Form Schedule R (Form 9 Schedule R (Form 9 Allocation Schedule for Aggregated Form 941 Filers

Schedule R (Form 941):

950413

Allocation Schedule for Aggregate Form 941 Filers

(Rev. January 2013)

Report for calendar year:

Department of the Treasury — Internal Revenue Service

Check the quarter (same as Form 941):

Employer identification number
(EIN)

—

1: January, February, March

Name as shown on
Form 941

2: April, May, June
3: July, August, September

Read the instructions before you complete Schedule R (Form 941). Type or print within the boxes.
Complete a separate line for the amounts allocated to each of your clients.

(a)
Client’s Employer
Identification
Number (EIN)

(b)
(c)
Wages, tips, and
Total income tax
other compensation withheld from wages,
allocated to the listed
tips, and other
client EIN from
compensation
Form 941, line 2
allocated to the listed
client EIN from
Form 941, line 3

4: October, November, December

(d)
(e)
(f)
(g)
Section 3121(q)
Total taxes after
Total social security
Total deposits and
adjustments
and Medicare taxes Notice and DemandCOBRA payments
Tax due on
allocated to the from Form 941, line 13,
allocated to the listed
unreported tips
listed client EIN from plus any payments
client EIN from Form
allocated to the listed Form 941, line 10
941, line 5e
made with the return
client EIN from
allocated to the listed
Form 941, line 5f
client EIN

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clients. Add all
amounts on lines
1 through 15

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Enter the
combined
subtotal from line
26 of all
Continuation
Sheets for
Schedule R
(Form 941)

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

17

OMB No. 1545-0029

18 Enter Form 941

amounts for your
employees

19 Totals. Add lines
16, 17, and 18.
The column
totals must
match the
related lines on
the aggregate
Form 941.

For Paperwork Reduction Act Notice, see the instructions.

Cat. No. 49301K

Schedule R (Form 941) (Rev. 1-2013)

Page

950513

of

Continuation Sheet for Schedule R (Form 941)

Report for calendar year:

(Rev. January 2013)

Check the quarter (same as Form 941):
Employer identification number
(EIN)

1: January, February, March

—

2: April, May, June

Name as shown on
Form 941

3: July, August, September
4: October, November, December

(a)
Client’s 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 line 17
of Schedule R
(Form 941).

(b)
(c)
(d)
(e)
(f)
(g)
Section 3121(q)
Total taxes after
Wages, tips, and
Total income tax
Total social security
Total deposits and
adjustments
other compensation withheld from wages, and Medicare taxes Notice and DemandCOBRA payments
Tax due on
allocated to the from Form 941, line 13,
allocated to the listed
tips, and other
allocated to the listed
unreported tips
listed client EIN from plus any payments
client EIN from
compensation
client EIN from
allocated to the listed Form 941, line 10
Form 941, line 2
allocated to the listed
Form 941, line 5e
made with the return
client EIN from
client EIN from
allocated to the listed
Form
941,
line
5f
Form 941, line 3
client EIN

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Schedule R (Form 941) (Rev. 1-2013)

950613
Schedule R (Form 941) (Rev. 1-2013)
Section references are to the Internal Revenue Code unless otherwise
noted.

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

General Instructions
Purpose of Schedule R
Use Schedule R to allocate the aggregate information reported on Form
941 to each client. If you have more than 15 clients, complete as many
continuation sheets as necessary. Attach Schedule R, including any
continuation sheets, to your aggregate Form 941.

Who Must File?
You must complete Schedule R each time you file an aggregate
Form 941, Employer’s QUARTERLY Federal Tax Return. 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, you must file
Form 2678, Employer/Payer Appointment of Agent, with the IRS. On
Schedule R, we call those employers your clients. Form 2678 must be
previously filed and approved by the IRS before filing Schedule R.

When Must You File?
If you are an aggregate Form 941 filer, file Schedule R with your
aggregate Form 941 every quarter when Form 941 is due. The
Schedule R may be filed electronically or by paper submission.
However, agents filing for 1,000 or more clients must file a paper return
unless they are e-filing through an approved transmitter that uses the
IRS's Modernized e-File system.

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 941.

Calendar Year
Enter the calendar year that applies to the quarter checked.

Check the Box for the Quarter
Check the appropriate box of the quarter for which you are filing
Schedule R. Make sure the quarter checked on the top of the
Schedule R matches the quarter checked on the attached Form 941.

Client and Employee Information
On Schedule R, including any continuation sheets, you must report the
following for each client.
Note. When entering amounts over 999.99 on Schedule R, do not enter
commas.

• The client’s employer identification number (EIN).
• Wages, tips, and other compensation allocated to the listed client EIN
from Form 941, line 2.
• Total income tax withheld from wages, tips, and other compensation
allocated to the listed client EIN from Form 941, line 3.
• Total social security and Medicare taxes allocated to the listed client
EIN from Form 941, line 5e.
• Section 3121(q) Notice and Demand—Tax due on unreported tips
allocated to the listed client EIN from Form 941, line 5f.
• Total taxes after adjustments allocated to the listed client EIN from
Form 941, line 10.
• Total deposits from Form 941, line 13, plus any payments made with
the return allocated to the listed client EIN.
You must also report the same information for your employees on line
18 of Schedule R.
Compare the total of each column on line 19 (including your
information on line 18) of Schedule R to the amounts reported on the
aggregate Form 941. For each column total of Schedule R, the relevant
line from Form 941 is noted in the column heading.
If the totals on line 19 of the Schedule R do not match the totals on
Form 941, there is an error that must be corrected before submitting
Form 941 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 . . . . . . . . . . . . 12 hr., 26 min.
Learning about the law or the form . . . . . . . . 12 min.
Preparing, copying, and assembling the form . . . . . 24 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 941)” 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 Should You File? in the Instructions for Form 941.