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a reduced COBRA premium in the quarter as one individual,

reported on Form 941-X on any amended Schedule B (Form

whether or not the reduced premium was for insurance that

941) you file.

covered more than one assistance eligible individual. For

If you owe tax and are filing a late Form 941-X, that is, after

example, if the reduced COBRA premium was for coverage for

the due date for Form 941 for the quarter in which you

a former employee, spouse, and two children, you would

discovered the error, you must file an amended Schedule B

include one individual in the number entered on line 18b for the

(Form 941) with the Form 941-X. Otherwise, the IRS may

premium assistance reported on line 18a. Further, each

assess an “averaged” FTD penalty.

individual is reported only once per quarter. For example, an

Payment methods. You may pay the amount you owe on

assistance eligible individual who made monthly premium

line 20 electronically using the Electronic Federal Tax Payment

payments during the quarter would only be reported as one

System (EFTPS), by credit or debit card, or by a check or

individual on line 18b for that quarter.

money order.

•

Enter in column 2 on line 18b the number of assistance

The preferred method of payment is EFTPS. For more

eligible individuals provided COBRA premium assistance

information, visit , call EFTPS Customer Service

originally reported on line 12b of Form 941.

at 1-800-555-4477 toll free, or get Pub. 966, The Secure Way to

Pay Your Federal Taxes.

Lines 18c and 18d apply only to the second quarter of

•

To pay by credit or debit card, visit the IRS website at

2010. These lines are used to report the number of

qualified employees, amount of exempt wages/tips, and

CAUTION

•

If you pay by check or money order, make it payable to

amount of employer social security tax exemption as if the

“United States Treasury.” On your check or money order, be

exemption were allowed for the first quarter of 2010.

sure to write your EIN, “Form 941-X,” and the quarter and year

18c. Number of Qualified Employees Paid

corrected.

Exempt Wages/Tips March 19-31

Do not use a federal tax deposit coupon (Form 8109 or

Complete this line when correcting Form 941 for the 2nd

Form 8109-B) to make a payment with Form 941-X.

quarter of 2010 only. Enter on line 18c the corrected number of

CAUTION

qualified employees paid exempt wages/tips from March 19,

You do not have to pay if the amount you owe is less than

2010, through March 31, 2010. Include only qualified

$1.

employees for which you are claiming the exemption. For the

Previously assessed FTD penalty. If line 20 reflects

definition of qualified employee, see the instructions for line

overreported tax and the IRS previously assessed a

11a.

failure-to-deposit (FTD) penalty, you may be able to reduce the

18d. Exempt Wages/Tips Paid to Qualified

penalty. For more information, see the Instructions for Schedule

Employees March 19-31

B (Form 941).

Complete this line when correcting Form 941 for the 2nd

Part 4: Explain Your Corrections for This

quarter of 2010 only. Enter on line 18d the amount of exempt

Quarter

wages/tips paid to qualified employees from March 19, 2010,

through March 31, 2010. For the definition of exempt wages/

tips, see the instructions for line 11a. Enter the corrected

21. Correction of Both Underreported and

amount in column 1. In column 2, enter the amount you

Overreported Amounts

originally reported or as previously corrected. In column 3, enter

the difference between columns 1 and 2. If the amount in

Check the box on line 21 if any corrections you entered in

column 2 is larger than the amount in column 1, use a minus

column 3 on lines 6 through 18d reflect both underreported and

overreported amounts.

enter the result in column 4. However, to properly show the

Example: If you had an increase to social security wages of

correction as a credit or balance due item, enter a positive

$15,000 for employee A and a decrease to social security

number in column 3 as a negative number in column 4 or a

wages of $5,000 for employee B, you would enter $10,000 on

negative number in column 3 as a positive number in column 4.

line 8, column 3. That $10,000 represents the net change from

corrections.

19–20. Total

On line 23, you must explain the reason for both the $15,000

Combine column 4 lines 16 – 18d and enter the result on line 19.

increase and the $5,000 decrease.

Copy the amount from line 19 on page 1 to line 20 on page 2.

22. Did You Reclassify Any Workers?

Your credit. If the amount entered on line 20 is less than zero,

for example, “-115.00,” you have a credit because you

Check the box on line 22 if you reclassified any workers to be

overreported your federal employment taxes.

independent contractors or nonemployees. Also check this box

•

If you checked the box on line 1, include this amount on line

if the IRS (or you) determined that workers you treated as

11 (“Total deposits”) of Form 941 for the quarter during which

independent contractors or nonemployees should be classified

you filed Form 941-X or line 10 of Form 944 for the year during

as employees. On line 23, give us a detailed reason why any

which you filed Form 941-X. Do not make any changes to your

worker was reclassified and, if you used section 3509 rates on

record of federal tax liability reported on line 17 of Form 941 or

lines 13 through 15, for any worker reclassified as an employee,

Schedule B (Form 941), if your Form 941-X is filed timely. The

explain why section 3509 rates apply and what rates you used.

amounts reported on the record should reflect your actual tax

Return not filed because you did not treat any workers as

liability for the period.

employees. If you did not previously file Form 941 because

•

If you checked the box on line 2, you are filing a claim for

you mistakenly treated all workers as independent contractors

refund or abatement of the amount shown.

or as nonemployees, file a Form 941 for each delinquent

If your credit is less than $1, we will send a refund or apply it

quarter.

only if you ask us in writing to do so.

On each Form 941 for which you are entitled to use section

Amount you owe. You must pay the amount you owe when

3509 rates:

•

you file Form 941-X. You may not use any credit that you show

Write “Misclassified Employees” in dark, bold letters across

on another Form 941-X to pay the amount you owe, even if you

the top margin of page 1,

•

filed for the amount you owe and the credit at the same time.

Enter a zero on line 10 (“Total taxes after adjustment for

advance EIC”),

If you owe tax and are filing a timely Form 941-X, do not file

•

Complete the signature area, and

an amended Schedule B (Form 941) unless you were assessed

•

Attach a completed Form 941-X (see instructions below).

an FTD penalty caused by an incorrect, incomplete, or missing

Schedule B (Form 941). Do not include the tax increase

On each Form 941-X:

-9-

Instructions For Form 941-X - Adjusted Employer'S Quarterly Federal Tax Return Or Claim For Refund - 2010 Page 10

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