Schedule R (Form 941) - Allocation Schedule For Aggregate Form 941 Filers - 2013 Page 2
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3950513
Page
of
Continuation Sheet for Schedule R (Form 941)
Report for calendar year:
(Rev. January 2013)
Check the quarter (same as Form 941):
1: January, February, March
Employer identification number
—
(EIN)
2: April, May, June
Name as shown on
Form 941
3: July, August, September
4: October, November, December
(a)
(b)
(c)
(d)
(e)
(f)
(g)
Client’s Employer
Wages, tips, and
Total income tax
Total social security
Section 3121(q)
Total taxes after
Total deposits and
Notice and Demand-
adjustments
Identification
other compensation
withheld from wages,
and Medicare taxes
COBRA payments
Tax due on
allocated to the
Number (EIN)
allocated to the listed
tips, and other
allocated to the listed
from Form 941, line 13,
unreported tips
listed client EIN from
compensation
client EIN from
client EIN from
plus any payments
allocated to the listed
Form 941, line 10
Form 941, line 2
allocated to the listed
Form 941, line 5e
made with the return
client EIN from
client EIN from
allocated to the listed
Form 941, line 5f
Form 941, line 3
client EIN
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Subtotals for clients.
Add lines 1 through 25.
Include the subtotals
from line 26 on line 17
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of Schedule R
(Form 941).
Schedule R (Form 941) (Rev. 1-2013)
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