IRS Form 941-X "Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund"

What Is Form 941-X?

IRS Form 941-X, Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund is a form used to correct mistakes on previously filed IRS Forms 941 or 941-SS. This form can be used to make Form 941 corrections for under-reported or over-reported amounts.

IRS Form 941-X is used to correct the following: wages, tips, and other compensation; income tax withheld from wages, tips, and other compensation; taxable social security wages; taxable social security tips; taxable Medicare wages and tips; taxable wages and tips subject to additional Medicare tax withholding, qualified small business payroll tax credit for increasing research activities; and credits for COBRA premium assistance payments.

The most recent version of the document was issued by the Internal Revenue Service (IRS) on October 1, 2020. A fillable version of the form is available for download below.

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When Is 941-X Due?

Over-reported taxes can be corrected within 2 years from the date when the over-reported taxes were paid or within 3 years from filing the form. Under-reported taxes should be corrected before the form due date for that quarter and the tax must be paid by the time the form is filed.

If the document is filed on time, under-reported taxes are paid by the time of filing, the grounds for corrections are explained in details and the date of error discovery is provided, the employer will not be subject to failure-to-pay penalties.

Where to File 941-X?

The mailing address for the form depends on the location of the person filing this form. The complete list of mailing addresses can be found in the IRS-issued instructions for IRS Form 941-X.

Form 941-X Instructions

  1. Part 1. The desired process.
  2. Part 2. Certifications.
  3. Part 3. Corrections for the quarter.
    • Lines 6-14 are self-explanatory;
    • Lines 15-18 apply only if you reclassified any workers to independent contractors or nonemployees. Enter additions to wages only for reclassified workers, not all employees. Enter the correct amount of additions to wages in Column 1 and the originally reported amounts in Column 2. Enter the difference between the amounts in Column 3. Use Section 3509 for rates and calculation the number for Column 4;
    • Line 19. Add amounts provided in Column 4 of Lines 7-18 and enter the resulting number;
    • Line 20a, COBRA premium assistance payments. Enter 65% if the total COBRA premium assistance payments for all eligible individuals. For tax periods ending before January 2014, enter any COBRA payments in Column 2. For tax periods beginning after December 2013, enter 0, unless you are correcting a previously filed IRS Form 941-X. Enter the difference between Columns 1 and 2 in Columns 3 and 4;
    • Line 20b, Number of individuals provided COBRA premium assistance. Enter the number of eligible individuals, who paid the reduces premium in the reported quarter in Column 1. If you are making a correction for a tax period beginning December 2013, enter 0 in Column 2. For tax periods ending before January 1, 2014, enter the number of assistance-eligible individuals provided COBRA premium assistance previously reported on Form 941 or 941-SS;
    • Line 21, Total. Add amounts entered in Column 4 in Lines 19 and 20a.
  4. Part 4. Explanations for corrections.
    • Line 22. Check the box if any of your corrections contain both under-reported and over-reported amounts;
    • Line 23. Check the box, if any of your corrections involve reclassified workers;
    • Line 24. Provide a detailed explanation of how you determined your corrections. If you checked the box in the previous item, explain this as well.
  5. Part 5. Signature field.
  6. Print your name and title, enter your best daytime phone number and sign the form. If you are a paid preparer, fill the Paid Preparer Use Only part. Check the box, if you are self-employed, provide your name, your firm's name, address, Preparer Tax Identification Number (PTIN), EIN and phone number.

The following people have authority to sign IRS Form 941-X: the owner of the business, president, vice president, other authorized principal officer, a responsible and authorized member, partner, or an officer having knowledge of partnership affairs, the owner of a limited liability company (LLC) or an authorized principal officer and fiduciary of a trust.

To request a refund or abatement of arrested interest or penalties, the employer should use IRS Form 843, Claim for Refund and Request for Abatement. IRS Form 941-X cannot be used for these purposes.

How to Correct Form 941-X?

If you discovered a mistake on your form, file another one, correcting the same form and mail it before the due date.

IRS 941-X Related Forms

  • IRS Form 941, Employer's Quarterly Federal Tax Return is a form used to report Medicare, social security and income taxes withheld from the employee's paychecks and pay the employer's share of Medicare and social security taxes. This form is filed four times a year.
  • IRS Form 941-SS, Employer's Quarterly Federal Tax Return - American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands is a form used for the same purpose as IRS Form 941, but is used by employers, located in the above-mentioned territories.
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Download IRS Form 941-X "Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund"

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941-X:
Adjusted Employer’s QUARTERLY Federal Tax Return or Claim for Refund
Form
Department of the Treasury — Internal Revenue Service
(Rev. October 2020)
OMB No. 1545-0029
Employer identification number
Return You’re Correcting...
(EIN)
Check the type of return you’re correcting.
941
Name (not your trade name)
941-SS
Trade name (if any)
Check the ONE quarter you’re correcting.
Address
1: January, February, March
Number
Street
Suite or room number
2: April, May, June
City
State
ZIP code
3: July, August, September
4: October, November, December
Foreign country name
Foreign province/county
Foreign postal code
Enter the calendar year of the
Read the separate instructions before completing this form. Use this form to correct errors you
quarter you’re correcting.
made on Form 941 or 941-SS. Use a separate Form 941-X for each quarter that needs
correction. Type or print within the boxes. You MUST complete all four pages. Don’t attach this
(YYYY)
form to Form 941 or 941-SS unless you’re reclassifying workers; see the instructions for line 36.
Part 1:
Select ONLY one process. See page 5 for additional guidance.
Enter the date you discovered errors.
1. Adjusted employment tax return. Check this box if you underreported amounts. Also
check this box if you overreported amounts and you would like to use the adjustment
/
/
process to correct the errors. You must check this box if you’re correcting both
underreported and overreported amounts on this form. The amount shown on line 27, if
(MM / DD / YYYY)
less than zero, may only be applied as a credit to your Form 941, Form 941-SS, or
Form 944 for the tax period in which you’re filing this form.
2. Claim. Check this box if you overreported amounts only and you would like to use the
claim process to ask for a refund or abatement of the amount shown on line 27. Don’t
check this box if you’re correcting ANY underreported amounts on this form.
Part 2:
Complete the certifications.
3. I certify that I’ve filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement,
as required.
Note: If you’re correcting underreported amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you’re correcting overreported
amounts, for purposes of the certifications on lines 4 and 5, Medicare tax doesn’t include Additional Medicare Tax. Form 941-X can’t be
used to correct overreported amounts of Additional Medicare Tax unless the amounts weren’t withheld from employee wages or an
adjustment is being made for the current year.
4. If you checked line 1 because you’re adjusting overreported federal income tax, social security tax, Medicare tax, or Additional
Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a.
I repaid or reimbursed each affected employee for the overcollected federal income tax or Additional Medicare Tax for the current
year and the overcollected social security tax and Medicare tax for current and prior years. For adjustments of employee social
security tax and Medicare tax overcollected in prior years, I have a written statement from each affected employee stating that he
or she hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
b.
The adjustments of social security tax and Medicare tax are for the employer’s share only. I couldn’t find the affected employees or
each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
claim a refund or credit for the overcollection.
The adjustment is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
c.
employee wages.
5. If you checked line 2 because you’re claiming a refund or abatement of overreported federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a.
I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax. For claims of employee
social security tax and Medicare tax overcollected in prior years, I have a written statement from each affected employee stating
that he or she hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
b.
I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social security
tax and Medicare tax. For refunds of employee social security tax and Medicare tax overcollected in prior years, I also have a
written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and won’t claim a
refund or credit for the overcollection.
c.
The claim for social security tax and Medicare tax is for the employer’s share only. I couldn’t find the affected employees, or each
affected employee didn’t give me a written consent to file a claim for the employee’s share of social security tax and Medicare tax,
or each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
claim a refund or credit for the overcollection.
d.
The claim is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
employee wages.
Next
941-X
For Paperwork Reduction Act Notice, see the separate instructions.
Form
(Rev. 10-2020)
www.irs.gov/Form941X
Cat. No. 17025J
941-X:
Adjusted Employer’s QUARTERLY Federal Tax Return or Claim for Refund
Form
Department of the Treasury — Internal Revenue Service
(Rev. October 2020)
OMB No. 1545-0029
Employer identification number
Return You’re Correcting...
(EIN)
Check the type of return you’re correcting.
941
Name (not your trade name)
941-SS
Trade name (if any)
Check the ONE quarter you’re correcting.
Address
1: January, February, March
Number
Street
Suite or room number
2: April, May, June
City
State
ZIP code
3: July, August, September
4: October, November, December
Foreign country name
Foreign province/county
Foreign postal code
Enter the calendar year of the
Read the separate instructions before completing this form. Use this form to correct errors you
quarter you’re correcting.
made on Form 941 or 941-SS. Use a separate Form 941-X for each quarter that needs
correction. Type or print within the boxes. You MUST complete all four pages. Don’t attach this
(YYYY)
form to Form 941 or 941-SS unless you’re reclassifying workers; see the instructions for line 36.
Part 1:
Select ONLY one process. See page 5 for additional guidance.
Enter the date you discovered errors.
1. Adjusted employment tax return. Check this box if you underreported amounts. Also
check this box if you overreported amounts and you would like to use the adjustment
/
/
process to correct the errors. You must check this box if you’re correcting both
underreported and overreported amounts on this form. The amount shown on line 27, if
(MM / DD / YYYY)
less than zero, may only be applied as a credit to your Form 941, Form 941-SS, or
Form 944 for the tax period in which you’re filing this form.
2. Claim. Check this box if you overreported amounts only and you would like to use the
claim process to ask for a refund or abatement of the amount shown on line 27. Don’t
check this box if you’re correcting ANY underreported amounts on this form.
Part 2:
Complete the certifications.
3. I certify that I’ve filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement,
as required.
Note: If you’re correcting underreported amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you’re correcting overreported
amounts, for purposes of the certifications on lines 4 and 5, Medicare tax doesn’t include Additional Medicare Tax. Form 941-X can’t be
used to correct overreported amounts of Additional Medicare Tax unless the amounts weren’t withheld from employee wages or an
adjustment is being made for the current year.
4. If you checked line 1 because you’re adjusting overreported federal income tax, social security tax, Medicare tax, or Additional
Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a.
I repaid or reimbursed each affected employee for the overcollected federal income tax or Additional Medicare Tax for the current
year and the overcollected social security tax and Medicare tax for current and prior years. For adjustments of employee social
security tax and Medicare tax overcollected in prior years, I have a written statement from each affected employee stating that he
or she hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
b.
The adjustments of social security tax and Medicare tax are for the employer’s share only. I couldn’t find the affected employees or
each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
claim a refund or credit for the overcollection.
The adjustment is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
c.
employee wages.
5. If you checked line 2 because you’re claiming a refund or abatement of overreported federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a.
I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax. For claims of employee
social security tax and Medicare tax overcollected in prior years, I have a written statement from each affected employee stating
that he or she hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
b.
I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social security
tax and Medicare tax. For refunds of employee social security tax and Medicare tax overcollected in prior years, I also have a
written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and won’t claim a
refund or credit for the overcollection.
c.
The claim for social security tax and Medicare tax is for the employer’s share only. I couldn’t find the affected employees, or each
affected employee didn’t give me a written consent to file a claim for the employee’s share of social security tax and Medicare tax,
or each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
claim a refund or credit for the overcollection.
d.
The claim is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
employee wages.
Next
941-X
For Paperwork Reduction Act Notice, see the separate instructions.
Form
(Rev. 10-2020)
www.irs.gov/Form941X
Cat. No. 17025J
Name (not your trade name)
Employer identification number (EIN)
Correcting quarter
(1, 2, 3, 4)
Correcting calendar year (YYYY)
Part 3:
Enter the corrections for this quarter. If any line doesn’t apply, leave it blank.
Column 2
Column 3
Column 4
Column 1
Amount originally
Difference
Total corrected
reported or as
(If this amount is a
amount (for ALL
Tax correction
employees)
previously corrected
negative number,
=
(for ALL employees)
use a minus sign.)
6.
Wages, tips, and other
Use the amount in Column 1 when you
=
.
.
.
compensation (Form 941, line 2)
prepare your Forms W-2 or Forms W-2c.
7.
Federal income tax withheld
Copy Column
=
from wages, tips, and other
.
.
.
.
3 here
compensation (Form 941, line 3)
8.
Taxable social security wages
=
(Form 941 or 941-SS, line 5a,
.
.
.
.
× 0.124* =
Column 1)
* If you’re correcting your employer share only, use 0.062. See instructions.
9.
Qualified sick leave wages
=
(Form 941 or 941-SS, line 5a(i),
.
.
.
.
× 0.062 =
Column 1)
10.
Qualified family leave wages
=
(Form 941 or 941-SS, line 5a(ii),
.
.
.
.
× 0.062 =
Column 1)
11.
Taxable social security tips (Form
=
941 or 941-SS, line 5b, Column 1)
.
.
.
.
× 0.124* =
* If you’re correcting your employer share only, use 0.062. See instructions.
12.
Taxable Medicare wages & tips (Form
=
941 or 941-SS, line 5c, Column 1)
.
.
.
.
× 0.029* =
* If you’re correcting your employer share only, use 0.0145. See instructions.
13.
Taxable wages & tips subject to
=
Additional Medicare Tax
.
.
.
.
× 0.009* =
withholding (Form 941 or
* Certain wages and tips reported in Column 3 shouldn’t be multiplied by 0.009. See instructions.
941-SS, line 5d)
14.
Section 3121(q) Notice and
=
Copy Column
.
.
.
.
Demand—Tax due on
3 here
unreported tips (Form 941 or
941-SS, line 5f)
15.
Tax adjustments (Form 941 or
=
Copy Column
.
.
.
.
941-SS, lines 7 through 9)
3 here
16.
Qualified small business payroll
=
See
.
.
.
.
tax credit for increasing
instructions
research activities (Form 941 or
941-SS, line 11a; you must attach
Form 8974)
17.
Nonrefundable portion of credit
=
See
.
.
.
.
for qualified sick and family
instructions
leave wages (Form 941 or
941-SS, line 11b)
18.
Nonrefundable portion of
=
See
employee retention credit
.
.
.
.
instructions
(Form 941 or 941-SS, line 11c)
19.
Special addition to wages for
=
See
.
.
.
.
federal income tax
instructions
20.
Special addition to wages for
=
See
.
.
.
.
social security taxes
instructions
21.
Special addition to wages for
=
See
.
.
.
.
Medicare taxes
instructions
22.
Special addition to wages for
=
See
.
.
.
.
Additional Medicare Tax
instructions
.
23.
Combine the amounts on lines 7 through 22 of Column 4
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
24.
Deferred amount of social
=
See
security tax* (Form 941 or
.
.
.
.
instructions
941-SS, line 13b)
* Use this line to correct the employer deferral for the second quarter of 2020 and the employer and employee deferral for the third and fourth quarters of 2020.
25.
Refundable portion of credit for
=
See
qualified sick and family leave
.
.
.
.
instructions
wages (Form 941 or 941-SS, line
13c)
Next
2
941-X
Page
Form
(Rev. 10-2020)
Name (not your trade name)
Employer identification number (EIN)
Correcting quarter
(1, 2, 3, 4)
Correcting calendar year (YYYY)
Part 3:
Enter the corrections for this quarter. If any line doesn’t apply, leave it blank. (continued)
Column 2
Column 3
Column 4
Column 1
Amount originally
Difference
Total corrected
reported or as
(If this amount is a
amount (for ALL
Tax correction
previously corrected
negative number,
employees)
=
(for ALL employees)
use a minus sign.)
26.
Refundable portion of employee
=
See
.
.
.
.
retention credit (Form 941 or
instructions
941-SS, line 13d)
27.
Total. Combine the amounts on lines 23 through 26 of Column 4 .
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
If line 27 is less than zero:
• If you checked line 1, this is the amount you want applied as a credit to your Form 941 or 941-SS for the tax period in which you’re
filing this form. (If you’re currently filing a Form 944, Employer’s ANNUAL Federal Tax Return, see the instructions.)
• If you checked line 2, this is the amount you want refunded or abated.
If line 27 is more than zero, this is the amount you owe. Pay this amount by the time you file this return. For information on how to
pay, see Amount you owe in the instructions.
28.
Qualified health plan expenses
=
.
.
.
allocable to qualified sick leave
wages (Form 941 or 941-SS, line
19)
29.
Qualified health plan expenses
=
.
.
.
allocable to qualified family
leave wages (Form 941 or
941-SS, line 20)
30.
Qualified wages for the
=
.
.
.
employee retention credit
(Form 941 or 941-SS, line 21)
31.
Qualified health plan expenses
=
.
.
.
allocable to wages reported on
Form 941 or 941-SS, line 21
(Form 941 or 941-SS, line 22)
32.
Credit from Form 5884-C, line
=
.
.
.
11, for this quarter (Form 941 or
941-SS, line 23)
33 a.
Qualified wages paid March 13
=
.
.
.
through March 31, 2020, for the
employee retention credit (use
this line to correct only the
second quarter of 2020) (Form
941 or 941-SS, line 24)
33 b.
Deferred amount of the
=
.
.
.
employee share of social
security tax included on Form
941 or 941-SS, line 13b (use this
line to correct only the third and
fourth quarters of 2020) (Form
941 or 941-SS, line 24)
34.
Qualified health plan expenses
=
.
.
.
allocable to wages reported on
Form 941 or 941-SS, line 24 (use
this line to correct only the
second quarter of 2020) (Form
941 or 941-SS, line 25)
Next
3
941-X
Page
Form
(Rev. 10-2020)
Name (not your trade name)
Employer identification number (EIN)
Correcting quarter
(1, 2, 3, 4)
Correcting calendar year (YYYY)
Part 4:
Explain your corrections for this quarter.
35.
Check here if any corrections you entered on a line include both underreported and overreported amounts. Explain both
your underreported and overreported amounts on line 37.
36.
Check here if any corrections involve reclassified workers. Explain on line 37.
37.
You must give us a detailed explanation of how you determined your corrections. See the instructions.
Part 5:
Sign here. You must complete all four pages of this form and sign it.
Under penalties of perjury, I declare that I have filed an original Form 941 or Form 941-SS and that I have examined this adjusted return or claim, including
accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than
taxpayer) is based on all information of which preparer has any knowledge.
Print your
name here
Sign your
Print your
name here
title here
Date
/
/
Best daytime phone
Check if you’re self-employed .
.
.
Paid Preparer Use Only
Preparer’s name
PTIN
Date
/
/
Preparer’s signature
Firm’s name (or yours
EIN
if self-employed)
Address
Phone
City
State
ZIP code
4
941-X
Page
Form
(Rev. 10-2020)
Form 941-X: Which process should you use?
Type of errors
you’re
correcting
Use the adjustment process to correct underreported amounts.
Underreported
• Check the box on line 1.
amounts
ONLY
• Pay the amount you owe from line 27 by the time you file Form 941-X.
If you’re filing Form 941-X
The process you
Choose either the adjustment process or the claim
Overreported
use depends on
MORE THAN 90 days before
process to correct the overreported amounts.
amounts
when you file
the period of limitations on
ONLY
Choose the adjustment process if you want the
credit or refund for Form 941
Form 941-X.
amount shown on line 27 credited to your Form 941,
or Form 941-SS expires...
Form 941-SS, or Form 944 for the period in which you
file Form 941-X. Check the box on line 1.
OR
Choose the claim process if you want the amount
shown on line 27 refunded to you or abated. Check
the box on line 2.
If you’re filing Form 941-X
You must use the claim process to correct the
WITHIN 90 days of the
overreported amounts. Check the box on line 2.
expiration of the period of
limitations on credit or refund
for Form 941 or Form 941-SS...
The process you
If you’re filing Form 941-X
Choose either the adjustment process or both the
BOTH
use depends on
MORE THAN 90 days before
adjustment process and the claim process when you
underreported
when you file
the period of limitations on
correct both underreported and overreported
and
credit or refund for Form 941
Form 941-X.
amounts.
overreported
or Form 941-SS expires...
amounts
Choose the adjustment process if combining your
underreported amounts and overreported amounts results
in a balance due or creates a credit that you want applied
to Form 941, Form 941-SS, or Form 944.
• File one Form 941-X, and
• Check the box on line 1 and follow the instructions
on line 27.
OR
Choose both the adjustment process and the
claim process if you want the overreported amount
refunded to you or abated.
File two separate forms.
1. For the adjustment process, file one Form 941-X
to correct the underreported amounts. Check the
box on line 1. Pay the amount you owe from line
27 by the time you file Form 941-X.
2. For the claim process, file a second Form 941-X
to correct the overreported amounts. Check the
box on line 2.
If you’re filing Form 941-X
You must use both the adjustment process and
the claim process.
WITHIN 90 days of the
expiration of the period of
File two separate forms.
limitations on credit or
1. For the adjustment process, file one Form 941-X
refund for Form 941 or
to correct the underreported amounts. Check the
Form 941-SS...
box on line 1. Pay the amount you owe from line
27 by the time you file Form 941-X.
2. For the claim process, file a second Form 941-X
to correct the overreported amounts. Check the
box on line 2.
5
941-X
Page
Form
(Rev. 10-2020)
Page of 5