860512
Schedule R (Form 940): Allocation Schedule for Aggregate Form 940 Filers
OMB No. 1545-0028
(Rev. December 2014)
Department of the Treasury — Internal Revenue Service
Report for calendar year:
Employer identification number
(Same as Form 940):
—
(EIN)
Name as shown on
Form 940
Read the instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate line for the
amounts allocated to each of your clients.
(a)
(b)
(c)
(d)
(e)
(f)
(g)
Client Employer
State
Total taxable FUTA
Total adjustments
Credit reduction
Total FUTA tax
Total FUTA tax
Identification Number
abbreviation
wages allocated to
to FUTA tax
amount allocated
after adjustments
deposits from
(EIN)
from Form
the listed client EIN
allocated to the
to the listed client
allocated to the
Form 940, line 13,
940, line 1a,
from Form 940, line 7
listed client EIN from
EIN from Form 940,
listed client EIN from
plus any payment
or Schedule
Form 940, line 9 or
line 11
Form 940, line 12
made with the
A (Form 940)
line 10
return allocated to
the listed client EIN
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2
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3
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4
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5
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6
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7
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8
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9
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10
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11
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12
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13
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14
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15
16
Subtotals for clients.
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Add all amounts on lines 1
through 15.
17
Enter the combined
subtotal from line 26 of
all Continuation Sheets
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for Schedule R (Form
940).
18
Enter Form 940 amounts
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for employees of the
agent.
19
Totals. Add lines 16, 17,
and 18. The column totals
must match the related
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lines on the aggregate
Form 940.
For Paperwork Reduction Act Notice, see the instructions.
Cat. No. 53082A
Schedule R (Form 940) (Rev. 12-2014)