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

OK-to-Print As Corrected

Reviewed by ME 5/7/2010
Comments in blue. Text Edits (deletions) in red.

Instructions for Form 941
(Rev. April 2010)
Employer’s QUARTERLY Federal Tax Return

Department of the Treasury
Internal Revenue Service
www.irs.gov/e-pay.

business. Use e-file and the Electronic Federal Tax Payment
System (EFTPS) to your benefit.
, Allocation Schedule for
• For e-file, visit www.irs.gov for additional information.
• For EFTPS, visit www.eftps.gov or call EFTPS Customer
Aggregate Form 941 Filers,
Service at 1-800-555-4477, 1-800-733-4829 (TDD), or
1-800-244-4829 (Spanish).
Qualified employer’s social security tax credit. Qualified
Electronic funds withdrawal (EFW). If you file
employers are allowed a credit in the second quarter of 2010 for
Form 941 electronically, you can e-file and e-pay (electronic
their share (6.2%) of social security tax on wages/tips paid to
funds withdrawal) the balance due in a single step using tax
qualified employees after March 18, 2010, and before April 1,
preparation software or through a tax professional. However,
2010. See the instructions for lines 12c through 12e on page 6.
do not use EFW to make federal tax deposits.
For more information regarding the employer’s social security
For more information on paying your taxes using EFW, visit the
tax credit visit the IRS website at www.IRS.gov and enter the
IRS website at www.irs.gov and type e-pay in the search box. A
keywords “HIRE Act” in the search box.
or debit fee may be charged to file electronically.
or debit
Credit card payments. Employers can pay the balance due
Qualified employer’s social security tax exemption.
shown on Form 941 by credit card. Do not use a credit card to
Qualified employers are allowed an exemption for their share
make federal tax deposits. For more information on paying your
(6.2%) of social security taxes on wages/tips paid to qualified
taxes with a credit card, visit the IRS website at www.irs.gov
employees after March 31, 2010, and before January 1, 2011.
www.irs.gov/e-pay.
and type e-pay in the
search box.
See the instructions for lines 6a through 6d on page 5. For
more information regarding the employer’s social security tax
Employer’s liability. Employers are responsible to ensure
exemption visit the IRS website at www.IRS.gov and enter the
that tax returns are filed and deposits and payments are made,
keywords “HIRE Act” in the search box.
or debit even if the employer contracts with a third party. The employer
remains liable if the third party fails to perform a required action.
Aggregate Form 941 filers. Agents must complete Schedule
R (Form 941) when filing an aggregate Form 941. Aggregate
Where can you get telephone help? You can call the IRS
Forms 941 are filed by agents approved by the IRS under
Business and Specialty Tax Line toll free at 1-800-829-4933,
section 3504 of the Internal Revenue Code. To request
Monday through Friday from 7 a.m. to 10 p.m. local time
approval to act as an agent for an employer, the agent files
(Alaska and Hawaii follow Pacific time) to order tax deposit
Form 2678, Employer/Payer Appointment of Agent, with the
coupons (Form 8109) and for answers to your questions about
IRS.
completing Form 941, tax deposit rules, or obtaining an
employer identification number (EIN).
COBRA premium assistance credit extended. The credit for
Photographs of missing children. The Internal Revenue
COBRA premium assistance payments has been extended. It
Service is a proud partner with the National Center for Missing
now applies to p
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paid for employees
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involuntarilyy
and Exploited Children. Photographs of missing children
terminated between September 1, 2008, and Mayy 31,, 2010,,
selected by the Center may appear in instructions on pages that
and to p
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paid for up
p to 15 months. Congress
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mayy take
would otherwise be blank. You can help bring these children
additional legislative
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action that extends the credit. To find out if
home by looking at the photographs and calling
additional legislation
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is enacted,, monitor the news media or visit
1-800-THE-LOST (1-800-843-5678) if you recognize a child.
the IRS website at www.irs.gov
v and enter the keyword COBRA.
See COBRA premium assistance
e paymentss on
o 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
Purpose of Form 941
944. See Revenue Procedure 2009-51 2009-45 I.R.B. 625,
available at
These instructions give you some background information
www.irs.gov/irb/2009-45_IRB/ar12.html.
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.
Social security wage base for 2010. Do not withhold or pay
social security tax after an employee reaches $106,800 in
If you want more in-depth information about payroll tax
social security wages in 2010.
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
Correcting a previously filed Form 941. If you discover an
from your employees’ paychecks. Each time you pay wages,
error on a previously filed Form 941, make the correction using
you must withhold – or take out of your employees’ paychecks
Form 941-X, Adjusted Employer’s QUARTERLY Federal Tax
– certain amounts for federal income tax, social security tax,
Return or Claim for Refund. Form 941-X is filed separately from
and
Medicare tax. Under the withholding system, taxes withheld
Form 941. For more information, see section 13 of Pub. 15
from your employees are credited to your employees in
(Circular E) or visit the IRS website at www.irs.gov and enter
payment of their tax liabilities.
the keywords Correcting Employment Taxes.
Federal law also requires you to pay any liability for the
Paid preparers must sign Form 941. Paid preparers must
employer’s portion of social security and Medicare taxes. This
complete and sign the paid preparer’s section of Form 941.
portion of social security and Medicare taxes is not withheld
Electronic filing and payment. Now, more than ever before,
from employees.
businesses can enjoy the benefits of filing and paying their
federal taxes electronically. Whether you rely on a tax
Who Must File Form 941?
professional or handle your own taxes, the IRS offers you
convenient programs to make filing and paying easier. Spend
Use Form 941 to report the following amounts.
• Wages you have paid.
less time and worry on taxes and more time running your
Section references are to the Internal Revenue Code unless
otherwise noted.

What’s New

General Instructions:

Reminders

Cat. No. 14625L

• Tips your employees have received.
• Federal income tax you withheld.
• Both the employer’s and the employee’s share of social

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.

security and Medicare taxes.

tax • Current quarter’s adjustments to social security and Medicare

When Must You File?

taxes for fractions of cents, sick pay, tips, and group-term life
insurance.
• Advance earned income credit (EIC) payments.
• Credit for COBRA premium
p
assistance payments.
p y
• Exemption
p
for qualified
q
employer’s
p y
share of social security
taxes
t
on wages/tips paid to qualified employees.
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 you
filed a final return or one of the exceptions listed below
applies.

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

When To File Form 941

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.
If none of the above exceptions applies and you have
TIP 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.

Your Form 941 is due by the last day of the month that follows the end of the
quarter.
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, you generally 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.

What if you reorganize or close your business?
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 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... below.
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.”

If your business has closed . . .
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

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Reconciling Forms 941 and Form W-3

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 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.

The IRS matches amounts reported on your four quarterly
Forms 941 with Form W-2 amounts totaled on your yearly Form
W-3. 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 EIC payments.
For more information, see section 12 of Pub. 15
(Circular E) and the Instructions for Schedule D (Form 941).

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.

Depositing Your Taxes:
When Must You Deposit Your Taxes?
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.

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.

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.

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

TIP Deposit Rule on taxes of $100,000 or more accumulated
on any day during the deposit period.

How Must You Deposit Your Taxes?

Completing and Filing Form 941

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 depository) with
Form 8109, Federal Tax Deposit Coupon. See section 11 of
Pub. 15 (Circular E).
You may reduce your deposits during the quarter by the
amount of:
• COBRA premium
p
assistance payments
p y
on line 12a,,
• Employer’s
p y
exempt
p social security
y tax on line 6d,, and
• Employer’s exempt social security tax on line12e.

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.

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.

EFTPS is an easy, safe, and convenient way for all

TIP employers to make their tax deposits. Using EFTPS

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

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.

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What About Penalties and Interest?

Specific Instructions:

Avoiding penalties and interest

Part 1: Answer these questions for this
quarter.

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.
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.
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.
A trust fund recovery penalty may apply if federal
income, social security, and Medicare taxes that must
CAUTION 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).

1. Number of employees who received wages,
tips, or other compensation this quarter
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
This URL should be on 1
• Active members of the Armed Forces.

line so it works correctly

If you enter “250” or more on line 1, you must file Forms
TIP 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

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
Insert
line
break
Where Should You File?
the policyholders timely notice of the payments.
Where you file depends on whether you include a payment with
3. Income tax withheld from wages, tips, and
Form 941.
other compensation
Without a
Enter the federal income tax you withheld (or were required to
If you are in . . .
payment . . .
With a payment . . .
withhold) from your employees on this quarter’s wages, tips,
taxable fringe benefits, and supplemental unemployment
Special filing addresses for
Department of the
Internal Revenue
exempt organizations; federal,
Treasury
Service
compensation benefits. Do not include any income tax withheld
state, and local governmental
Internal Revenue
P.O. Box 105083
by a third-party payer of sick pay even if you reported it on
entities; and Indian tribal
Service
Atlanta, GA
Form W-2. You will reconcile this difference on Form W-3. Also
governmental entities; regardless Ogden, UT 84201-0005 30348-5083
include here any excise taxes you were required to withhold on
of location
golden parachute payments (section 4999).
Connecticut
New Jersey
Department of the
Internal Revenue
If you are a third-party payer of sick pay, enter the federal
Delaware
New York
Treasury
Service
income tax you withheld (or were required to withhold) on
District of
North Carolina Internal Revenue
P.O. Box 804522
third-party sick pay here.
Columbia
Ohio
Service
Cincinnati, OH
Georgia
Illinois
Indiana
Kentucky
Maine
Maryland
Massachusetts
Michigan
New Hampshire

Pennsylvania
Cincinnati, OH
Rhode Island
45999-0005
South Carolina
Tennessee
Vermont
Virginia
West Virginia
Wisconsin

45280-4522

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

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

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

No legal residence or principal
place of business in any state

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

4. If no wages, tips, and other compensation are
subject to social security or Medicare tax . . .
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
Delete line break
Pub. 15-A.
If you are a government employer, wages you pay are
not automatically exempt from social security and
CAUTION 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.

!

5. Taxable social security and Medicare wages
and tips

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

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

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

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

!

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Insert comma
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.

Opportunity Credit for the same employee. For more
information, see Form 5884, Work Opportunity Credit.
For more information about the employer’s social security
tax exemption visit the IRS website at www.IRS.gov and enter
the keywords “HIRE Act” in the search box.
6a. Number of qualified employees first paid exempt
wages/tips this quarter.
line 5a (column 1)
A qualified employee is an employee who:
x
.124
• Begins employment with you after February 3, 2010, and
line 5a (column 2)
before January 1, 2011;
• Certifies by signed affidavit (Form W-11, Hiring Incentives to
Do not reduce the amount reported on line 5a by any
Restore Employment (HIRE) Act Employee Affidavit), or similar
amount paid to qualified new employees. Your liability
statement under penalties of perjury, that he or she has not
CAUTION for exempt wages/tips will be reduced on line 6d.
been employed for more than 40 hours during the 60-day
period (including 2009) ending on the date the employee begins
5b. Taxable social security tips. Enter all tips your
employment with you;
employees reported to you during the quarter until the total of
• Is not employed by you to replace another employee unless
the tips and wages for an employee reach $106,800
the other employee separated from employment voluntarily or
in 2010. Do this even if you were unable to withhold the
for cause (including downsizing); and
employee tax of 6.2%.
• Is not related to you. An employee is related to you if he or
An employee must report cash tips to you, including tips you
she is your child or a descendant of your child, your sibling or
paid the employee for charge customers, totaling $20 or more
stepsibling, your parent or ancestor of your parent, your
in a month by the 10th of the next month. Employees may use
stepparent, your niece or nephew, your aunt or uncle, or your
Form 4070, Employee’s Report of Tips to Employer (available
in-law. An employee is also related to you if he or she is related
only in Pub. 1244, Employee’s Daily Record of Tips and Report
to anyone who owns more than 50% of your outstanding stock
to Employer), or submit a written statement or electronic tip
or capital and profits interest or is your dependent or a
record.
dependent of anyone who owns more than 50% of your
Do not include allocated tips on this line. Instead, report
outstanding stock or capital and profits interest.
them on Form 8027, Employer’s Annual Information Return of
If you are an estate or trust, see section 51(i)(1) and section
Tip Income and Allocated Tips. Allocated tips are not reportable
152(d)(2) for more details.
on Form 941 and are not subject to withholding of federal
Exempt wages/tips are the wages/tips paid to qualified
income, social security, or Medicare taxes.
employees for which the employer is exempt from paying the
line 5b (column 1)
employer’s 6.2% share of social securityy tax. Enter on line 6a
x
.124
the number of qualified employees first paid wages/tips
g
p to which
line 5b (column 2)
you applied the social security tax exemption in this quarter. Do
not include on line 6a qualified employees that are included on
line 12c.
Do not reduce the amount reported on line 5b by any
amount paid to qualified new employees. Your liability
6b. Number of qualified employees p
paid exempt wages/
CAUTION for exempt wages/tips will be reduced on line 6d.
tips this quarter. Enter on line 6b the total number of qualified
employees paid exempt wages/tips
p to which you applied the
5c. Taxable Medicare wages & tips. Report all wages,
social security tax exemption in this quarter. Qualified
tips, sick pay, and taxable fringe benefits that are subject to
employees included on line 6a will also be included on line 6b.
Medicare tax. Unlike social security wages, there is no limit on
Qualified employees included on line 12c may also be included
the amount of wages subject to Medicare tax.
Include all tips your employees reported during the quarter, the on line 6b. See line 6a for definition of qualified employees.
6c. Exempt wages/tips paid to qualified employees this
even if you were unable to withhold the employee tax of 1.45%.
quarter. Enter the amount of exempt wages/tips paid this
line 5c (column 1)
quarter to all qualified employees reported on line 6b. See line
x
.029
6a for definition of exempt wages/tips.
line 17 for details about
line 5c (column 2)
6d. Social security tax exemption. Multiply the amount
the
of exempt wages/tips reported on line 6c by .062 and enter the
For more information on tips, see section 6 of Pub. 15
result on line 6d. See the instructions for Line 17 in applying this
(Circular E).
exemption to your tax liability.
Do not reduce the amount reported on line 5c by any
6e. Total taxes before adjustments. Add the total federal
amount paid to qualified new employees. The tax
income tax withheld from wages, tips, and other compensation
CAUTION exemption does not apply to the Medicare tax.
(line 3) and the total social security and Medicare taxes before
adjustments (line 5d), and subtract the qualified employer’s
5d. Total social security and Medicare taxes. Add the
social security tax exemption (line 6d). Enter the result on line
social security tax (line 5a), social security tips tax (line 5b), and
6e.
Medicare tax (line 5c) and enter the result on line 5d.
Make text highlighted in blue above BOLD

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!

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6. Employer’s social security tax exemption

7. TAX ADJUSTMENTS

Complete lines 6a – 6d to figure the payroll tax exemption for the
employer’s share (6.2%) of social security tax on wages/tips
paid to one or more qualified employees.
An employer must be a qualified employer to be eligible for
the employer’s social security tax exemption. A qualified
employer is any employer other than Federal, State, and any
related government entities. All public institutions of higher
education and Indian tribal governments are also qualified
employers.
An employer may elect not to apply the social security tax
exemption with respect to a qualified employee. The election is
made by not including that employee or that employee’s wages
on lines 6a-6d and lines 12c-12e. An election not to apply the
social security tax exemption for a qualified employee may
allow a qualified employer to claim the Work Opportunity Credit
for that employee. A qualified employer cannot apply both the
social security tax exemption on Form 941 and claim the Work

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 6e 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).

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d

7a. Current quarter’s adjustment for 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 adjustment for 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.

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 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.

8. Total taxes after adjustments
Combine the amounts shown on lines 6e through 7c and enter
the result here.

9. Advance earned income credit (EIC)
payments made to employees

12b. Number of individuals provided COBRA
premium assistance on line 12a

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

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.

Lines 12c – 12e only apply to the second quarter of
2010. These lines are used to determine the number of
CAUTION qualified employees, amount of exempt wages/tips, and
amount of employer social security tax exemption as if the
exemption were allowed for the first quarter of 2010. An
employer is allowed to treat this exemption as a payment
credited against deposit requirements for employment taxes
due for the second quarter 2010. If any of these lines are
completed for any quarter other than the second quarter of
2010, Form 941 may be considered incomplete and subject to
correction and penalties.
endash

!

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 and enter the result on line 10.

• 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. 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 the quarter”
shown on Form 941, line 17 or the “Total liability for the quarter”
shown on Schedule B (Form 941).

12c. Number of qualified employees paid
the
exempt wages/tips March 19-31
Complete this line when filing Form 941 for the 2nd quarter of
2010 only. Enter on line 12c the number of qualified employees
paid exempt wages/tips from March 19, 2010, through March
31, 2010. Include only qualified employees for which you are
claiming
g the social security tax exemption. For definition of
qualified employee see the instructions for line 6a on page 5.

12d. Exempt wages/tips paid to qualified
employees March 19-31
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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).

comma

If you are a semiweekly depositor, you must complete
Schedule B (Form 941). If you fail to complete and
CAUTION submit Schedule B (Form 941), the IRS will assert
deposit penalties based on available information.

!

11. Total deposits for this quarter...

The amount reported on line 12a is treated as a deposit
of taxes on the first day of your return period and must
not be used to adjust line 17 or Schedule B (Form 941).

endash

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.

Complete this line when filing Form 941 for the 2nd quarter of
2010 only. Enter the amount of exempt wages/tips paid March
19, 2010, through March 31, 2010, to all qualified
employees
q
p y
reported on line 12c. For definition of exempt wages/tips see
the instructions for line 6a on page 5.

12e. Social security tax exemption for March
19-31

comma

Multiply the amount of exempt wages/tips reported on line 12d
by .062 and enter the result on line 12e.

!

CAUTION

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Delete the bold
from highlight text .

The amount reported on line 12e is treated as a deposit
of taxes on April 1, 2010, and must not be used to adjust
line 17 or Schedule B (Form 941).

For more information
on electronic payment
13. Total deposits and credits options, visit the IRS
Add lines 11, 12a, and 12e.
website at www.irs.
gov/e-pay.
14. Balance due

• 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
If line 10 is more than line 13, write the difference in line 14.
month in the quarter. Add the amounts for each month. Enter
Otherwise, see Overpayment below. You do not have to pay if
the result in the Total liability for quarter box.
line 14 is under $1. Generally, you should have a balance due
only if your total taxes after adjustment for advance EIC (line
Note that your total tax liability for the quarter must equal
10), for the current quarter or preceding quarter are less than
your total taxes shown on line 10. If it does not, your tax
$2,500, and you did not incur a $100,000 next-day deposit
deposits and payments may not be counted as timely. Do not
obligation during the current quarter. However, see section 11
change your tax liability on line 17 by adjustments reported on
of Pub. 15 (Circular E) for information about payments made
any Forms 941-X.
under the accuracy of deposits rule.
or debit
You are a monthly schedule depositor for the calendar
or debit You may pay the amount shown on line 14 using EFTPS, a
year if the amount of your Form 941 taxes reported for the
lookback period is $50,000 or less. The lookback period is the
credit card, a check or money order, or electronic funds
four consecutive quarters ending on June 30 of the prior year.
withdrawal (EFW). Do not use a credit card or EFW to pay
For 2010, the lookback period begins July 1, 2008, and ends
taxes that were required to be deposited. For more information
June 30, 2009. For details on the deposit rules, see section 11
on paying your taxes with a credit card or EFW, visit the IRS
of Pub. 15 (Circular E). If you filed Form 944 in either 2008 or
website at www.irs.gov and click on the Online Services link.
2009, your lookback period is the 2008 calendar year.
If you pay by EFTPS, credit card, or EFW, file your return
using the Without a payment address on page 4 under Where
The amounts reported on line 17 are a summary of your
Should You File? and do not file Form 941-V, Payment
monthly tax liability, not a summary of deposits you
Voucher.
CAUTION made. If you do not properly report your liabilities when
If you pay by check or money order, make it payable to the
required or if you are a semiweekly schedule depositor and
“United States Treasury.” Enter your EIN, Form 941, and the
report your liabilities on line 17 instead of on Schedule B (Form
tax period on your check or money order. Complete Form
941), you may be assessed an “averaged” failure-to-deposit
941-V and enclose with Form 941.
(FTD) penalty. See Deposit Penalties in section 11 of Pub. 15
If line 10 is $2,500 or more and you have deposited all taxes
(Circular E) for more information.
when due, the balance due on line 14 should be zero.
• If you reported more than $50,000 of taxes for the lookback
If you do not deposit as required and, instead, pay the
period (see above), you are a semiweekly schedule
taxes with Form 941, you may be subject to a penalty.
depositor. Check the appropriate box on line 17.
CAUTION
You must complete Schedule B (Form 941) and submit it
15. Overpayment
with your Form 941. Do not use Schedule B (Form 941) if you
are a monthly schedule depositor.
If line 13 is more than line 10, write the difference in line 15.
Never make an entry in both lines 14 and 15.
Do not change your tax liability on Schedule B (Form 941)
by adjustments reported on any Forms 941-X.
If you deposited more than the correct amount for the
quarter, you can choose to have the IRS either refund the
Adjusting tax liability for employer’s social security tax
overpayment or apply it to your next return. Check only one box
exemption reported on line 6d. Monthly schedule depositors
in line 15. If you do not check either box or if you check both
and semiweekly schedule depositors must account for the
boxes, generally we will apply the overpayment to your account.
employer’s social security tax exemption (line 6d) when
We may apply your overpayment to any past due tax account
reporting their tax liabilities on line 17 or Schedule B (Form
that is shown in our records under your EIN.
941). The total liability for the quarter must equal the amount
If line 15 is under $1, we will send a refund or apply it to your
reported on line 10. Failure to account for the social security tax
next return only if you ask us in writing to do so.
exemption on line 17 or Schedule B (Form 941) may cause line
10 to be less than the total tax liability reported on line 17 or
Complete both pages.
Schedule B (Form 941). Do not reduce the tax liability reported
You must complete both pages of Form 941 and sign on page
on line 17 or Schedule B (Form 941) below zero.
2. An incomplete return may delay processing.

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!

Part 3: Tell us about your business.

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

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.

16. State abbreviation
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.
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.

18. If your business has closed . . .
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.

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.
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.

17. Tax liability for the quarter
• 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.

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.

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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.

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 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.

How to Order Forms and Publications
from the IRS
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

Part 5: Sign Here

•

Form W-5, Earned Income Credit Advance Payment Certificate

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.

•

Form W-11,, Hiring
g Incentives to Restore Employment (HIRE) Act
Employee Affidavit

•

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

Paid Preparer’s Use Only

•

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

•

Schedule R (Form 941), Allocation Schedule for Aggregate Form
941 Filers

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

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