Instructions For Form 8941 - Credit For Small Employer Health Insurance Premiums - 2010 Page 8
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8Worksheet 7. FTEs Enrolled in Coverage
Line 19
Enter the passive activity credit for small employer health
1. Enter the total enrolled employee hours of
insurance premiums allowed for 2010 from Form
service from Worksheet 4, column (d) . . 1.
8582-CR or Form 8810.
2. Hours of service per FTE . . . . . . . . . . . 2.
2,080
Line 20
3. Divide line 1 by line 2. If the result is not a
Use line 20 to show any carryback if you amend your
whole number (0, 1, 2, etc.), generally
2010 return to carry back an unused credit for small
round the result down to the next lowest
employer health insurance premiums from 2011.
whole number. However, if the result is
less than one, enter 1. Report this amount
Line 22
on Form 8941, line 14 . . . . . . . . . . . . . . 3.
Cooperatives. A cooperative described in section
1381(a) must allocate to its patrons the credit in excess
of its tax liability. Therefore, to figure the unused amount
Line 15
of the credit allocated to patrons, the cooperative must
Enter any credit for small employer health insurance
first figure its tax liability. While any excess is allocated to
premiums from:
patrons, any credit recapture applies as if the cooperative
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Schedule K-1 (Form 1065), box 15 (code P),
had claimed the entire credit.
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Schedule K-1 (Form 1120S), box 13 (code P),
Estates and Trusts. Allocate the credit on line 21
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Schedule K-1 (Form 1041), box 13 (code G), and
between the estate or trust and the beneficiaries in the
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same proportion as income was allocated and enter the
Any notice of credit allocation you receive from a
beneficiaries’ share on line 22.
cooperative.
Line 24
Line 17
Enter the total amount of certain payroll taxes. Payroll
Enter the amount included on line 16 that is from a
taxes, for this purpose, means only the following taxes.
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passive activity. Generally, a passive activity is a trade or
Federal income taxes the tax-exempt employer was
business in which you did not materially participate.
required to withhold from employees’ wages in calendar
Rental activities are generally considered passive
year 2010.
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activities, whether or not you materially participate. For
Medicare taxes the tax-exempt employer was required
details, see Form 8582-CR, Passive Activity Credit
to withhold from employees’ wages in calendar year
Limitations (for individuals, trusts, and estates), or Form
2010.
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8810, Corporate Passive Activity Loss and Credit
Medicare taxes the tax-exempt employer was required
Limitations (for corporations).
to pay for calendar year 2010.
Paperwork Reduction Act Notice. We ask for the information on this form to carry out the Internal Revenue laws of
the United States. You are required to give us the information. We need it to ensure that you are complying with these
laws and to allow us to figure and collect the right amount of tax.
You are not required to provide the information requested on a form that is subject to the Paperwork Reduction Act
unless the form displays a valid OMB control number. Books or records relating to a form or its instructions must be
retained as long as their contents may become material in the administration of any Internal Revenue law. Generally,
tax returns and return information are confidential, as required by section 6103.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated
burden for individual taxpayers filing this form is approved under OMB control number 1545-0074 and is included in the
estimates shown in the instructions for their individual income tax return. The estimated burden for all other taxpayers
who file this form is shown below.
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
12 hr., 46 min.
Learning about the law or the form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1 hr., 23 min.
Preparing and sending the form to the IRS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2 hr., 48 min.
If you have comments concerning the accuracy of these time estimates or suggestions for making this form simpler,
we would be happy to hear from you. See the instructions for the tax return with which this form is filed.
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