Form Schedule R (940) Schedule R (940) Allocation Schedule for Aggregate Form 940 Filers

860512

Schedule R (Form 940): Allocation Schedule for Aggregate Form 940 Filers

OMB No. 1545-0028

(Rev. December 2012)
Department of the Treasury — Internal Revenue Service
Employer identification number
(EIN)

Report for calendar year:
(Same as Form 940):

—

Name as shown on
Form 940

Read the separate instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate line
for the amounts allocated to each of your clients.
(a)
Client Employer
Identification Number
(EIN)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16 Subtotals for clients.

Add all amounts on lines 1
through 15.

(b)
State
abbreviation
from Form
940, line 1a,
or Schedule
A (Form 940)

(c)
Total taxable FUTA
wages allocated to
the listed client EIN
from Form 940, line 7

(d)
Total adjustments
to FUTA tax
allocated to the
listed client EIN from
Form 940, line 9 or
line 10

(e)
Credit reduction
amount allocated
to the listed client
EIN from Form 940,
line 11

(f)
Total FUTA tax
after adjustments
allocated to the
listed client EIN from
Form 940, line 12

(g)
Total FUTA tax
deposits from
Form 940, line 13,
plus any payment
made with the
return allocated to
the listed client EIN

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17 Enter the combined

subtotal from line 26 of
all Continuation Sheets
for Schedule R (Form
940).

18 Enter Form 940 amounts
for employees of the
agent.

19 Totals. Add lines 16, 17,

and 18. The column totals
must match the related
lines on the aggregate
Form 940.

For Paperwork Reduction Act Notice, see the instructions.

.
Cat. No. 53082A

Schedule R (Form 940) (Rev. 12-2012)

Page

860612

of

Continuation Sheet for Schedule R (Form 940)

Report for calendar year:

(Rev. December 2012)

(Same as Form 940):
Employer identification number
(EIN)

—

Name as shown on
Form 940

Read the separate instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate line
for the amounts allocated to each of your clients.
(a)
Client Employer
Identification Number
(EIN)

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26 Subtotals for clients. Add
lines 1 through 25. Include
the subtotals from line 26
on Schedule R (Form 940),
line 17.

(b)
State
abbreviation
from Form
940, line 1a,
or Schedule
A (Form 940)

(c)
Total taxable FUTA
wages allocated to
the listed client EIN
from Form 940, line 7

(d)
Total adjustments
to FUTA tax
allocated to the
listed client EIN from
Form 940, line 9 or
line 10

(e)
Credit reduction
amount allocated
to the listed client
EIN from Form 940,
line 11

(f)
Total FUTA tax
after adjustments
allocated to the
listed client EIN from
Form 940, line 12

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(g)
Total FUTA tax
deposits from
Form 940, line 13,
plus any payment
made with the
return allocated to
the listed client EIN

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Schedule R (Form 940) (Rev. 12-2012)

860712
Schedule R (Form 940) (Rev. 12-2012)

Section references are to the Internal Revenue Code unless
otherwise noted.

General Instructions
Purpose of Schedule R
Use Schedule R to allocate the aggregate information reported
on Form 940, Employer's Annual Federal Unemployment (FUTA)
Tax Return, to each home care service recipient client. An
aggregate Form 940 may only be filed by section 3504 Agents
acting on behalf of home care service recipients. If you are an
agent for home care service recipients and have more than 15
clients, complete continuation sheets as necessary. Attach
Schedule R, including any continuation sheets, to your
aggregate Form 940 and file it with your Form 940.

Who Must File?
You must complete Schedule R if you file an aggregate Form
940. Aggregate Forms 940 are filed by agents of home care
service recipients approved by the IRS under section 3504. To
request approval to act as an agent for a home care service
recipient, you must file Form 2678, Employer/Payer
Appointment of Agent, with the IRS, unless you are a state or
local government agency acting as agent under the special
procedures provided in Notice 2003-70. On Schedule R, we call
those home care service recipients your clients.

When Must You File?
If you are an aggregate Form 940 filer, file Schedule R with your
aggregate Form 940 every year when your Form 940 is due.
Schedule R may be filed electronically or by paper submission.
However, agents filing for 1,000 or more clients must file a
paper return.

Specific Instructions
Completing Schedule R
Enter Your Business Information
Carefully enter your employer identification number (EIN) and
the name of your business at the top of the schedule. Make
sure they exactly match the EIN and name shown on the
attached Form 940.

Calendar Year
Enter the calendar year for which you are filing your Form 940.
Make sure that the year entered on the top of Schedule R
matches the year on the attached Form 940.

Client and Employee Information
On Schedule R, including any continuation sheets, you must
report the following for each client.
• Your client's employer identification number (EIN).
• The state abbreviation of the client's location.

• Total taxable FUTA wages (Form 940, line 7) allocated to the
client.
• Total adjustments to FUTA tax (Form 940, line 9 or line 10)
allocated to the client.
• Credit reduction amount (Form 940, line 11) allocated to the
client.
• Total FUTA tax after adjustments (Form 940, line 12)
allocated to the client.
• Total FUTA tax deposits for the tax year plus any other
payments (Form 940, line 13) allocated to the client.
You must also report the same information for your
employees from line 18 of Schedule R.
Compare the total of each column on line 19 (including your
information from line 18) to the amounts reported on the
aggregate Form 940. For each column total, the relevant line
from Form 940 is noted in the column heading.
If the totals on line 19 of the Schedule R do not match the
totals on Form 940, there is an error that must be corrected
before submitting Form 940 and Schedule R.
Paperwork Reduction Act Notice. We ask for the
information on Schedule R to carry out the Internal Revenue
laws of the United States. You are required to give us this
information. We need it to ensure that you are complying with
these laws and to allow us to figure and collect the right amount
of tax.
You are not required to provide the information requested
on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books
or records relating to a form or its instructions must be
retained as long as their contents may become material in the
administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
section 6103.
The time needed to complete and file Schedule R will vary
depending on individual circumstances. The estimated average
time is:
Recordkeeping . . . . . . . . . . . 10 hrs., 45 min.
Learning about the law or the form . . . . . . . 12 min.
Preparing, copying, and assembling the form . . . 22 min.
If you have comments concerning the accuracy of these
time estimates or suggestions for making Schedule R simpler,
we would be happy to hear from you. You can email us at
taxforms@irs.gov. Enter “Schedule R (Form 940)” on the subject
line. Or write to: Internal Revenue Service, Tax Products
Coordinating Committee, SE:W:CAR:MP:T:M:S, 1111
Constitution Ave., NW, IR-6526, Washington, DC 20224. Do not
send Schedule R to this address. Instead, see Where Do You
File? in the Instructions for Form 940.