Instructions For Form Ct-1 X (Rev. February 2015) Page 6

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Part 3: Enter the Corrections for the
Employee Additional Medicare Tax that you did not
withhold from your employees.
Calendar Year You Are Correcting
5. Certifying Claims
What Amounts Should You Report in Part 3?
If you are filing a claim for refund or abatement of
overreported RRTA tax and/or Tier 1 Employee Additional
On lines 6–18, columns 1 and 2, show amounts for all of
Medicare Tax and checked the box on line 2, check the
your employees, not just for those employees whose
appropriate box on line 5. You may need to check more
amounts you are correcting.
than one box. If you obtained written statements or
If a correction that you report in column 4 includes both
consents from some employees but you could not locate
underreported and overreported amounts (see the
employees or secure the statements of the remaining
instructions for line 21), provide details for each error on
employees, check all applicable boxes. Provide a
line 23.
summary on line 23 of the amount of the corrections for
the employees who provided statements or consents and
If you previously adjusted or amended Form CT-1
those who did not.
using Form CT-1 X, or because of an IRS
!
examination change, show amounts in column 2
You may not file a refund claim to correct Tier 1
CAUTION
that include those previously reported corrections.
Employee Additional Medicare Tax actually
!
withheld from employees.
CAUTION
6. Tier 1 Employer Tax—Compensation
5a. Check the box on line 5a if your overreported tax
If you are correcting the compensation (other than tips
includes overcollected Employee RRTA taxes for each
and sick pay) for the Tier 1 Employer tax you reported on
affected employee. You are certifying that you repaid or
Form CT-1, line 1, enter the total corrected amount for all
reimbursed to the employees their share of the prior year
employees in column 1. In column 2, enter the amount
Employee RRTA taxes and you received written
you originally reported. In column 3, enter the difference
statements from those employees stating that they did not
between columns 1 and 2. If you (or the IRS) previously
and will not receive a refund or credit for the prior year
corrected the amount reported on Form CT-1, line 1, enter
taxes.
in column 2 the amount after any previous corrections.
5b. Check the box on line 5b if your overreported tax
includes overcollected prior year Employee RRTA taxes
line 6 (column 1)
for each affected employee and you have not yet repaid or
-line 6 (column 2)
reimbursed the Employee RRTA taxes. You are certifying
line 6 (column 3)
If the amount in column 2 is larger than
that you received consent from each affected employee to
the amount in column 1, use a minus
file a claim on the employee share of those taxes and you
sign in column 3.
received written statements from those employees stating
that they did not and will not receive a refund or credit for
the overcollected taxes. Do not send these statements
Multiply the amount in column 3 by .062 (6.2% tax rate)
and consents to the IRS. Keep them for your records.
and enter the result in column 4.
Generally, all employment tax records must be kept for at
least 4 years.
line 6 (column 3)
In certain situations, you may not have repaid or
x
.062
reimbursed your employees or obtained their consents
line 6 (column 4)
If the amount in column 3 used a minus sign,
prior to filing a claim, such as in cases where the period of
also use a minus sign in column 4.
limitations on credit or refund is about to expire. In those
situations, file Form CT-1 X, but do not check a box on
line 5. Tell us on line 23 that you have not repaid or
Example—Tier 1 Employer compensation
reimbursed employees or obtained consents at the time
decreased. You reported $9,000 as Tier 1 Employer
you file the claim. However, you must repay or reimburse
compensation in computing the tax on line 1 of your 2013
your employees and certify that you have done so before
Form CT-1. In December of 2014, you discovered that you
the IRS can allow the claim.
included $2,000 in compensation for one of your
employees twice. To correct the error, figure the
5c. Check the box on line 5c to certify that your
difference on Form CT-1 X as shown.
overreported tax is only for the Employer RRTA taxes.
This applies when affected employees did not give you
consent to file a claim for refund for the Employee RRTA
Column 1 (corrected amount)
7,000.00
taxes, they could not be found, or they did not give you a
Column 2 (Form CT-1, line 1)
- 9,000.00
statement described on line 5b.
Column 3 (difference)
-2,000.00
5d. Check the box on line 5d to certify that your
overreported amount is only for RRTA taxes and/or Tier 1
Use the difference in column 3 to determine your tax
Employee Additional Medicare Tax that you did not
correction.
withhold from your employees.
-6-
Instructions for Form CT-1 X (Rev. 2-2015)

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