860510
Schedule R (Form 940):
Allocation Schedule for Aggregate Form 940 Filers
OMB No. 1545-0028
(December 2010)
Department of the Treasury — Internal Revenue Service
Report for calendar year:
Employer identification number
—
(Same as Form 940):
(EIN)
Name as shown on
Form 940
Read the separate instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate
line for the allocated amounts of each of your clients.
(c)
(a)
(b)
(d)
(e)
(f)
(g)
State
Total taxable FUTA
Client’s Employer
Total adjustments
Credit reduction
Total FUTA tax
Total FUTA tax
abbreviation
wages allocated to
Identification Number
to FUTA tax
amount allocated
after adjustments
deposits from line
from line 1a
the listed client EIN
(EIN)
allocated to the
to the listed client
allocated to the
13 of Form 940
of Form 940
from line 7 of
listed client EIN from
EIN from line 11 of
listed client EIN from
plus any payment
or line 1 of
Form 940
line 9 or line 10 of
Form 940
line 12 of Form 940
made with the
Schedule A
Form 940
return allocated to
(Form 940)
the listed client EIN
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1
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2
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3
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4
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5
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6
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7
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8
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9
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10
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11
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12
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13
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14
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15
16
Subtotal for clients.
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Add all amounts on lines 1
through 15
17
Enter the combined
subtotal from line 26 of
all Continuation Sheets
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for Schedule R (Form
940)
18
Enter Form 940 amounts
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for employees of the
agent
19
Totals. Add lines 16, 17,
and 18. The column totals
must match the related
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lines on the aggregate
Form 940
For Paperwork Reduction Act Notice, see the instructions.
Schedule R (Form 940) (12-2010)
Cat. No. 53082A