Looking for a Form 941-x Templates? Download it for free!

Alternative signature method. Corporate officers or duly

Paperwork Reduction Act Notice We ask for the information

authorized agents may sign Form 941-X by rubber stamp,

on Form 941-X to carry out the Internal Revenue laws of the

mechanical device, or computer software program. For details

United States. We need it to figure and collect the right amount

and required documentation, see Rev. Proc. 2005-39. You can

of tax. Subtitle C, Employment Taxes, of the Internal Revenue

find Rev. Proc. 2005-39, 2005-28 I.R.B. 82, at

Code imposes employment taxes on wages, including income

tax withholding. This form is used to determine the amount of

taxes that you owe. Section 6011 requires you to provide the

Paid Preparer Use Only

requested information if the tax is applicable to you.

A paid preparer must sign Form 941-X and provide the

You are not required to provide the information requested on

information in the Paid Preparer Use Only section of Part 5 if

a form that is subject to the Paperwork Reduction Act unless

the preparer was paid to prepare Form 941-X and is not an

the form displays a valid OMB control number. Books and

employee of the filing entity. Paid preparers must sign paper

records relating to a form or instructions must be retained as

returns with a manual signature. The preparer must give you a

long as their contents may become material in the

copy of the return in addition to the copy to be filed with the

administration of any Internal Revenue law.

IRS.

The time needed to complete and file Form 941-X will vary

If you are a paid preparer, enter your Preparer Tax

depending on individual circumstances. The estimated average

Identification Number (PTIN) in the space provided. Include

time is:

your complete address. If you work for a firm, enter the firm’s

name and the EIN of the firm. You can apply for a PTIN online

Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . .

16 hr., 15 min.

or by filing Form W-12, IRS Paid Preparer Tax Identification

Learning about the law or the form . . . . . . . . . . . . .

30 min.

Number (PTIN) Application. For more information about

Preparing and sending the form to the IRS . . . . . . . .

47 min.

applying for a PTIN online, visit the IRS website at

You cannot use your PTIN in place of the EIN

If you have comments concerning the accuracy of these time

of the tax preparation firm.

estimates or suggestions for making Form 941-X simpler, we

would be happy to hear from you. You can email us at:

Generally, you are not required to complete this section if

taxforms@irs.gov. Enter ‘‘Form 941-X Comment’’ on the subject

you are filing the return as a reporting agent and have a valid

line. Or write to: Internal Revenue Service, Tax Products

Form 8655, Reporting Agent Authorization, on file with the IRS.

Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111

However, a reporting agent must complete this section if the

Constitution Ave. NW, IR-6526, Washington, DC 20224. Do not

reporting agent offered legal advice, for example, advising the

send Form 941-X to this address. Instead, see Where Should

client on determining whether its workers are employees or

You File Form 941-X? on page 3.

independent contractors for federal tax purposes.

How Can You Order Forms and

Publications from the IRS?

Call 1-800-829-3676.

Visit the IRS website at

Additional Information

You may find the following products helpful when using Form

941-X.

•

Form W-2, Wage and Tax Statement

•

Form W-3, Transmittal of Wage and Tax Statements

•

Instructions for Forms W-2 and W-3

•

Form W-2AS, American Samoa Wage and Tax Statement

•

Form W-2CM, Wage and Tax Statement (Northern Mariana

Islands)

•

Form W-2GU, Guam Wage and Tax Statement

•

Form W-2VI, U.S. Virgin Islands Wage and Tax Statement

•

Form W-3SS, Transmittal of Wage and Tax Statements

•

Instructions for Forms W-2AS, W-2GU, W-2VI, and W-3SS

•

Form W-2c, Corrected Wage and Tax Statement

•

Form W-3c, Transmittal of Corrected Wage and Tax

Statements

•

Instructions for Forms W-2c and W-3c

•

Form W-11, Hiring Incentives to Restore Employment (HIRE)

Act Employee Affidavit

•

Instructions for Form 843

•

Instructions for Form 941

•

Instructions for Schedule B (Form 941)

•

Instructions for Form 941-SS

•

Pub. 15 (Circular E), Employer’s Tax Guide

•

Pub. 80 (Circular SS), Federal Tax Guide for Employers in

the U.S. Virgin Islands, Guam, American Samoa, and the

Commonwealth of the Northern Mariana Islands

•

Pub. 966, The Secure Way to Pay Your Federal Taxes

-11-

Instructions for Form 941-X (Rev. 1-2011)

Instructions For Form 941-X - Adjusted Employer'S Quarterly Federal Tax Return Or Claim For Refund - 2011 Page 12

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