Instructions For Form 943-X - 2015 (Page 6 of 13) in pdf

box on line 1, check the appropriate box on line 4. You may

In certain situations, you may not have repaid or

need to check more than one box. If you obtained written

reimbursed your employees or obtained their consents prior

statements from some employees but you could not locate

to filing a claim, such as in cases where the period of

employees or secure the statements of the remaining

limitations on credit or refund is about to expire. In those

employees, check all applicable boxes. Provide a summary

situations, file Form 943-X, but do not check a box on line 5.

on line 20 of the amount of the corrections for the employees

Tell us on line 20 that you have not repaid or reimbursed

who provided written statements and for those who did not.

employees or obtained consents at the time you file the

claim. However, you must repay or reimburse your

You may not use Form 943-X to correct

employees and certify that you have done so before the IRS

overreported amounts of Additional Medicare Tax

can allow the claim.

unless the amounts were not withheld from

CAUTION

5c. Check the box on line 5c to certify that your overreported

employee wages.

tax is only for the employer share of social security and

4a. Check the box on line 4a if your overreported amount

Medicare tax. This applies when affected employees did not

includes each affected employee share of overcollected

give you consent to file a claim for refund for the employee

taxes. You are certifying that you repaid or reimbursed the

share of social security and Medicare tax, they could not be

employee share of prior year taxes and you received written

found, or they did not give you a statement described on

statements from the employees stating that they did not and

line 5b.

will not receive a refund or credit for the prior year taxes. Do

5d. Check the box on line 5d to certify that your overreported

not send these statements to the IRS. Keep them for your

amount is only for federal income tax, social security tax,

records. Generally, all employment tax records must be kept

Medicare tax, or Additional Medicare Tax that you did not

for at least 4 years.

withhold from your employees.

4b. Check the box on line 4b to certify that your overreported

Part 3: Enter the Corrections for the

amount is only for the employer share of taxes on those

Calendar Year You Are Correcting

employees who you were unable to find or those who did not

give you a statement described on line 4a.

What Amounts Should You Report in Part 3?

4c. Check the box on line 4c to certify that your overreported

amount is only for federal income tax, social security tax,

On lines 6–9, columns 1 and 2, show amounts for all of your

Medicare tax, or Additional Medicare Tax that you did not

employees, not just for those employees whose amounts you

withhold from your employees.

are correcting.

5. Certifying Claims

If a correction that you report in column 4 includes both

If you are filing a claim for refund or abatement of

underreported and overreported amounts (see the

overreported federal income tax, social security tax,

instructions for line 18), give us details for each error on

Medicare tax, or Additional Medicare Tax and checked the

line 20.

box on line 2, check the appropriate box on line 5. You may

Because special circumstances apply for lines 10–14,

need to check more than one box. If you obtained written

16a, and 16b, read the instructions for each line carefully

statements or consents from some employees but you could

before entering amounts in the columns.

not locate employees or secure the statements of the

remaining employees, check all applicable boxes. Provide a

If you previously adjusted or amended Form 943

summary on line 20 of the amount of the corrections for the

using Form 943-X or because of an IRS examination

employees who provided statements or consents and for

change, show amounts in column 2 that include

those who did not.

CAUTION

those previously reported corrections.

You may not file a refund claim to correct federal

6. Total Wages Subject to Social Security Tax

income tax or Additional Medicare Tax actually

withheld from employees.

CAUTION

The 2011 and 2012 employee tax rate for social

security was 4.2%.

5a. Check the box on line 5a if your overreported tax

includes each affected employee share of prior year social

CAUTION

security and Medicare tax. You are certifying that you repaid

If you are correcting the taxable social security wages you

or reimbursed to the employees their share of prior year

reported on Form 943, line 2, enter the total corrected

social security and Medicare tax and you received written

amount in column 1. In column 2, enter the amount you

statements from those employees stating that they did not

originally reported or as previously corrected. In column 3,

and will not receive a refund or credit for the prior year taxes.

enter the difference between columns 1 and 2.

5b. Check the box on line 5b if your overreported tax

includes each affected employee share of prior year social

line 6 (column 1)

security and Medicare tax and you have not yet repaid or

- line 6 (column 2)

reimbursed the employee share of taxes. You are certifying

line 6 (column 3)

If the amount in column 2 is larger than the

that you received consent from each affected employee to

amount in column 1, use a minus sign in

file a claim on the employee share of those taxes and you

column 3.

received written statements from those employees stating

that they did not and will not receive a refund or credit for the

prior year taxes. Do not send these statements and

Multiply the amount in column 3 by .124 (.104 for

consents to the IRS. Keep them for your records. Generally,

corrections to a 2011 or 2012 return) and enter that result in

all employment tax records must be kept for at least 4 years.

column 4.

-6-

Instructions for Form 943-X (Rev. 2-2015)

Instructions For Form 943-X - 2015 Page 6

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