wages increased.
Following Example—Qualified sick leave wages
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
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
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
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
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
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
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 941‐X filed for the second
quarter of 2020. Don’t file Form 941‐X 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 941‐X
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
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
information about the credit for qualified sick and family
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
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
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
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
•
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
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
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
the employee retention credit for qualified wages paid
after December 31, 2020, and before July 1, 2021. Also
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
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
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
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
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-
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
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
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
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
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
The preferred method of payment is EFTPS. For more
•
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
qualified wages paid after March 12, 2020, and before
July 1, 2021. Enter the corrected amount from column 1
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 941‐X 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
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
expenses allocable to qualified wages paid after March
12, 2020, and before July 1, 2021. Enter the corrected
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
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
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
32. Credit From Form 5884‐C, 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 5884‐C,
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
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
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
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
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
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
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
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
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
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
Where Should You File Form 941-X, earlier.
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-