Form 941-SS - 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-SS
(Rev. January 2017)

Department of the Treasury
Internal Revenue Service

Employer's QUARTERLY Federal Tax Return—American Samoa, Guam, the
Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands
Section references are to the Internal Revenue Code unless
otherwise noted.

Future Developments

For the latest information about developments related to
Form 941-SS and its instructions, such as legislation enacted
after they were published, go to IRS.gov/form941ss.

What's New
Social security and Medicare tax for 2017. The social
security tax rate is 6.2% each for the employee and
employer, unchanged from 2016. The social security wage
base limit is $127,200.
The Medicare tax rate is 1.45% each for the employee
and employer, unchanged from 2016. There is no wage base
limit for Medicare tax.
Social security and Medicare taxes apply to the wages of
household workers you pay $2,000 or more in cash wages in
2017. Social security and Medicare taxes apply to election
workers who are paid $1,800 or more in cash or an
equivalent form of compensation in 2017.
Qualified small business payroll tax credit for increasing research activities. For tax years beginning after
December 31, 2015, a qualified small business may elect to
claim up to $250,000 of its credit for increasing research
activities as a payroll tax credit against the employer’s share
of social security tax. The portion of the credit used against
the employer’s share of social security tax is allowed in the
first calendar quarter beginning after the date that the
qualified small business filed its income tax return. The
election and determination of the credit amount that will be
used against the employer’s share of social security tax is
made on Form 6765, Credit for Increasing Research
Activities. The amount from Form 6765, line 44, must then be
reported on Form 8974, Qualified Small Business Payroll Tax
Credit for Increasing Research Activities. Form 8974 is used
to determine the amount of the credit that can be used in the
current quarter. The amount from Form 8974, line 12, is
reported on Form 941-SS, line 11. If you are claiming the
research payroll tax credit on your Form 941-SS, you must
attach Form 8974 to that Form 941-SS.
New certification program for professional employer organizations. The Tax Increase Prevention Act of 2014
required the IRS to establish a voluntary certification program
for professional employer organizations (PEOs). PEOs
handle various payroll administration and tax reporting
responsibilities for their business clients and are typically
paid a fee based on payroll costs. To become and remain
certified under the certification program, certified
professional employer organizations (CPEOs) must meet tax
status, background, experience, business location, financial
reporting, bonding and other requirements described in
sections 3511 and 7705 and related published guidance. The
IRS began accepting applications for PEO certification in July
2016. Certification as a CPEO affects the employment tax
liabilities of both the CPEO and its customers. A CPEO is
Feb 27, 2017

generally treated as the employer of any individual
performing services for a customer of the CPEO and covered
by a contract described in section 7705(e)(2) between the
CPEO and the customer (CPEO contract), but only for wages
and other compensation paid to the individual by the CPEO.
For more information, visit the IRS website at IRS.gov/cpeo.
CPEOs generally must file Form 941-SS and Schedule R
(Form 941), Allocation Schedule for Aggregate Form 941
Filers, electronically. For more information about a CPEO’s
requirement to file electronically, see Rev. Proc. 2017-14,
2017-3 I.R.B. 426, available at IRS.gov/irb/2017-03_IRB/
ar14.html.

Reminders
Work opportunity tax credit for qualified tax-exempt organizations hiring qualified veterans. The work
opportunity tax credit is available for eligible unemployed
veterans who begin work on or after November 22, 2011, and
before January 1, 2020. 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. For more information, visit IRS.gov and enter
“work opportunity tax credit” in the search box.
COBRA premium assistance credit. Effective for tax
periods beginning after December 31, 2013, the credit for
COBRA premium assistance payments can't be claimed on
Form 941-SS. Instead, after filing your Form 941-SS, file
Form 941-X, Adjusted Employer's QUARTERLY Federal Tax
Return or Claim for Refund, to claim the COBRA premium
assistance credit. Filing a Form 941-X before filing a Form
941-SS for the quarter may result in errors or delays in
processing your Form 941-X. For more information, visit
IRS.gov and enter “COBRA” in the search box.
If you’re entitled to claim the COBRA premium

TIP assistance credit, but aren't otherwise required to file

Form 941-SS, file a Form 941-SS with -0- entered on
line 14 before filing a Form 941-X to claim the credit.
Aggregate Form 941-SS filers. Agents and CPEOs must
complete Schedule R (Form 941) when filing an aggregate
Form 941-SS. Aggregate Forms 941-SS 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 with the IRS. Aggregate Forms 941-SS are also
filed by CPEOs approved by the IRS under section 7705.
CPEOs file Form 8973, Certified Professional Employer
Organization/Customer Reporting Agreement, to notify the
IRS that they started or ended a service contract with a
customer. CPEOs generally must file Form 941-SS and
Schedule R (Form 941) electronically. For more information
about a CPEO’s requirement to file electronically, see Rev.
Proc. 2017-14, 2017-3 I.R.B. 426, available at IRS.gov/irb/
2017-03_IRB/ar14.html.
Correcting a previously filed Form 941-SS. If you
discover an error on a previously filed Form 941-SS, make
the correction using Form 941-X. Form 941-X is filed

Cat. No. 35530F

separately from Form 941-SS. For more information, see the
Instructions for Form 941-X, section 9 of Pub. 80, or visit
IRS.gov and enter “correcting employment taxes” in the
search box.

For an EFTPS deposit to be on time, you must
submit the deposit by 8 p.m. Eastern time the day
CAUTION before the date the deposit is due. See section 8 of
Pub. 80 for details.

!

Employers can choose to file Forms 941-SS instead of
Form 944. Employers in American Samoa, Guam, the
Commonwealth of the Northern Mariana Islands, and the
U.S. Virgin Islands 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-SS
instead of annual Form 944. To request to file quarterly
Forms 941-SS to report your social security and Medicare
taxes for the 2017 calendar year, you must either call the IRS
at 1-800-829-4933 (U.S. Virgin Islands only), or
267-941-1000 (toll call) between January 1, 2017, and April
3, 2017, or send a written request postmarked between
January 1, 2017, and March 15, 2017. After you contact the
IRS, the IRS will send you a written notice that your filing
requirement has been changed to Forms 941-SS. You must
receive written notice from the IRS to file Forms 941-SS
instead of Form 944 before you may file these forms. If you
don't receive this notice, you must file Form 944 for calendar
year 2017. See Rev. Proc. 2009-51, 2009-45 I.R.B. 625,
available at IRS.gov/irb/2009-45_IRB/ar12.html.

Same-day wire payment option. If you fail to submit 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 Collection Service
(FTCS). 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 the IRS website at IRS.gov/payments and click on
Same-day wire.
Timeliness of federal tax deposits. If a deposit is
required to be made on a day that isn't 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. 80.

Requesting to file Form 944 instead of Forms 941-SS. If
you’re required to file Forms 941-SS 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-SS by calling the IRS at 1-800-829-4933 (U.S. Virgin
Islands only), or 267-941-1000 (toll call) between January 1,
2017, and April 3, 2017, or sending a written request
postmarked between January 1, 2017, and March 15, 2017.
After you contact the IRS, the IRS will send you a written
notice that your filing requirement has been changed to Form
944. You must receive written notice from the IRS to file Form
944 instead of Forms 941-SS before you may file this form. If
you don't receive this notice, you must file Forms 941-SS for
calendar year 2017. See Rev. Proc. 2009-51, 2009-45 I.R.B.
625, available at IRS.gov/irb/2009-45_IRB/ar12.html.

Electronic filing and payment. Now, more than ever
before, businesses can enjoy the benefits of filing and paying
their federal taxes electronically. Whether you rely on a tax
professional or handle your own taxes, the IRS offers you
convenient programs to make filing and paying easier. Spend
less time and worry on taxes and more time running your
business. Use e-file and EFTPS to your benefit.
For e-file, visit the IRS website at IRS.gov/employmentefile
for additional information.
For EFTPS, visit eftps.gov or call one of the numbers
provided under Federal tax deposits must be made by
electronic funds transfer (EFT), earlier.
If you’re 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 isn't provided, the
return or payment won't be processed. This may result in
penalties.

!

Federal tax deposits must be made by electronic funds
transfer (EFT). You must use EFT to make all federal tax
deposits. Generally, an EFT is made using the Electronic
Federal Tax Payment System (EFTPS). If you don't 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 8 of Pub. 80. To get more information about EFTPS
or to enroll in EFTPS, visit eftps.gov or call one of the
following numbers.
1-800-555-4477 (toll free; for use by U.S. Virgin Islands
only)
1-800-733-4829 (TDD)
1-800-244-4829 (Spanish)
303-967-5916 (toll call)
Additional information about EFTPS is available in Pub.
966.

Electronic funds withdrawal (EFW). If you file Form
941-SS electronically, you can e-file and e-pay (EFW) the
balance due in a single step using tax preparation software or
through a tax professional. However, don't use EFW to make
federal tax deposits. For more information on paying your
taxes using EFW, visit the IRS website at IRS.gov/payments.
A fee may be charged to file electronically.
Credit or debit card payments. You can pay the balance
due shown on Form 941-SS by credit or debit card. Don't 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 IRS.gov/payments.
Online payment agreement. You may be eligible to apply
for an installment agreement online if you have a balance
due when you file your return. For more information, see
What if you can't pay in full, later.
Paid preparers must sign Form 941-SS. Paid preparers
must complete and sign the paid preparer's section of Form
941-SS.
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Instructions for Form 941-SS (Rev. 1-2017)

Who Must File Form 941-SS?

Outsourcing payroll duties. Unless the wages and other
compensation to the individual performing services for you
are paid by a CPEO and are covered by a contract described
in section 7705(e)(2) between you and a CPEO (CPEO
contract), you're responsible to ensure that tax returns are
filed and deposits and payments are made, even if you
contract with a third party to perform these acts. You remain
responsible if the third party fails to perform any required
action. If you choose to outsource any of your payroll and
related tax duties (that is, withholding, reporting, and paying
over social security, Medicare, FUTA, and income taxes) to a
third-party payer, such as a payroll service provider or
reporting agent, visit IRS.gov and enter “outsourcing payroll
duties” in the search box for helpful information on this topic.
For more information on the different types of third party
payer arrangements, see section 16 in Pub. 15.

Generally, you must file a return for the first quarter in which
you pay wages subject to social security and Medicare taxes,
and for each quarter thereafter until you file a final return. Use
Form 941-SS if your principal place of business is in
American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, or the U.S. Virgin Islands, or if you have
employees who are subject to income tax withholding for
these jurisdictions.
Use Form 941-SS to report the following amounts.
Wages/tips subject to social security and Medicare taxes.
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.
Qualified small business payroll tax credit for increasing
research activities.

Where can you get telephone help? For answers to your
questions about completing Form 941-SS or tax deposit
rules, call the IRS at one of the numbers listed below.
1-800-829-4933 (toll free; for use by U.S. Virgin Islands
only) or 1-800-829-4059 (TDD/TTY for persons who are
deaf, hard or hearing, or have a speech disability) Monday–
Friday from 7:00 a.m. to 7:00 p.m. local time.
267-941-1000 (toll call) Monday–Friday from 6:00 a.m. to
11:00 p.m. Eastern time.

Don't use Form 941-SS if you have both employees who
are subject to U.S. income tax withholding and employees
who aren't subject to U.S. income tax withholding. Instead,
you must file only Form 941 (or Form 944) and include all of
your employees' wages on that form.

Photographs of missing children. The IRS is a proud
partner with the National Center for Missing & Exploited
Children®(NCMEC). 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.

Don't use Form 941-SS 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-SS, you must file a return
each quarter, even if you have no tax liability to report, unless
you filed a final return or one of the exceptions listed next
applies.

General Instructions:
Purpose of Form 941-SS

Exceptions

Use Form 941-SS to report social security and Medicare
taxes for workers in American Samoa, Guam, the
Commonwealth of the Northern Mariana Islands, and the
U.S. Virgin Islands.

Special rules apply to some employers.
Seasonal employers don't have to file a Form 941-SS for
quarters in which they have no tax liability because they have
paid no wages. To tell the IRS that you won't file a return for
one or more quarters during the year, check the box on
line 18 every quarter you file Form 941-SS. The IRS generally
won't inquire about unfiled returns if at least one taxable
return is filed each year. However, you must check the box
on line 18 on every quarterly return you file. Otherwise, the
IRS will expect a return to be filed for each quarter.
Employers of household employees don't usually file
Form 941-SS. See Pub. 80, Pub. 926, and Schedule H (Form
1040) for more information.
Employers of farm employees don't usually file Form
941-SS. See Form 943 and Pub. 51 for more information.

Pub. 80 explains the requirements for withholding,
depositing, and paying social security and Medicare taxes. It
explains the forms you must give your employees, those your
employees must give you, and those you must send to the
IRS. See Pub. 15-A, Employer's Supplemental Tax Guide, for
specialized employment tax information supplementing the
basic information provided in Pub. 80.
Federal law requires you, as an employer, to withhold
certain taxes from your employees' pay. Each time you pay
wages, you must withhold – or take out of your employees'
pay – certain amounts for 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.

If none of the above exceptions applies and you

TIP haven't filed a final return, you must fileForm 941-SS

each quarter even if you didn't pay wages during the
quarter. Use IRS e-file, if possible.

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

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 isn't
withheld from employees.

Instructions for Form 941-SS (Rev. 1-2017)

If you sell or transfer your business, you and the new owner
must each file a Form 941-SS for the quarter in which the
transfer occurred. Report only the wages you paid.
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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.

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

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. 80. 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.

The Quarter Includes . . .

Quarter Ends

Form 941-SS
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 the quarter, you may file by the 10th day of the
second month that follows the end of the quarter. For
example, you may file Form 941-SS by May 10 if you made
timely deposits in full payment of your taxes for the first
quarter.

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-SS 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.

If we receive Form 941-SS after the due date, we will treat
Form 941-SS as filed on time if the envelope containing Form
941-SS 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 don't follow these
guidelines, we generally will consider Form 941-SS filed
when it is actually received. See Pub. 80 for more information
on IRS-designated private delivery services.

See the General Instructions for Forms W-2 and W-3 for
information about earlier dates for the expedited furnishing
and filing of the following Wage and Tax Statements when a
final Form 941-SS is filed.
W-2AS, American Samoa
W-2CM, Commonwealth of the Northern Mariana Islands
W-2GU, Guam
W-2VI, U.S. Virgin Islands

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

How Should You Complete Form
941-SS?

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.

Type or print your EIN, name, and address in the spaces
provided. Also enter your name and EIN on the top of page 2.
Don't 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. For example, if you’re 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.”

When Must You File?
File your initial Form 941-SS for the quarter in which you first
paid wages that are subject to social security and Medicare
taxes. See the table below titled When To File Form 941-SS.

Employer Identification Number (EIN). To make sure that
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 aren't 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 (toll free; for use by U.S. Virgin
Islands only) or 267-941-1099 (toll call).
If you don't have an EIN, you may apply for one online by
visiting the IRS website at IRS.gov/ein. You may also apply
for an EIN by calling 267-941-1099 (toll call), or you can fax
or mail Form SS-4 to the IRS. If you haven't received your
EIN by the due date of Form 941-SS, write “Applied For” and
the date you applied in this entry space.

Then you must file for every quarter after that—every 3
months—even if you have no taxes to report, unless you’re a
seasonal employer or are filing your final return. See
Seasonal employers and If Your Business Has Closed,
earlier.
File Form 941-SS only once for each quarter. If you filed
electronically, don't file a paper Form 941-SS. For more
information about filing Form 941-SS electronically, see
Electronic filing and payment, earlier.

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Instructions for Form 941-SS (Rev. 1-2017)

Also see Rev. Proc. 2004-53 for more information. You can
find Rev. Proc. 2004-53 on page 320 of I.R.B. 2004-34 at
IRS.gov/pub/irs-irbs/irb04-34.pdf.

If you’re filing your tax return electronically, a valid
EIN is required at the time the return is filed. If a valid
CAUTION EIN isn't provided, the return won't be accepted. This
may result in penalties.

!

Where Should You File?

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

Always be sure the EIN on the form you file exactly

TIP matches the EIN the IRS assigned to your business.

Don't use your SSN or ITIN on forms that ask for an
EIN. Filing a Form 941-SS with an incorrect EIN or using
another business's EIN may result in penalties and delays in
processing your return.
If you change your business name, business address,
or responsible party... Notify the IRS immediately if you
change your business name, business address, or
responsible party.
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 business name change.
See Pub. 1635 to see if you need to apply for a new EIN.
Complete and mail Form 8822-B to notify the IRS of a
business address or responsible party change. Don't mail
Form 8822-B with your Form 941-SS. For a definition of
“responsible party” see the Form 8822-B instructions.

Without a
payment . . .

American Samoa, Guam,
Commonwealth of the Northern
Mariana Islands, U.S. Virgin
Islands

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

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

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

With a payment . . .

Your filing address may have changed from that
used to file your employment tax return in prior years.
CAUTION Don't send Form 941-SS or any payments to the
SSA. Private delivery services can't deliver to P.O. boxes.

!

Check the Box for the Quarter

Depositing Your Taxes

Under “Report for this Quarter of 2017” at the top of Form
941-SS, check the appropriate box of the quarter for which
you're 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.

You must deposit all depository taxes electronically
by EFT. For more information, see Federal tax
CAUTION deposits must be made by electronic funds transfer
(EFT) under Reminders.

!

Completing and Filing Form 941-SS

Must You Deposit Your Taxes?

Make entries on Form 941-SS as follows to enable accurate
processing.
Use 10-point Courier font (if possible) for all entries if
you’re typing or using a computer to complete your form.
Portable Document Format (PDF) forms on IRS.gov have
fillable fields with acceptable font specifications.
Don't 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 and 12) 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.

You may have to deposit both the employer and employee
social security taxes and Medicare taxes.
If your total taxes after adjustments and credits
(line 12) are less than $2,500 for the current quarter or
the prior quarter (total taxes reported on line 10 if the
prior quarter was the fourth quarter of 2016), and you
didn't incur a $100,000 next-day deposit obligation
during the current quarter. You don't 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’re not sure
your total tax liability for the current quarter will be less than
$2,500, (and your liability for the prior quarter wasn't 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 after adjustments and credits
(line 12) are $2,500 or more for the current quarter and
the prior quarter (total taxes reported on line 10 if the
prior quarter was the fourth quarter of 2016). You must
make deposits according to your deposit schedule. See
section 8 of Pub. 80 for information and rules about federal
tax deposits.

Reconciling Forms 941-SS and W-3SS

The IRS matches amounts reported on your four quarterly
Forms 941-SS with Form W-2AS, W-2CM, W-2GU, or W-2VI
amounts totaled on your yearly Form W-3SS, Transmittal of
Wage and Tax Statements. If the amounts don't agree, you
may be contacted by the IRS or the Social Security
Administration (SSA). The following amounts are reconciled.
Social security wages.
Social security tips.
Medicare wages and tips.

You may reduce your deposits during the quarter by the
amount of the COBRA premium assistance credit that will be
reflected on your Form 941-X, only if you use the claim
process and not the adjustment process to claim the COBRA
premium assistance credit on your Form 941-X for the
quarter.

Use Schedule D (Form 941) to explain certain wage, tax,
and payment discrepancies between Forms 941-SS and
Forms W-2AS, W-2CM, W-2GU, W-2VI, W-3SS, and W-2c,
Corrected Wage and Tax Statement, that were caused by
acquisitions, statutory mergers, or consolidations. For more
information, see the Instructions for Schedule D (Form 941).
Instructions for Form 941-SS (Rev. 1-2017)

If you’re in . . .

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Penalties and interest are charged on taxes paid late and
returns filed late at a rate set by law. See section 8 of Pub. 80
for details.

The COBRA premium assistance credit is treated as a
credit on the first day of the return period (that is, January 1,
April 1, July 1, or October 1). However, because the credit is
now claimed on Form 941-X filed after submission of the
Form 941-SS, an employer that reduces its required deposits
in anticipation of the credit will receive a system-generated
notice reflecting a balance due and associated penalties and
interest, if applicable. The balance due, including any related
penalties and interest, resulting from the reduction in
deposits in anticipation of the credit will be abated when the
credit is applied. Such abatement will generally occur without
any further action from the employer.

Use Form 843 to request abatement of assessed
penalties or interest. Don't request abatement of assessed
penalties or interest on Form 941-SS or Form 941-X.
If federal income, social security, and Medicare taxes
(that is, trust fund taxes) that must be withheld aren't
CAUTION withheld or aren't deposited or paid to the United
States Treasury, the trust fund recovery penalty may apply.
The penalty is the full amount of the unpaid trust fund tax.
This penalty may apply to you if these unpaid taxes can't be
immediately collected from the employer or business. The
trust fund recovery penalty may be imposed on all persons
who are determined by the IRS to be responsible for
collecting, accounting for, or paying over these taxes, and
who acted willfully in not doing so. For more information, see
section 8 of Pub. 80.

!

Alternatively, to prevent triggering a system-generated
balance due notice, the employer can make its deposits
without a reduction in anticipation of the COBRA premium
assistance credit and follow the ordinary procedures for filing
a claim for refund or adjusted return using Form 941-X.

When Must You Deposit Your Taxes?
Determine If You’re a Monthly or Semiweekly
Schedule Depositor for the Quarter

Adjustment of Tax on Tips

If, by the 10th of the month after the month you received an
employee's report on tips, you don't 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.

The IRS uses two different sets of deposit rules to determine
when businesses must deposit their social security and
Medicare taxes. These schedules tell you when a deposit is
due after you have a payday.
Your deposit schedule isn't determined by how often you
pay your employees. Your deposit schedule depends on the
total tax liability you reported on Form 941-SS during the
previous four-quarter lookback period (July 1 of the second
preceding calendar year through June 30 of the preceding
calendar year). See section 8 of Pub. 80 for details. If you
filed Form 944 in either 2015 or 2016, your lookback period is
the 2015 calendar year.

Where Can You Obtain Forms?
See Pub. 80 for information on ordering IRS forms. You may
also be able to get some IRS forms at the addresses listed
next.

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’re a monthly schedule depositor.
If you reported more than $50,000 of taxes during the
lookback period, you’re a semiweekly schedule depositor.
If you’re a monthly schedule depositor and
accumulate a $100,000 tax liability on any day during
CAUTION the deposit period, you become a semiweekly
schedule depositor on the next day and remain so for at least
the rest of the calendar year and for the following calendar
year. See $100,000 Next-Day Deposit Rule in section 8 of
Pub. 80 for more information.

!

What About Penalties and Interest?
Avoiding Penalties and Interest

You can avoid paying penalties and interest if you do all of
the following.
Deposit or pay your taxes when they are due.
File your fully completed Form 941-SS on time.
Report your tax liability accurately.
Submit valid checks for tax payments.
Furnish accurate Forms W-2AS, W-2CM, W-2GU, or
W-2VI to employees.
File Form W-3SS and Copy A of Forms W-2AS, W-2CM,
W-2GU, or W-2VI with the SSA on time and accurately.

American Samoa

Tax Office
Executive Office Building
First Floor
Pago Pago, AS 96799

Commonwealth of the
Northern Mariana Islands

CNMI Social Security System Administrator
Saipan, MP 96960

Guam

Department of Revenue and Taxation
Government of Guam
Building 13–1, Mariner Avenue
Barrigada, GU 96913

U.S. Virgin Islands

Bureau of Internal Revenue
6115 Estate Smith Bay
St. Thomas, VI 00802

Specific Instructions:
Part 1: Answer These Questions for
This Quarter
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
-6-

Instructions for Form 941-SS (Rev. 1-2017)

report should include charged tips (for example, credit and
debit card charges) 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 report is
required for months when tips are less than $20. Employees
may use Form 4070 (available only in Pub. 1244) or submit a
written statement or electronic tip record.
Don't include allocated tips on this line. Instead, report
them on Form 8027. Allocated tips aren't reportable on Form
941-SS and aren't subject to withholding of social security or
Medicare taxes.

December 12 for the quarter indicated at the top of the Form
941-SS. Don't include:
Household employees,
Employees in nonpay status for the pay period,
Farm employees,
Pensioners, or
Active members of the Armed Forces.
If you enter “250” or more on line 1, you must file

TIP Forms W-2AS, W-2CM, W-2GU, and W-2VI

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

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

line 5b (column 1)
x   0.124
line 5b (column 2)

If no wages, tips, and compensation are subject to social
security or Medicare tax, check the box on line 4. If this
question doesn't apply to you, leave the box blank. For more
information about exempt wages, see section 12 of Pub. 80
and section 4 of Pub. 15-A.

5c. Taxable Medicare wages and 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% (0.0145) each for the
employer and employee, or 2.9% (0.029) for both. Include all
tips your employees reported during the quarter, even if you
were unable to withhold the employee tax of 1.45%.

If you’re a government employer, wages you pay
aren't 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.

!

line 5c (column 1)
x   0.029
line 5c (column 2)

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

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. Don't include tips on
this line. For information on types of wages subject to social
security taxes, see section 4 of Pub. 80.
For 2017, the rate of social security tax on taxable wages
is 6.2% (0.062) each for the employer and employee or
12.4% (0.124) 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 $127,200 for
the year. However, continue to withhold Medicare taxes for
the whole year on wages and tips even when the social
security wage base of $127,200 has been reached.

For more information, see sections 4, 5, and 7 of Pub. 80.
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’re 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 Employment and Payments, in section 12 of Pub. 80. For
more information on Additional Medicare Tax, visit IRS.gov
and enter “Additional Medicare Tax” in the search box.
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%.

line 5a (column 1)
x  0.124
line 5a (column 2)

line 5d (column 1)
x     0.009
line 5d (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 $127,200 for the
year. Include all tips your employees reported to you even if
you were unable to withhold the employee tax of 6.2%. Don't
include service charges on line 5b.
Your employee must report cash tips to you by the 10th
day of the month after the month the tips are received. The
Instructions for Form 941-SS (Rev. 1-2017)

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

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

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.

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 isn't liable for the employer
share of the social security and Medicare taxes on
unreported tips until notice and demand for the taxes is made
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 weren't 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 IRS.gov/irb/2012-26_IRB/ar07.html.

Prior quarter's adjustments. If you need to correct any
adjustment reported on a previously filed Form 941-SS,
complete and file Form 941-X. Form 941-X is an adjusted
return or claim for refund and is filed separately from Form
941-SS. See section 9 of Pub. 80.

10. Total Taxes After Adjustments

Combine the amounts shown on lines 6–9 and enter the
result on line 10.

11. Qualified Small Business Payroll Tax Credit
for Increasing Research Activities

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-SS for a monthly schedule depositor or
Schedule B (Form 941) for a semiweekly schedule
depositor).

Enter the amount of the credit from Form 8974, line 12.

!

If you enter an amount on line 11, you must attach
Form 8974.

CAUTION

12. Total Taxes After Adjustments and Credits

Subtract line 11 from line 10 and enter the result on line 12.

6. Total Taxes Before Adjustments

If line 12 is less than $2,500 or line 12 on the prior
quarterly return (total taxes reported on line 10 if the
prior quarter was the fourth quarter of 2016) was less
than $2,500, and you didn't incur a $100,000 next-day
deposit obligation during the current quarter. You may
pay the amount with Form 941-SS 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 below.
If line 12 is $2,500 or more and line 12 on the prior
quarterly return (total taxes reported on line 10 if the
prior quarter was the fourth quarter of 2016) 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 12 must equal the “Total liability for quarter”
shown on line 16 or the “Total liability for the quarter” shown
on Schedule B (Form 941).

Add 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.

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.
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-SS. See
section 9 of Pub. 80.
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’re the third-party sick pay payer, enter the adjustment for
any employer share of these taxes required to be paid by the
employer.

For more information and rules about federal tax deposits,
see Depositing Your Taxes, earlier, and section 8 of Pub. 80.
If you’re a semiweekly depositor, you must complete
Schedule B (Form 941). If you fail to complete and
CAUTION submit Schedule B (Form 941), the IRS may assert
deposit penalties based on available information.

!

13. Total Deposits for This Quarter

Enter your deposits for this quarter, including any
overpayment from a prior quarter that you applied to this
return. 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.

14. Balance Due

If line 12 is more than line 13, enter the difference on line 14.
Otherwise, see Overpayment, later.

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Instructions for Form 941-SS (Rev. 1-2017)

both boxes, generally we will apply the overpayment to your
account. We may apply your overpayment to any past due
tax account that is shown in our records under your EIN.

Never make an entry on both lines 14 and 15.
You don't have to pay if line 14 is under $1. Generally,
you should have a balance due only if your total taxes after
adjustments and credits (line 12) for the current quarter or
prior quarter (total taxes reported on line 10 if the prior
quarter was the fourth quarter of 2016) are less than $2,500,
and you didn't incur a $100,000 next-day deposit obligation
during the current quarter. However, see section 8 of Pub. 80
for information about payments made under the accuracy of
deposits rule.

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

Complete Both Pages

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

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

If you were required to make federal tax deposits, pay the
amount shown on line 14 by EFT. If you weren't required to
make federal tax deposits, you may pay the amount shown
on line 14 by EFT, credit card, debit card, check, money
order, or EFW. For more information on electronic payment
options, visit the IRS website at IRS.gov/payments.

16. Tax Liability for the Quarter

De minimis exception. If line 12 is less than $2,500 or
line 12 on the prior quarterly return (total taxes reported on
line 10 if the prior quarter was the fourth quarter of 2016) was
less than $2,500, and you didn't incur a $100,000 next-day
deposit obligation during the current quarter, check the
appropriate box on line 16 and go to Part 3.

If you pay by EFT, credit card, or debit card, file your
return using the Without a payment address under Where
Should You File, earlier, and don't file Form 941-V(SS),
Payment Voucher.
If you pay by check or money order, make it payable to the
“United States Treasury.” Enter your EIN, Form 941-SS, and
the tax period (“1st Quarter 2017,” “2nd Quarter 2017,” “3rd
Quarter 2017,” or “4th Quarter 2017”) on your check or
money order. Complete Form 941-V(SS) and enclose it with
Form 941-SS.

If you meet the de minimis exception based on the
prior quarter and line 12 for the current quarter is
CAUTION $100,000 or more, you must provide a record of your
federal tax liability. If you’re a monthly schedule depositor,
complete the deposit schedule on line 16. If you’re a
semiweekly schedule depositor, attach Schedule B (Form
941).

!

If line 12 is $2,500 or more and you’ve deposited all taxes
when due, the balance due on line 14 should be zero, unless
you’ve reduced your deposits in anticipation of filing a Form
941-X to claim COBRA premium assistance credits. See
Depositing Your Taxes, earlier.

!

CAUTION

If you reported $50,000 or less in taxes during the
lookback period (see below), you’re a monthly schedule
depositor unless the $100,000 Next-Day Deposit Rule
discussed in section 8 of Pub. 80 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.
Note that your total tax liability for the quarter must equal
your total taxes shown on line 12. If it doesn't, your tax
deposits and payments may not be counted as timely. Don't
change your tax liability on line 16 by adjustments reported
on any Forms 941-X.
You’re a monthly schedule depositor for the calendar year
if the amount of your Form 941-SS 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 2017, the lookback period begins July 1, 2015, and
ends June 30, 2016. For details on the deposit rules, see
section 8 of Pub. 80. If you filed Form 944 in 2015 or 2016,
your lookback period is the 2015 calendar year.

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

What if you can't pay in full? If you can't pay the full
amount of tax you owe, you can apply for an installment
agreement online. You can apply for an installment
agreement online if:
You can't pay the full amount shown on line 14,
The total amount you owe is $25,000 or less, and
You can pay the liability in full in 24 months.
To apply using the Online Payment Agreement
Application, visit the IRS website at IRS.gov/opa.
Under an installment agreement, you can pay what you
owe in monthly installments. There are certain conditions you
must meet to enter into and maintain an installment
agreement, such as paying the liability within 24 months, and
making all required deposits and timely filing tax returns
during the length of the agreement.
If your installment agreement is accepted, you will be
charged a fee and you will be subject to penalties and
interest on the amount of tax not paid by the due date of the
return.

15. Overpayment

The amounts entered on line 16 are a summary of
your monthly tax liability, not a summary of deposits
CAUTION you made. If you don't properly enter your liabilities
when required or if you’re a semiweekly schedule depositor
and report 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 8 of Pub. 80 for more information.

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 don't check either box or if you check

If you reported more than $50,000 of taxes for the
lookback period, you’re a semiweekly schedule depositor.
Check the appropriate box on line 16.
You must complete Schedule B (Form 941) and submit it
with your Form 941-SS. Don't use Schedule B (Form 941) if
you’re a monthly schedule depositor.

!

If line 13 is more than line 12, enter the difference on line 15.
Never make an entry on both lines 14 and 15.

Instructions for Form 941-SS (Rev. 1-2017)

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Don't change your tax liability on Schedule B (Form 941)
by adjustments reported on any Forms 941-X.

represent you before the IRS. If you want to expand your
designee's authorization, see Pub. 947.

Adjusting tax liability for the qualified small business
payroll tax credit for increasing research activities reported on line 11. Monthly schedule depositors and
semiweekly schedule depositors must account for the
qualified small business payroll tax credit for increasing
research activities (line 11) when reporting their tax liabilities
on line 16 or Schedule B (Form 941). The total tax liability for
the quarter must equal the amount reported on line 12.
Failure to account for the qualified small business payroll tax
credit for increasing research activities on line 16 or
Schedule B (Form 941) may cause line 12 to be less than the
total tax liability reported on line 16 or Schedule B (Form
941). Don't reduce the tax liability reported on line 16 or
Schedule B (Form 941) below zero.

The authorization will automatically expire 1 year from the
due date (without regard to extensions) for filing your Form
941-SS. 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.

Part 5: Sign Here (Approved Roles)
Complete all information in Part 5 and sign Form 941-SS.
The following persons are authorized to sign the return for
each type of business entity.
• Sole proprietorship— The individual who owns the
business.

Part 3: Tell Us About Your Business

• Corporation (including a limited liability company
(LLC) treated as a corporation)— The president, vice
president, or other principal officer duly authorized to sign.

In Part 3, answer only those questions that apply to your
business. If the questions don't apply, leave them blank and
go to Part 4.

• 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.

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-SS 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.

• 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.

18. If You’re a Seasonal Employer . . .

Form 941-SS may be signed by a duly authorized agent of
the taxpayer if a valid power of attorney has been filed.

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-SS from you
throughout the year because you haven't paid wages
regularly.

Alternative signature method. Corporate officers or duly
authorized agents may sign Form 941-SS 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, available at IRS.gov/irb/2005-28_IRB/
ar16.html.

Generally, we won't 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-SS.

Paid Preparer Use Only

Also, when you complete Form 941-SS, be sure to check
the box on the top of the form that corresponds to the quarter
reported.

A paid preparer must sign Form 941-SS and provide the
information in the Paid Preparer Use Only section of Part 5 if
the preparer was paid to prepare Form 941-SS and isn't 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.

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-SS 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.

If you’re 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. For more information about
applying for a PTIN online, visit the IRS website at IRS.gov/
ptin. You can't use your PTIN in place of the EIN of the tax
preparation firm.

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’ve shared with
your designee about math errors and return preparation. The
IRS won't send notices to your designee.

Generally, don't complete this section if you’re filing the
return as a reporting agent and have a valid Form 8655 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.

You’re not authorizing your designee to bind you to
anything (including additional tax liability) or to otherwise
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Instructions for Form 941-SS (Rev. 1-2017)

How to Order Forms, Instructions,
and Publications from the IRS
Visit IRS.gov/orderforms

Instructions for Form 941-SS (Rev. 1-2017)

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