Schedule R (Form 941) - Allocation Schedule For Aggregate Form 941 Filers - 2013
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Schedule R (Form 941):
Allocation Schedule for Aggregate Form 941 Filers
OMB No. 1545-0029
(Rev. January 2013)
Report for calendar year:
Department of the Treasury — Internal Revenue Service
Check the quarter (same as Form 941):
Employer identification number
—
(EIN)
1: January, February, March
Name as shown on
Form 941
2: April, May, June
3: July, August, September
Read the instructions before you complete Schedule R (Form 941). Type or print within the boxes.
Complete a separate line for the amounts allocated to each of your clients.
4: October, November, December
(a)
(b)
(c)
(d)
(e)
(f)
(g)
Section 3121(q)
Total taxes after
Client’s Employer
Wages, tips, and
Total income tax
Total social security
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)
tips, and other
allocated to the listed
allocated to the listed
from Form 941, line 13,
unreported tips
listed client EIN from
client EIN from
compensation
client EIN from Form
plus any payments
allocated to the listed
Form 941, line 10
Form 941, line 2
allocated to the listed
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 all
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.
amounts on lines
1 through 15
17
Enter the
combined
subtotal from line
26 of all
Continuation
Sheets for
.
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.
Schedule R
(Form 941)
18
Enter Form 941
amounts for your
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employees
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Totals. Add lines
16, 17, and 18.
The column
totals must
match the
related lines on
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the aggregate
Form 941.
For Paperwork Reduction Act Notice, see the instructions.
Cat. No. 49301K
Schedule R (Form 941) (Rev. 1-2013)
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