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

Allocation Schedule for Aggregate Form 941 Filers

(Rev. June 2020)

Department of the Treasury — Internal Revenue Service

Employer identification number (EIN)

950420

Schedule R (Form 941):

Report for calendar year:

OMB No. 1545-0029

Check the quarter (same as Form 941):

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1: January, February, March
Name as shown on Form 941

2: April, May, June

Type of filer (check one):

Section 3504 Agent

CPEO

3: July, August, September

Other Third Party

Read the instructions before you complete Schedule R. Type or print within the boxes. Complete a separate line for the amounts
allocated to each of your clients. The term “client” as used on this form includes the term “customer.” See the instructions.
(a) Client’s EIN

(b) Type of wages
(CPEO only)

(c) Form 941, line 1

(d) Form 941, line 2

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6 Subtotals for clients. Add lines 1 through 5
7 Enter the combined subtotal from line 9 of
all Continuation Sheets for Schedule R

8 Enter Form 941 amounts for your employees
9 Totals. Add lines 6, 7, and 8.
(j) Form 941, line 11a

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(r) Form 941, line 13f

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(k) Form 941, line 11b

(l) Form 941, line 11c

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(s) Form 941, line 19

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(t) Form 941, line 20

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For Paperwork Reduction Act Notice, see the separate instructions.

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(e) Form 941, line 3

4: October, November, December

(f) Form 941, line 5a(i), (g) Form 941, line 5a(ii), (h) Form 941, line 5e
column 1
column 1

(i) Form 941, line 5f

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(m) Form 941, line 12

(n) Form 941, line 13a

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(u) Form 941, line 21

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(v) Form 941, line 22

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www.irs.gov/Form941

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(o) Form 941, line 13b

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(w) Form 941, lines 5a
and 5b, column 2, total

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Cat. No. 49301K

(p) Form 941, line 13c

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(x) Form 941, line 24

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(q) Form 941, line 13d

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(y) Form 941, line 25

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Schedule R (Form 941) (Rev. 6-2020)

Page

of

950520

Continuation Sheet for Schedule R (Form 941)

Report for calendar year:

(Rev. June 2020)
Employer identification number (EIN)

Check the quarter (same as Form 941):

—

1: January, February, March
Name as shown on Form 941
Type of filer (check one):

2: April, May, June
Section 3504 Agent

CPEO

3: July, August, September

Other Third Party

4: October, November, December
(a) Client’s EIN

(b) Type of wages
(CPEO only)

(c) Form 941, line 1

(d) Form 941, line 2

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8

(e) Form 941, line 3

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(f) Form 941, line 5a(i), (g) Form 941, line 5a(ii), (h) Form 941, line 5e
column 1
column 1

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(i) Form 941, line 5f

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9 Subtotals for clients. Add lines 1 through 8.
Include the subtotals from this line on
Schedule R, Page 1, line 7.

(j) Form 941, line 11a

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9

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(r) Form 941, line 13f

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(k) Form 941, line 11b

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(s) Form 941, line 19

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(l) Form 941, line 11c

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(t) Form 941, line 20

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(m) Form 941, line 12

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(u) Form 941, line 21

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(n) Form 941, line 13a

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(v) Form 941, line 22

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(o) Form 941, line 13b

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(w) Form 941, lines 5a
and 5b, column 2, total

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(p) Form 941, line 13c

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(x) Form 941, line 24

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(q) Form 941, line 13d

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(y) Form 941, line 25

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Schedule R (Form 941) (Rev. 6-2020)