EMPLOYER'S QUARTERLY FEDERAL TAX RETURN, QUARTERLY RETURN OF WITHHELD INCOME TAX AND HOSPITAL INSURANCE (MEDICARE) TAX, & RECORD OF FED. BACKUP WITHHOLDING TAX LIABILITY
ICR 198803-1545-010
OMB: 1545-0029
Federal Form Document
⚠️ Notice: This information collection may be outdated. More recent filings for OMB 1545-0029 can be found here:
EMPLOYER'S QUARTERLY FEDERAL
TAX RETURN, QUARTERLY RETURN OF WITHHELD INCOME TAX AND HOSPITAL
INSURANCE (MEDICARE) TAX, & RECORD OF FED. BACKUP WITHHOLDING
TAX LIABILITY
FORM 941 IS USED BY EMPLOYERS TO
REPORT PAYMENTS MADE TO EMPLOYEES SUBJECT TO INCOME AND FICA TAXES
AND THE AMOUNTS OF THESE TAXES. FORM 941E IS USED PRIMARILY BY
STATE AND LOCAL GOVERNMENTS TO REPORT WITHHELD INCOME AND HOSPITAL
INSURANCE TAXES ONLY. FORM 941R IS USED B EMPLOYERS IN PUERTO RICO
TO REPORT FICA TAXES ONLY AND FORM 941SS IS USED BY EMPLOYERS IN
THE POSSESSIONS TO REPORT FICA TAX ONLY. SCHEDULE
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.