Form Il-941 - Information And Instructions - 2016 Page 6

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Form IL-941 Information and Instructions
Form IL-941 Step-by-Step Instructions
Follow the instructions on the form. Remember to complete each line using the total for the full reporting period. Do not file
more than one Form IL-941 per reporting period.
Step 1: Provide your information
Enter your information and check any box that is applicable.
Where do I get help?
Note: Your sequence number should be “000” unless you have been assigned a
• Visit our website at tax.illinois.gov
different sequence number when you registered.
• Call us at 1 800 732-8866 or
Reporting Period — Complete this section.
217 782-3336
Check the correct quarter you are reporting (even if you have no withholding to
• Call our TDD (telecommunications
report). File one return for each quarter. Do not file an annual return.
device for the deaf) at 1 800 544-5304
Step 2: Tell us about your business
• Write to
Complete Items A and B only if this is your 4th quarter return or you have
ILLINOIS DEPARTMENT OF REVENUE
permanently stopped withholding and this is your final return.
PO BOX 19044
Item A — Enter the total number of W-2 forms reporting Illinois withholding you
SPRINGFIELD IL 62794-9044
were required to issue for the entire year.
Item B — Check this box if applicable.
Item C — Illinois Secure Choice Savings Program - complete Worksheet 1
below.
Worksheet 1 - Illinois Secure Choice Savings Program Requirements
Complete this worksheet to find out if you should check Box C.
1. Are you subject to the Illinois Secure Choice Savings Program Act (820 ILCS 80/)? Answer the following questions.
YES NO
Do you employ fewer than 25 people?
YES NO
Have you been in business less than 2 years?
If you answered “YES” to either of the questions, you are not subject to the Illinois Secure Choice Savings
Program Act, check Box “C” on your Form IL-941.
If you answered “NO” to both questions, continue to Number 2.
2. If you are subject to the Illinois Secure Choice Savings Program Act, do you offer a “qualified” retirement
savings plan, such as a pension or 401(k), to your employees? (A “qualified” plan is a plan that meets the
requirements for Section 401(a), Section 401(k), Section 403(a), Section 403(b), Section 408(k), Section
408(p), or Section 457(b) of the Internal Revenue Code of 1986.)
YES NO
If you answered “YES,” check Box “C” on your Form IL-941.
If you answered “NO,” you will be contacted by the Illinois Secure Choice Savings Program. You are required
to either
participate in the Illinois Secure Choice Savings Program, which will begin a phase enrollment in 2018, OR
begin offering a qualified retirement savings plan to your employees.
illinoisretirement.gov.
After enrollment in the Illinois Secure Choice Program
For more information, go to
is available, failure to comply may result in assessment of fees and penalties.
Step 3: Tell us about the amount subject to withholding
Line 1 — Enter the total of all amounts subject to Illinois withholding income tax (either required or by voluntary agreement)
including payroll, compensation, gambling winnings (such as Illinois Lottery winnings), amounts paid to purchase the rights
to Illinois Lottery winnings, or any other non-wage income. Do not leave blank - if you had no amount subject to Illinois
withholding, enter zero.
IL-941 Instructions (R-12/16)
Page 6 of 9

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