Create Form 941-X

Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund. $24.99 per form, with instant download.

Details

Tax year

Employer and the return you are correcting

Employer identification number (EIN)

NumberEnter all nine digits.

Name (not your trade name)

Trade name, if any (optional)

Address: number, street, suite or room

City

State

ZIP code

The one quarter you are correcting (the year is the tax year above)

Date you discovered the errors

Parts 1 and 2: Process and certifications

Process (select only one)

3 · I filed or will file Forms W-2 or W-2c as required

Part 3: Corrections for the quarter

For each line that changes, enter the corrected total and the amount you originally reported; the difference and the tax correction are worked out for you. Leave other lines blank.

6 · Wages, tips and other compensation: corrected amount

6 · Wages, tips and other compensation: amount originally reported

7 · Federal income tax withheld: corrected amount

7 · Federal income tax withheld: amount originally reported

8 · Taxable Social Security wages: corrected amount

8 · Taxable Social Security wages: amount originally reported

11 · Taxable Social Security tips: corrected amount

11 · Taxable Social Security tips: amount originally reported

12 · Taxable Medicare wages and tips: corrected amount

12 · Taxable Medicare wages and tips: amount originally reported

13 · Wages and tips subject to Additional Medicare Tax withholding: corrected amount

13 · Wages and tips subject to Additional Medicare Tax withholding: amount originally reported

14 · Section 3121(q) Notice and Demand: tax on unreported tips: corrected amount

14 · Section 3121(q) Notice and Demand: tax on unreported tips: amount originally reported

15 · Tax adjustments (Form 941, lines 7 to 9): corrected amount

15 · Tax adjustments (Form 941, lines 7 to 9): amount originally reported

Calculated for you from your entries

6 · Wages, tips and other compensation: difference: –
7 · Federal income tax withheld: difference: –
7 · Federal income tax withheld: tax correction: –
8 · Taxable Social Security wages: difference: –
8 · Taxable Social Security wages: tax correction: –
11 · Taxable Social Security tips: difference: –
11 · Taxable Social Security tips: tax correction: –
12 · Taxable Medicare wages and tips: difference: –
12 · Taxable Medicare wages and tips: tax correction: –
13 · Wages and tips subject to Additional Medicare Tax withholding: difference: –
13 · Wages and tips subject to Additional Medicare Tax withholding: tax correction: –
14 · Section 3121(q) Notice and Demand: tax on unreported tips: difference: –
14 · Section 3121(q) Notice and Demand: tax on unreported tips: tax correction: –
15 · Tax adjustments (Form 941, lines 7 to 9): difference: –
15 · Tax adjustments (Form 941, lines 7 to 9): tax correction: –
23 · Lines 7 to 22, column 4: –
27 · Total: amount you owe, or (if negative) your credit or refund: –

Parts 4 and 5: Explanation and signature details

41 · The corrections include both underreported and overreported amounts

42 · The corrections involve reclassified workers

43 · Detailed explanation of how you determined the corrections

Name of the person signing

Title (optional)

Best daytime phone (optional)

Checkout

You'll get the official Form 941-X, filled in and ready to sign, as a PDF.

Sign it and file it separately from Form 941, as the instructions describe; pay any amount owed when you file.

Order summary

Form 941-X$24.99

Total$24.99

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Employer identification number (EIN): Required

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