Use your mouse or Tab key to move through the fields. Use your mouse or space bar to enable check boxes.
                   Illinois Department of Revenue 
                                                                                                *71012221W*
                   Form IL-941
                   2022 Illinois Withholding Income Tax Return                                  Instructions available at tax.illinois.gov
This form is required to be filed electronically. To request a waiver, complete and submit Form IL-900-EW.  To file electronically, use MyTax 
Illinois at mytax.illinois.gov or an IDOR-approved Tax-Prep software program. 
                                                                                                            Check this 
Step 1:  Provide your information                                                                           box  if this is                              Reporting Period 
                                                                                                            your first           Check the quarter you are reporting.
                                                                                                            return.               
   ___ ___    ___ ___ ___ ___ ___ ___ ___  ___ ___ ___ 
   Federal employer identification number (FEIN) Seq. number                                                Check    this                               1st (January/February/ March)
                                                                                                            box if your                                 due May 2, 2022
   ____________________________________________________________                      business                                                           2nd (April/May/June) 
                                                                                                            name has
  Business name                                                                                             changed.                                     due August 1, 2022
   ____________________________________________________________                                              Check this                                 3rd (July/August/September)
 C/O                                                                                                        box if your                                  due October 31, 2022
                                                                                                            address
                                                                                                            has                                         4th (October/November/December)
   ____________________________________________________________                                                      changed.                           due January 31, 2023 
   Mailing address 
  ______________________________     _______     __________________ 
 City                                            State                   ZIP
Step 2:  Tell us about your business
 A1   Enter the total number of Forms W-2 reporting Illinois withholding you issued for the entire year.*    A1 ________________
   A2 Enter the total number of Forms 1099 reporting Illinois withholding you issued for the entire year.*                                                   A2 ________________ 
      *Only complete Lines A1 and A2 when you file your 4th quarter or final return.
   B  If your business has permanently stopped withholding because it has closed, or you no 
      longer  pay Illinois wages or withhold Illinois taxes from other payments, check Box B and 
      enter the date you stopped withholding. This is considered your final return. Do not file future 
      returns, unless you resume withholding Illinois income tax.                                                                                            B      __ __  /  __ __  /  2022

Step 3:  Tell us about the amount subject to withholding
   1  Enter the total dollar amount subject to Illinois withholding tax this reporting period, including 
      payroll,  compensation, and other amounts. See instructions.                                                                                           1 _________________

Step 4:  Tell us about the amount withheld 
   2  Enter the exact amount of Illinois Income Tax you actually withheld from your employees or others on the date 
      you paid the compensation.  Only enter amounts on days you made withholding - leave the remaining “Day” lines  
      blank. If you withheld no Illinois Income Tax during the month, enter “0” on the corresponding “Total” line - Line 2a, 
      2c, or 2d (noted by “ ”).
      2a  First month of quarter (i.e., January for 1st quarter; April for 2nd quarter; July for 3rd quarter; and October for 4th quarter)   
      Day     Amount                      Day     Amount                                     Day     Amount                      Day     Amount

      1 ____________.___                      ____________.___9                              17 ____________.___                 25 ____________.___
      2 ____________.___                  10 ____________.___                                18 ____________.___                 26 ____________.___
      3 ____________.___                  11 ____________.___                                19 ____________.___                 27 ____________.___
      4 ____________.___                  12 ____________.___                                20 ____________.___                 28 ____________.___
      5 ____________.___                  13 ____________.___                                21 ____________.___                 29 ____________.___
      6 ____________.___                  14 ____________.___                                22 ____________.___                 30 ____________.___
      7 ____________.___                  15 ____________.___                                23 ____________.___                 31 ____________.___
      8 ____________.___                  16 ____________.___                                24 ____________.___
      Total Illinois Income Tax withheld this month. (Add Section 2a, Lines 1-31.)                                               2a ____________.___

   Printed by the authority of the state of Illinois - web only, 1 copy. 
                                                                                                Continue on the next page.

                                   This form is authorized as outlined under the Illinois Income Tax Act.  Disclosure of this information is required.  
            IL-941 (R-12/21)       Failure to provide information could result in a penalty.                                                             Page 1 of 3

                                                                                *71012222W*
 Step 4:  Continued
    2b  Enter the amount from Page 1, Step 4, Line 2a.                                                 2b ____________.___
2c  Second month of quarter (i.e., February for 1st quarter; May for 2nd quarter; August for 3rd quarter; and November for 4th quarter)  
        Day     Amount                 Day     Amount                    Day     Amount                   Day     Amount

      1 ____________.___             ____________.___9                  17 ____________.___       25 ____________.___
      2 ____________.___         10 ____________.___                    18 ____________.___       26 ____________.___
      3 ____________.___         11 ____________.___                    19 ____________.___       27 ____________.___
      4 ____________.___         12 ____________.___                    20 ____________.___       28 ____________.___
      5 ____________.___         13 ____________.___                    21 ____________.___       29 ____________.___
      6 ____________.___         14 ____________.___                    22 ____________.___       30 ____________.___
      7 ____________.___         15 ____________.___                    23 ____________.___       31 ____________.___
      8 ____________.___         16 ____________.___                    24 ____________.___
      Total Illinois Income Tax withheld this month. (Add Section 2c, Lines 1-31.)                2c ____________.___

      2d  Third month of quarter (i.e., March for 1st quarter; June for 2nd quarter; September for 3rd quarter; and December for 4th quarter)   
        Day     Amount                 Day     Amount                    Day     Amount                   Day     Amount

      1 ____________.___             ____________.___9                  17 ____________.___       25 ____________.___
      2 ____________.___         10 ____________.___                    18 ____________.___       26 ____________.___
      3 ____________.___         11 ____________.___                    19 ____________.___       27 ____________.___
      4 ____________.___         12 ____________.___                    20 ____________.___       28 ____________.___
      5 ____________.___         13 ____________.___                    21 ____________.___       29 ____________.___
      6 ____________.___         14 ____________.___                    22 ____________.___       30 ____________.___
      7 ____________.___         15 ____________.___                    23 ____________.___       31 ____________.___
      8 ____________.___         16 ____________.___                    24 ____________.___
      Total Illinois Income Tax withheld this month. (Add Section 2d, Lines 1-31.)                2d ____________.___
      Add Lines 2b, 2c, and 2d and enter the total amount here. This is the total dollar amount of 
      Illinois Income Tax actually withheld from your employees or others for this quarter.                       2 _________________
Step 5:  Tell us about your payments and credits
 3    Enter the amount of credit from the Schedule WC you are using this period. See instructions.                3 _________________ 
 4    Enter the total dollar amount of withholding payments you made to the Illinois Department of 
      Revenue (IDOR) for this period. This  includes all IL-501 payments (electronic and paper 
      coupons). Do not estimate this amount.                                                                      4 _________________
 5    Add Lines 3 and 4 and enter the total amount here.                                                          5 _________________

Step 6:  Figure your balance 
  6   If Line 2 is greater than Line 5, subtract Line 5 from Line 2. This is your remaining 
      balance due. Make your payment electronically  or make your remittance payable 
      to “Illinois Department of Revenue.”   If Line 5 is greater than Line 2, see the instructions. 
      (Semi-weekly payersmust pay electronically.)                                                                6 _________________
                                                                                                                                                   
Step 7:  Sign here  Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete. 
Sign                                                                                                                 Check if the      Department 
                       Here                                                           (      )             may discuss this return with the 
      Signature                       Date (mm/dd/yyyy)  Title                       Phone                 paid preparer shown in this step.
                                                                                                                   Check if  
Paid     Paid preparer’s name                         Paid preparer’s signature       Date (mm/dd/yyyy)     self-employed    Paid Preparer’s PTIN
Preparer
         Firm’s name                                                                                   Firm’s FEIN
Use Only
         Firm’s address                                                                                Firm’s phone  (      )
         NS                 IR DR_______________ Mail to:ILLINOIS DEPARTMENT OF REVENUE
         IL-941 (R-12/21)                                  PO BOX 19052                                            Page 2 of 3
                                                          SPRINGFIELD IL  62794-9052

                                        *72012221W*
  Illinois Department of Revenue
                                                                                                                               Filing period:
  2022 Schedule PIllinois Withholding Schedule                                                                                 __________   

Complete and attach to Form IL-941 to verify Illinois income and withholding records. This form is required. 

Business name _____________________________________  FEIN ______________________________

  Payee’s/Employee’s            SSN (do not include Income for                                                                  Withholding 
#
                     name       dashes)             Quarter                                                                     for Quarter
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34

                          This form is authorized under the Income Tax Act. Disclosure of this information is required. Failure
Schedule P (R-12/21)      to provide information may result in this form not being processed and may result in a penalty.      Page 3 of 3

                                Reset   Print