Form Il-941-X - Amended Illinois Quarterly Withholding Tax Return Form - State Of Illinois
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Illinois Department of Revenue
IL-941-X
Amended Illinois Quarterly Withholding Tax Return
Read this information first.
Which parts must I complete?
Everyone must complete Steps 1, 3, and 4 to report changes to any
You must complete this form to report corrections to your Form IL‑941.
amounts previously reported on Form IL‑941. Complete Step 2 only if
When is Form IL-941-X due?
you are making changes to tax withheld from payments to a recipient.
You should report any increases in your tax due as soon as possible
What if I need additional assistance?
to minimize penalties and interest. If your change decreases your tax
If you need assistance, visit our web site at tax.illinois.gov; call our
due, you must file Form IL‑941‑X no later than
Taxpayer Assistance Division at 1 800 732-8866 or 217 782-3336;
• three years after the 15th day of the 4th month following the close
or call our TDD (telecommunications device for the deaf) at
of the calendar year in which the tax was withheld, or
1 800 544-5304. Our office hours are 8 a.m. to 5 p.m.
• one year after the date the tax was paid.
Step 1: Complete the following account information
_______________________________________________________
___ ___ ‑ ___ ___ ___ ___ ___ ___ ___
___ ___ ___
Business name
Federal employer identification number (FEIN)
Seq. number
_______________________________________________________
___ ___ ___ ___ / ___ ___
Owner(s)
Tax year
Quarter
_______________________________________________________
Are you a sole proprietor?
Yes
No
Number and street address
If “yes”, write your
_______________________________________________________
Social Security number ___ ___ ___ ‑ ___ ___ ‑ ___ ___ ___ ___
City
State
ZIP
(
)
_______________________________________________________
Is this a new address?
Yes
No
Daytime telephone number
Step 2: Complete recipient information
(Complete only if you are making changes to taxes withheld from payments to a recipient.)
Complete Columns A through E to correct withholding errors on your most recently filed IL‑941 for the current year only. See Publication 131,
Withholding Income Tax Filing and Payment Requirements.
Column A
Column B
Column C
Column D
Column E
Recipient’s Social Security
Recipient’s name and
Amount previously reported on
Net change
number (SSN)
state of residency
W‑2, W‑2G, and 1099 forms
increase or (decrease)
Corrected amount
1
‑
‑
__________________________
________________
________________
________________
___ ___ ___
___ ___
___ ___ ___ ___
‑
‑
__________________________
________________
________________
________________
___ ___ ___
___ ___
___ ___ ___ ___
‑
‑
__________________________
________________
________________
________________
___ ___ ___
___ ___
___ ___ ___ ___
‑
‑
__________________________
________________
________________
________________
___ ___ ___
___ ___
___ ___ ___ ___
If you need additional space, attach a sheet that follows this format.
2
2
________________
Add Column C and write the result.
3
3
Add Column D and write the result here and on Step 3, Line 6, Column B.
________________
4
4 __ __ / __ __ / __ __ __ __
Were W‑2‑Cs issued?
Yes
No If “yes,” write the date the W‑2‑Cs were issued.
Month
Day
Year
Step 3: Figure your correct withholding
Column A
Column B
Column C
Amount previously
Net change
reported
increase or (decrease)
Corrected amount
5
Write the amount of compensation and gambling winnings
5
(including Illinois lottery winnings) subject to withholding.
_______________
________________
________________
6
Write the total Illinois Income Tax required to be withheld.
6
(If applicable, complete Step 2 before you write an entry.)
_______________
________________
________________
7
Write the total amount of payments (i.e., electronic and Forms IL‑501
7
and IL‑941), plus any credit or overpayment from a previous quarter.
_______________
________________
________________
8
If Line 6, Column C, is more than Line 7, Column C, write the difference.
8
________________
This is the amount of tax you owe. Make your remittance payable to “Illinois Department of Revenue.”
You may be assessed penalties and interest if this amended return is filed after the due date
of your original Form IL‑941. If so, we will send you a notice.
9
9
If Line 6, Column C, is less than Line 7, Column C, write the difference. This is the amount of your overpayment.
________________
You must answer the following questions.
a
Do you want your overpayment applied to a subsequent quarter?
Yes
No
If “yes”, write the year and quarter.
___ ___ ___ ___ / ___ ___
Tax year
Quarter
b
Do you want your overpayment to be refunded to you?
Yes
No
If you have an unpaid liability for any Illinois tax, your overpayment will be applied to that liability. Any remaining overpayment will be
applied as you specified on Line 9a or 9b.
1 0
Write a detailed explanation of your changes
(e.g., Step 3, Line 5, Column B, is a decrease in wages and tax previously reported for this quarter) .
_____________________________________________________________________________________________________________
_____________________________________________________________________________________________________________
Step 4: Sign below
Under penalties of perjury, I state that I have examined this form and, to the best of my knowledge, it is true, correct, and complete.
_________________________________ __________________________ __________ __________________
(
)
Authorized signature (full name required)
Title
Date
Daytime telephone number
Mail this return to: Illinois Department of Revenue, P.O. Box 19007, Springfield, IL 62794-9007
This form is authorized as outlined by the Illinois Income Tax Act. Disclosure of this information is REQUIRED. Failure to provide
IL‑941‑X (R‑12/07)
information could result in a penalty. This form has been approved by the Forms Management Center.
IL‑492‑0048
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