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
(Rev. January 2013)

Department of the Treasury
Internal Revenue Service

Employer's QUARTERLY Federal Tax Return
Section references are to the Internal Revenue Code unless
otherwise noted.

Future Developments

For the latest information about developments related to
Form 941 and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/form941.

What's New
Social security and Medicare tax for 2013. The employee
tax rate for social security is 6.2%. Previously, the employee
tax rate for social security was 4.2%. The employer tax rate
for social security remains unchanged at 6.2%. The social
security wage base limit is $113,700.
Employers should implement the 6.2% employee social
security tax rate as soon as possible, but not later than
February 15, 2013. After implementing the new 6.2% rate,
employers should make an adjustment in a subsequent pay
period to correct any underwithholding of social security tax
as soon as possible, but not later than March 31, 2013.
The Medicare tax rate is 1.45% each for the employee
and employer, unchanged from 2012. There is no wage base
limit for Medicare tax.
Social security and Medicare taxes apply to the wages of
household workers you pay $1,800 or more in cash or an
equivalent form of compensation in 2013. Social security and
Medicare taxes apply to election workers who are paid
$1,600 or more in cash or an equivalent form of
compensation in 2013.
Additional Medicare Tax withholding. In addition to
withholding Medicare tax at 1.45%, you must withhold a
0.9% Additional Medicare Tax from wages you pay to an
employee in excess of $200,000 in a calendar year. You are
required to begin withholding Additional Medicare Tax in the
pay period in which you pay wages in excess of $200,000 to
an employee and continue to withhold it each pay period until
the end of the calendar year. Additional Medicare Tax is only
imposed on the employee. There is no employer share of
Additional Medicare Tax. All wages that are subject to
Medicare tax are subject to Additional Medicare Tax
withholding if paid in excess of the $200,000 withholding
threshold. For more information on what wages are subject to
Medicare tax, see the chart, Special Rules for Various Types
of Services and Payments, in section 15 of Pub. 15 (Circular
E), Employer's Tax Guide.
Leave-based donation programs to aid victims of Hurricane Sandy. Under these programs, employees may
donate their vacation, sick, or personal leave in exchange for
employer cash payments made before January 1, 2014, to
qualified tax-exempt organizations providing relief for the
victims of Hurricane Sandy. The donated leave will not be
included in the income or wages of the employee. The
employer may deduct the cash payments as business
expenses or charitable contributions. For more information,
see Notice 2012-69, 2012-51 I.R.B. 712, available at
www.irs.gov/irb/2012-51_IRB/ar09.html.

Mar 04, 2013

Work opportunity tax credit for qualified tax-exempt organizations hiring qualified veterans extended. The
work opportunity tax credit is now available for eligible
unemployed veterans who begin work before January 1,
2014. Previously, the credit was available for unemployed
veterans who began work on or after November 22, 2011,
and before January 1, 2013. Qualified tax-exempt
organizations that hire eligible unemployed veterans can
claim the work opportunity tax credit against their payroll tax
liability using Form 5884-C, Work Opportunity Credit for
Qualified Tax-Exempt Organizations Hiring Qualified
Veterans. For more information, visit IRS.gov and enter “work
opportunity tax credit” in the search box.

Reminders
COBRA premium assistance credit. The credit for
COBRA premium assistance payments applies to premiums
paid for employees involuntarily terminated between
September 1, 2008, and May 31, 2010, and to premiums
paid for up to 15 months. See COBRA Premium Assistance
Payments, later.
Section 3121(q) Notice and Demand—Tax due on unreported tips. An employer enters the amount of social
security and Medicare taxes on unreported tips shown on the
Section 3121(q) Notice and Demand on line 5f of the
employer's Form 941 for the calendar quarter corresponding
to the “Date of Notice and Demand.”
Aggregate Form 941 filers. Agents must complete
Schedule R (Form 941), Allocation Schedule for Aggregate
Form 941 Filers, when filing an aggregate Form 941.
Aggregate Forms 941 are filed by agents approved by the
IRS under section 3504. To request approval to act as an
agent for an employer, the agent files Form 2678, Employer/
Payer Appointment of Agent, with the IRS.
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 IRS.gov and enter
“correcting employment taxes” in the search box.
Employers can choose to file Forms 941 instead of
Form 944. Employers that would otherwise be required to
file Form 944, Employer's ANNUAL Federal Tax Return, can
notify the IRS if they want to file quarterly Forms 941 instead
of annual Form 944. See Rev. Proc. 2009-51, 2009-45 I.R.B.
625, available at www.irs.gov/irb/2009-45_IRB/ar12.html.
Requesting to file Form 944 instead of Forms 941. If you
are required to file Form 941 but believe your employment
taxes for the calendar year will be $1,000 or less, you may
request to file Form 944 instead of Forms 941 by calling the
IRS at 1-800-829-4933 by April 1, 2013, or sending a written
request postmarked on or before March 15, 2013. You must
receive written notice from the IRS to file Form 944 instead of
Forms 941 before you may file this form. For more

Cat. No. 14625L

If you are filing your tax return or paying your federal
taxes electronically, a valid employer identification
CAUTION
number (EIN) is required at the time the return is
filed or the payment is made. If a valid EIN is not provided,
the return or payment will not be processed. This may result
in penalties.

information on requesting to file Form 944, visit IRS.gov and
enter “ file employment taxes annually” in the search box.

!

Federal tax deposits must be made by electronic funds
transfer. You must use electronic funds transfer to make all
federal tax deposits. Generally, electronic funds transfers are
made using the Electronic Federal Tax Payment System
(EFTPS). If you do not want to use EFTPS, you can arrange
for your tax professional, financial institution, payroll service,
or other trusted third party to make electronic deposits on
your behalf. Also, you may arrange for your financial
institution to initiate a same-day wire payment on your behalf.
EFTPS is a free service provided by the Department of
Treasury. Services provided by your tax professional,
financial institution, payroll service, or other third party may
have a fee.
For more information on making federal tax deposits, see
section 11 of Pub. 15 (Circular E). To get more information
about EFTPS or to enroll in EFTPS, visit www.eftps.gov or
call 1-800-555-4477 or 1-800-733-4829 (TDD). Additional
information about EFTPS is also available in Pub. 966,
Electronic Federal Tax Payment System: A Guide To Getting
Started.

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CAUTION

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/e-pay. A fee may be charged to file
electronically.
Credit or debit card payments. Employers can pay the
balance due shown on Form 941 by credit or debit card. Do
not use a credit or debit card to make federal tax deposits.
For more information on paying your taxes with a credit or
debit card, visit the IRS website at www.irs.gov/e-pay.
Paid preparers must sign Form 941. Paid preparers must
complete and sign the paid preparer's section of Form 941.
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. Employers who enroll in EFTPS can view
EFTPS deposits and payments made on their behalf.

For an EFTPS deposit to be on time, you must
initiate the deposit by 8 p.m. Eastern time the day
before the date the deposit is due.

Same-day wire payment option. If you fail to initiate a
deposit transaction on EFTPS by 8 p.m. Eastern time the day
before the date a deposit is due, you can still make your
deposit on time by using the Federal Tax Application (FTA).
To use the same-day wire payment method, you will need to
make arrangements with your financial institution ahead of
time. Please check with your financial institution regarding
availability, deadlines, and costs. Your financial institution
may charge you a fee for payments made this way. To learn
more about the information you will need to provide your
financial institution to make a same-day wire payment, visit
www.eftps.gov to download the Same-Day Payment
Worksheet.
Timeliness of federal tax deposits. If a deposit is
required to be made on a day that is not a business day, the
deposit is considered timely if it is made by the close of the
next business day. A business day is any day other than a
Saturday, Sunday, or legal holiday. The term “legal holiday”
for deposit purposes includes only those legal holidays in the
District of Columbia. Legal holidays in the District of
Columbia are provided in Pub. 15 (Circular E).

Where can you get telephone help? For answers to your
questions about completing Form 941, tax deposit rules, or
obtaining an EIN, you can call the IRS at 1-800-829-4933 or
1-800-829-4059 (TDD/TTY for persons who are deaf, hard of
hearing, or have a speech disability), Monday–Friday from
7:00 a.m. to 7:00 p.m. local time (Alaska and Hawaii follow
Pacific time).
Photographs of missing children. The IRS 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

Electronic filing and payment. Now, more than ever
before, businesses can enjoy the benefits of filing tax returns
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 EFTPS to your benefit.
For e-file, visit the IRS website at www.irs.gov/efile for
additional information.
For EFTPS, visit www.eftps.gov or call EFTPS Customer
Service at 1-800-555-4477 or 1-800-733-4829 (TDD) for
additional information.

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) or visit
the IRS website at www.irs.gov/businesses and click on the
Employment Taxes link under Businesses Topics.
Federal law requires you, as an employer, to withhold
taxes from your employees' pay. Each time you pay wages,
you must withhold – or take out of your employees' pay –
certain amounts for federal income tax, social security tax,
and Medicare tax. You must also withhold Additional
Medicare Tax from wages you pay to an employee in excess
of $200,000 in a calendar year. Under the withholding
system, taxes withheld from your employees are credited to
your employees in payment of their tax liabilities.
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Instructions for Form 941 (Rev. 1-2013)

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.

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.
Additional Medicare Tax withheld from employees.
Current quarter's adjustments to social security and
Medicare taxes for fractions of cents, sick pay, tips, and
group-term life insurance.
Credit for COBRA premium assistance payments.

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 17 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.

Do not use 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.

See the General Instructions for Forms W-2 and W-3 for
information about earlier dates for the expedited furnishing
and filing of Forms W-2, Wage and Tax Statement, when a
final Form 941 is filed.

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.

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.

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 18 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 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 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,
earlier.
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, earlier.

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.

When To File Form 941

What if You Reorganize or Close Your
Business?
If You Sell or Transfer Your Business . . .

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

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.

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 30. 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.

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
Instructions for Form 941 (Rev. 1-2013)

The Quarter Includes . . .

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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.

Complete and mail Form 8822-B, Change of
Address—Business, for any address change.

If any due date for filing falls on a Saturday, Sunday, or
legal holiday, you may file your return on the next business
day.

Completing and Filing Form 941

Check the Box for the Quarter

Under “Report for this Quarter of 2013” 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.
Make entries on Form 941 as follows to enable accurate
scanning and processing.
Use 10-point Courier font (if possible) for all entries if you
are typing or using a computer to complete your form.
Portable Document Format (PDF) forms on IRS.gov have
fillable fields with acceptable font specifications.
Do not enter dollar signs and decimal points. Commas are
optional. Enter 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.
Staple multiple sheets in the upper left corner when filing.

How Should You Complete 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 nine-digit 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 under Where Should You File, later) or call
the IRS at 1-800-829-4933.
If you do not have an EIN, you may apply for one online.
Go to IRS.gov and click on the Apply for an EIN Online link
under Tools. 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 not received your EIN by the due date of
Form 941, write “Applied For” and the date you applied in this
entry space.

Required Notice to Employees About the
Earned Income Credit (EIC)

To notify employees about the EIC, you must give the
employees one of the following items.
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.
For more information, see section 10 of Pub. 15 (Circular
E) and Pub. 596, Earned Income Credit (EIC).

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.

If you are filing your tax return electronically, a valid
EIN is required at the time the return is filed. If a valid
CAUTION
EIN is not provided, the return will not be accepted.
This may result in penalties.

!

Always be sure the EIN on the form you file exactly
matches the EIN the IRS assigned to your business.
Do not use your SSN or ITIN 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.

TIP

For more information, see section 12 of Pub. 15
(Circular E) and the Instructions for Schedule D (Form 941).

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 under Where Should You
File, later) to notify the IRS of any name change. See Pub.
1635, Employer Identification Number: Understanding Your
EIN, to see if you need to apply for a new EIN.

Where Should You File?
Where you file depends on whether you include a payment
with Form 941.

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Instructions for Form 941 (Rev. 1-2013)

If you are in . . .

Without a
payment . . .

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

Internal Revenue
Service
P.O. Box 37941
Hartford, CT
06176-7941

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

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

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

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

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

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

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

No legal residence or principal
place of business in any state

You may reduce your deposits during the quarter by the
amount of COBRA premium assistance payments on
line 12a.

With a payment . . .

The IRS has issued regulations under section 6302
which provide that you must deposit all depository
CAUTION
taxes electronically by electronic funds transfers. For
more information about electronic funds transfers, see
Federal tax deposits must be made by electronic funds
transfer under Reminders.

!

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.

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

Internal Revenue
Service
P.O. Box 37941
Hartford, CT
06176-7941

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 2011 or 2012, your lookback period is the 2011
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.
If you reported more than $50,000 of taxes during the
lookback period, you are a semiweekly schedule
depositor.

Internal Revenue
Service
P.O. Box 37941
Hartford, CT
06176-7941

Your filing address may have changed from that
used to file your employment tax return in prior
CAUTION
years. Do not send Form 941 or any payments to the
SSA. Private delivery services cannot deliver to P.O. boxes.

!

!

CAUTION

period.

Depositing Your Taxes

What About Penalties and Interest?

Must You Deposit Your Taxes?

Avoiding Penalties and Interest

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 (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. For more information on paying with a timely filed
return, see the instructions for line 14, later. If you are not
sure your total tax liability for the current quarter will be less
than $2,500 (and your liability for the preceding quarter was
not less than $2,500), make deposits using the semiweekly
or monthly rules so you won't be subject to failure to deposit
penalties.
If your total taxes (line 10) are $2,500 or more for the
current quarter and the preceding quarter.You must
make deposits according to your deposit schedule. See
section 11 of Pub. 15 (Circular E) for information and rules
about federal tax deposits.
Instructions for Form 941 (Rev. 1-2013)

See $100,000 Next-Day Deposit Rule in section 11
of Pub. 15 (Circular E) if you accumulate $100,000
or more of taxes on any day during the deposit

You can avoid paying penalties and interest if you do all of
the following.
Deposit or pay your taxes when they are due.
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 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.

!

CAUTION

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A trust fund recovery penalty may apply if federal
income, social security, or Medicare taxes that must
be withheld are not withheld or are not deposited or

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).

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 over
these taxes, and who acted willfully in not doing so. For
details, see section 11 of Pub. 15 (Circular E).

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.

Adjustment of Tax on Tips

4. If No Wages, Tips, and Other Compensation
are Subject to Social Security or Medicare
Tax . . .

If, by the 10th of the month after the month you received an
employee's report on tips, you do not have enough employee
funds available to withhold the employee's share of social
security and Medicare taxes, you no longer have to collect it.
Report the entire amount of these tips on line 5b (Taxable
social security tips), line 5c (Taxable Medicare wages and
tips), and, if the withholding threshold is met, line 5d (Taxable
wages and tips subject to Additional Medicare Tax
withholding). Include as an adjustment on line 9 the total
uncollected employee share of the social security and
Medicare taxes.

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, Employer's Supplemental Tax Guide.

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.

!

Specific Instructions:
Part 1: Answer These Questions for
This Quarter

5a–5e. Taxable Social Security and Medicare
Wages and Tips

1. Number of Employees Who Received Wages,
Tips, or Other Compensation This Quarter

5a. Taxable social security wages. Enter the total
wages, sick pay, and taxable 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).
For 2013, the rate of social security tax on taxable wages
is 6.2% (.062) each for the employer and employee or 12.4%
(.124) for both. Stop paying social security tax on and
entering an employee's wages on line 5a when the
employee's taxable wages (including tips) reach $113,700 for
the year. However, continue to withhold income and
Medicare taxes for the whole year on wages and tips even
when the social security wage base of $113,700 has been
reached.

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

TIP

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 the third party transferred liability for the employer's
taxes to you. See the General Instructions for Forms W-2 and
W-3 for details.

line 5a (column 1)
x    .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 $113,700 for the
year. Include all tips your employee reported to you even if
you were unable to withhold the employee tax of 6.2%.
Your employee must report cash tips to you by the 10th
day of the month after the month the tips are received. The
report should include charged tips you paid over to the
employee for charge customers, tips the employee received
directly from customers, and tips received from other
employees under any tip-sharing arrangement. Both directly
and indirectly tipped employees must report tips to you. No

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
-6-

Instructions for Form 941 (Rev. 1-2013)

to the employer by the IRS in a Section 3121(q) Notice and
Demand. The tax due may have been determined from tips
reported to the IRS on employees' Forms 4137, Social
Security and Medicare Tax on Unreported Tip Income, or
other tips that were not reported to their employer as
determined by the IRS during an examination. For additional
information, see Rev. Rul. 2012-18, 2012-26 I.R.B. 1032,
available at www.irs.gov/irb/2012-26_IRB/ar07.html.

report is required for months when tips are less than $20.
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.

Deposit the tax within the time period required under your
deposit schedule to avoid any possible deposit penalty. The
tax is treated as accumulated by the employer on the “Date
of Notice and Demand” as printed on the Section 3121(q)
Notice and Demand. The employer must include this amount
on the appropriate line of the record of federal tax liability
(Part 2 of Form 941 for a monthly schedule depositor or
Schedule B (Form 941) for a semiweekly schedule
depositor).

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

5c. Taxable Medicare wages & tips. Enter 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.
The rate of Medicare tax is 1.45% (.0145) each for the
employer and employee or 2.9% (.029) for both. Include all
tips your employees reported during the quarter, even if you
were unable to withhold the employee tax of 1.45%.

6. Total Taxes Before Adjustments

Add the total federal income tax withheld from wages, tips,
and other compensation (line 3), the total social security and
Medicare taxes before adjustments (line 5e), and any tax due
under a Section 3121(q) Notice and Demand (line 5f). Enter
the result on line 6.

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

7–9. Tax Adjustments

Enter tax amounts on lines 7–9 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, enter “-10.59” instead of
“(10.59).” However, if your software only allows for
parentheses in entering negative amounts, you may use
them.

For more information on tips, see section 6 of Pub. 15
(Circular E).
5d. Taxable wages & tips subject to Additional
Medicare Tax withholding. Enter all wages, tips, sick pay,
and taxable fringe benefits that are subject to Additional
Medicare Tax withholding. You are required to begin
withholding Additional Medicare Tax in the pay period in
which you pay wages in excess of $200,000 to an employee
and continue to withhold it each pay period until the end of
the calendar year. Additional Medicare Tax is only imposed
on the employee. There is no employer share of Additional
Medicare Tax. All wages that are subject to Medicare tax are
subject to Additional Medicare Tax withholding if paid in
excess of the $200,000 withholding threshold. For more
information on what wages are subject to Medicare tax, see
the chart, Special Rules for Various Types of Services and
Payments, in section 15 of Pub. 15 (Circular E).
Once wages and tips exceed the $200,000 withholding
threshold, include all tips your employees reported during the
quarter, even if you were unable to withhold the employee tax
of 0.9%.

Current quarter's adjustments. In certain cases, you must
adjust the amounts you entered as social security and
Medicare taxes in column 2 of lines 5a–5d to figure your
correct tax liability for this quarter's Form 941. See section 13
of Pub. 15 (Circular E).
7. 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 of amounts
shown in column 2 of lines 5a–5d may differ slightly from
amounts actually withheld from employees' pay due to the
rounding of social security and Medicare taxes based on
statutory rates.
8. Current quarter's adjustment for sick pay. Enter the
adjustment for the employee share of social security and
Medicare taxes that were withheld and deposited by your
third-party sick pay payer with regard to sick pay paid by the
third-party. These wages should be included on line 5a,
line 5c, and, if the withholding threshold is met, line 5d. If you
are the third-party sick pay payer, enter the adjustment for
any employer share of these taxes required to be paid by the
employer.
9. 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.

line 5d (column 1)
x     .009
line 5d (column 2)

5e. Total social security and Medicare taxes. Add the
column 2 amounts on lines 5a–5d. Enter the result on line 5e.

5f. Section 3121(q) Notice and Demand—Tax
Due on Unreported Tips

Enter the tax due from your Section 3121(q) Notice and
Demand on line 5f. The IRS issues a Section 3121(q) Notice
and Demand to advise an employer of the amount of tips
received by employees who failed to report or underreported
tips to the employer. An employer is not liable for the
employer share of the social security and Medicare taxes on
unreported tips until notice and demand for the taxes is made

Instructions for Form 941 (Rev. 1-2013)

-7-

entered on this line, or file Form 941-X to report the amount
for the prior quarter of the current year.

Prior quarter's adjustments. If you need to correct any
adjustment reported on 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).

12b. Number of Individuals Provided COBRA
Premium Assistance on Line 12a

Enter the total number of assistance eligible individuals
provided COBRA premium assistance for the amount
entered 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 entered only once per quarter. For
example, an assistance eligible individual who made monthly
premium payments during the quarter would only be entered
as one individual.

10. Total Taxes After Adjustments

Combine the amounts shown on lines 6–9 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. For more
information on paying with a timely filed return, see the
instructions for line 14, later.
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 make deposits according to
your deposit schedule. The amount shown on line 10 must
equal the “Total liability for quarter” shown on line 16 or the
“Total liability for the quarter” shown on Schedule B (Form
941).

13. Total Deposits and Credits
Add lines 11 and 12a.

14. Balance Due

If line 10 is more than line 13, enter the difference on 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 (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.

For more information and rules about federal tax deposits,
see Depositing Your Taxes, earlier, 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.

!

You may pay the amount shown on line 14 using EFTPS,
credit card, debit card, check, money order, or electronic
funds withdrawal (EFW). Do not use a credit card, debit
card, or EFW to pay taxes that were required to be
deposited. For more information on electronic payment
options, visit the IRS website at www.irs.gov/e-pay.

11. Total Deposits for This Quarter

Enter your deposits for this quarter, including any
overpayment from a prior quarter. Also include in the amount
shown any overpayment that you applied from filing Form
941-X or Form 944-X, Adjusted Employer's ANNUAL Federal
Tax Return or Claim for Refund, in the current quarter.

If you pay by EFTPS, credit or debit card, or EFW, file your
return using the Without a payment address under Where
Should You File, earlier, and do not file Form 941-V,
Payment Voucher.

12a. COBRA Premium Assistance Payments

Enter 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 IRS.gov and enter “COBRA” in the search box.

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.

The amount entered on line 12a is treated as a
deposit of taxes on the first day of your return period
CAUTION
and must not be used to adjust line 16 or
Schedule B (Form 941).

15. Overpayment

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.

!

CAUTION

!

If you are required to make deposits and instead pay
the taxes with Form 941, you may be subject to a
penalty. See Must You Deposit Your Taxes, earlier.

If line 13 is more than line 10, enter the difference on line 15.
Never make an entry on 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 on line 15. If you do not check either box or if you check
both boxes, generally we will apply the overpayment to your

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
-8-

Instructions for Form 941 (Rev. 1-2013)

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.

account. We may apply your overpayment to any past due
tax account that is shown in our records under your EIN.
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

Part 3: Tell Us About Your Business

You must complete both pages of Form 941 and sign on
page 2. Failure to do so may delay processing of your return.

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.

Part 2: Tell Us About Your Deposit
Schedule and Tax Liability for This
Quarter

17. 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 17 and enter the date
you last paid wages in the space provided. For additional
filing requirements, see If Your Business Has Closed, earlier.

16. Tax Liability for the Quarter
De minimis exception. 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 on line 16 and go to Part 3.

18. If You are a Seasonal Employer . . .

If you hire employees seasonally—such as for summer or
winter only—check the box on line 18. Checking the box tells
the IRS not to expect four Forms 941 from you throughout the
year because you have not paid wages regularly.

If you meet the de minimis exception based on the
prior quarter and line 10 for the current quarter is
CAUTION
$100,000 or more, you must provide a record of your
federal tax liability. If you are a monthly schedule depositor,
complete the deposit schedule on line 16. If you are a
semiweekly schedule depositor, attach Schedule B (Form
941).

!

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 complete Form 941, be sure to check the
box on the top of the form that corresponds to the quarter
reported.

If you reported $50,000 or less in taxes during the
lookback period, 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 16 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.

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. Enter 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 that
prepared your tax return. The designee may choose any five
numbers as his or her PIN.

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 16 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 2013, the lookback period begins July 1, 2011, and
ends June 30, 2012. For details on the deposit rules, see
section 11 of Pub. 15 (Circular E). If you filed Form 944 in
either 2011 or 2012, your lookback period is the 2011
calendar year.

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 do all of the following.
Give us any information that is missing from your return.
Call us for information about processing your return.
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.

The amounts entered on line 16 are a summary of
your monthly tax liability, not a summary of
CAUTION
deposits you made. If you do not properly report
your liabilities when required or if you are a semiweekly
schedule depositor and enter your liabilities on line 16
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.

!

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 location using
the Without a payment address under Where Should You
File, earlier.

If you reported more than $50,000 of taxes for the
lookback period, you are a semiweekly schedule
depositor. Check the appropriate box on line 16.

Instructions for Form 941 (Rev. 1-2013)

-9-

Part 5: Sign Here

Call 1-800-TAX-FORM (1-800-829-3676).

Complete all information in Part 5 and sign Form 941 as
follows.

Other IRS Forms, Notices, and
Publications You May Need

• 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, partner, 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 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/irb/2005-28_IRB/
ar16.html.

Paid Preparer Use Only

A paid preparer must sign Form 941 and provide the
information in the Paid Preparer 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, enter your Preparer Tax
Identification Number (PTIN) in the space provided. Include
your complete address. If you work for a firm, enter the firm's
name and the EIN of the firm. You can apply for a PTIN
online or by filing Form W-12, IRS Paid Preparer Tax
Identification Number (PTIN) Application and Renewal. For
more information about applying for a PTIN online, visit the
IRS website at www.irs.gov/ptin. 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.

How to Order Forms, Instructions,
and Publications from the IRS

•

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

•

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

•

Form 941-X, Adjusted Employer's QUARTERLY Federal Tax
Return or Claim for Refund

•

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

•

Form 944, Employer's ANNUAL Federal Tax Return

•

Form 944-X, Adjusted Employer's ANNUAL Federal Tax Return
or Claim for Refund

•

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. 1244, Employee's Daily Record of Tips and Report to
Employer

•

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

Visit www.irs.gov/formspubs.

-10-

Instructions for Form 941 (Rev. 1-2013)