Form Il-941 - Illinois Withholding Income Tax Return - 2017
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Illinois Department of Revenue
Form IL-941
2017
Illinois Withholding Income Tax Return
File only one Form IL-941 per quarter. Make your payments using IL-501.
Step 1: Provide your information
Check this
Reporting Period
box if this is
0
0
0
your first
___ ___
___ ___ ___ ___ ___ ___ ___
___ ___ ___
Check the quarter you are reporting.
return.
Federal employer identification number (FEIN)
Seq. number
1st
(January/February/ March)
Check this
____________________________________________________________
due May 1, 2017
box if your
Business name
business
2nd
(April/May/June)
name has
due July 31, 2017
changed.
____________________________________________________________
3rd
(July/August/September)
C/O
Check this
box if your
due October 31, 2017
____________________________________________________________
address
4th
(October/November/December)
has
Mailing address
changed.
due January 31, 2018
______________________________
_______
__________________
City
State
ZIP
Step 2: Tell us about your business
A
Enter the total number of W-2 forms reporting Illinois withholding you were required to issue for
the entire year. Only complete this line when you file your 4th quarter or final return.
A _________________
B
If your business has permanently stopped withholding because it has closed, or you no
longer pay Illinois wages or withhold Illinois taxes from other payments, check Box B and
enter the date you stopped withholding.
B
__ __ / __ __ / 2017
Month
Day
C
Check Box C if
you are not subject to the Illinois Secure Choice Savings Program Act (820 ILCS 80/), or
•
you are subject to the Illinois Secure Choice Savings Program Act (820 ILCS 80/) and you offer
•
a qualified retirement savings plan, such as a pension or 401(k), to your employees.
For more information, see the instructions or go to illinoisretirement.gov.
C
Step 3: Tell us about the amount subject to withholding
1
Enter the total dollar amount subject to Illinois withholding tax this reporting period, including
1 _________________
payroll, compensation, and other amounts. See instructions.
Step 4: Tell us about the amount withheld
2
Enter the exact amount of Illinois Income Tax you actually withheld from your employees or others on the date
you paid the compensation. Only enter amounts on days you made withholding - leave the remaining “Day” lines
blank. If you withheld no Illinois Income Tax during the month, enter “0” on the corresponding “Total” line - Line 2a,
2c, or 2d (noted by “ ”).
2a First month of quarter
(i.e., January for 1st quarter; April for 2nd quarter; July for 3rd quarter; and October for 4th quarter)
Day
Amount
Day
Amount
Day
Amount
Day
Amount
____________.___
____________.___
____________.___
____________.___
1
9
17
25
____________.___
____________.___
____________.___
____________.___
2
10
18
26
____________.___
____________.___
____________.___
____________.___
3
11
19
27
____________.___
____________.___
____________.___
____________.___
4
12
20
28
____________.___
____________.___
____________.___
____________.___
5
13
21
29
____________.___
____________.___
____________.___
____________.___
6
14
22
30
____________.___
____________.___
____________.___
____________.___
7
15
23
31
____________.___
____________.___
____________.___
8
16
24
____________.___
Total Illinois Income Tax withheld this month. (Add Section 2a, Lines 1-31.)
2a
This form is authorized as outlined under the Illinois Income Tax Act. Disclosure of
*177100001*
this information is required. Failure to provide information could result in a penalty.
Continue on the next page.
IL-941 front (R-12/16)
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