Form Il-941 - Illinois Withholding Income Tax Return - 2016
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Illinois Department of Revenue
Form IL-941
2016
Illinois Withholding Income Tax Return
File electronically using MyTax Illinois at tax.illinois.gov. Do not mail this form if you file electronically.
Quarterly filers: File only one IL-941 return per quarter. Make your payments using IL-501.
Reporting Period
Step 1: Provide your information
Check this
If you are a quarterly filer:
box if this is
Check the quarter you are reporting.
0
0
0
your first
___ ___
___ ___ ___ ___ ___ ___ ___
___ ___ ___
return.
1st
(January, February, March)
Federal employer identification number (FEIN)
Seq. number
due May 2, 2016
Check this
2nd
____________________________________________________________
(April, May, June)
box if your
due August 1, 2016
Business name
business
3rd
name has
(July, August, September)
changed.
____________________________________________________________
due October 31, 2016
4th
(October, November, December)
C/O
Check this
due January 31, 2017
box if your
____________________________________________________________
If you are an annual filer:
address
has
Mailing address
Check the box if you are not required to file quarterly.
changed.
January — December
______________________________
_______
__________________
due January 31, 2017
City
State
ZIP
Step 2: Tell us about your W-2 forms and your business
A
Enter the total number of W-2 forms reporting Illinois withholding, you were required to issue for the
A __________________
entire year. (Quarterly filers — Only complete this line when you file your 4th quarter or final return.)
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 the box and enter the date
B
you stopped withholding.
__ __ / __ __ / 2016
Month
Day
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 payroll,
1 __________________
compensation, and other amounts. See instructions.
Step 4: Tell us about the amount withheld
(Do not leave this line blank. )
2
Enter the total dollar amount of Illinois Income Tax actually withheld from your employees or others for this
2 __________________
reporting period.
Step 5: Tell us about your payments and credits
3
Enter the total dollar amount of withholding payments you made to the Illinois Department of Revenue (IDOR)
3 __________________
for this period. This includes all IL-501 payments (electronic and paper coupons). Do not estimate this amount.
4
Enter the amount of IDOR-approved credit you are using this period. Credits are only valid if you have
4 __________________
received written confirmation from IDOR. See instructions.
5
5 __________________
Enter the amount of credit through DCEO you are using this period. See instructions.
6
6 __________________
Add Lines 3, 4, and 5 and enter the total amount here.
Step 6: Figure your balance
7
If Line 2 is greater than Line 6, subtract Line 6 from Line 2. This is your remaining
balance due. Make your payment electronically or make your remittance payable
7 __________________
to “Illinois Department of Revenue.” (Semi-weekly payers must pay electronically.)
8
If Line 2 is less than Line 6, subtract Line 2 from Line 6. IMPORTANT: This amount is not available for use on
future IL-941 returns until you receive written verification of this amount as an IDOR-approved credit. See
8 __________________
instructions for requesting a refund or for more information.
Step 7: Sign here
Check this box if we may
discuss this return with the
Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete.
preparer shown in this step.
___________________________________(____)________________ __ __ / __ __ / __ __ __ __
Signature
Daytime telephone number
Month
Day
Year
___________________________________ _____________________ (____)________________ __ __ / __ __ / __ __ __ __
Paid Preparer (please print)
PTIN
Daytime telephone number
Month
Day
Year
NS
DR_______________
ILLINOIS DEPARTMENT OF REVENUE
Mail to:
PO BOX 19052
*IL-941*
SPRINGFIELD IL 62794-9052
IL-941 (R-12/15)
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