Forms 941, Employer's Quarterly Federal Tax Return; American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands

Instructions for Form 941

Department of the Treasury
Internal Revenue Service

(Rev. February 2010)
Employer’s QUARTERLY Federal Tax Return
Section references are to the Internal Revenue Code unless
otherwise noted.

What’s New
COBRA premium assistance credit extended. The credit
for COBRA premium assistance payments has been
extended. It now applies to premiums paid for employees
terminated before March 1, 2010, and to premiums paid for
15 months. See COBRA premium assistance credit on page
6.
Employers can choose to file Forms 941 instead of
Form 944 for 2010. Beginning with tax year 2010,
employers that would otherwise be required to file Form 944
can notify the IRS if they want to file quarterly Forms 941
instead of annual Form 944. See Revenue Procedure
2009-51 2009-45 I.R.B. 625, available at
www.irs.gov/irb/2009-45_IRB/ar12.html.
Social security wage base for 2010. Do not withhold
social security tax after an employee reaches $106,800 in
social security wages in 2010.

Reminders
Correcting a previously filed Form 941. If you discover
an error on a previously filed Form 941, make the correction
using Form 941-X, Adjusted Employer’s QUARTERLY
Federal Tax Return or Claim for Refund. Form 941-X is filed
separately from Form 941. For more information, see
section 13 of Pub. 15 (Circular E) or visit the IRS website at
www.irs.gov and enter the keywords Correcting Employment
Taxes.
Paid preparers must sign Form 941. Paid preparers must
complete and sign the paid preparer’s section of Form 941.
Electronic filing and payment. Now, more than ever
before, businesses can enjoy the benefits of filing and
paying their federal taxes electronically. Whether you rely on
a tax professional or handle your own taxes, the IRS offers
you convenient programs to make filing and paying easier.
Spend less time and worry on taxes and more time running
your business. Use e-file and the Electronic Federal Tax
Payment System (EFTPS) to your benefit.
• For e-file, visit www.irs.gov for additional information.
• For EFTPS, visit www.eftps.gov/eftps or call EFTPS
Customer Service at 1-800-555-4477, 1-800-733-4829
(TDD), or 1-800-244-4829 (Spanish).
Electronic funds withdrawal (EFW). If you file
Form 941 electronically, you can e-file and e-pay (electronic
funds withdrawal) the balance due in a single step using tax
preparation software or through a tax professional.
However, do not use EFW to make federal tax deposits.
For more information on paying your taxes using EFW, visit
the IRS website at www.irs.gov and type e-pay in the search
box. A fee may be charged to file electronically.
Credit card payments. Employers can pay the balance
due shown on Form 941 by credit card. Do not use a credit
card to make federal tax deposits. For more information on
paying your taxes with a credit card, visit the IRS website at
www.irs.gov and type e-pay in the search box.
Employer’s liability. Employers are responsible to ensure
that tax returns are filed and deposits and payments are
made, even if the employer contracts with a third party. The

employer remains liable if the third party fails to perform a
required action.
Where can you get telephone help? You can call the IRS
Business and Specialty Tax Line toll free at 1-800-829-4933,
Monday through Friday from 7 a.m. to 10 p.m. local time
(Alaska and Hawaii follow Pacific time) to order tax deposit
coupons (Form 8109) and for answers to your questions
about completing Form 941, tax deposit rules, or obtaining
an employer identification number (EIN).
Photographs of missing children. The Internal Revenue
Service is a proud partner with the National Center for
Missing and Exploited Children. Photographs of missing
children selected by the Center may appear in instructions
on pages that would otherwise be blank. You can help bring
these children home by looking at the photographs and
calling 1-800-THE-LOST (1-800-843-5678) if you recognize
a child.

General Instructions:
Purpose of Form 941
These instructions give you some background information
about Form 941. They tell you who must file Form 941, how
to complete it line by line, and when and where to file it.
If you want more in-depth information about payroll tax
topics relating to Form 941, see Pub. 15 (Circular E),
Employer’s Tax Guide, or visit the IRS website at
www.irs.gov/businesses and click on the Employment Taxes
link.
Federal law requires you, as an employer, to withhold
taxes from your employees’ paychecks. Each time you pay
wages, you must withhold – or take out of your employees’
paychecks – certain amounts for federal income tax, social
security tax, and Medicare tax. Under the withholding
system, taxes withheld from your employees are credited to
your employees in payment of their tax liabilities.
Federal law also requires you to pay any liability for the
employer’s portion of social security and Medicare taxes.
This portion of social security and Medicare taxes is not
withheld from employees.

Who Must File Form 941?
Use Form 941 to report the following amounts.
• Wages you have paid.
• Tips your employees have received.
• Federal income tax you withheld.
• Both the employer’s and the employee’s share of social
security and Medicare taxes.
• Current quarter’s adjustments to social security and
Medicare taxes for fractions of cents, sick pay, tips, and
group-term life insurance.
• Advance earned income tax credit (EIC) payments.
• Credit for COBRA premium assistance payments.
Do not use the Form 941 to report backup withholding or
income tax withholding on nonpayroll payments such as
pensions, annuities, and gambling winnings. Report these
types of withholding on Form 945, Annual Return of
Withheld Federal Income Tax.
After you file your first Form 941, you must file a return
for each quarter, even if you have no taxes to report, unless

Cat. No. 14625L

you filed a final return or one of the exceptions listed below
applies.

taxes or subject to federal income tax withholding. See the
table below titled, When To File Form 941.
Then you must file for every quarter after that — every 3
months — even if you have no taxes to report, unless you
are a seasonal employer or are filing your final return. See
Seasonal employers and If your business has closed . . .
above.
File Form 941 only once for each quarter. If you filed
electronically, do not file a paper Form 941. For more
information about filing Form 941 electronically, see
Electronic filing and payment on page 1.

Exceptions
Special rules apply to some employers.

• Seasonal employers do not have to file a Form 941 for

quarters in which they have no tax liability because they
have paid no wages. To tell the IRS that you will not file a
return for one or more quarters during the year, check the
box on line 19 every quarter you file Form 941. See
section 12 of Pub. 15 (Circular E) for more information.
• Employers of household employees do not usually file
Form 941. See Pub. 926, Household Employer’s Tax Guide,
and Schedule H (Form 1040), Household Employment
Taxes, for more information.
• Employers of farm employees do not usually file
Form 941. See Form 943, Employer’s Annual Federal Tax
Return for Agricultural Employees, and Pub. 51 (Circular A),
Agricultural Employer’s Tax Guide.

When To File Form 941
Your Form 941 is due by the last day of the month that follows the end of the
quarter.

If none of the above exceptions applies and you
TIP have not filed a final return, you must file Form 941
each quarter even if you did not pay wages during
the quarter. Use IRS e-file, if possible.

What if you reorganize or close your
business?

The Quarter Includes . . .

Quarter Ends

Form 941
Is Due

1. January, February, March

March 31

April 30

2. April, May, June

June 30

July 31

3. July, August, September

September 30

October 31

4. October, November, December

December 31

January 31

For example, generally you must report wages you pay
during the first quarter — which is January through
March — by April 30th. If you made timely deposits in full
payment of your taxes for a quarter, you have 10 more days
after the due dates shown above to file your Form 941.
If we receive Form 941 after the due date, we will treat
Form 941 as filed on time if the envelope containing
Form 941 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 IRS-designated private delivery
service on or before the due date. If you do not follow these
guidelines, we will consider Form 941 filed when it is
actually received. See Pub. 15 (Circular E) for more
information on IRS-designated private delivery services.
If any due date for filing shown above falls on a Saturday,
Sunday, or legal holiday, you may file your return on the
next business day.

If you sell or transfer your business . . .
If you sell or transfer your business, you and the new owner
must each file a Form 941 for the quarter in which the
transfer occurred. Report only the wages you paid.
When two businesses merge, the continuing firm must file
a return for the quarter in which the change took place and
the other firm should file a final return.
Changing from one form of business to another — such as
from a sole proprietorship to a partnership or
corporation — is considered a transfer. If a transfer occurs,
you may need a new EIN. See section 1 of Pub. 15 (Circular
E). Attach a statement to your return with:
• The new owner’s name (or the new name of the
business);
• Whether the business is now a sole proprietorship,
partnership, or corporation;
• The kind of change that occurred (a sale or transfer);
• The date of the change; and
• The name of the person keeping the payroll records and
the address where those records will be kept.

How Should You Complete Form 941?
Review Your Business Information at the
Top of the Form

If your business has closed . . .

If you are using a copy of Form 941 that has your business
name and address preprinted at the top of the form, check
to make sure the information is correct. Carefully review
your EIN to make sure it exactly matches the EIN assigned
to your business by the IRS. If any information is incorrect,
cross it out and type or print the correct information. See If
you change your name or address... on page 3.
If you use a tax preparer to fill out Form 941, make sure
the preparer uses your business name and EIN exactly as
they appear on the preprinted form we sent you.
If you are not using a preprinted Form 941, type or print
your EIN, name, and address in the spaces provided. Also
enter your name and EIN on the top of page 2. Do not use
your social security number (SSN) or individual taxpayer
identification number (ITIN). Generally, enter the business
(legal) name you used when you applied for your EIN on
Form SS-4, Application for Employer Identification Number.
For example, if you are a sole proprietor, enter “Haleigh
Smith” on the “Name” line and “Haleigh’s Cycles” on the
“Trade name” line. Leave the “Trade name” line blank if it is
the same as your “Name.”
Employer identification number (EIN). To make sure
businesses comply with federal tax laws, the IRS monitors
tax filings and payments by using a numerical system to
identify taxpayers. A unique 9-digit employer identification

If you go out of business or stop paying wages to your
employees, you must file a final return. To tell the IRS that
Form 941 for a particular quarter is your final return, check
the box on line 18 and enter the date you last paid wages.
Also attach a statement to your return showing the name of
the person keeping the payroll records and the address
where those records will be kept.
See the Instructions for Forms W-2, Wage and Tax
Statement, and W-3, Transmittal of Wage and Tax
Statement, for information about earlier dates for the
expedited furnishing and filing of Forms W-2 when a final
Form 941 is filed.
If you participated in a statutory merger or consolidation,
or qualify for predecessor-successor status due to an
acquisition, you should generally file Schedule D (Form
941), Report of Discrepancies Caused by Acquisitions,
Statutory Mergers, or Consolidations. See the Instructions
for Schedule D (Form 941) to determine whether you should
file Schedule D (Form 941) and when you should file it.

When Must You File?
File your initial Form 941 for the quarter in which you first
paid wages that are subject to social security and Medicare

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number (EIN) is assigned to all corporations, partnerships,
and some sole proprietors. Businesses needing an EIN
must apply for a number and use it throughout the life of the
business on all tax returns, payments, and reports.
Your business should have only one EIN. If you have
more than one and are not sure which one to use, write to
the IRS office where you file your returns (using the Without
a payment address on page 4) or call the IRS at
1-800-829-4933.
If you do not have an EIN, you may apply for one online.
Go to the IRS website at www.irs.gov and click on the Apply
for an Employer Identification Number (EIN) Online link. You
may also apply for an EIN by calling 1-800-829-4933, or you
can fax or mail Form SS-4 to the IRS. If you have applied for
an EIN but do not have your EIN by the time a return is due,
write “Applied For” and the date you applied in the space
shown for the number.

Payment Certificate. For more information, see section 10 of
Pub. 15 (Circular E) and Pub. 596, Earned Income Credit.

Reconciling Forms 941 and Form W-3
The IRS matches amounts reported on your four quarterly
Forms 941 with Form W-2 amounts totaled on your yearly
Form W-3, Transmittal of Wage and Tax Statements. If the
amounts do not agree, you may be contacted by the IRS or
the Social Security Administration (SSA). The following
amounts are reconciled.
• Federal income tax withholding.
• Social security wages.
• Social security tips.
• Medicare wages and tips.
• Advance earned income credit (EIC) payments.
For more information, see section 12 of Pub. 15
(Circular E) and the Instructions for Schedule D (Form 941).

Depositing Your Taxes:
When Must You Deposit Your Taxes?

Always be sure the EIN on the form you file exactly

TIP matches the EIN the IRS assigned to your business.
Do not use your social security number on forms that
ask for an EIN. Filing a Form 941 with an incorrect EIN or
using another business’s EIN may result in penalties and
delays in processing your return.
If you change your name or address... Notify the IRS
immediately if you change your business name or address.
• Write to the IRS office where you file your returns (using
the Without a payment address on page 4) to notify the IRS
of any name change. Get Pub. 1635, Understanding Your
Employer Identification Number (EIN), to see if you need to
apply for a new EIN.
• Complete and mail Form 8822, Change of Address, for
any address change.

Determine if you are a monthly or
semiweekly schedule depositor for the
quarter.
The IRS uses two different sets of deposit rules to determine
when businesses must deposit their social security,
Medicare, and withheld federal income taxes. These
schedules tell you when a deposit is due after you have a
payday.
Your deposit schedule is not determined by how often
you pay your employees. Your deposit schedule depends on
the total tax liability you reported on Form 941 during the
previous four-quarter lookback period (July 1 of the second
preceding calendar year through June 30 of last year). See
section 11 of Pub. 15 (Circular E) for details. If you filed
Form 944 in either 2008 or 2009, your lookback period is the
2008 calendar year.
Before the beginning of each calendar year, determine
which type of deposit schedule you must use. If you
reported:
• $50,000 or less in taxes during the lookback period, you
are a monthly schedule depositor.
• More than $50,000 of taxes for the lookback period, you
are a semiweekly schedule depositor.

Check the Box for the Quarter
Under “Report for this Quarter of 2010” at the top of
Form 941, check the appropriate box of the quarter for
which you are filing. Make sure the quarter checked is the
same as shown on any attached Schedule B (Form 941),
Report of Tax Liability for Semiweekly Schedule Depositors.

Completing and Filing Form 941
Make entries on Form 941 as follows to enable accurate
scanning and processing.
• Use 12-point Courier font (if possible) for all entries if you
are typing or using a computer to fill out your form.
• Omit dollar signs and decimal points. Commas are
optional. Report dollars to the left of the preprinted decimal
point and cents to the right of it.
• Leave blank any data field (except lines 1, 2, and 10) with
a value of zero.
• Enter negative amounts using a minus sign (if possible).
Otherwise, use parentheses.
• Enter your name and EIN on all pages and attachments.
Filers using the IRS-preaddressed Form 941 do not have to
enter their name and EIN on page 2.
• Staple multiple sheets in the upper left corner when filing.

See section 11 of Pub. 15 (Circular E) for the Next

TIP Day Deposit Rule on taxes of $100,000 or more

accumulated on any day during the deposit period.

How Must You Deposit Your Taxes?
You may have to deposit the federal income taxes you
withheld and both the employer and employee social
security taxes and Medicare taxes. If your total taxes after
adjustment for advance EIC (line 10) are:
• Less than $2,500 for the current quarter or the
preceding quarter, and you did not incur a $100,000
next-day deposit obligation during the current quarter.
You do not have to make a deposit. To avoid a penalty, you
must pay the amount in full with a timely filed return or you
must deposit the amount timely. However, if your taxes for
the preceding quarter were less than $2,500, you are unsure
whether you will incur a $100,000 next-day deposit
obligation in the current quarter, and you are unsure your
taxes will be less than $2,500 in the current quarter, deposit
your taxes using the appropriate rules (above) to avoid
failure to deposit penalties.
• $2,500 or more for the current quarter and the
preceding quarter. You must deposit your taxes by using
EFTPS or by depositing them at a financial institution that is
authorized to accept federal tax deposits (that is, authorized

Other Forms You Must Use
To notify employees about the earned income credit (EIC),
you must give the employees one of the following:
• The IRS Form W-2, which has the required information
about the EIC on the back of Copy B.
• A substitute Form W-2 with the same EIC information on
the back of the employee’s copy that is on Copy B of the
IRS Form W-2.
• Notice 797, Possible Federal Tax Refund Due to the
Earned Income Credit (EIC).
• Your written statement with the same wording as Notice
797.
Each eligible employee who wishes to receive any
advance earned income credit payments must give you a
completed Form W-5, Earned Income Credit Advance

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depository) with Form 8109, Federal Tax Deposit Coupon.
See section 11 of Pub. 15 (Circular E).

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Florida
Hawaii
Idaho
Iowa
Kansas
Louisiana
Minnesota
Mississippi

You may reduce your deposits during the quarter by the
amount of COBRA premium assistance payments reported
on line 12a. See the instructions for line 12a on page 6.
EFTPS is an easy, safe, and convenient way for all

TIP employers to make their tax deposits. Using EFTPS
helps eliminate errors commonly made on federal tax
deposit (FTD) coupons. Some taxpayers are required to
use EFTPS to deposit their taxes. See section 11 of
Pub. 15 (Circular E) for details.

What About Penalties and Interest?
You can avoid paying penalties and interest if you do all of
the following:
• Deposit or pay your taxes when they are due, using
EFTPS if required.
• File your fully completed Form 941 on time.
• Report your tax liability accurately.
• Submit valid checks for tax payments.
• Furnish accurate Forms W-2 to employees.
• File Form W-3 and Copies A of Form W-2 with the Social
Security Administration (SSA) on time and accurately.

Enter the number of employees on your payroll for the pay
period including March 12, June 12, September 12, or
December 12, for the quarter indicated at the top of
Form 941. Do not include:
• Household employees,
• Employees in nonpay status for the pay period,
• Farm employees,
• Pensioners, or
• Active members of the Armed Forces.
If you enter “250” or more on line 1, you must file

TIP Forms W-2 electronically. For details, call the SSA at
1-800-772-6270 or visit SSA’s Employer W-2 Filing
Instructions and Information website at www.socialsecurity.
gov/employer.

2. Wages, tips, and other compensation

Where you file depends on whether you include a payment
with Form 941.

Connecticut
Delaware
District of
Columbia
Georgia
Illinois
Indiana
Kentucky
Maine
Maryland
Massachusetts
Michigan
New Hampshire

Department of the
Treasury
Internal Revenue
Service
Cincinnati, OH
45999-0005

Internal Revenue
Service
P.O. Box 804522
Cincinnati, OH
45280-4522

New Jersey
New York
North Carolina
Ohio
Pennsylvania
Rhode Island
South Carolina
Tennessee
Vermont
Virginia
West Virginia
Wisconsin

Internal Revenue
Service
P.O. Box 105273
Atlanta, GA
30348-5273

1. Number of employees who received
wages, tips, or other compensation this
quarter

Where Should You File?

Internal Revenue
Service
P.O. Box 105083
Atlanta, GA
30348-5083

Internal Revenue
Service
P.O. Box 409101
Ogden, UT 84409

Part 1: Answer these questions for
this quarter.

A trust fund recovery penalty may apply if federal
income, social security, and Medicare taxes that
CAUTION must be withheld are not withheld or paid. The
penalty is the full amount of the unpaid trust fund tax. This
penalty may apply when these unpaid taxes cannot be
collected from the employer. The trust fund recovery penalty
may be imposed on all people the IRS determines to be
responsible for collecting, accounting for, and paying these
taxes, and who acted willfully in not doing so. For details,
see section 11 of Pub. 15 (Circular E).

Department of the
Treasury
Internal Revenue
Service
Ogden, UT 84201-0005

Internal Revenue
Service
P.O. Box 105083
Atlanta, GA
30348-5083

Specific Instructions:

!

Special filing addresses 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

Your filing or payment address may have changed
from prior years. If you are using an IRS-provided
CAUTION envelope, use only the labels and envelope provided
with the tax package. Do not send Form 941 or any
payments to the SSA.

Use Form 843, Claim for Refund and Request for
Abatement, to request abatement of assessed penalties or
interest. Do not request abatement of assessed penalties or
interest on Form 941 or Form 941-X.

With a payment . . .

With a payment . . .

!

Penalties and interest are charged on taxes paid late
and returns filed late at a rate set by law. See sections 11
and 12 of Pub. 15 (Circular E) for details.

Without a
payment . . .

Missouri
Montana
Nebraska
Nevada
New Mexico
North Dakota
Oklahoma
Oregon
South Dakota
Texas
Utah
Washington
Wyoming

No legal residence or principal
place of business in any state

Avoiding penalties and interest

If you are in . . .

Without a
payment . . .

If you are in . . .

Enter amounts on line 2 that would also be included in box 1
of your employees’ Forms W-2. Include sick pay paid by a
third party if you were given timely notice of the payments
and transferred liability for the employees’ taxes. See the
Instructions for Forms W-2 and W-3 for details.
If you are a third-party payer of sick pay, do not include
sick pay that you paid to policyholders’ employees here if
you gave the policyholders timely notice of the payments.

3. Income tax withheld from wages, tips,
and other compensation
Enter the federal income tax you withheld (or were required
to withhold) from your employees on this quarter’s wages,
tips, taxable fringe benefits, and supplemental
unemployment compensation benefits. Do not include any
income tax withheld by a third-party payer of sick pay even if
you reported it on Form W-2. You will reconcile this
difference on Form W-3. Also include here any excise taxes
you were required to withhold on golden parachute
payments (section 4999).

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If you are a third-party payer of sick pay, enter the federal
income tax you withheld (or were required to withhold) on
third-party sick pay here.

Include all tips your employees reported during the
quarter, even if you were unable to withhold the employee
tax of 1.45%.

4. If no wages, tips, and other
compensation are subject to social security
or Medicare tax . . .

x

line 5c (column 1)
.029
line 5c (column 2)

If no wages, tips, and other compensation on line 2 are
subject to social security or Medicare tax, check the box on
line 4. If this question does not apply to you, leave the box
blank. For more information about exempt wages, see
section 15 of Pub. 15 (Circular E) and section 4 of
Pub. 15-A.

For more information on tips, see section 6 of Pub. 15
(Circular E).
5d. Total social security and Medicare taxes. Add
the social security tax (line 5a), social security tips tax (line
5b), and Medicare tax (line 5c) and enter the result on line
5d.

If you are a government employer, wages you pay
are not automatically exempt from social security
CAUTION and Medicare taxes. Your employees may be
covered by law or by a voluntary Section 218 Agreement
with the SSA. For more information, see Pub. 963,
Federal-State Reference Guide.

Add the total federal income tax withheld from wages, tips,
and other compensation (line 3) and the total social security
and Medicare taxes before adjustments (line 5d).

6. Total taxes before adjustments

!

7. TAX ADJUSTMENTS
Enter tax amounts on lines 7a through 7c that result from
current quarter adjustments. Use a minus sign (if possible)
to show an adjustment that decreases the total taxes shown
on line 6 instead of parentheses. Doing so enhances the
accuracy of our scanning software. For example, report
“-10.59” instead of “(10.59).” However, if your software only
allows for parentheses in reporting negative amounts, you
may use them.
Current quarter’s adjustments. In certain cases, you
must adjust the amounts you reported as social security and
Medicare taxes in column 2 of lines 5a, 5b, and 5c to figure
your correct tax liability for this quarter’s Form 941. See
section 13 of Pub. 15 (Circular E).
Prior quarter’s adjustments. If you need to adjust any
amount reported on lines 7a, 7b, or 7c from a previously
filed Form 941, complete and file Form 941-X. Form 941-X
is an adjusted return and is filed separately from Form 941.
See section 13 of Pub. 15 (Circular E).
7a. Current quarter’s fractions of cents. Enter
adjustments for fractions of cents (due to rounding) relating
to the employee share of social security and Medicare taxes
withheld. The employee share (one-half) of amounts shown
in column 2 of lines 5a, 5b, and 5c may differ slightly from
amounts actually withheld from employees’ paychecks due
to the rounding of social security and Medicare taxes based
on statutory rates.
7b. Current quarter’s sick pay. Enter the adjustment
for the employee share of social security and Medicare
taxes that were withheld by your third-party sick pay payer.
7c. Current quarter’s adjustments for tips and
group-term life insurance. Enter adjustments for:
• Any uncollected employee share of social security and
Medicare taxes on tips and
• The uncollected employee share of social security and
Medicare taxes on group-term life insurance premiums paid
for former employees.
7d. TOTAL ADJUSTMENTS. Combine all adjustments
shown on lines 7a through 7c and enter the result here.

5. Taxable social security and Medicare
wages and tips
5a. Taxable social security wages. Report the total
wages, sick pay, and fringe benefits subject to social
security taxes you paid to your employees during the
quarter. For this purpose, sick pay includes payments made
by an insurance company to your employees for which you
received timely notice from the insurance company. See
Section 6 in Pub. 15-A for more information about sick pay
reporting.
Enter the amount before deductions. Do not include tips
on this line. For information on types of wages subject to
social security taxes, see section 5 of Pub. 15 (Circular E).
The rate of social security tax on taxable wages is 6.2
percent (.062) each for the employer and employee or 12.4
percent (.124) for both. Stop paying social security tax on
and reporting an employee’s wages on line 5a when the
employee’s taxable wages (including tips) reach $106,800
during 2010, unchanged from 2009. However, continue to
withhold income and Medicare taxes for the whole year on
wages and tips even when the social security wage base of
$106,800 has been reached.
x

line 5a (column 1)
.124
line 5a (column 2)

5b. Taxable social security tips. Enter all tips your
employees reported to you during the quarter until the total
of the tips and wages for an employee reach $106,800
in 2010. Do this even if you were unable to withhold the
employee tax of 6.2%.
An employee must report cash tips to you, including tips
you paid the employee for charge customers, totaling $20 or
more in a month by the 10th of the next month. Employees
may use Form 4070, Employee’s Report of Tips to Employer
(available only in Pub. 1244, Employee’s Daily Record of
Tips and Report to Employer), or submit a written statement
or electronic tip record.
Do not include allocated tips on this line. Instead, report
them on Form 8027, Employer’s Annual Information Return
of Tip Income and Allocated Tips. Allocated tips are not
reportable on Form 941 and are not subject to withholding of
federal income, social security, or Medicare taxes.
x

8.

Total taxes after adjustments

Combine the amounts shown on lines 6 and 7d and enter
the result here.

9. Advance earned income credit (EIC)
payments made to employees
Enter the amount of the advance earned income credit (EIC)
payments that you made to your employees. Eligible
employees may choose to receive part of the EIC as an
advance payment. Those who expect to have a qualifying
child must give you a completed Form W-5 stating they
expect to qualify for the EIC. Once the employee gives you
a signed and completed Form W-5 you must make the
advance EIC payments starting with the employee’s next

line 5b (column 1)
.124
line 5b (column 2)

5c. Taxable Medicare wages & tips. Report all
wages, tips, sick pay, and taxable fringe benefits that are
subject to Medicare tax. Unlike social security wages, there
is no limit on the amount of wages subject to Medicare tax.

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wage payment. Advance EIC payments are generally made
from withheld federal income tax and employee and
employer social security and Medicare taxes.

12b. Number of individuals provided
COBRA premium assistance on line 12a
Enter the total number of assistance eligible individuals
provided COBRA premium assistance reported on line 12a.
Count each assistance eligible individual who paid a
reduced COBRA premium in the quarter as one individual,
whether or not the reduced premium was for insurance that
covered more than one assistance eligible individual. For
example, if the reduced COBRA premium was for coverage
for a former employee, spouse, and two children, you would
include one individual in the number entered on line 12b for
the premium assistance. Further, each individual is reported
only once per quarter. For example, an assistance eligible
individual who made monthly premium payments during the
quarter would only be reported as one individual.

If the amount of your advance EIC payments is more
than your total taxes after adjustments (line 8) for the
quarter, you may claim a refund of the overpayment or elect
to have the credit applied to your return for the next quarter.
Attach a statement to Form 941 identifying the amount of
excess payments and the pay periods in which you paid it.
For more information on advance EIC, see section 10 of
Pub. 15 (Circular E) and Pub. 596.

10. Total taxes after adjustment for
advance EIC
Subtract line 9 from line 8.

13. Total deposits and COBRA credit

• Line 10 is less than $2,500 or line 10 on the preceding

Add lines 11 and 12a.

quarterly return was less than $2,500, and you did not
incur a $100,000 next-day deposit obligation during the
current quarter. You may pay the amount with Form 941 or
you may deposit the amount. To avoid a penalty, you must
pay the amount in full with a timely filed return or you must
deposit the amount timely.
• If line 10 is $2,500 or more and line 10 on the
preceding quarterly return was $2,500 or more, or if you
incurred a $100,000 next-day deposit obligation during
the current quarter. You must deposit the amount by
using EFTPS or at an authorized financial institution with
Form 8109. The amount shown on line 10 must equal the
“Total liability for quarter” shown on
Form 941, line 17 or the “Total liability for the quarter” shown
on Schedule B (Form 941).

14. Balance due
If line 10 is more than line 13, write the difference in line 14.
Otherwise, see Overpayment below. You do not have to
pay if line 14 is under $1. Generally, you should have a
balance due only if your total taxes after adjustment for
advance EIC (line 10), for the current quarter or preceding
quarter are less than $2,500, and you did not incur a
$100,000 next-day deposit obligation during the current
quarter. However, see section 11 of Pub. 15 (Circular E) for
information about payments made under the accuracy of
deposits rule.
You may pay the amount shown on line 14 using EFTPS,
a credit card, a check or money order, or electronic funds
withdrawal (EFW). Do not use a credit card or EFW to pay
taxes that were required to be deposited. For more
information on paying your taxes with a credit card or EFW,
visit the IRS website at www.irs.gov and click on the Online
Services link.

For more information on federal tax deposits, see
Depositing Your Taxes on page 3 of these instructions and
section 11 of Pub. 15 (Circular E).
If you are a semiweekly depositor, you must
complete Schedule B (Form 941). If you fail to
CAUTION complete and submit Schedule B (Form 941), the
IRS will assert deposit penalties based on available
information.

!

If you pay by EFTPS, credit card, or EFW, file your return
using the Without a payment address on page 4 under
Where Should You File? and do not file Form 941-V,
Payment Voucher.
If you pay by check or money order, make it payable to
the United States Treasury. Enter your EIN, Form 941, and
the tax period on your check or money order. Complete
Form 941-V and enclose with Form 941.

11. Total deposits for this quarter...
Enter your deposits for this quarter, including any
overpayment that you applied from filing Form 941-X or
Form 944-X in the current quarter. Also include in the
amount shown any overpayment from a previous period that
you applied to this return.

If line 10 is $2,500 or more and you have deposited all
taxes when due, the balance due on line 14 should be zero.

12a. COBRA premium assistance payments

!

Report on this line 65% of the COBRA premiums for
assistance eligible individuals. Take the COBRA premium
assistance credit on this line only after the assistance
eligible individual’s 35% share of the premium has been
paid. For COBRA coverage provided under a self-insured
plan, COBRA premium assistance is treated as having been
made for each assistance eligible individual who pays 35%
of the COBRA premium. Do not include the assistance
eligible individual’s 35% of the premium in the amount
entered on this line. For more information on the COBRA
premium assistance credit visit the IRS website at
www.irs.gov and enter the keyword COBRA.

CAUTION

If you do not deposit as required and, instead, pay
the taxes with Form 941, you may be subject to a
penalty.

15. Overpayment
If line 13 is more than line 10, write the difference in line 15.
Never make an entry in both lines 14 and 15.
If you deposited more than the correct amount for the
quarter, you can choose to have the IRS either refund the
overpayment or apply it to your next return. Check only one
box in line 15. If you do not check either box or if you check
both boxes, generally we will apply the overpayment to your
account. We may apply your overpayment to any past due
tax account that is shown in our records under your EIN.

If you provided premium assistance in a prior quarter of
the current year and did not report the amount of that
premium assistance on Form 941 for that quarter, you may
include the amount of that premium assistance in the
amount entered on this line, or file form 941-X, Adjusted
Employer’s QUARTERLY Federal Tax Return or Claim for
Refund, to report the amount for the prior quarter of the
current year.

If line 15 is under $1, we will send a refund or apply it to
your next return only if you ask us in writing to do so.

Complete both pages.
You must complete both pages of Form 941 and sign on
page 2. An incomplete return may delay processing.

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Part 2: Tell us about your deposit
schedule and tax liability for this
quarter.

Part 3: Tell us about your business.

16. State abbreviation

18. If your business has closed . . .

In Part 3, answer only those questions that apply to your
business. If the questions do not apply, leave them blank
and go to Part 4.
If you go out of business or stop paying wages, you must file
a final return. To tell the IRS that a particular Form 941 is
your final return, check the box on line 18 and enter the date
you last paid wages in the space provided. For additional
filing requirements, see If your business has closed... on
page 2.

In the spaces provided, write the two-letter U.S. Postal
Service abbreviation for the bank branch in the state where
you deposit your taxes using Form 8109 or initiate EFTPS
transfers. The IRS uses the state shown to determine
banking days for purposes of deposit due dates. Official
state holidays for the state shown are not counted as
banking days. If you deposit in multiple states, enter “MU” in
the spaces provided.

19. If you are a seasonal employer . . .
If you hire employees seasonally — such as for summer or
winter only — check the box on line 19. Checking the box
tells the IRS not to expect four Forms 941 from you
throughout the year because you have not paid wages
regularly.

When you deposit in multiple states, the IRS cannot
determine what portion of your liability was affected by a
state holiday and may propose a deposit penalty for one or
more of the states where you made deposits. If you receive
a notice and your deposit due date was extended because
of a state bank holiday, respond to the notice citing the state
holiday and applicable deposit amount.

Generally, we will not ask about unfiled returns if you file
at least one return showing tax due each year. However,
you must check the box every time you file a Form 941.
Also, when you fill out Form 941, be sure to check the
box on the top of the form that corresponds to the quarter
reported.

17. Check one
• If line 10 is less than $2,500 or line 10 on the preceding

quarterly return was less than $2,500, and you did not incur
a $100,000 next-day deposit obligation during the current
quarter, check the appropriate box in line 17 and go to Part
3.
• If you reported $50,000 or less in taxes during the
lookback period (see below), you are a monthly schedule
depositor unless the $100,000 Next-Day Deposit Rule
discussed in section 11 of Pub. 15 (Circular E) applies.
Check the appropriate box on line 17 and enter your tax
liability for each month in the quarter. Add the amounts for
each month. Enter the result in the Total liability for quarter
box.
Note that your total tax liability for the quarter must equal
your total taxes shown on line 10. If it does not, your tax
deposits and payments may not be counted as timely. Do
not change your tax liability on line 17 by adjustments
reported on any Forms 941-X.
You are a monthly schedule depositor for the calendar
year if the amount of your Form 941 taxes reported for the
lookback period is $50,000 or less. The lookback period is
the four consecutive quarters ending on June 30 of the prior
year. For 2010, the lookback period begins July 1, 2008,
and ends June 30, 2009. For details on the deposit rules,
see section 11 of Pub. 15 (Circular E). If you filed Form 944
in either 2008 or 2009, your lookback period is the 2008
calendar year.

Part 4: May we speak with your
third-party designee?
If you want to allow an employee, a paid tax preparer, or
another person to discuss your Form 941 with the IRS,
check the “Yes” box in Part 4. Then tell us the name, phone
number, and the five-digit personal identification number
(PIN) of the specific person to speak with — not the name of
the firm who prepared your tax return. The designee may
choose any five numbers as his or her PIN.
By checking “Yes,” you authorize the IRS to talk to the
person you named (your designee) about any questions we
may have while we process your return. You also authorize
your designee to:
• give us any information that is missing from your return,
• call us for information about processing your return, and
• respond to certain IRS notices that you have shared with
your designee about math errors and return preparation.
The IRS will not send notices to your designee.
You are not authorizing your designee to bind you to
anything (including additional tax liability) or to otherwise
represent you before the IRS. If you want to expand your
designee’s authorization, see Pub. 947, Practice Before the
IRS and Power of Attorney.

The amounts reported on line 17 are a summary of
your monthly tax liability, not a summary of deposits
CAUTION you made. If you do not properly report your liabilities
when required or if you are a semiweekly schedule
depositor and report your liabilities on line 17 instead of on
Schedule B (Form 941), you may be assessed an
“averaged” failure-to-deposit (FTD) penalty. See Deposit
Penalties in section 11 of Pub. 15 (Circular E) for more
information.

!

The authorization will automatically expire 1 year from the
due date (without regard to extensions) for filing your Form
941. If you or your designee want to terminate the
authorization, write to the IRS office for your locality using
the Without a payment address under Where Should You
File? on page 4.

• If you reported more than $50,000 of taxes for the

lookback period (see above), you are a semiweekly
schedule depositor. Check the appropriate box on line 17.
You must complete Schedule B (Form 941) and submit it
with your Form 941. Do not use Schedule B (Form 941) if
you are a monthly schedule depositor.
Do not change your tax liability on Schedule B (Form
941) by adjustments reported on any Forms 941-X.

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Part 5: Sign Here

How to Order Forms and Publications
from the IRS

Complete all information in Part 5 and sign Form 941 as
follows.
• 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.
• Partnership (including an LLC treated as a
partnership) or unincorporated organization — A
responsible and duly authorized member or officer having
knowledge of its affairs.
• 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 may also be signed by a duly authorized agent
of the taxpayer if a valid power of attorney has been filed.
Alternative signature method. Corporate officers or duly
authorized agents may sign Form 941 by rubber stamp,
mechanical device, or computer software program. For
details and required documentation, see Rev. Proc.
2005-39, 2005-28 I.R.B. 82, at
www.irs.gov/pub/irb/2005-28_IRB/ar16.pdf.

Call 1-800-829-3676.

Visit the IRS website at www.irs.gov.

Other IRS Products You May Need
•

Form SS-4, Application for Employer Identification Number

•

Form W-2, Wage and Tax Statement

•

Form W-2c, Corrected Wage and Tax Statement

•

Form W-3, Transmittal of Wage and Tax Statements

•

Form W-3c, Transmittal of Corrected Wage and Tax Statements

•

Form W-4, Employee’s Withholding Allowance Certificate

Paid Preparer’s Use Only

•

Form W-5, Earned Income Credit Advance Payment Certificate

A paid preparer must sign Form 941 and provide the
information in the Paid preparer’s use only section of Part 5
if the preparer was paid to prepare Form 941 and is not 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 are a paid preparer, write your SSN or your
Preparer Tax Identification Number (PTIN) in the space
provided. Include your complete address. If you work for a
firm, write the firm’s name and the EIN of the firm. You can
apply for a PTIN using Form W-7P, Application for Preparer
Tax Identification Number. You cannot use your PTIN in
place of the EIN of the tax preparation firm.
Generally, do not complete this section if you are filing
the return as a reporting agent and have a valid Form 8655,
Reporting Agent Authorization, 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.

•

Form 940, Employer’s Annual Federal Unemployment (FUTA)
Tax Return

•

Form 943, Employer’s Annual Federal Tax Return for Agricultural
Employees

•

Form 944, Employer’s ANNUAL Federal Tax Return

•

Form 4070, Employee’s Report of Tips to Employer

•

Form 8027, Employer’s Annual Information Return of Tip Income
and Allocated Tips

•

Form 8655, Reporting Agent Authorization

•

Notice 797, Possible Federal Tax Refund Due to the Earned
Income Credit (EIC)

•

Pub. 15 (Circular E), Employer’s Tax Guide

•

Pub. 15-A, Employer’s Supplemental Tax Guide

•

Pub. 15-B, Employer’s Tax Guide to Fringe Benefits

•

Pub. 596, Earned Income Credit

•

Pub. 926, Household Employer’s Tax Guide

•

Schedule B (Form 941), Report of Tax Liability for Semiweekly
Schedule Depositors

•

Schedule D (Form 941), Report of Discrepancies Caused by
Acquisitions, Statutory Mergers, or Consolidations

•

Schedule H (Form 1040), Household Employment Taxes

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