Form Il-941-X - Amended Illinois Withholding Income Tax Return - 2014
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Illinois Department of Revenue
Form IL-941-X
2014
Amended Illinois Withholding Income Tax Return
Step 1: Provide your information
Reporting Period
If you are a quarterly filer:
___ ___
___ ___ ___ ___ ___ ___ ___
___ ___ ___
Check the quarter you are amending.
Federal employer identification number (FEIN)
Seq. number
Check this
1st
____________________________________________________________
(January, February, March)
box if your
Business name
business
2nd
(April, May, June)
name has
____________________________________________________________
changed.
3rd
(July, August, September)
C/O
Check this
____________________________________________________________
4th
(October, November, December)
box if you
Mailing address
have an
If you are an annual filer:
address
______________________________
_______
__________________
Check the box if you are amending an annual return.
change.
City
State
ZIP
January — December
Step 2: Tell us about your business
A
If your business has permanently stopped withholding because it has closed or you
A
no longer pay wages, check the box and write the date you stopped paying wages.
__ __ / __ __ / 2014
Month
Day
Step 3: Tell us your payroll information
Column A
Column B
Most recent amount reported
Corrected amount
1
Write the total amount subject to Illinois withholding tax this reporting period,
1 __________________ 1 __________________
including payroll, compensation, and other amounts. See instructions.
Step 4: Tell us your withholding and previous overpayments
2
2 __________________
2 __________________
Write the amount of Illinois Income Tax actually withheld for this period.
If applicable, attach W-2-C forms.
3
Write the total of all overpayments (whether or not received)
3 __________________
you reported on your original return or previously filed IL-941-X.
4
4 __________________
Add Column B, Lines 2 and 3 and write the total amount here.
Step 5: Tell us about your payments and credits
5
Write the total amount of withholding payments you have made during this
period. This includes all IL-501 payments (electronic and paper coupons), as
5 __________________ 5 __________________
well as any subsequent payments. Do not include any penalty or interest paid.
6
6 __________________ 6 __________________
Write the amount of any credit carried forward from any prior period.
7
7 __________________
7 __________________
Write the total amount of credits you have received through DCEO.
8
8 __________________ 8 __________________
Add Lines 5 through 7 and write the total amounts here.
Step 6: Figure your credit or the amount you owe
9
If Line 4 is greater than Column B, Line 8, subtract Column B, Line 8, from Line 4. This is your remaining
balance due. Make your payment electronically (semi-weekly payers must pay electronically) or your
9 _________________
remittance payable to “Illinois Department of Revenue” and go to Step 7.
10
10 _________________
If Line 4 is less than Column B, Line 8, subtract Line 4 from Column B, Line 8. This is your overpayment.
Note: You must complete Line 11.
11
Check the appropriate box to tell us what to do with your overpayment and
Credit
complete the Overpayment Worksheet on Page 2 to explain the reason
for your overpayment. Note: Checking the refund box does not guarantee a refund.
Refund
Step 7: Sign here
Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete.
_________________________________
(____)________________ __ __ / __ __ / __ __ __ __
Check this box if we may
Signature
Daytime telephone number
Month
Day
Year
discuss this return with the
preparer shown in this step.
___________________________________(____)________________ __ __ / __ __ / __ __ __ __
Name of Preparer (Please print)
Daytime telephone number
Month
Day
Year
ILLINOIS DEPARTMENT OF REVENUE
Mail to:
NS
DR
PO BOX 19016
SPRINGFIELD IL 62794-9016
IL-941-X Page 1 (R-12/13)
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