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Worksheet 7. Information Needed To

its tax liability. Therefore, to figure the unused amount of

the credit allocated to patrons, the cooperative must first

Complete Line 14 (If Line 12 is More

figure its tax liability. While any excess is allocated to

Than Zero)

patrons, any credit recapture applies as if the cooperative

had claimed the entire credit.

If the cooperative is subject to the passive activity rules,

1. Enter the total enrolled employee hours of

include on line 15 any credit for small employer health

service from Worksheet 4, column

insurance premiums from passive activities disallowed for

(d)

. . . . . . . . . . . . . . . . . . . . . . . . . .

prior years and carried forward to this year. Complete

2. Hours of service per FTE

2,080

. . . . . . . . . .

Form 8810, Corporate Passive Activity Loss and Credit

3. Divide line 1 by line 2. If the result is not a

Limitations, to determine the allowed credit that must be

whole number (0, 1, 2, etc.), generally

allocated to patrons. For details, see the Instructions for

round the result down to the next

Form 8810.

lowest whole number. For example,

Estates and trusts. Allocate the credit on line 16

round 2.99 down to 2. However, if the

between the estate or trust and the beneficiaries in the

result is less than one, enter 1. Report

same proportion as income was allocated and enter the

this number on Form 8941, line 14

. . .

beneficiaries' share on line 17.

Line 15

If the estate or trust is subject to the passive activity

rules, include on line 15 any credit for small employer

Enter any credit for small employer health insurance

health insurance premiums from passive activities

premiums from:

disallowed for prior years and carried forward to this year.

Schedule K-1 (Form 1065), box 15 (code P);

Complete Form 8582-CR, Passive Activity Credit

Schedule K-1 (Form 1120S), box 13 (code P);

Limitations, to determine the allowed credit that must be

Schedule K-1 (Form 1041), box 13 (code G); and

allocated between the estate or trust and the

Form 1099-PATR, Taxable Distributions Received

beneficiaries. For details, see the Instructions for Form

From Cooperatives, box 10, or other notice of credit

8582-CR.

allocation.

Line 19

Partnerships, S corporations, cooperatives,

estates, trusts, and tax-exempt eligible small

Enter the total amount of certain payroll taxes. Payroll

TIP

employers always must report the above credits

taxes, for this purpose, mean only the following taxes.

on line 15. All other filers figuring a separate credit on

Federal income taxes the tax-exempt employer was

earlier lines also must report the above credits on line 15.

required to withhold from employees' wages in calendar

All others not using earlier lines to figure a separate credit

year 2017.

must report the above credits directly on Form 3800, Part

Medicare taxes the tax-exempt employer was required

lll, line 4h.

to withhold from employees' wages in calendar year 2017.

Medicare taxes the tax-exempt employer was required

Line 17

to pay for calendar year 2017.

Cooperatives. A cooperative described in section

1381(a) must allocate to its patrons the credit in excess of

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 and business taxpayers filing this form is approved under OMB control number 1545-0074 and 1545-0123

and is included in the estimates shown in the instructions for their individual and business income tax return. The

estimated burden for all other taxpayers who file this form is shown below.

Recordkeeping

10 hr., 51 min.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Learning about the law or the form

1 hr., 23 min.

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Preparing and sending the form to the IRS

2 hr., 46 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.

-9-

Instructions for Form 8941 (2017)

Instructions For Form 8941 - Credit For Small Employer Health Insurance Premiums - 2016 Page 9

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