Schedule R (Form 943) - Allocation Schedule For Aggregate Form 943 Filers
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3Schedule R (Form 943):
Allocation Schedule for Aggregate Form 943 Filers
OMB No. 1545-0035
(December 2017)
Department of the Treasury — Internal Revenue Service
Report for calendar year:
(Same as Form 943):
Employer identification number (EIN)
—
Name as shown on Form 943
Type of filer (check one):
Section 3504 Agent
Certified Professional Employer Organization (CPEO)
Read the instructions before you complete Schedule R. Type or print within the boxes. Complete a separate line for the amounts allocated to each of your clients. The term “client” as used on this form
includes the term “customer.” See the instructions.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
(h)
(i)
Client’s
Type of wages
Social security tax
Medicare tax allocated
Additional Medicare
Federal income tax
Qualified small business
Total taxes
Total deposits
Employer
and other
allocated to the
to the listed client EIN
Tax withholding
withheld allocated
payroll tax credit for
after adjustments and
from Form 943, line 14,
identification
compensation
increasing research
credits
listed client EIN from
from Form 943, line 5
allocated to the
to the listed
plus any payments
number (EIN)
(CPEO Use Only)
Form 943, line 3
listed client EIN from
client EIN from
activities allocated to the
allocated to the
made with the return
Form 943, line 7
Form 943, line 8
listed client EIN from
listed client EIN from
allocated to the
Form 943, line 12
Form 943, line 13
listed client EIN
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Subtotals for
clients. Add all
amounts on lines
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1 through 10
12
Enter the
combined
subtotal from
line 24 of all
Continuation
Sheets for
Schedule R
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13
Enter Form 943
amounts for
your
agricultural
employees
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14
Totals. Add lines
11, 12, and 13.
The column
totals must
match the
related lines on
the aggregate
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Form 943.
For Paperwork Reduction Act Notice, see the instructions.
Cat. No. 69329E
Schedule R (Form 943) (12-2017)
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