Instructions For Form 941-Ss - Employer'S Quarterly Federal Tax Returnamerican Samoa, Guam, The Commonwealth Of The Northern Mariana Islands, And The U.s. Virgin Islands - 2011 Page 7
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812a. COBRA Premium Assistance
If you do not deposit as required and instead pay the
!
taxes with Form 941-SS, you may be subject to a
Payments
penalty.
CAUTION
Report on this line 65% of the COBRA premiums for
15. Overpayment
assistance eligible individuals. Take the COBRA premium
assistance credit on this line only after the assistance
If line 13 is more than line 10, enter the difference on line
eligible individual’s 35% share of the premium has been
15. Never make an entry on both lines 14 and 15.
paid. For COBRA coverage provided under a self-insured
If you deposited more than the correct amount for the
plan, COBRA premium assistance is treated as having been
quarter, you can choose to have the IRS either refund the
made for each assistance eligible individual who pays 35%
overpayment or apply it to your next return. Check only one
of the COBRA premium. Do not include the assistance
box on line 15. If you do not check either box or if you check
eligible individual’s 35% of the premium in the amount
both boxes, generally we will apply the overpayment to your
entered on this line. For more information on the COBRA
account. We may apply your overpayment to any past due
premium assistance credits, visit IRS.gov and enter the
tax account that is shown in our records under your EIN.
keyword COBRA.
If line 15 is under $1, we will send a refund or apply it to
The amount reported on line 12a is treated as a
your next return only if you ask us in writing to do so.
!
deposit of taxes on the first day of your return period
Complete Both Pages
and must not be used to adjust line 17 or Schedule B
CAUTION
(Form 941).
You must complete both pages of Form 941-SS and sign on
page 2. Failure to do so may delay processing of your
If you provided premium assistance in a prior quarter of
return.
the current year and did not report the amount of that
premium assistance on Form 941-SS for that quarter, you
may include the amount of that premium assistance in the
Part 2: Tell Us About Your Deposit
amount entered on this line, or file Form 941-X to report the
amount for the prior quarter of the current year.
Schedule and Tax Liability for this
12b. Number of Individuals Provided
Quarter
COBRA Premium Assistance on Line 12a
Enter the total number of assistance eligible individuals
17. Tax Liability for the Quarter
provided COBRA premium assistance reported on line 12a.
•
If line 10 is less than $2,500, or total taxes after
Count each assistance eligible individual who paid a
adjustments on the preceding quarterly return was less than
reduced COBRA premium in the quarter as one individual,
$2,500, and you did not incur a $100,000 next-day deposit
whether or not the reduced premium was for insurance that
obligation during the current quarter, check the appropriate
covered more than one assistance eligible individual. For
box on line 17 and go to Part 3.
example, if the reduced COBRA premium was for coverage
•
If you reported $50,000 or less in taxes during the
for a former employee, spouse, and two children, you would
lookback period (see below), you are a monthly schedule
include one individual in the number entered on line 12b for
depositor unless the $100,000 Next-Day Deposit Rule
the premium assistance. Further, each individual is reported
discussed in section 8 of Pub. 80 (Circular SS) applies.
only once per quarter. For example, an assistance eligible
Check the appropriate box on line 17 and enter your tax
individual who made monthly premium payments during the
liability for each month in the quarter. Add the amounts for
quarter would only be reported as one individual.
each month. Enter the result in the Total liability for quarter
13. Total Deposits and Credits
box.
Note that your total tax liability for the quarter must equal
Add lines 11 and 12a.
your total taxes shown on line 10. If it does not, your tax
deposits and payments may not be counted as timely. Do
14. Balance Due
not change your tax liability on line 17 by adjustments
If line 10 is more than line 13, enter the difference on line
reported on any Forms 941-X.
14. Otherwise, see Overpayment below. You do not have
You are a monthly schedule depositor for the calendar
to pay if line 14 is under $1. Generally, you should have a
year if the amount of your Form 941-SS taxes reported for
balance due only if your total taxes for the current quarter or
the lookback period is $50,000 or less. The lookback
preceding quarter are less than $2,500, and you did not
period is the four consecutive quarters ending on June 30
incur a $100,000 next-day deposit obligation during the
of the prior year. For 2011, the lookback period begins July
current quarter. However, see section 8 of Pub. 80 (Circular
1, 2009, and ends June 30, 2010. For details on the deposit
SS) for information about payments made under the
rules, see section 8 of Pub. 80 (Circular SS). If you filed
Accuracy of Deposits Rule.
Form 944-SS in either 2009 or 2010, your lookback period is
You may pay the amount shown on line 14 using EFTPS,
the 2009 calendar year.
credit card, debit card, check, money order, or EFW. Do not
The amounts reported on line 17 are a summary of
use a credit card, debit card, or EFW to pay taxes that were
!
your monthly tax liability, not a summary of deposits
required to be deposited. For more information on electronic
you made. If you do not properly report your liabilities
CAUTION
payment options, visit the IRS website at
when required or if you are a semiweekly schedule
If you pay by EFTPS, credit card, debit card, or EFW, file
depositor and report your liabilities on line 17 instead of on
your return using the Without a payment address on page 3
Schedule B (Form 941), you may be assessed an
under Where Should You File? and do not file Form 941-V,
“averaged” failure-to-deposit (FTD) penalty. See Deposit
Payment Voucher.
Penalties in section 8 of Pub. 80 (Circular SS) for more
information.
If you pay by check or money order, make it payable to
•
If you reported more than $50,000 of taxes for the
the “United States Treasury.” Enter your EIN, Form 941-SS,
lookback period (see above), you are a semiweekly
and the tax period on your check or money order. Complete
schedule depositor. Check the appropriate box on line 17.
Form 941-V(SS) and enclose it with Form 941-SS.
You must complete Schedule B (Form 941) and submit it
If line 10 is $2,500 or more and you have deposited all
with your Form 941-SS. Do not use Schedule B (Form 941)
taxes when due, the balance due on line 14 should be zero.
if you are a monthly schedule depositor.
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