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Department of the Treasury
Internal Revenue Service
Instructions for Form 941-X

(Rev. April 2024)
Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund

Section references are to the Internal Revenue Code Instructions for Form 941 are available at IRS.gov/
unless otherwise noted. Form941 (select the link for “All Form 941 revisions” under
“Other items you may find useful”).
Contents Page
General Instructions: Understanding Form 941-X . . . . 5
What Is the Purpose of Form 941-X? . . . . . . . . . . 5 What's New
Where Can You Get Help? . . . . . . . . . . . . . . . . . . 6
Period of limitations to make certain corrections ex-
When Should You File Form 941-X? . . . . . . . . . . . 6 pired; Form 941-X, lines 24, 33a, 33b, and 34 are now
Is There a Deadline for Filing Form 941-X? . . . . . . 7 reserved for future use. Lines 24, 33a, 33b, and 34 are
Where Should You File Form 941-X? . . . . . . . . . . 7 now reserved for future use because the period of
How Should You Complete Form 941-X? . . . . . . . 7 limitations for correcting these lines has generally expired
Overview of the Process . . . . . . . . . . . . . . . . . . . 8 for most employers. Generally, you may correct
overreported taxes on a previously filed Form 941 if you
Specific Instructions: . . . . . . . . . . . . . . . . . . . . . . . . . 9
file Form 941-X within 3 years of the date Form 941 was
Part 1: Select ONLY One Process . . . . . . . . . . . . 9 filed or 2 years from the date you paid the tax reported on
Part 2: Complete the Certifications . . . . . . . . . . . . 9 Form 941, whichever is later. You may correct
Part 3: Enter the Corrections for This Quarter . . . 11 underreported taxes on a previously filed Form 941 if you
Part 4: Explain Your Corrections for This file Form 941-X within 3 years of the date the Form 941
Quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26 was filed. We call each of these time frames a period of
Part 5: Sign Here . . . . . . . . . . . . . . . . . . . . . . . 26 limitations. For purposes of the period of limitations,
Worksheet 1. Adjusted Credit for Qualified Sick and Forms 941 for a calendar year are considered filed on
Family Leave Wages for Leave Taken After April 15 of the succeeding year if filed before that date. For
March 31, 2020, and Before April 1, 2021 . . . . . . 28 an example of the period of limitations, see Is There a
Deadline for Filing Form 941-X, later. Other lines that can
Worksheet 2. Adjusted Employee Retention Credit
still be used where the period of limitations may have
for Qualified Wages Paid After March 12, 2020,
expired remain on Form 941-X because the lines are also
and Before July 1, 2021 . . . . . . . . . . . . . . . . . . . 29
used to make corrections for quarters on which the period
Worksheet 3. Adjusted Credit for Qualified Sick and of limitations hasn’t expired (for example, lines 18a and
Family Leave Wages for Leave Taken After 26a). Therefore, before using any line on Form 941-X, you
March 31, 2021, and Before October 1, 2021 . . . 30 must consider if the period of limitations, as described
Worksheet 4. Adjusted Employee Retention Credit above, is still open for the quarter that you’re correcting.
for Qualified Wages Paid After June 30, 2021,
Lines 24 and 33b were previously used to correct the
and Before January 1, 2022 . . . . . . . . . . . . . . . . 31
deferred amount of the employer share of social security
Worksheet 5. Adjusted COBRA Premium tax for the second, third, and fourth quarters of 2020
Assistance Credit . . . . . . . . . . . . . . . . . . . . . . . 32 and/or the deferred amount of the employee share of
How Can You Get Forms, Instructions, and social security tax for the third and fourth quarters of 2020.
Publications From the IRS? . . . . . . . . . . . . . . . . 32 The period of limitations for making corrections to the
deferred amount of the employer or employee share of
Future Developments social security tax generally expired for most employers
on April 15, 2024. These instructions no longer discuss
For the latest information about developments related to these deferrals. If you think that the period of limitations is
Form 941-X and its instructions, such as legislation still open for correcting your second, third, of fourth
enacted after they were published, go to IRS.gov/ quarter 2020 Form 941, you can still file the April 2023
Form941X. revision of Form 941-X to use lines 24 and 33b.
You may use these instructions and the April 2024 Lines 33a and 34 were used only when correcting
TIP revision of Form 941-X for all years for which the qualified wages paid March 13 through March 31, 2020,
period of limitations on corrections hasn't expired. for the employee retention credit and qualified health plan
Before you proceed with these instructions and expenses allocable to those wages on a Form 941 filed for
completing Form 941-X, you'll need a copy of the the second quarter of 2020. The period of limitations for
Instructions for Form 941 for the quarter that you're making corrections to qualified wages paid March 13
correcting because these instructions don't repeat all of through March 31, 2020, for the employee retention credit
the information included in the Instructions for Form 941. and qualified health plan expenses allocable to those
For example, these instructions don't discuss who is wages generally expired for most employers on April 15,
eligible to claim the credit for qualified sick and family 2024. These instructions no longer discuss these lines.
leave wages, the employee retention credit, or the COBRA However, other references to the period March 13 through
premium assistance credit. Prior revisions of the

May 16, 2024 Cat. No. 20331U

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March 31, 2020 (for example, in the instructions for Form 941-PR discontinued after 2023. Form 941-PR,
line 18a and Worksheet 2), are retained in these Planilla para la Declaración Federal TRIMESTRAL del
instructions as the generally applicable period of qualified Patrono, was discontinued after the fourth quarter of 2023.
wages paid for the employee retention credit. If you think Instead, employers in Puerto Rico file Form 941 or, if you
that the period of limitations is still open for correcting your prefer your form and instructions in Spanish, you can file
second quarter 2020 Form 941, you can still file the April new Form 941 (sp). If you're correcting a Form 941-PR
2023 revision of Form 941-X to use lines 33a and 34. filed for the fourth quarter of 2023 or an earlier quarter,
The COVID-19 related credit for qualified sick and you should file Form 941-X (PR). However, you will use
family leave wages is limited to leave taken after Form 941-X or Form 941-X (sp) to correct a Form 941 or
March 31, 2020, and before October 1, 2021, and can Form 941 (sp), respectively, filed for the first quarter of
no longer be claimed on Form 941. Generally, the 2024 or later quarters.
credit for qualified sick and family leave wages, as Electronically filing Form 941-X. Beginning sometime
enacted under the Families First Coronavirus Response in 2024, the IRS expects to make filing an electronic Form
Act (FFCRA) and amended and extended by the 941-X available as part of Modernized e-File (MeF).
COVID-related Tax Relief Act of 2020, for leave taken after Monitor IRS.gov for more information on availability.
March 31, 2020, and before April 1, 2021, and the credit
for qualified sick and family leave wages under sections Reminders
3131, 3132, and 3133 of the Internal Revenue Code, as
enacted under the American Rescue Plan Act of 2021 (the If a line on Form 941-X doesn't apply to you, leave
ARP), for leave taken after March 31, 2021, and before TIP it blank. If you're correcting a quarter that began
October 1, 2021, have expired. However, employers that before April 1, 2021, you must leave blank lines
pay qualified sick and family leave wages in 2024 for leave 18b, 18c, 18d, 26b, 26c, 35, 36, 37, 38, 39, and 40. If
taken after March 31, 2020, and before October 1, 2021, you're correcting a quarter that began before July 1, 2021,
are eligible to claim a credit for qualified sick and family you must leave blank line 31b. If you're correcting a
leave wages in 2024. Effective for tax periods beginning quarter that began after December 31, 2021, you must
after December 31, 2023, the lines used to claim the leave blank lines 18a, 26a, 30, 31a, and 31b.
credit for qualified sick and family leave wages were
Qualified small business payroll tax credit for in-
removed from Form 941 because it would be extremely
creasing research activities. For tax years beginning
rare for an employer to pay wages in 2024 for qualified
before January 1, 2023, a qualified small business may
sick and family leave taken after March 31, 2020, and
elect to claim up to $250,000 of its credit for increasing
before October 1, 2021. Instead, if you're eligible to claim
research activities as a payroll tax credit. The Inflation
the credit for qualified sick and family leave wages
Reduction Act of 2022 (the IRA) increases the election
because you paid the wages in 2024 for an earlier
amount to $500,000 for tax years beginning after
applicable leave period, file Form 941-X after filing Form
December 31, 2022. The payroll tax credit election must
941, to claim the credit for qualified sick and family leave
be made on or before the due date of the originally filed
wages paid in 2024. Filing a Form 941-X before filing a
income tax return (including extensions). The portion of
Form 941 for the quarter may result in errors or delays in
the credit used against payroll taxes is allowed in the first
processing your Form 941-X.
calendar quarter beginning after the date that the qualified
You will also continue to use Form 941-X to make small business filed its income tax return. The election
corrections to the credit for qualified sick and family leave and determination of the credit amount that will be used
wages for earlier quarters if the period of limitations is still against the employer's payroll taxes are made on Form
open. Corrections to amounts reported on Form 941, lines 6765, Credit for Increasing Research Activities. The
5a(i), 5a(ii), 11b, 13c, 19, and 20, for the credit for amount from Form 6765 must then be reported on Form
qualified sick and family leave wages for leave taken after 8974, Qualified Small Business Payroll Tax Credit for
March 31, 2020, and before April 1, 2021, are reported on Increasing Research Activities.
Form 941-X, lines 9, 10, 17, 25, 28, and 29, respectively.
For quarters beginning before January 1, 2023, the
Corrections to amounts reported on Form 941, lines 11d,
payroll tax credit can be used only against the employer
13e, 23, 24, 25, 26, 27, and 28, for the credit for qualified
share of social security tax for the quarter and any
sick and family leave wages for leave taken after March
remaining credit is carried forward to the next quarter.
31, 2021, and before October 1, 2021, are reported on
Starting in the first quarter of 2023, the payroll tax credit is
Form 941-X, lines 18b, 26b, 35, 36, 37, 38, 39, and 40,
first used to reduce the employer share of social security
respectively.
tax up to $250,000 per quarter and any remaining credit
Form 941-SS discontinued after 2023. Form 941-SS, reduces the employer share of Medicare tax for the
Employer’s QUARTERLY Federal Tax Return—American quarter. Any remaining credit, after reducing the employer
Samoa, Guam, the Commonwealth of the Northern share of social security tax and the employer share of
Mariana Islands, and the U.S. Virgin Islands, was Medicare tax, is then carried forward to the next quarter.
discontinued after the fourth quarter of 2023. Instead, Form 8974 is used to determine the amount of the credit
employers in these U.S. territories file Form 941 or, if you that can be used in the current quarter. Corrections to this
prefer your form and instructions in Spanish, you can file credit are made on Form 941-X, line 16. If you make a
new Form 941 (sp). Form 941-X is still used to correct a correction to Form 941-X, line 16, you must attach a
Form 941-SS filed for the fourth quarter of 2023 and corrected Form 8974. For more information, see the
earlier quarters if the period of limitations is still open.

2 Instructions for Form 941-X (Rev. 4-2024)

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Instructions for Form 8974 and go to IRS.gov/ 2021-33 I.R.B. 303, available at IRS.gov/irb/
ResearchPayrollTC. 2021-33_IRB#NOT-2021-46.
The COVID-19 related employee retention credit has Corrections to amounts reported on Form 941, lines
expired. The employee retention credit enacted under 11e, 11f, and 13f, for the COBRA premium assistance
the Coronavirus Aid, Relief, and Economic Security credit are reported on Form 941-X, lines 18c, 18d, and
(CARES) Act and amended and extended by the Taxpayer 26c, respectively.
Certainty and Disaster Tax Relief Act of 2020 was limited If you claimed the credit for qualified sick and
to qualified wages paid after March 12, 2020, and before ! family leave wages for leave taken after March 31,
July 1, 2021. The employee retention credit under section CAUTION 2020, and before April 1, 2021, and you make any
3134 of the Internal Revenue Code, as enacted by the corrections on Form 941-X to amounts used to figure this
ARP and amended by the Infrastructure Investment and credit, you'll need to refigure the amount of this credit
Jobs Act, was limited to qualified wages paid after June using Worksheet 1. You'll also use this worksheet to figure
30, 2021, and before October 1, 2021, unless the this credit if you’re claiming it for the first time on Form
employer was a recovery startup business. An employer 941-X. If you claimed the credit for qualified sick and
that was a recovery startup business could also claim the family leave wages for leave taken after March 31, 2021,
employee retention credit for qualified wages paid after and before October 1, 2021, and you make any
September 30, 2021, and before January 1, 2022. For corrections on Form 941-X to amounts used to figure this
more information about the employee retention credit, credit, you'll need to refigure the amount of this credit
including the dates for which the credit may be claimed, using Worksheet 3. You'll also use this worksheet to figure
go to IRS.gov/ERC. this credit if you’re claiming it for the first time on Form
Corrections to amounts reported on Form 941, lines 941-X. If you claimed the employee retention credit for
11c, 13d, 21, and 22, for the employee retention credit are wages paid after March 12, 2020, and before July 1, 2021,
reported on Form 941-X, lines 18a, 26a, 30, and 31a, and you make any corrections on Form 941-X to amounts
respectively, if the period of limitations is still open. used to figure this credit, you'll need to refigure the
However, how you figure the employee retention credit for amount of this credit using Worksheet 2. You'll also use
qualified wages paid after March 12, 2020, and before this worksheet to figure this credit if you’re claiming it for
July 1, 2021, is different from how you figure the credit for the first time on Form 941-X. If you claimed the employee
qualified wages paid after June 30, 2021, and before retention credit for wages paid after June 30, 2021, and
January 1, 2022. Also, for corrections to qualified wages before January 1, 2022, and you make any corrections on
paid after June 30, 2021, you may need to complete Form 941-X to amounts used to figure this credit, you'll
line 31b to tell us if you're eligible for the employee need to refigure the amount of this credit using Worksheet
retention credit solely because your business is a 4. You'll also use this worksheet to figure this credit if
recovery startup business. you’re claiming it for the first time on Form 941-X. If you
claimed the COBRA premium assistance credit and you
Credit for COBRA premium assistance payments is
make any corrections on Form 941-X to amounts used to
limited to periods of coverage beginning on or after
figure this credit, you'll need to refigure the amount of this
April 1, 2021, through periods of coverage beginning
credit using Worksheet 5. You'll also use this worksheet to
on or before September 30, 2021. Section 9501 of the
figure this credit if you’re claiming it for the first time on
ARP provides for COBRA premium assistance in the form
Form 941-X.
of a full reduction in the premium otherwise payable by
certain individuals and their families who elect COBRA
Form 941-X is filed to correct Form 941 or Form
continuation coverage due to a loss of coverage as the
941-SS. Unless otherwise noted, references to Form 941
result of a reduction in hours or an involuntary termination
on Form 941-X and in these instructions also apply to a
of employment (assistance eligible individuals). This
Form 941-SS filed for quarters beginning before January
COBRA premium assistance was available for periods of
1, 2024.
coverage beginning on or after April 1, 2021, through
periods of coverage beginning on or before September Payroll tax credit for certain tax-exempt organiza-
30, 2021. A premium payee was entitled to the COBRA tions affected by qualified disasters. Section 303(d) of
premium assistance credit at the time an eligible individual the Taxpayer Certainty and Disaster Tax Relief Act of 2020
elects coverage. Therefore, other than in rare allows for a payroll tax credit for certain tax-exempt
circumstances, due to the COBRA notice and election organizations affected by certain qualified disasters not
period requirements (generally, employers have 60 days related to COVID-19. This credit is claimed on Form
to provide notice and assistance eligible individuals have 5884-D. Form 5884-D is filed after the Form 941 for the
60 days to elect coverage), the first quarter of 2022 was quarter for which the credit is being claimed has been
the last quarter in which employers may have been eligible filed. If applicable to the quarter that you're correcting,
to claim the COBRA premium assistance credit on Form you'll enter the credit claimed on Form 5884-D on
941. Employers eligible to claim the COBRA premium Worksheet 1 to figure your credit for qualified sick and
assistance credit after March 31, 2022, must file Form family leave wages for leave taken before April 1, 2021, or
941-X to claim the credit. Worksheet 2 to figure the employee retention credit for
For more information on COBRA premium assistance wages paid after March 12, 2020, and before July 1, 2021.
payments and the credit, see Notice 2021-31, 2021-23 For more information about this credit, go to IRS.gov/
I.R.B. 1173, available at IRS.gov/irb/ Form5884D.
2021-23_IRB#NOT-2021-31; and Notice 2021-46,

Instructions for Form 941-X (Rev. 4-2024) 3

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Employee consents to support a claim for refund. The amount actually withheld is reflected on
Rev. Proc. 2017-28, 2017-14 I.R.B. 1061, available at TIP payroll information or on Form W-2, which can be
IRS.gov/irb/2017-14_IRB#RP-2017-28, provides used by the employee to claim a credit for
guidance to employers on the requirements for employee withholding for individual income tax return purposes.
consents used by an employer to support a claim for
refund of overcollected social security tax and Medicare Correcting Additional Medicare Tax withholding and
tax. The revenue procedure clarifies the basic wages and tips subject to Additional Medicare Tax
requirements for both a request for employee consent and withholding. Wages and tips subject to Additional
for the employee consent, and permits a consent to be Medicare Tax withholding are reported on Form 941,
requested, furnished, and retained in an electronic format line 5d. Certain errors discovered on a previously filed
as an alternative to a paper format. The revenue Form 941 are corrected on Form 941-X, line 13. However,
procedure also contains guidance concerning when an you can’t file a Form 941-X to correct the wrong amount of
employer may claim a refund of only the employer share of Additional Medicare Tax actually withheld from an
overcollected social security tax and Medicare tax. The employee in a prior year, including any amount you paid
revenue procedure requires that any request for consent on behalf of your employee rather than deducting it from
include an Additional Medicare Tax notice indicating that the employee’s pay (which resulted in additional wages
any claim on the employee’s behalf won’t include a claim subject to tax). See the instructions for line 13, later, for
for overpaid Additional Medicare Tax. more information on the types of errors that can be
corrected and how the correction is reported on Form
Correcting federal income tax withheld. Generally, 941-X. For more information about Additional Medicare
you may correct federal income tax withholding errors only Tax withholding, see the Instructions for Form 941 or go to
if you discovered the errors in the same calendar year you IRS.gov/ADMTfaqs.
paid the wages. In addition, for an overcollection, you may
correct federal income tax withholding only if you also You may need to attach Schedule R (Form 941) to
repaid or reimbursed the employees in the same year. your Form 941-X. If you were required to file Schedule R
(Form 941), Allocation Schedule for Aggregate Form 941
For prior years, you may only correct administrative Filers, when you filed Form 941, you must complete
errors to federal income tax withholding (that is, errors in Schedule R (Form 941) when correcting an aggregate
which the amount reported on Form 941, line 3, isn't the Form 941. Schedule R (Form 941) is completed only for
amount you actually withheld from an employee’s wages) those clients and customers who have corrections
and errors for which section 3509 rates apply. See section reported on Form 941-X. Schedule R (Form 941) is filed
13 of Pub. 15, Employer’s Tax Guide, for more information as an attachment to Form 941-X.
about corrections during the calendar year and about
administrative errors. See section 2 of Pub. 15 for more Approved section 3504 agents and certified
information about section 3509. If section 3509 rates professional employer organizations (CPEOs) must
apply, see the instructions for lines 19–22, later. complete and file Schedule R (Form 941) when filing an
aggregate Form 941. Aggregate Forms 941 are filed by
Only transposition or math errors involving the agents approved by the IRS under section 3504. To
! inaccurate reporting of the amount withheld are request approval to act as an agent for an employer, the
CAUTION administrative errors. agent files Form 2678 with the IRS. Aggregate Forms 941
You can’t file a Form 941-X to correct federal income are also filed by CPEOs approved by the IRS under
tax withholding for prior years for nonadministrative errors. section 7705. To become a CPEO, the organization must
In other words, you can’t correct federal income tax apply through the IRS Online Registration System at
actually withheld from an employee in a prior year if you IRS.gov/CPEO. CPEOs file Form 8973, Certified
discover that you didn’t withhold the right amount. For Professional Employer Organization/Customer Reporting
example, you can’t correct federal income tax withheld in Agreement, to notify the IRS that they started or ended a
a prior year because you used the wrong income tax service contract with a customer.
withholding table or you didn’t treat a payment correctly as Other third-party payers that file aggregate Forms 941,
taxable or nontaxable. Similarly, if you paid federal income such as non-certified PEOs, must complete and file
tax in a prior year on behalf of your employee, rather than Schedule R (Form 941) if they have clients that are
deducting it from the employee’s pay (which resulted in claiming the qualified small business payroll tax credit for
additional wages subject to tax), and in a subsequent year increasing research activities, the credit for qualified sick
you determine that you incorrectly calculated the amount and family leave wages, the employee retention credit,
of tax, you can’t correct the federal income tax and/or the COBRA premium assistance credit. If you're an
withholding. However, you must still correct the amount of other third-party payer that didn't file Schedule R (Form
wages you reported on Form 941 and Form W-2, Wage 941) with Form 941 because you didn't meet these
and Tax Statement, for a prior year by filing Form 941-X requirements, but are now filing Form 941-X to report
and Form W-2c, Corrected Wage and Tax Statement, these credits for your clients, then you must now file
respectively. You'll report the correct wages on Form Schedule R (Form 941) and attach it to Form 941-X.
941-X, line 6, column 1. See the March 2022 revision of the Instructions for
Form 941 for information about when a third party is
considered the person to whom COBRA premium
assistance payments are payable.

4 Instructions for Form 941-X (Rev. 4-2024)

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• Generally, file Form 941-X separately. Don't file Form
General Instructions: 941-X with Form 941. However, if you didn't previously file
Form 941 because you mistakenly treated your employees
Understanding Form 941-X as nonemployees, you may have to file Form 941-X with
Form 941. See the instructions for line 42, later.
What Is the Purpose of Form 941-X?
If you didn’t file a Form 941 for one or more quarters,
References to federal income tax withholding
don’t use Form 941-X. Instead, file Form 941 for each of
! don't apply to employers in American Samoa, those quarters. Also, see When Should You File Form
CAUTION Guam, the Commonwealth of the Northern
941-X, later. However, if you didn’t file Forms 941 because
Mariana Islands (CNMI), the U.S. Virgin Islands (USVI),
you improperly treated workers as independent
and Puerto Rico unless you have employees who are
contractors or nonemployees and are now reclassifying
subject to U.S. income tax withholding.
them as employees, see the instructions for line 42, later.
Use Form 941-X to correct errors on a Form 941 that Unless otherwise specified in these instructions,
you previously filed. Use Form 941-X to correct: TIP an underreported employment tax credit should
• Wages, tips, and other compensation; be treated like an overreported tax amount. An
• Federal income tax withheld from wages, tips, and other overreported employment tax credit should be treated like
compensation; an underreported tax amount. For more information,
• Taxable social security wages; including which process to select on lines 1 and 2, see
• Taxable social security tips; Correcting an employment tax credit, later.
• Taxable Medicare wages and tips;
• Taxable wages and tips subject to Additional Medicare Report the correction of underreported and
Tax withholding; overreported tax amounts for the same tax period on a
• Qualified small business payroll tax credit for increasing single Form 941-X, unless you’re requesting a refund or
research activities; abatement. If you’re requesting a refund or abatement and
• Amounts reported on Form 941 for the credit for are correcting both underreported and overreported tax
qualified sick and family leave wages for leave taken after amounts, file one Form 941-X correcting the
March 31, 2020, and before April 1, 2021, including underreported tax amounts only and a second Form
adjustments to Form 941, lines 5a(i), 5a(ii), 11b, 13c, 19, 941-X correcting the overreported tax amounts.
and 20;
• Amounts reported on Form 941 for the credit for You’ll use the adjustment process if you underreported
qualified sick and family leave wages for leave taken after employment taxes and are making a payment, or if you
March 31, 2021, and before October 1, 2021, including overreported employment taxes and will be applying the
adjustments to Form 941, lines 11d, 13e, 23, 24, 25, 26, credit to Form 941 for the period during which you file
27, and 28; Form 941-X. However, see the Caution under Is There a
• Amounts reported on Form 941 for the employee Deadline for Filing Form 941-X, later, if you’re correcting
retention credit, including adjustments to Form 941, lines overreported tax amounts during the last 90 days of a
11c, 13d, 21, and 22; and period of limitations. You’ll use the claim process if you
• Amounts reported on Form 941 for the COBRA overreported employment taxes and are requesting a
premium assistance credit, for periods of coverage refund or abatement of the overreported tax amount.
beginning on or after April 1, 2021, through periods of Follow the chart on page 6 of Form 941-X for help in
coverage beginning on or before September 30, 2021, choosing whether to use the adjustment process or the
including adjustments to Form 941, lines 11e, 11f, and claim process. Be sure to give us a detailed explanation
13f. on line 43 for each correction that you show on Form
941-X.
Use Form 843, Claim for Refund and Request for
Abatement, to request a refund or abatement of assessed Continue to report current quarter fractions of cents,
interest or penalties. Don’t request a refund or abatement third-party sick pay, tips, and group-term life insurance on
of assessed interest or penalties on Form 941 or 941-X. Form 941, lines 7–9.
We use the terms “correct” and “corrections” on You have additional requirements to complete when
TIP Form 941-X and in these instructions to include filing Form 941-X, such as certifying that you filed (or will
interest-free adjustments under sections 6205 and file) all applicable Forms W-2 and Forms W-2c with the
6413 and claims for refund and abatement under sections Social Security Administration (SSA). For corrections of
6402, 6414, and 6404. See Rev. Rul. 2009-39 for overreported federal income tax, social security tax,
examples of how the interest-free adjustment and claim Medicare tax, or Additional Medicare Tax, you must make
for refund rules apply in 10 different situations. You can any certifications that apply to your situation.
find Rev. Rul. 2009-39, 2009-52 I.R.B. 951, at IRS.gov/irb/ Don’t use Form 941-X to correct Form CT-1, 943,
2009-52_IRB#RR-2009-39. ! 944, or 945. Instead, use the “X” form that
CAUTION corresponds to those forms (Form CT-1 X, 943-X,
When you discover an error on a previously filed Form 944-X, or 945-X).
941, you must:
• Correct that error using Form 941-X;
• File a separate Form 941-X for each Form 941 that
you’re correcting; and

Instructions for Form 941-X (Rev. 4-2024) 5

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Where Can You Get Help? about PDSs, see Where Should You File Form 941-X,
later.
For quarters beginning after December 31, 2023,
TIP Pub. 15 will be used by all employers, including Underreported tax. If you’re correcting underreported
employers in the U.S. territories. Pub. 80, Federal tax, you must file Form 941-X by the due date of the return
Tax Guide for Employers in the U.S. Virgin Islands, Guam, for the return period in which you discovered the error and
American Samoa, and the Commonwealth of the Northern pay the amount you owe by the time you file. Doing so
Mariana Islands, is discontinued, but you may still need to will generally ensure that your correction is interest free
reference the Pub. 80 that was applicable for the tax year and not subject to failure-to-pay (FTP) or failure-to-deposit
that you're correcting. (FTD) penalties. See What About Penalties and Interest,
later. For details on how to make a payment, see the
For help filing Form 941-X or for questions about instructions for line 27, later.
federal employment taxes and tax corrections, you can:
If Form 941-X is filed late (after the due date of the
• Go to IRS.gov/EmploymentTaxes and IRS.gov/
return for the return period in which you discovered the
CorrectingEmploymentTaxes;
error), you must attach an amended Schedule B (Form
• See Pub. 15 for correcting Form 941, or Pub. 80 for
941) to Form 941-X. Otherwise, the IRS may assess an
correcting Form 941-SS; or
“averaged” FTD penalty. See “Averaged” FTD penalty in
• Call the IRS Business and Specialty Tax Line at
section 11 of Pub. 15 for more information about
800-829-4933 or 800-829-4059 (TDD/TTY for persons
“averaged” FTD penalties. The total tax reported on the
who are deaf, hard of hearing, or have a speech
“Total liability for the quarter” line of Schedule B (Form
disability), Monday–Friday from 7:00 a.m. to 7:00 p.m.
941) must match the corrected tax (Form 941, line 12,
local time (Alaska and Hawaii follow Pacific time;
combined with any correction entered on Form 941-X,
employers in Puerto Rico receive service from 8:00 a.m.
line 23) for the quarter, less any previous abatements and
to 8:00 p.m. local time); or call 267-941-1000 if you're
interest-free tax assessments.
outside the United States (toll call), Monday–Friday from
6:00 a.m. to 11:00 p.m. Eastern time. If you discover an error in . . . Form 941-X is due . . .
See also How Can You Get Forms, Instructions, and 1. January, February, March April 30
Publications From the IRS, later. 2. April, May, June July 31
3. July, August, September October 31
When Should You File Form 941-X? 4. October, November, December January 31
File Form 941-X when you discover an error on a
The dates shown in the table above apply only to corrections of
previously filed Form 941. underreported amounts. If any due date falls on a Saturday,
Sunday, or legal holiday, you may file Form 941-X on the next
However, if your only errors on Form 941 relate to the business day.
number of employees who received wages (Form 941,
line 1) or to federal tax liabilities reported on Form 941,
Part 2, or on Schedule B (Form 941), Report of Tax Example—You owe tax. On July 5, 2024, you
Liability for Semiweekly Schedule Depositors, don’t file discover that you underreported $10,000 of social security
Form 941-X. For more information about correcting federal and Medicare wages on your 2024 first quarter Form 941.
tax liabilities reported on Form 941, Part 2, or on File Form 941-X and pay the amount you owe by October
Schedule B (Form 941), see the Instructions for 31, 2024, because you discovered the error in the third
Schedule B (Form 941). quarter of 2024, and October 31, 2024, is the due date for
Due dates. The due date for filing Form 941-X depends that quarter. If you file Form 941-X before October 31,
on when you discover an error and if you underreported or 2024, pay the amount you owe by the time you file.
overreported tax. If you underreported tax, see The due date for filing the adjusted return is
Underreported tax, later. For overreported tax amounts, TIP determined by the type of return (Form 941 or
you may choose to either make an interest-free Form 944) being corrected, without regard to your
adjustment or file a claim for refund or abatement. If you’re current filing requirements. Therefore, if you're currently
correcting overreported tax amounts, see Overreported filing Form 941 and you're correcting a previously filed
tax—Adjustment process or Overreported tax—Claim Form 944, you must file Form 944-X by January 31 of the
process, later. year following the year you discover the error.
If any due date falls on a Saturday, Sunday, or legal
holiday, you may file Form 941-X on the next business day. Overreported tax—Adjustment process. If you
If we receive Form 941-X after the due date, we will treat overreported tax on Form 941 and choose to apply the
Form 941-X as filed on time if the envelope containing credit to Form 941 or Form 944, file an adjusted return on
Form 941-X is properly addressed, contains sufficient Form 941-X soon after you discover the error but more
postage, and is postmarked by the U.S. Postal Service on than 90 days before the period of limitations on the credit
or before the due date, or sent by an IRS-designated or refund for Form 941 expires. See Is There a Deadline
private delivery service (PDS) on or before the due date. If for Filing Form 941-X, later.
you don’t follow these guidelines, we will consider Form
Overreported tax—Claim process. If you overreported
941-X filed when it is actually received. See Pub. 15 for
tax on Form 941, you may choose to file a claim for refund
more information on legal holidays. For more information
or abatement on Form 941-X any time before the period of

6 Instructions for Form 941-X (Rev. 4-2024)

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limitations on credit or refund expires on Form 941. If you IF you’re in . . . THEN use this address . . .
also need to correct any underreported tax amounts, you Connecticut, Delaware, District of
must file another Form 941-X reporting only corrections to Columbia, Florida, Georgia,
the underreported amounts. See Is There a Deadline for Illinois, Indiana, Kentucky, Maine,
Filing Form 941-X? next. Maryland, Massachusetts,
Department of the Treasury
Michigan, New Hampshire, New
Internal Revenue Service
You may not file a refund claim to correct federal Jersey, New York, North Carolina,
Cincinnati, OH 45999-0005
! income tax or Additional Medicare Tax actually Ohio, Pennsylvania, Rhode
CAUTION withheld from employees. Island, South Carolina,
Tennessee, Vermont, Virginia,
Is There a Deadline for Filing Form West Virginia, Wisconsin
Alabama, Alaska, Arizona,
941-X? Arkansas, California, Colorado,
Generally, you may correct overreported taxes on a Hawaii, Idaho, Iowa, Kansas,
Louisiana, Minnesota, Department of the Treasury
previously filed Form 941 if you file Form 941-X within 3 Mississippi, Missouri, Montana, Internal Revenue Service
years of the date Form 941 was filed or 2 years from the Nebraska, Nevada, New Mexico, Ogden, UT 84201-0005
date you paid the tax reported on Form 941, whichever is North Dakota, Oklahoma,
later. You may correct underreported taxes on a previously Oregon, South Dakota, Texas,
filed Form 941 if you file Form 941-X within 3 years of the Utah, Washington, Wyoming
date the Form 941 was filed. We call each of these time No legal residence or principal Internal Revenue Service
frames a period of limitations. For purposes of the period place of business in any state P.O. Box 409101
of limitations, Forms 941 for a calendar year are Ogden, UT 84409
considered filed on April 15 of the succeeding year if filed Special filing address for
before that date. exempt organizations; federal,
Department of the Treasury
Example. You filed your 2023 fourth quarter Form 941 state, and local governmental
Internal Revenue Service
on January 25, 2024, and payments were timely made. entities; and Indian tribal
Ogden, UT 84201-0005
The IRS treats the return as if it were filed on April 15, governmental entities, regardless
of location
2024. On January 29, 2027, you discover that you
overreported social security and Medicare wages on that
form by $350. To correct the error, you must file Form
941-X by April 15, 2027, which is the end of the period of PDSs can't deliver to P.O. boxes. You must use the U.S.
limitations for Form 941, and use the claim process. Postal Service to mail an item to a P.O. box address. Go to
IRS.gov/PDS for the current list of PDSs. If you file Form
If you file Form 941-X to correct overreported tax 941-X using a PDS, send it to the following address.
! amounts in the last 90 days of a period of
CAUTION limitations, you must use the claim process. You
Ogden - Internal Revenue Submission Processing
can’t use the adjustment process. If you’re also correcting Center
underreported tax amounts, you must file another Form 1973 Rulon White Blvd.
941-X to correct the underreported tax amounts using the Ogden, UT 84201
adjustment process and pay any tax due.
Use this address even if your business is located in a state
Where Should You File Form 941-X? that files in Cincinnati.

You're encouraged to file Form 941-X electronically once How Should You Complete Form
that option becomes available. Until electronic filing
becomes available, or if you prefer to mail a paper Form 941-X?
941-X, send your completed Form 941-X to the address
shown next. Use a Separate Form 941-X for Each Quarter
You’re Correcting
Use a separate Form 941-X for each Form 941 that you’re
correcting. For example, if you found errors on your Forms
941 for the third and fourth quarters of 2023, file one Form
941-X to correct the 2023 third quarter Form 941 and file a
second Form 941-X to correct the 2023 fourth quarter
Form 941.

Employer Identification Number (EIN), Name,
and Address
Enter your EIN, name, and address in the spaces
provided. Also enter your name and EIN on the top of
pages 2, 3, 4, and 5, and on any attachments. If your
address has changed since you filed your Form 941, enter
the corrected information and the IRS will update your
address of record. Be sure to write your name, EIN, “Form

Instructions for Form 941-X (Rev. 4-2024) 7

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941-X,” the calendar quarter you’re correcting (for • Explain in detail the grounds and facts relied on to
example, “Quarter 2”), and the calendar year of the support the correction.
quarter you’re correcting on the top of any attachments.
No correction will be eligible for interest-free treatment
Return You’re Correcting if any of the following apply.
In the box at the top of page 1, check the type of return • The amounts underreported relate to an issue that was
(Form 941 or Form 941-SS) you’re correcting. Check the raised in an examination of a prior period.
appropriate box for the one quarter you’re correcting. • You knowingly underreported your employment tax
Enter the calendar year of the Form 941 you’re correcting. liability.
Enter the quarter and calendar year on pages 2, 3, 4, and • You received a notice and demand for payment.
5. • You received a notice of determination under section
7436.
Enter the Date You Discovered Errors If you receive a notice about a penalty after you file this
You must enter the date you discovered errors. You return, reply to the notice with an explanation and we will
discover an error when you have enough information to be determine if you meet the reasonable-cause criteria. Don’t
able to correct it. If you’re reporting several errors that you attach an explanation when you file your return.
discovered at different times, enter the earliest date you
discovered them here. Report any subsequent dates and Overview of the Process
related errors on line 43.
To correct a previously filed Form 941, use Form 941-X to
Must You Make an Entry on Each Line? file either an adjusted employment tax return or a claim for
You must provide all of the information requested at the refund or abatement. The adjustment process and the
top of page 1 of Form 941-X. You must check one box (but claim process are outlined below.
not both) in Part 1. In Part 2, you must check the box on If you underreported the tax. If you underreported
line 3 and any applicable boxes on lines 4 and 5. In Part 3, the tax on a previously filed Form 941, check the box on
if any line doesn’t apply, leave it blank. Complete Parts 4 line 1 and pay any additional amount you owe by the
and 5 as instructed. time you file Form 941-X. For details on how to make a
payment, see the instructions for line 27, later.
How Should You Report Negative Amounts? Example—You underreported employment taxes.
Form 941-X uses negative numbers to show reductions in On July 5, 2024, you discover an error that results in
tax (credits) and positive numbers to show additional tax additional tax on your 2023 third quarter Form 941. File
(amounts you owe). Form 941-X by October 31, 2024, and pay the amount you
owe by the time you file. See When Should You File Form
When reporting a negative amount in columns 3 and 4,
941-X, earlier. Don’t attach Form 941-X to your 2024 third
use a minus sign instead of parentheses. For example,
quarter Form 941.
enter “-10.59” instead of “(10.59).” However, if you’re
completing the return on your computer and your software If you overreported the tax. If you overreported the
only allows you to use parentheses to report negative tax on a previously filed Form 941, you may choose one
amounts, you may use them. of the following options.
• Use the adjustment process. Check the box on line 1 to
How Should You Make Entries on Form 941-X? apply any credit (negative amount) from line 27 to Form
941 for the quarter during which you file Form 941-X.
You can help the IRS process Form 941-X timely and
accurately if you follow these guidelines. • Use the claim process. Check the box on line 2 to file a
claim on Form 941-X requesting a refund or abatement of
• Type or print your entries.
the amount shown on line 27.
• Use Courier font (if possible) for all typed or
computer-generated entries. To ensure that the IRS has enough time to
• Omit dollar signs. You may use commas and decimal TIP process a credit for an overreporting tax
points, if desired. Enter dollar amounts to the left of any adjustment in the quarter during which you file
preprinted decimal point and cents to the right of it. Form 941-X, you’re encouraged to file Form 941-X
• Always show an amount for cents, even if it is zero. correcting the overreported tax amount in the first 2
Don’t round entries to whole dollars. months of a quarter. For example, if you discover an
• Complete all five pages and sign Form 941-X on overreported tax amount in March, June, September, or
page 5. December, you may want to file Form 941-X in the first 2
• Staple multiple sheets in the upper-left corner. months of the next quarter. However, there must be 90
days remaining on the period of limitations when you file
What About Penalties and Interest? Form 941-X. See the Caution under Is There a Deadline
Generally, your correction of an underreported tax amount for Filing Form 941-X, earlier. This should ensure that the
won’t be subject to an FTP penalty, an FTD penalty, or IRS will have enough time to process Form 941-X so the
interest if you: credit will be posted before you file Form 941, thus
• File on time (by the due date of Form 941 for the quarter avoiding an erroneous balance due notice from the IRS.
in which you discover the error), See the example below.
• Pay the amount shown on line 27 by the time you file
Form 941-X, Example—You want your overreported tax applied
• Enter the date you discovered the error, and as a credit to Form 941. On September 16, 2024, you

8 Instructions for Form 941-X (Rev. 4-2024)

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discover you overreported your tax on your 2023 fourth Don’t check the box on line 1 if you’re correcting
quarter Form 941 and want to choose the adjustment ! overreported tax amounts and the period of
process. To allow the IRS enough time to process the CAUTION limitations on credit or refund for Form 941 will
credit, you file Form 941-X on October 7, 2024, and take expire within 90 days of the date you file Form 941-X. See
the credit on your fourth quarter 2024 Form 941. Is There a Deadline for Filing Form 941-X, earlier.
If you currently file Form 944 and you’re making a
TIP correction to a previously filed Form 941 that will 2. Claim
be claimed as a credit on Form 944, file Form Check the box on line 2 to use the claim process if you’re
941-X before December in any year before the expiration correcting overreported tax amounts only and you’re
of the period of limitations for the previously filed Form claiming a refund or abatement for the negative amount
941. In the year that the period of limitations for the (credit) shown on line 27. Don’t check this box if you’re
previously filed Form 941 expires, file Form 941-X at least correcting any underreported tax amounts on this form.
90 days before the expiration date. You must check the box on line 2 if you have a credit (a
negative amount on line 27) and the period of limitations
on credit or refund for Form 941 will expire within 90 days
Specific Instructions: of the date you file Form 941-X. See Is There a Deadline
for Filing Form 941-X, earlier.
Part 1: Select ONLY One Process
The IRS usually processes claims shortly after they are
Because Form 941-X may be used to file either an filed. The IRS will notify you if your claim is denied,
adjusted employment tax return or a claim for refund or accepted as filed, or selected to be examined. See Pub.
abatement, you must check one box on either line 1 or 556, Examination of Returns, Appeal Rights, and Claims
line 2. Don’t check both boxes. for Refund, for more information.
Correcting an employment tax credit. For lines 1 and Unless the IRS corrects Form 941-X during processing
2, if you underreported an employment tax credit, treat it or you owe other taxes, penalties, or interest, the IRS will
like you overreported a tax amount. If you overreported an refund the amount shown on line 27, plus any interest that
employment tax credit, treat it like you underreported a tax applies.
amount. If you're filing Form 941-X to adjust only an You may not file a refund claim to correct federal
employment tax credit and you're not correcting any ! income tax or Additional Medicare Tax actually
overreported taxes on Form 941-X, lines 6–13, skip lines 4 CAUTION withheld from employees.
and 5.
1. Adjusted Employment Tax Return Part 2: Complete the Certifications
Check the box on line 1 if you’re correcting underreported You must complete all certifications that apply by checking
tax amounts or overreported tax amounts and you would the appropriate boxes. If all of your corrections relate to
like to use the adjustment process to correct the errors. underreported tax amounts, complete line 3 only; skip
If you’re correcting both underreported tax amounts lines 4 and 5 and go to Part 3. If your corrections relate to
and overreported tax amounts on this form, you must overreported tax amounts, other than corrections related
check this box. If you check this box, any negative amount to underreported employment tax credits, you have a duty
shown on line 27 will be applied as a credit (tax deposit) to to ensure that your employees' rights to recover overpaid
your Form 941 or Form 944 for the period in which you’re employee social security and Medicare taxes that you
filing this form. See Example—You want your overreported withheld are protected. The certifications on lines 4 and 5
tax applied as a credit to Form 941, earlier. address the requirement to:
• Repay or reimburse your employees for the
If you owe tax. Pay the amount shown on line 27 by the overcollection of employee social security and Medicare
time you file Form 941-X. Generally, you won’t be taxes, or
charged interest if you file on time, pay on time, enter the • Obtain consents from your employees to file a claim on
date you discovered the error, and explain the correction their behalf. See Rev. Proc. 2017-28 for guidance on the
on line 43. requirements for both a request for employee consent and
If you have a credit. You overreported employment for the employee consent.
taxes (you have a negative amount on line 27) and want
the IRS to apply the credit to Form 941 or Form 944 for the 3. Filing Forms W-2 or Forms W-2c
period during which you filed Form 941-X. The IRS will Check the box on line 3 to certify that you filed or will file
apply your credit on the first day of the Form 941 or Form Forms W-2 or Forms W-2c with the SSA, as required,
944 period during which you filed Form 941-X. However, showing your employees' correct wage and tax amounts.
the credit you show on Form 941-X, line 27, may not be See the General Instructions for Forms W-2 and W-3 for
fully available on your Form 941 or Form 944 if the IRS detailed information about filing requirements. Unless
corrects it during processing or you owe other taxes, otherwise noted, references throughout these instructions
penalties, or interest. The IRS will notify you if your to Form W-2 include Forms W-2AS, W-2CM, W-2GU,
claimed credit changes or if the amount available as a W-2VI, and 499R-2/W-2PR; references to Form W-2c
credit on Form 941 or Form 944 was reduced because of include Form 499R-2c/W-2cPR; references to Form W-3
unpaid taxes, penalties, or interest. include Form W-3SS and Form W-3 (PR); and references
to Form W-3c include Form W-3C (PR).

Instructions for Form 941-X (Rev. 4-2024) 9

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You must check the box on line 3 to certify that you filed corrections for both the employees who provided
Forms W-2 or Forms W-2c even if your corrections on statements or consents and for those who didn’t.
Form 941-X don’t change amounts shown on those forms.
You can’t file a refund claim to correct the incorrect
For example, if your only correction to Form 941 involves
amount of federal income tax or Additional
misstated tax adjustments, which don't impact the CAUTION!
Medicare Tax actually withheld from employees in
amounts reported on your employees’ Forms W-2 (see the
a prior year. If you request their consent to file a claim for
instructions for line 15, later), check the box on line 3 to
social security tax or Medicare tax, you must tell your
certify that you already filed all required Forms W-2 and
employees that you can’t claim a refund of any Additional
W-2c with the SSA. In this situation, you're certifying that
Medicare Tax on their behalf. See Rev. Proc. 2017-28 for
you don't need to file Form W-2c because you already
sample language to use in your request.
filed a correct Form W-2.
5a. Check the box on line 5a if your overreported tax
4. Certifying Overreporting Adjustments
includes each affected employee share of social security
If you overreported federal income tax, social security tax, and Medicare taxes. You’re certifying that you repaid or
Medicare tax, or Additional Medicare Tax and checked the reimbursed to the employees their share of social security
box on line 1, check the appropriate box on line 4. You and Medicare taxes. For refunds of employee social
may need to check more than one box. If you obtained security and Medicare taxes overcollected in prior years,
written statements from some employees but you couldn’t you’re certifying that you received written statements from
locate employees or secure the statements of the those employees stating that they didn’t and won’t receive
remaining employees, check all applicable boxes. Provide a refund or credit for the prior year taxes. Don’t send these
a summary on line 43 of the amount of the corrections statements to the IRS. Keep them for your records.
both for the employees who provided written statements Generally, all employment tax records must be kept for at
and for those who didn’t. least 4 years. Records related to qualified sick leave
4a. Check the box on line 4a if your overreported amount wages and qualified family leave wages for leave taken
includes each affected employee share of overcollected after March 31, 2021, and before October 1, 2021, and
taxes. You’re certifying that you repaid or reimbursed the records related to qualified wages for the employee
employee share of current and prior year taxes and you retention credit paid after June 30, 2021, should be kept
received written statements from the employees stating for at least 6 years. Copies must be submitted to the IRS if
that they didn’t and won’t receive a refund or credit for the requested.
prior year taxes. You’re certifying that you adjusted federal 5b. Check the box on line 5b if your overreported tax
income tax or Additional Medicare Tax withheld from includes each affected employee share of social security
employees for the current calendar year only. Don’t send and Medicare taxes and you haven’t yet repaid or
these statements to the IRS. Keep them for your records. reimbursed the employee share of taxes. You’re certifying
Generally, all employment tax records must be kept for at that you received consent from each affected employee to
least 4 years. Records related to qualified sick leave file a claim on the employee share of those taxes and you
wages and qualified family leave wages for leave taken received written statements from those employees stating
after March 31, 2021, and before October 1, 2021, and that they didn’t and won’t receive a refund or credit for the
records related to qualified wages for the employee prior year taxes.
retention credit paid after June 30, 2021, should be kept
An employee consent must:
for at least 6 years. Copies must be submitted to the IRS if
requested. • Contain the name, address, and social security number
(or truncated taxpayer identification number, when
4b. Check the box on line 4b to certify that your appropriate) of the employee;
overreported amount is only for the employer share of • Contain the name, address, and EIN of the employer;
taxes on those employees who you were unable to find or • Contain the tax period(s), the type of tax, and the
those who didn’t give you a statement described on amount of tax for which the consent is provided;
line 4a. • Affirmatively state that the employee authorizes the
4c. Check the box on line 4c to certify that your employer to claim a refund for the overpayment of the
overreported amount is only for federal income tax, social employee share of tax;
security tax, Medicare tax, or Additional Medicare Tax that • For amounts collected in a prior year, include the
you didn’t withhold from your employees. employee’s written statement certifying that the employee
hasn’t made any previous claims (or the claims were
5. Certifying Claims rejected) and won’t make any future claims for refund or
If you’re filing a claim for refund or abatement of credit of the amount of the overcollection;
overreported federal income tax, social security tax, • Identify the basis of the claim; and
Medicare tax, or Additional Medicare Tax and checked the • Be dated and contain the employee’s signature under
box on line 2, check the appropriate box on line 5. You penalties of perjury. The penalties of perjury statement
may need to check more than one box. If you obtained should be located immediately above the required
written statements or consents from some employees but signature.
you couldn’t locate employees or secure the statements or Don’t send these statements and consents to the IRS.
consents of the remaining employees, check all applicable Keep them for your records. Generally, all employment tax
boxes. Provide a summary on line 43 of the amount of the records must be kept for at least 4 years. Records related
to qualified sick leave wages and qualified family leave

10 Instructions for Form 941-X (Rev. 4-2024)

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wages for leave taken after March 31, 2021, and before between columns 1 and 2. This line doesn’t apply to Form
October 1, 2021, and records related to qualified wages 941-SS.
for the employee retention credit paid after June 30, 2021,
If you or the IRS previously corrected the amount
should be kept for at least 6 years. Copies must be
reported on Form 941, line 2, enter in column 2 the
submitted to the IRS if requested.
amount after any previous corrections.
In certain situations, you may not have repaid or
reimbursed your employees or obtained their consents line 6 (column 1)
prior to filing a claim, such as in cases where the period of - line 6 (column 2)
limitations on credit or refund is about to expire. In those line 6 (column 3) If the amount in column 2 is larger than the
situations, file Form 941-X, but don’t check a box on line 5. amount in column 1, use a minus sign in
Tell us on line 43 that you haven’t repaid or reimbursed column 3.
employees or obtained consents at the time you file the
claim. However, you must repay or reimburse your
employees and certify that you’ve done so before the IRS Example—Wages, tips, and other compensation
can allow the claim. increased. You reported $9,000 as total wages, tips, and
5c. Check the box on line 5c to certify that your other compensation on line 2 of your 2024 first quarter
overreported tax is only for the employer share of social Form 941. In May of 2024, you discovered that you had
security and Medicare taxes. This applies when affected overlooked $1,000 in tips for one of your employees. To
employees didn’t give you consent to file a claim for refund correct the error, figure the difference on Form 941-X as
for the employee share of social security and Medicare shown.
taxes, they couldn’t be found, or they didn’t give you a
statement described on line 5b. Column 1 (corrected amount) 10,000.00
Column 2 (Form 941, line 2) - 9,000.00
5d. Check the box on line 5d to certify that your
Column 3 (difference) 1,000.00
overreported amount is only for federal income tax, social
security tax, Medicare tax, or Additional Medicare Tax that
you didn’t withhold from your employees.
Example—Wages, tips, and other compensation
Part 3: Enter the Corrections for This decreased. You reported $9,000 as wages, tips, and
other compensation on line 2 of your 2024 first quarter
Quarter Form 941. In May of 2024, you discovered that you
Employers in American Samoa, Guam, the CNMI, included $2,000 in wages for one of your employees
TIP the USVI, and Puerto Rico may skip lines 6 and 7, twice. To correct the error, figure the difference on Form
unless you have employees who are subject to 941-X as shown.
U.S. income tax withholding.
Column 1 (corrected amount) 7,000.00
Column 2 (Form 941, line 2) - 9,000.00
What Amounts Should You Report in Part 3?
Column 3 (difference) -2,000.00
On lines 6–13, columns 1 and 2, for each line you're
correcting, show amounts for all of your employees, not
just for those employees whose amounts you’re
correcting. Example—Auto allowance; wages, tips, and other
compensation increased. You paid one of your
If a correction that you report in column 4 includes both employees a $500 monthly auto allowance from October
underreported and overreported amounts (see the through December 2023, and didn’t treat the payments as
instructions for line 41, later), give us details for each error taxable wages. In February 2024, you realized that the
on line 43. payments were wages because they weren’t
reimbursements of deductible business expenses that
Because special circumstances apply for lines 14–22, were substantiated and paid under an accountable plan.
25–26c, 28–32, and 35–40, read the instructions for each You correct the error by treating the auto allowance as
line carefully before entering amounts in the columns. wages subject to income, social security, and Medicare
If any line doesn't apply to you, leave it blank. taxes. Report the additional $1,500 of wages on Form
941-X, lines 6, 8, 12, and, if applicable, 13.
If you previously adjusted or amended Form 941
Be sure to explain the reasons for the corrections on
! by using Form 941-X or because of an IRS line 43.
CAUTION examination change, show amounts in column 2
that include those previously reported corrections. The quarterly amount on line 6, column 1, should
TIP be used to figure the annual amount to report on
6. Wages, Tips, and Other Compensation your Forms W-2 or Forms W-2c. This amount
If you’re correcting the wages, tips, and other should also generally be used for any business expense
compensation you reported on Form 941, line 2, enter the deduction on your income tax return (or amended return)
total corrected amount for all employees in column 1. In for wages paid.
column 2, enter the amount you originally reported or as
previously corrected. In column 3, enter the difference

Instructions for Form 941-X (Rev. 4-2024) 11

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7. Federal Income Tax Withheld From Wages, previously reported for the employee represents the actual
Tips, and Other Compensation amount withheld from the employee during 2023.
If you’re correcting the federal income tax withheld from Example—Prior year administrative error
wages, tips, and other compensation you reported on (incorrectly reported amount of federal income tax
Form 941, line 3, enter the total corrected amount in actually withheld). You had three employees. In the
column 1. In column 2, enter the amount you originally fourth quarter of 2023, you withheld $1,000 of federal
reported or as previously corrected. In column 3, enter the income tax from Xavier Black, $2,000 from Sophie Rose,
difference between columns 1 and 2. This line doesn’t and $6,000 from Leo Wood. The total amount of federal
apply to Form 941-SS. income tax you withheld was $9,000. You mistakenly
reported $6,000 on line 3 of your 2023 fourth quarter Form
line 7 (column 1) 941. You discovered the error on March 8, 2024. This is an
- line 7 (column 2) example of an administrative error that may be corrected
in a later calendar year because the amount actually
line 7 (column 3) If the amount in column 2 is larger than the
amount in column 1, use a minus sign in withheld from the employees' wages isn’t the amount
column 3. reported on Form 941. Use Form 941-X to correct the
error. Enter $9,000 in column 1 and $6,000 in column 2.
Subtract the amount in column 2 from the amount in
Copy the amount in column 3 to column 4. Include any column 1.
minus sign shown in column 3.
Generally, you may correct federal income tax Column 1 (corrected amount) 9,000.00
Column 2 (Form 941, line 3) - 6,000.00
! withholding errors only if you discovered the errors
CAUTION in the same calendar year you paid the wages. In Column 3 (difference) 3,000.00
addition, for an overcollection, you may correct federal
income tax withholding only if you also repaid or
reimbursed the employees in the same year. For prior Report the $3,000 as a tax correction in column 4.
years, you may only correct administrative errors to federal Be sure to explain the reasons for this correction on
income tax withholding (that is, errors in which the amount line 43.
reported on Form 941, line 3, isn't the amount you actually Example—Nonadministrative error reporting
withheld from an employee’s wages) and errors for which federal income tax because of repayment of wages
section 3509 rates apply. Only transposition or math errors paid in prior year. You prepaid Jack Brown $4,000 of
involving the inaccurate reporting of the amount withheld wages for 2 months of work in September 2023. You
are administrative errors. See section 13 of Pub. 15 for withheld $400 of federal income tax at the time you paid
more information about corrections during the calendar Jack. These amounts were reported on your 2023 third
year and about administrative errors. See section 2 of quarter Form 941. Jack left employment in October 2023
Pub. 15 for more information about section 3509. If section (after only 1 month of service). In January 2024, Jack
3509 rates apply, see the instructions for lines 19–22, repaid $2,000 to you for the 1 month Jack didn't work. You
later. can’t file Form 941-X to reduce the federal income tax
withheld because you actually withheld the federal income
You can’t file a Form 941-X to correct federal income tax from wages. You also can’t file Form 941-X to reduce
tax withholding for prior years for nonadministrative errors. wages because the wages were income to Jack for the
In other words, you can’t correct federal income tax prior year. These amounts were correctly reported on
actually withheld from an employee in a prior year if you Form 941.
discover that you didn’t withhold the right amount. For
example, you can’t correct federal income tax withheld in a 8. Taxable Social Security Wages
prior year because you used the wrong income tax
withholding table or you didn’t treat a payment correctly as Qualified sick leave wages and qualified family
taxable or nontaxable. Similarly, if you paid federal income TIP leave wages for leave taken after March 31, 2021,
tax in a prior year on behalf of your employee, rather than and before October 1, 2021, were included on
deducting it from the employee’s pay (which resulted in Form 941, line 5a, column 1, and can be adjusted only on
additional wages subject to tax), and in a subsequent year Form 941-X, line 8.
you determine that you incorrectly calculated the amount If you’re correcting the taxable social security wages
of tax, you can’t correct the federal income tax you reported on Form 941, line 5a, column 1, enter the
withholding. total corrected amount in column 1. In column 2, enter the
Example—Prior year nonadministrative error amount you originally reported or as previously corrected.
(failure to withhold federal income tax when In column 3, enter the difference between columns 1 and
required). You were required to withhold $400 of federal 2.
income tax from an employee's bonus that was paid in
December of 2023 but you withheld nothing. You
discovered the error on March 11, 2024. You can’t file
Form 941-X to correct federal income tax withheld
reported on your 2023 fourth quarter Form 941 because
the error involves a previous year and the amount

12 Instructions for Form 941-X (Rev. 4-2024)

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line 8 (column 1) the credit for qualified sick and family leave wages for
- line 8 (column 2) leave taken after March 31, 2020, and before April 1,
line 8 (column 3) If the amount in column 2 is larger than the 2021, are reported on Form 941-X, line 17, and
amount in column 1, use a minus sign in adjustments to the refundable portion of the credit are
column 3. reported on Form 941-X, line 25. Adjustments to qualified
health plan expenses allocable to qualified sick leave
wages and to qualified family leave wages for leave taken
after March 31, 2020, and before April 1, 2021, are
Multiply the amount in column 3 by 0.124 and enter that
reported on Form 941-X, lines 28 and 29, respectively. If
result in column 4.
you claimed the credit for qualified sick and family leave
wages for leave taken after March 31, 2020, and before
line 8 (column 3) April 1, 2021, on your original Form 941 for the quarter,
x 0.124 and you make any corrections on Form 941-X for the
line 8 (column 4) If the amount in column 3 used a minus sign, quarter to amounts used to figure this credit, you'll need to
also use a minus sign in column 4. refigure the amount of this credit using Worksheet 1. You'll
also use this worksheet to figure this credit if you’re
claiming the credit for the first time on Form 941-X. For
Note. If you checked the box on Form 941-X, line 4b or more information about the credit for qualified sick and
line 5c, because you’re correcting only the employer share family leave wages, go to IRS.gov/PLC.
of tax on a decrease to social security wages, use 0.062 Qualified sick leave wages paid with respect to leave
(6.2%) when multiplying the amount shown in column 3. If taken after March 31, 2020, and before April 1, 2021,
you’re correcting both shares of tax for some employees aren't subject to the employer share of social security tax;
and only the employer share for other employees, enter therefore, the tax rate on these wages is 6.2% (0.062). For
the properly calculated amount in column 4. Be sure to more information about qualified sick leave wages, see
show your calculations on line 43. Definition of qualified sick and family leave wages for
Example—Social security wages decreased. leave taken after March 31, 2020, and before April 1,
Following Example—Wages, tips, and other 2021, later, and go to IRS.gov/PLC. If you’re correcting the
compensation decreased in the instructions for line 6, the qualified sick leave wages you reported on Form 941,
wages that you counted twice were also taxable social line 5a(i), column 1, enter the total corrected amount in
security wages. To correct the error, figure the difference column 1. In column 2, enter the amount you originally
on Form 941-X as shown. reported or as previously corrected. In column 3, enter the
difference between columns 1 and 2.
Column 1 (corrected amount) 7,000.00
Column 2 (Form 941, line 5a, column 1) - 9,000.00 line 9 (column 1)
Column 3 (difference) -2,000.00 - line 9 (column 2)
line 9 (column 3) If the amount in column 2 is larger than the
amount in column 1, use a minus sign in
Use the difference in column 3 to determine your tax column 3.
correction.

Column 3 (difference) -2,000.00 Multiply the amount in column 3 by 0.062 and enter that
Tax rate (12.4%) x 0.124 result in column 4.
Column 4 (tax correction) -248.00
line 9 (column 3)
x 0.062
Be sure to explain the reasons for this correction on line 9 (column 4) If the amount in column 3 used a minus sign,
also use a minus sign in column 4.
line 43.

9. Qualified Sick Leave Wages (For Leave Taken
After March 31, 2020, and Before April 1, 2021) Note. If you erroneously reported qualified sick leave
wages for leave taken after March 31, 2020, and before
Generally, the period of limitations for correcting
April 1, 2021, on Form 941, line 5a, instead of on
! qualified sick leave wages paid in the second, line 5a(i), you'll need to make a correction on Form 941-X,
CAUTION third, and fourth quarters of 2020 expired on April
lines 8 and 9, and enter the properly calculated amount in
15, 2024, for most employers. For more information about
column 4 for each line.
the period of limitations, see Is There a Deadline for Filing
Form 941-X, earlier. Example—Qualified sick leave wages increased.
You paid $2,000 of qualified sick leave wages to only one
Adjustments to the social security tax on qualified of your employees in the first quarter of 2021. In March
TIP sick leave wages and qualified family leave wages 2024, you discovered that you only reported $1,000 of
for leave taken after March 31, 2020, and before qualified sick leave wages on Form 941 for the first
April 1, 2021, are reported on Form 941-X, lines 9 and 10, quarter. To correct the error, figure the difference on Form
respectively. Adjustments to the nonrefundable portion of 941-X as shown.

Instructions for Form 941-X (Rev. 4-2024) 13

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Column 1 (corrected amount) 2,000.00 Example—Qualified family leave wages
Column 2 (Form 941, line 5a(i), column 1) - 1,000.00 decreased. You paid $1,000 of qualified family leave
Column 3 (difference) 1,000.00 wages to only one of your employees in the first quarter of
2021. In March 2024, you discovered that you erroneously
reported $3,000 of qualified family leave wages on Form
Use the difference in column 3 to determine your tax 941 for the first quarter. To correct the error, figure the
correction. difference on Form 941-X as shown.

Column 3 (difference) 1,000.00 Column 1 (corrected amount) 1,000.00
Tax rate (6.2%) x 0.062 Column 2 (Form 941, line 5a(ii), column 1) - 3,000.00
Column 4 (tax correction) 62.00 Column 3 (difference) -2,000.00

Use the difference in column 3 to determine your tax
Be sure to explain the reasons for this correction on
correction.
line 43.
10. Qualified Family Leave Wages (For Leave Column 3 (difference) -2,000.00
Taken After March 31, 2020, and Before April 1, Tax rate (6.2%) x 0.062
2021) Column 4 (tax correction) -124.00

Generally, the period of limitations for correcting
! qualified family leave wages paid in the second, Be sure to explain the reasons for this correction on
CAUTION third, and fourth quarters of 2020 expired on April line 43.
15, 2024, for most employers. For more information about
the period of limitations, see Is There a Deadline for Filing 11. Taxable Social Security Tips
Form 941-X, earlier. If you’re correcting the taxable social security tips you
Qualified family leave wages paid with respect to leave reported on Form 941, line 5b, column 1, enter the total
taken after March 31, 2020, and before April 1, 2021, corrected amount in column 1. In column 2, enter the
aren't subject to the employer share of social security tax; amount you originally reported or as previously corrected.
therefore, the tax rate on these wages is 6.2% (0.062). For In column 3, enter the difference between columns 1 and
more information about qualified family leave wages, see 2.
Definition of qualified sick and family leave wages for
leave taken after March 31, 2020, and before April 1, line 11 (column 1)
2021, later, and go to IRS.gov/PLC. If you’re correcting the - line 11 (column 2)
qualified family leave wages you reported on Form 941, line 11 (column 3) If the amount in column 2 is larger than the
line 5a(ii), column 1, enter the total corrected amount in amount in column 1, use a minus sign in
column 1. In column 2, enter the amount you originally column 3.
reported or as previously corrected. In column 3, enter the
difference between columns 1 and 2.
Multiply the amount in column 3 by 0.124 and report
line 10 (column 1) that result in column 4.
- line 10 (column 2)
line 10 (column 3) If the amount in column 2 is larger than the line 11 (column 3)
amount in column 1, use a minus sign in x 0.124
column 3. line 11 (column 4) If the amount in column 3 used a minus sign,
also use a minus sign in column 4.

Multiply the amount in column 3 by 0.062 and enter that
result in column 4. Note. If you checked the box on Form 941-X, line 4b or
line 5c, because you’re correcting only the employer share
line 10 (column 3) of tax on a decrease to social security tips, use 0.062
x 0.062 (6.2%) when multiplying the amount shown in column 3. If
line 10 (column 4) If the amount in column 3 used a minus sign, you’re correcting both shares of tax for some employees
also use a minus sign in column 4. and only the employer share for other employees, report
the properly calculated amount in column 4. Be sure to
show your calculations on line 43.
Note. If you erroneously reported qualified family leave Example—Social security tips increased. Following
wages for leave taken after March 31, 2020, and before Example—Wages, tips, and other compensation
April 1, 2021, on Form 941, line 5a, instead of on increased in the instructions for line 6, the tips that you
line 5a(ii), you'll need to make a correction on Form 941-X, overlooked were also taxable social security tips. To
lines 8 and 10, and enter the properly calculated amount correct the error, figure the difference on Form 941-X as
in column 4 for each line. shown.

14 Instructions for Form 941-X (Rev. 4-2024)

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Column 1 (corrected amount) 10,000.00 Use the difference in column 3 to determine your tax
Column 2 (Form 941, line 5b, column 1) - 9,000.00 correction.
Column 3 (difference) 1,000.00
Column 3 (difference) -2,000.00
Tax rate (2.9%) x 0.029
Use the difference in column 3 to determine your tax Column 4 (tax correction) -58.00
correction.

Column 3 (difference) 1,000.00 Be sure to explain the reasons for this correction on
Tax rate (12.4%) x 0.124 line 43.

Column 4 (tax correction) 124.00 13. Taxable Wages & Tips Subject to Additional
Medicare Tax Withholding
Generally, you may correct errors to Additional Medicare
Be sure to explain the reasons for this correction on
Tax withholding only if you discovered the errors in the
line 43.
same calendar year the wages and tips were paid to
12. Taxable Medicare Wages & Tips employees. However, you may correct errors to Additional
Medicare Tax withholding for prior years if the amount
If you’re correcting the taxable Medicare wages and tips
reported on Form 941, line 5d, column 2, isn’t the amount
you reported on Form 941, line 5c, column 1, enter the
you actually withheld, including any amount you paid on
total corrected amount in column 1. In column 2, enter the
behalf of your employee rather than deducting it from the
amount you originally reported or as previously corrected.
employee’s pay (which resulted in additional wages
In column 3, enter the difference between columns 1 and
subject to tax). This type of error is an administrative error.
2.
The administrative error adjustment corrects the amount
reported on Form 941 to agree with the amount actually
line 12 (column 1) withheld from employees.
- line 12 (column 2)
line 12 (column 3) If the amount in column 2 is larger than the You may also correct errors to Additional Medicare Tax
amount in column 1, use a minus sign in withholding for prior years if section 3509 rates apply. If
column 3. section 3509 rates apply, see the instructions for lines 19–
22, later.

Multiply the amount in column 3 by 0.029 (2.9% tax If a prior year error was a nonadministrative error, you
rate) and enter that result in column 4. may correct only the wages and tips subject to Additional
Medicare Tax withholding that were originally reported on
line 12 (column 3) Form 941, line 5d, column 1, or previously corrected on
x 0.029 Form 941-X. You can’t correct the tax reported on Form
941, line 5d, column 2.
line 12 (column 4) If the amount in column 3 used a minus sign,
also use a minus sign in column 4. Errors discovered in the same calendar year or prior
year administrative errors. If you’re correcting the
taxable wages and tips subject to Additional Medicare Tax
withholding that you reported on Form 941, line 5d,
Note. If you checked the box on Form 941-X, line 4b or
column 1, enter the total corrected amount in column 1. In
line 5c, because you’re correcting only the employer share
column 2, enter the amount you originally reported or as
of tax on a decrease to Medicare wages and tips, use
previously corrected. In column 3, enter the difference
0.0145 (1.45%) when multiplying the amount in column 3.
between columns 1 and 2.
If you’re correcting both shares of tax for some employees
and only the employer share for other employees, enter
the properly calculated amount in column 4. Be sure to line 13 (column 1)
explain your calculations on line 43. - line 13 (column 2)
line 13 (column 3) If the amount in column 2 is larger than the
Example—Medicare wages and tips decreased. amount in column 1, use a minus sign in
Following Example—Wages, tips, and other column 3.
compensation decreased in the instructions for line 6, the
wages that you counted twice were also taxable Medicare
wages and tips. To correct the error, figure the difference Multiply the amount in column 3 by 0.009 (0.9% tax
on Form 941-X as shown. rate) and enter that result in column 4.

Column 1 (corrected amount) 7,000.00 line 13 (column 3)
Column 2 (Form 941, line 5c, column 1) - 9,000.00 x 0.009
Column 3 (difference) -2,000.00 line 13 (column 4) If the amount in column 3 used a minus sign,
also use a minus sign in column 4.

Instructions for Form 941-X (Rev. 4-2024) 15

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Example—Prior year administrative error Medicare Tax withheld (column 4) because the error
(incorrectly reported amount of Additional Medicare involves a previous year and the amount previously
Tax actually withheld). Xavier Black's wages exceeded reported for Sophie represents the actual amount withheld
the $200,000 withholding threshold for Additional from Sophie during 2023.
Medicare Tax in November 2023. The total wages paid to
Combination of prior year administrative and nonad-
Xavier for 2023 were $230,000. You withheld $270
ministrative errors. If you’re reporting both
($30,000 x 0.009) from Xavier's wages. However, on your
administrative errors and nonadministrative errors for the
fourth quarter 2023 Form 941, you mistakenly reported
same quarter of a prior year, enter the total corrected
$3,000 on line 5d, column 1, and Additional Medicare Tax
amount in column 1. In column 2, enter the amount you
withheld of $27 on line 5d, column 2. You discover the
originally reported or as previously corrected. In column 3,
error on March 11, 2024. This is an example of an
enter the difference between columns 1 and 2. However,
administrative error that may be corrected in a later
multiply only the amount of wages and tips reported in
calendar year because the amount actually withheld isn’t
column 3 that are related to administrative errors by 0.009
the amount reported on your fourth quarter 2023 Form
(0.9% tax rate). Don’t multiply any wages and tips
941. Use Form 941-X, line 13, to correct the error as
reported in column 3 that are related to nonadministrative
shown below.
errors by 0.009 (0.9% tax rate). Use line 43 to explain in
detail your corrections. The explanation must include the
Column 1 (corrected amount) 30,000.00 reasons for the corrections and a breakdown of the
Column 2 (Form 941, line 5d, column 1) - 3,000.00 amount reported in column 3 into the amounts related to
Column 3 (difference) 27,000.00 administrative errors and nonadministrative errors.
Example—Combination of prior year administrative
and nonadministrative errors. Xavier Black’s wages
Use the difference in column 3 to determine your tax exceeded the $200,000 withholding threshold for
correction. Additional Medicare Tax in November 2023. The total
wages paid to Xavier for 2023 were $230,000. You
Column 3 (difference) 27,000.00 withheld $270 ($30,000 x 0.009) from Xavier's wages.
Tax rate (0.9%) x 0.009 However, on your fourth quarter 2023 Form 941, you
Column 4 (tax correction) 243.00 mistakenly reported $3,000 on line 5d, column 1, and
Additional Medicare Tax withheld of $27 on line 5d,
column 2. The difference in wages subject to Additional
Be sure to explain the reasons for this correction on Medicare Tax related to this administrative error is
line 43. $27,000 ($30,000 - $3,000).
Prior year nonadministrative errors. You may correct Sophie Rose’s wages exceeded the $200,000
only the taxable wages and tips subject to Additional withholding threshold for Additional Medicare Tax in
Medicare Tax withholding that you reported on Form 941, December 2023. The total wages paid to Sophie for 2023
line 5d, column 1. Enter the total corrected amount in were $220,000. You were required to withhold $180
column 1. In column 2, enter the amount you originally ($20,000 x 0.009) but you withheld nothing and didn’t
reported or as previously corrected. In column 3, enter the report Sophie's $20,000 in wages subject to Additional
difference between columns 1 and 2. Medicare Tax withholding on line 5d of your fourth quarter
2023 Form 941.
line 13 (column 1) You discover both errors on March 11, 2024. Use Form
- line 13 (column 2) 941-X, line 13, to correct the errors as shown below.
line 13 (column 3) If the amount in column 2 is larger than the
amount in column 1, use a minus sign in Column 1 (corrected amount) 50,000.00
column 3. Column 2 (Form 941, line 5d, column 1) - 3,000.00
Column 3 (difference) 47,000.00
Don’t multiply the amount in column 3 by 0.009 (0.9%
tax rate). Leave column 4 blank and explain the reasons Determine the portion of wages and tips reported in
for this correction on line 43. column 3 that is related to the administrative error
Example—Prior year nonadministrative error ($47,000 - $20,000 (nonadministrative error) = $27,000
(failure to withhold Additional Medicare Tax when (administrative error)). Multiply this portion of column 3 by
required). Sophie Rose’s wages exceeded the $200,000 0.009 (0.9% tax rate) to determine your tax correction.
withholding threshold for Additional Medicare Tax in
December 2023. The total wages paid to Sophie for 2023 Difference related to administrative error 27,000.00
were $220,000. You were required to withhold $180 Tax rate (0.9%) x 0.009
($20,000 x 0.009) but you withheld nothing and didn’t
Column 4 (tax correction) 243.00
report an amount on line 5d of your fourth quarter 2023
Form 941. You discover the error on March 11, 2024. File
Form 941-X to correct wages and tips subject to
Be sure to explain the reasons for these corrections on
Additional Medicare Tax withholding for your 2023 fourth
line 43. You must also report that $20,000 of the amount
quarter Form 941, but you may not correct the Additional
shown in column 3 was related to the correction of a prior

16 Instructions for Form 941-X (Rev. 4-2024)

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year nonadministrative error and $27,000 of the amount Column 1 (corrected amount) -9,600.00
shown in column 3 was related to the correction of an Column 2 (Form 941, line 8) - (6,900.00)
administrative error. Column 3 (difference) -2,700.00
14. Section 3121(q) Notice and Demand—Tax on
Unreported Tips Here is how you would enter the numbers on Form
Enter on line 14 any corrections to amounts reported on 941-X.
Form 941, line 5f, for the tax due from a Section 3121(q)
Notice and Demand. The IRS issues a Section 3121(q) Column 1 Column 2 Column 3
Notice and Demand to advise an employer of the amount (corrected (Form 941, line 8) (difference)
of tips received by employees who failed to report or amount)
underreported tips to the employer. An employer isn’t -9,600.00 -6,900.00 -2,700.00
liable for the employer share of the social security and
Medicare taxes on unreported tips until a Section 3121(q)
Notice and Demand for the taxes is made to the employer Report “-2,700.00” as your correction in column 4.
by the IRS.
In this example, you’re claiming a credit for $2,700 in
Be sure to explain the reasons for any corrections on overreported tax for your 2023 second quarter Form 941.
line 43. Always enter the same amount in column 4 (including any
minus sign) that you enter in column 3.
15. Tax Adjustments Be sure to explain the reasons for this correction on
For purposes of these instructions, all references line 43.
TIP to “sick pay” mean ordinary sick pay, not “qualified
sick leave wages.” 16. Qualified Small Business Payroll Tax Credit
for Increasing Research Activities
Use line 15 to correct any adjustments reported on
Form 941, lines 7–9. Enter in column 1 the total corrected The payroll tax credit election must be made on or
amount for Form 941, lines 7–9. ! before the due date of the originally filed income
CAUTION tax return (including extensions). Any election to
Enter in column 2 the total originally reported or take the payroll tax credit may be revoked only with the
previously corrected amounts from Form 941, lines 7–9. In consent of the IRS.
column 3, enter the difference between columns 1 and 2.
If you’re correcting the qualified small business payroll
line 15 (column 1) tax credit for increasing research activities that you
-line 15 (column 2) reported on Form 941, line 11a (line 11 for quarters
beginning after December 31, 2023), enter the total
line 15 (column 3)
corrected amount in column 1. In column 2, enter the
amount you originally reported or as previously corrected.
In column 3, enter the difference between columns 1 and
You may need to report negative numbers in any 2.
TIP column. Make sure that the difference you enter in
column 3 accurately represents the change to Copy the amount in column 3 to column 4. However, to
adjustments originally reported or previously corrected on properly show the amount as a credit or balance due item,
Form 941, lines 7–9. enter a positive number in column 3 as a negative number
in column 4 or a negative number in column 3 as a
Copy the amount in column 3 to column 4. Include any positive number in column 4.
minus sign shown in column 3.
You must attach a corrected Form 8974 and explain the
On line 43, describe what you misreported on Form reasons for this correction on line 43.
941. Tell us if your adjustment is for fractions of cents,
third-party sick pay, tips, or group-term life insurance. 17. Nonrefundable Portion of Credit for Qualified
Sick and Family Leave Wages for Leave Taken
Example—Current quarter's third-party sick pay
underreported. You reported $6,900 (shown as After March 31, 2020, and Before April 1, 2021
“-6,900.00”) as a third-party sick pay adjustment Form 941-X and these instructions use the terms
(reduction to tax) on line 8 of your 2023 second quarter TIP “nonrefundable” and “refundable” when
Form 941. You didn’t report any amounts on lines 7 and 9. discussing credits. The term “nonrefundable”
Your third-party sick pay adjustment should’ve been means the portion of the credit which is limited by law to
$9,600 (shown as “-9,600.00”) because your third-party certain taxes. The term “refundable” means the portion of
sick pay payer withheld that amount of social security and the credit which is in excess of those taxes.
Medicare taxes from your employees. You discovered the
error in April of 2024. To correct the error, figure the
difference on Form 941-X as shown.

Instructions for Form 941-X (Rev. 4-2024) 17

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        Generally, the period of limitations for correcting       because you paid qualified sick leave wages and/or 
!       the nonrefundable portion of credit for qualified         qualified family leave wages that meet an exclusion under 
CAUTION sick and family leave wages paid in the second,           sections 3121(b)(1)–(22) and the period of limitations is 
third, and fourth quarters of 2020 expired on April 15,           still open, you may file Form 941-X and complete 
2024, for most employers. For more information about the          Worksheet 1 to claim the correct amount of the credit. 
period of limitations, see Is There a Deadline for Filing         You'll also include on Form 941-X, lines 28 and 29, and on 
Form 941-X, earlier.                                              Worksheet 1 any qualified health plan expenses allocable 
                                                                  to those wages. The appropriate lines related to the 
For corrections to Form 941, line 11b, the credit for 
                                                                  exclusions under sections 3121(b)(1)–(22) were added to 
qualified sick and family leave wages is only available for 
                                                                  Worksheet 1 in the first quarter 2021 Instructions for Form 
wages paid with respect to leave taken after March 31, 
                                                                  941 (Revised March 2021).
2020, and before April 1, 2021. Don't enter an amount on 
line 17 if you're correcting a quarter that began before          Example—Nonrefundable portion of credit for 
April 1, 2020.                                                    qualified sick and family leave wages increased. 
If you’re correcting the nonrefundable portion of the             Following Example—Qualified sick leave wages increased 
credit for qualified sick and family leave wages for leave        in the instructions for line 9, you originally reported a 
taken after March 31, 2020, and before April 1, 2021, that        $1,000 nonrefundable portion of the credit for qualified 
you reported on Form 941, line 11b, enter the total               sick and family leave wages on Form 941, line 11b, for the 
corrected amount from Worksheet 1, Step 2, line 2j, in            first quarter of 2021. You use Worksheet 1 to refigure the 
column 1. In column 2, enter the amount you originally            correct nonrefundable portion of the credit for qualified 
reported or as previously corrected. In column 3, enter the       sick and family leave wages and you determine that the 
difference between columns 1 and 2. For more information          correct credit is now $2,000. To correct the error, figure the 
about the credit for qualified sick and family leave wages,       difference on Form 941-X as shown.
go to IRS.gov/PLC.
                                                                  Column 1 (corrected amount)                 2,000.00
Copy the amount in column 3 to column 4. However, to              Column 2 (Form 941, line 11b)               - 1,000.00
properly show the amount as a credit or balance due item, 
                                                                  Column 3 (difference)                       1,000.00
enter a positive number in column 3 as a negative number 
in column 4 or a negative number in column 3 as a 
positive number in column 4.
                                                                  To properly show the credit increase as a reduction to 
Definition of qualified sick and family leave wages for           your tax balance, enter the positive number in column 3 as 
leave taken after March 31, 2020, and before April 1,             a negative number in column 4. Here is how you would 
2021. For purposes of the credit for qualified sick and           enter the numbers on Form 941-X, line 17.
family leave wages, qualified sick and family leave wages 
are wages for social security and Medicare tax purposes,          Column 1   Column 2            Column 3     Column 4
determined without regard to the exclusions from the              (corrected (Form 941,          (difference) (tax correction)
definition of employment under sections 3121(b)(1)–(22),          amount)    line 11b)
that an employer pays that otherwise meet the                      2,000.00  1,000.00            1,000.00     -1,000.00
requirements of the Emergency Paid Sick Leave Act 
(EPSLA) or the Emergency Family and Medical Leave 
Expansion Act (Expanded FMLA), as enacted under the               Be sure to explain the reasons for this correction on 
FFCRA and amended by the COVID-related Tax Relief Act             line 43.
of 2020. However, don't include any wages otherwise 
excluded under sections 3121(b)(1)–(22) when reporting            18a. Nonrefundable Portion of Employee 
qualified sick and family leave wages on your employment          Retention Credit
tax return and when figuring the credit on Worksheet 1,           Use line 18a only for corrections to quarters beginning 
Step 2, lines 2a and 2a(i), and on Step 2, lines 2e and           after March 31, 2020, and before January 1, 2022.
2e(i). Instead, include qualified sick leave wages and 
qualified family leave wages excluded from the definition                 Section 206(c) of the Taxpayer Certainty and 
of employment under sections 3121(b)(1)–(22) separately           TIP     Disaster Tax Relief Act of 2020 removed the 
in Step 2, line 2a(iii) and/or line 2e(iii), respectively, before         restriction on an employer who has received a 
you figure your total credit in Step 2, line 2d (credit for       Small Business Interruption Loan under the Paycheck 
qualified sick leave wages), or Step 2, line 2h (credit for       Protection Program (PPP) from claiming the employee 
qualified family leave wages).                                    retention credit. The eligible employer can claim the 
                                                                  employee retention credit on any qualified wages that 
The April 2020 revision and July 2020 revision of the 
                                                                  aren't counted as payroll costs in obtaining PPP loan 
Instructions for Form 941 were released before the 
                                                                  forgiveness. Any wages that could count toward eligibility 
COVID-related Tax Relief Act of 2020 was enacted on 
                                                                  for the employee retention credit or PPP loan forgiveness 
December 27, 2020; therefore, Worksheet 1, in those 
                                                                  can be applied to either of these two programs, but not 
Instructions for Form 941, didn't include lines to add the 
                                                                  both. If your Form 941 didn't claim the correct amount for 
wages that meet an exclusion under sections 3121(b)(1)–
                                                                  the employee retention credit because you received a 
(22) when figuring the credits for qualified sick and family 
                                                                  Small Business Interruption Loan under the PPP, you may 
leave wages. If your Form 941 for the second, third, or 
                                                                  file Form 941-X and complete Worksheet 2 to claim the 
fourth quarter of 2020 didn't claim the correct amount of 
                                                                  correct amount of the credit. For more information, see 
the credit for qualified sick and family leave wages 

18                                                                           Instructions for Form 941-X (Rev. 4-2024)

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Notice 2021-20, 2021-11 I.R.B. 922, available at and you make any corrections on Form 941-X for the
IRS.gov/irb/2021-11_IRB#NOT-2021-20; and Rev. Proc. quarter to amounts used to figure this credit, you'll need to
2021-33, 2021-34 I.R.B. 327, available at IRS.gov/irb/ refigure the amount of the credit using Worksheet 2. You'll
2021-34_IRB#REV-PROC-2021-33. also use this worksheet to figure this credit if you’re
claiming the credit for the first time on Form 941-X.
Instructions for Qualified Wages Paid After March
12, 2020, and Before July 1, 2021 Instructions for Qualified Wages Paid After June
30, 2021, and Before January 1, 2022
Generally, the period of limitations for correcting
! the nonrefundable portion of the employee The Infrastructure Investment and Jobs Act
CAUTION retention credit for the second, third, and fourth ! amends section 3134 of the Internal Revenue
quarters of 2020 expired on April 15, 2024, for most CAUTION Code, as enacted under the ARP, to limit the
employers. For more information about the period of availability of the employee retention credit in the fourth
limitations, see Is There a Deadline for Filing Form 941-X, quarter of 2021 to employers that are recovery startup
earlier. Although lines 33a and 34, which were used to businesses, as defined in section 3134(c)(5). Thus, for
correct qualified wages paid March 13 through March 31, wages paid after September 30, 2021, and before January
2020, for the employee retention credit, are now reserved, 1, 2022, only the wages paid by recovery startup
we continue to reference those dates throughout these businesses can be qualified wages. See the December
instructions and Worksheet 2. 2021 revision of the Instructions for Form 941 for more
information about a recovery startup business.
If you’re correcting the nonrefundable portion of the
employee retention credit for qualified wages paid after If you're correcting the nonrefundable portion of the
March 12, 2020, and before July 1, 2021, that you employee retention credit for qualified wages paid after
reported on Form 941, line 11c, enter the total corrected June 30, 2021, and before January 1, 2022, that you
amount from Worksheet 2, Step 2, line 2j, in column 1. In reported on Form 941, line 11c, enter the total corrected
column 2, enter the amount you originally reported or as amount from Worksheet 4, Step 2, line 2h, in column 1. In
previously corrected. In column 3, enter the difference column 2, enter the amount you originally reported or as
between columns 1 and 2. previously corrected. In column 3, enter the difference
between columns 1 and 2.
Copy the amount in column 3 to column 4. However, to
properly show the amount as a credit or balance due item, Copy the amount in column 3 to column 4. However, to
enter a positive number in column 3 as a negative number properly show the amount as a credit or balance due item,
in column 4 or a negative number in column 3 as a enter a positive number in column 3 as a negative number
positive number in column 4. For an example of how to in column 4 or a negative number in column 3 as a
report amounts in columns 1–4 for an employment tax positive number in column 4. For an example of how to
credit, see the instructions for line 17, earlier. report amounts in columns 1–4 for an employment tax
credit, see the instructions for line 17, earlier.
For more information about the employee retention
credit for qualified wages paid after March 12, 2020, and For more information about the employee retention
before January 1, 2021, see Notice 2021-20. See Notice credit for qualified wages paid after June 30, 2021, and
2021-23, 2021-16 I.R.B. 1113, available at IRS.gov/irb/ before January 1, 2022, see Notice 2021-49 and Rev.
2021-16_IRB#NOT-2021-23, for more information about Proc. 2021-33. See Notice 2021-65, 2021-51 I.R.B. 880,
the employee retention credit for qualified wages paid available at IRS.gov/irb/2021-51_IRB#NOT-2021-65, for
after December 31, 2020, and before July 1, 2021. Also modifications to Notice 2021-49.
see section IV of Notice 2021-49, 2021-34 I.R.B. 316,
Be sure to explain the reasons for this correction on
available at IRS.gov/irb/2021-34_IRB#NOT-2021-49; and
line 43.
Rev. Proc. 2021-33.
Adjustments to the nonrefundable portion of the
Be sure to explain the reasons for this correction on TIP employee retention credit for qualified wages paid
line 43. after June 30, 2021, and before January 1, 2022,
are reported on Form 941-X, line 18a, and adjustments to
Adjustments to the nonrefundable portion of the
the refundable portion of the credit are reported on Form
TIP employee retention credit for qualified wages paid
941-X, line 26a. Adjustments to qualified wages for the
after March 12, 2020, and before July 1, 2021, are
employee retention credit are reported on Form 941-X,
reported on Form 941-X, line 18a, and adjustments to the
line 30. Adjustments to qualified health plan expenses
refundable portion of the credit are reported on Form
allocable to the employee retention credit are reported on
941-X, line 26a. Adjustments to qualified wages for the
Form 941-X, line 31a. If you claimed the employee
employee retention credit are reported on Form 941-X,
retention credit on your original Form 941 for the quarter,
line 30. Adjustments to qualified health plan expenses
and you make any corrections on Form 941-X for the
allocable to the employee retention credit are reported on
quarter to amounts used to figure this credit, you'll need to
Form 941-X, line 31a. The employee retention credit may
refigure the amount of the credit using Worksheet 4. You'll
only be claimed on Form 941 filed for quarters beginning
also use this worksheet to figure this credit if you’re
after March 31, 2020. If you claimed the employee
claiming the credit for the first time on Form 941-X.
retention credit on your original Form 941 for the quarter,

Instructions for Form 941-X (Rev. 4-2024) 19

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18b. Nonrefundable Portion of Credit for through periods of coverage beginning on or before
Qualified Sick and Family Leave Wages for September 30, 2021 under Reminders, earlier. Use
Leave Taken After March 31, 2021, and Before line 18c only for corrections to quarters beginning after
March 31, 2021.
October 1, 2021
For corrections to Form 941, line 11d, the credit for Premium payees that receive an election from an
qualified sick and family leave wages is only available for TIP assistance eligible individual are entitled to the
wages paid with respect to leave taken after March 31, COBRA premium assistance credit for premiums
2021, and before October 1, 2021. Don't enter an amount not paid during the quarter in which the election is
on line 18b if you're correcting a quarter that began before received. See Notice 2021-31 for more information.
April 1, 2021.
If you’re correcting the nonrefundable portion of the
If you’re correcting the nonrefundable portion of the COBRA premium assistance credit that you reported on
credit for qualified sick and family leave wages for leave Form 941, line 11e, enter the total corrected amount from
taken after March 31, 2021, and before October 1, 2021, Worksheet 5, Step 2, line 2g, in column 1. In column 2,
that you reported on Form 941, line 11d, enter the total enter the amount you originally reported or as previously
corrected amount from Worksheet 3, Step 2, line 2r, in corrected. In column 3, enter the difference between
column 1. In column 2, enter the amount you originally columns 1 and 2.
reported or as previously corrected. In column 3, enter the
difference between columns 1 and 2. For more information Copy the amount in column 3 to column 4. However, to
about the credit for qualified sick and family leave wages, properly show the amount as a credit or balance due item,
go to IRS.gov/PLC. enter a positive number in column 3 as a negative number
Copy the amount in column 3 to column 4. However, to in column 4 or a negative number in column 3 as a
properly show the amount as a credit or balance due item, positive number in column 4. For an example of how to
enter a positive number in column 3 as a negative number report amounts in columns 1–4 for an employment tax
in column 4 or a negative number in column 3 as a credit, see the instructions for line 17, earlier.

positive number in column 4. For an example of how to Be sure to explain the reasons for this correction on
report amounts in columns 1–4 for an employment tax line 43.
credit, see the instructions for line 17, earlier.
Definition of qualified sick and family leave wages for 18d. Number of Individuals Provided COBRA
leave taken after March 31, 2021, and before October Premium Assistance
1, 2021. For purposes of this credit, qualified sick leave Use line 18d only for corrections to quarters beginning
wages and qualified family leave wages are wages for after March 31, 2021.
social security and Medicare tax purposes, determined
without regard to the exclusions from the definition of If you’re correcting the number of individuals provided
employment under sections 3121(b)(1)–(22), that an COBRA premium assistance that you reported on Form
employer pays that otherwise meet the requirements of 941, line 11f, enter the total corrected amount in column 1.
the EPSLA or Expanded FMLA, as enacted under the In column 2, enter the amount you originally reported or as
FFCRA and amended for purposes of the ARP. Taxable previously corrected. In column 3, enter the difference
qualified sick leave wages and qualified family leave between columns 1 and 2.
wages for leave taken after March 31, 2021, and before
October 1, 2021, were included on Form 941, line 5a, Be sure to explain the reasons for this correction on
column 1, and can be adjusted only on Form 941-X, line 8. line 43.
Total qualified sick and family leave wages for leave taken
after March 31, 2021, and before October 1, 2021, 19–22. Special Additions to Wages for Federal
including any qualified leave wages that were above the Income Tax, Social Security Taxes, Medicare
social security wage base and any qualified leave wages Taxes, and Additional Medicare Tax
excluded from the definition of employment under Section 3509 provides special rates for the employee
sections 3121(b)(1)–(22), were included on Form 941, share of federal income tax, social security tax, Medicare
lines 23 and 26, respectively, and can be adjusted only on tax, and Additional Medicare Tax withholding when
Form 941-X, lines 35 and 38, respectively. Use Worksheet workers are reclassified as employees in certain
3 to figure your credit. circumstances. The applicable rate depends on whether
Be sure to explain the reasons for this correction on you filed required information returns. An employer can’t
line 43. recover any tax paid under this provision from the
employees. The full employer share of social security tax
18c. Nonrefundable Portion of COBRA Premium and Medicare tax is due for all reclassifications.
Assistance Credit
Note. Section 3509 rates aren’t available if you
The COBRA premium assistance was available for
intentionally disregarded the requirements to withhold
periods of coverage beginning on or after April 1, 2021,
taxes from the employee, or if you withheld federal income
through periods of coverage beginning on or before
tax but didn’t withhold social security and Medicare taxes.
September 30, 2021. For more information, see Credit for
Section 3509 rates are also not available for certain
COBRA premium assistance payments is limited to
statutory employees.
periods of coverage beginning on or after April 1, 2021,

20 Instructions for Form 941-X (Rev. 4-2024)

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On lines 19–22, enter only corrections to wages 25. Refundable Portion of Credit for Qualified
resulting from reclassifying certain workers as employees Sick and Family Leave Wages for Leave Taken
when section 3509 rates are used to calculate the taxes. After March 31, 2020, and Before April 1, 2021
If the employer issued the required information returns, Generally, the period of limitations for correcting
use the section 3509 rates as follows. ! the refundable portion of credit for qualified sick
• For social security taxes, use the employer rate of 6.2% CAUTION and family leave wages paid in the second, third,
plus 20% of the employee rate of 6.2%, for a total rate of and fourth quarters of 2020 expired on April 15, 2024, for
7.44% of wages. most employers. For more information about the period of
• For Medicare taxes, use the employer rate of 1.45% limitations, see Is There a Deadline for Filing Form 941-X,
plus 20% of the employee rate of 1.45%, for a total rate of earlier.
1.74% of wages.
• For Additional Medicare Tax, 0.18% (20% of the For corrections to Form 941, line 13c, the credit for
employee rate of 0.9%) of wages subject to Additional qualified sick and family leave wages is only available for
Medicare Tax. wages paid with respect to leave taken after March 31,
• For federal income tax withholding, the rate is 1.5% of 2020, and before April 1, 2021. Don't enter an amount on
wages. line 25 if you're correcting a quarter that began before
April 1, 2020.
If the employer didn’t issue the required information
returns, use the section 3509 rates as follows. If you’re correcting the refundable portion of the credit
• For social security taxes, use the employer rate of 6.2% for qualified sick and family leave wages for leave taken
plus 40% of the employee rate of 6.2%, for a total rate of after March 31, 2020, and before April 1, 2021, that you
8.68% of wages. reported on Form 941, line 13c, enter the total corrected
• For Medicare taxes, use the employer rate of 1.45% amount from Worksheet 1, Step 2, line 2k, in column 1. In
plus 40% of the employee rate of 1.45%, for a total rate of column 2, enter the amount you originally reported or as
2.03% of wages. previously corrected. In column 3, enter the difference
• For Additional Medicare Tax, 0.36% (40% of the between columns 1 and 2. For more information about the
employee rate of 0.9%) of wages subject to Additional credit for qualified sick and family leave wages, go to
Medicare Tax. IRS.gov/PLC.
• For federal income tax withholding, the rate is 3.0% of
wages. Copy the amount in column 3 to column 4. However, to
properly show the amount as a credit or balance due item,
Unlike some other lines on Form 941-X, enter in column enter a positive number in column 3 as a negative number
1 only the corrected wages for workers being reclassified, in column 4 or a negative number in column 3 as a
not the amount paid to all employees. Enter in column 2 positive number in column 4. For an example of how to
previously reported wages (if any) to reclassified report amounts in columns 1–4 for an employment tax
employees. To get the amount for column 4, use the credit, see the instructions for line 17, earlier.
applicable section 3509 rates. If you filed the required
information returns for some employees but didn’t file Be sure to explain the reasons for this correction on
them for other employees, be sure to use the applicable line 43.
rates for each employee when calculating the amounts in
column 4 and show your calculations on line 43. The tax 26a. Refundable Portion of Employee Retention
correction in column 4 will be a positive number if you Credit
increased the amount of wages you previously reported. Use line 26a only for corrections to quarters beginning
See the instructions for line 42, later, for more information. after March 31, 2020, and before January 1, 2022.

23. Subtotal Instructions for Qualified Wages Paid After March
Combine the amounts from column 4 on lines 7–22 and 12, 2020, and Before July 1, 2021
enter the result on line 23.
Generally, the period of limitations for correcting
Example. You entered “1,400.00” in column 4 on ! the refundable portion of the employee retention
line 7, “-500.00” in column 4 on line 8, and “-100.00” in CAUTION credit for the second, third, and fourth quarters of
column 4 on line 12. Combine these amounts and enter 2020 expired on April 15, 2024, for most employers. For
“800.00” in column 4 on line 23. more information about the period of limitations, see Is
There a Deadline for Filing Form 941-X, earlier. Although
Line 7 1,400.00 lines 33a and 34, which were used to correct qualified
Line 8 (500.00) wages paid March 13 through March 31, 2020, for the
Line 12 + (100.00) employee retention credit, are now reserved, we continue
Line 23 800.00 to reference those dates throughout these instructions and
Worksheet 2.

If you’re correcting the refundable portion of the
employee retention credit that you reported on Form 941,
line 13d, for qualified wages paid after March 12, 2020,
and before July 1, 2021, enter the total corrected amount

Instructions for Form 941-X (Rev. 4-2024) 21

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from Worksheet 2, Step 2, line 2k, in column 1. In column 941, line 13f (13h), to reflect the correct advance
2, enter the amount you originally reported or as payments received by their clients or customers. If you’re
previously corrected. In column 3, enter the difference an aggregate filer that needs to correct the amount
between columns 1 and 2. For more information about the reported on Form 941, line 13f (13h), include any increase
employee retention credit for qualified wages paid after or decrease to the amount in the “Total” reported on Form
March 12, 2020, and before January 1, 2021, see Notice 941-X, line 27; write “Correction to line 13f” or "Correction
2021-20. See Notice 2021-23 for more information about to line 13h," as applicable, on the dotted line to the left of
the employee retention credit for qualified wages paid the entry box on line 27; explain your correction on line 43;
after December 31, 2020, and before July 1, 2021. Also and attach Schedule R (Form 941) to Form 941-X to show
see section IV of Notice 2021-49, and Rev. Proc. 2021-33. corrections for your clients or customers.

Copy the amount in column 3 to column 4. However, to 26b. Refundable Portion of Credit for Qualified
properly show the amount as a credit or balance due item, Sick and Family Leave Wages for Leave Taken
enter a positive number in column 3 as a negative number After March 31, 2021, and Before October 1,
in column 4 or a negative number in column 3 as a 2021
positive number in column 4. For an example of how to
report amounts in columns 1–4 for an employment tax For corrections to Form 941, line 13e, the credit for
credit, see the instructions for line 17, earlier. qualified sick and family leave wages is only available for
wages paid with respect to leave taken after March 31,
Be sure to explain the reasons for this correction on 2021, and before October 1, 2021. Don't enter an amount
line 43. on line 26b if you're correcting a quarter that began before
April 1, 2021.
Instructions for Qualified Wages Paid After June If you’re correcting the refundable portion of the credit
30, 2021, and Before January 1, 2022 for qualified sick and family leave wages for leave taken
after March 31, 2021, and before October 1, 2021, that
If you're correcting the refundable portion of the employee you reported on Form 941, line 13e, enter the total
retention credit that you reported on Form 941, line 13d, corrected amount from Worksheet 3, Step 2, line 2s, in
for qualified wages paid after June 30, 2021, and before column 1. In column 2, enter the amount you originally
January 1, 2022, enter the total corrected amount from reported or as previously corrected. In column 3, enter the
Worksheet 4, Step 2, line 2i, in column 1. In column 2, difference between columns 1 and 2. For more information
enter the amount you originally reported or as previously about the credit for qualified sick and family leave wages,
corrected. In column 3, enter the difference between go to IRS.gov/PLC.
columns 1 and 2. For more information about the
employee retention credit for qualified wages paid after Copy the amount in column 3 to column 4. However, to
June 30, 2021, and before January 1, 2022, see Notice properly show the amount as a credit or balance due item,
2021-49 and Rev. Proc. 2021-33. See Notice 2021-65 for enter a positive number in column 3 as a negative number
modifications to Notice 2021-49. in column 4 or a negative number in column 3 as a
positive number in column 4. For an example of how to
Copy the amount in column 3 to column 4. However, to report amounts in columns 1–4 for an employment tax
properly show the amount as a credit or balance due item, credit, see the instructions for line 17, earlier.
enter a positive number in column 3 as a negative number
in column 4 or a negative number in column 3 as a Be sure to explain the reasons for this correction on
positive number in column 4. For an example of how to line 43.
report amounts in columns 1–4 for an employment tax
26c. Refundable Portion of COBRA Premium
credit, see the instructions for line 17, earlier.
Assistance Credit
Be sure to explain the reasons for this correction on The COBRA premium assistance was available for
line 43. periods of coverage beginning on or after April 1, 2021,
through periods of coverage beginning on or before
Corrections to Form 941, Line 13f (For Quarters September 30, 2021. For more information, see Credit for
Beginning After March 31, 2020, and Ending COBRA premium assistance payments is limited to
Before April 1, 2021) or Line 13h (For Quarters periods of coverage beginning on or after April 1, 2021,
Beginning After March 31, 2021, and Ending through periods of coverage beginning on or before
September 30, 2021 under Reminders, earlier. Use
Before January 1, 2022) line 26c only for corrections to quarters beginning after
Form 941-X doesn't include a line to correct amounts March 31, 2021.
reported on Form 941, line 13f (13h), for the total
advances received from filing Form(s) 7200 for the If you’re correcting the refundable portion of the
quarter. If a discrepancy exists between the amount COBRA premium assistance credit that you reported on
reported on Form 941 and the amount of advance Form 941, line 13f, enter the total corrected amount from
payments issued, the IRS will generally correct the Worksheet 5, Step 2, line 2h, in column 1. In column 2,
amount reported on Form 941, line 13f (13h), to match the enter the amount you originally reported or as previously
amount of advance payments issued. However, aggregate corrected. In column 3, enter the difference between
filers may need to correct the amount reported on Form columns 1 and 2.

22 Instructions for Form 941-X (Rev. 4-2024)

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Copy the amount in column 3 to column 4. However, to people who are deaf, hard of hearing, or have a speech
properly show the amount as a credit or balance due item, disability, dial 711 and then provide the TRS assistant the
enter a positive number in column 3 as a negative number 800-555-4477 number above or 800-733-4829. Additional
in column 4 or a negative number in column 3 as a information about EFTPS is also available in Pub. 966.
positive number in column 4. For an example of how to • To pay by credit or debit card, go to IRS.gov/
report amounts in columns 1–4 for an employment tax PayByCard. Your payment will be processed by a payment
credit, see the instructions for line 17, earlier. processor who will charge a processing fee.
• If you pay by check or money order, make it payable to
Be sure to explain the reasons for this correction on “United States Treasury.” On your check or money order,
line 43. be sure to write your EIN, “Form 941-X,” the calendar
quarter you corrected (for example, “Quarter 2”), and the
27. Total calendar year of the quarter you corrected.
Combine the amounts from column 4 on lines 23–26c and You don’t have to pay if the amount you owe is less than
enter the result on line 27. $1.
Your credit. If the amount entered on line 27 is less than Previously assessed FTD penalty. If line 27 reflects
zero, for example, “-115.00,” you have a credit because overreported tax and the IRS previously assessed an FTD
you overreported your federal employment taxes. penalty, you may be able to reduce the penalty. For more
• If you checked the box on line 1, include this amount on information, see the Instructions for Schedule B (Form
the "Total deposits" line of Form 941 for the quarter during 941).
which you filed Form 941-X. If you currently file Form 944
because your filing requirement changed, include this Lines 28–40
amount on the "Total deposits" line of Form 944 for the For lines 28–31a, line 32, and lines 35–40, you'll only enter
year during which you filed Form 941-X. Don’t make any amounts in columns 1, 2, and 3. These lines don’t have an
changes to your record of federal tax liability reported on entry space for column 4 because these adjustments
Form 941, line 16, or Schedule B (Form 941) if your Form don’t directly result in an increase or decrease to your tax.
941-X is filed timely. The amounts reported on the record The amounts entered on lines 28–31a, line 32, and lines
should reflect your actual tax liability for the period. 35–40 are amounts that you use in Worksheets 1–5, as
• If you checked the box on line 2, you’re filing a claim for applicable, to figure your credits. If you reported an
refund or abatement of the amount shown. incorrect amount on lines 19–28 on your original Form
If your credit is less than $1, we will send a refund or 941, then you'll use lines 28–31a, line 32, and lines 35–40
apply it only if you ask us in writing to do so. of Form 941-X to report the correction. Use Worksheets
1–5, as applicable, to refigure your credits based on the
Amount you owe. If the amount on line 27 is a positive corrected amounts reported in column 1. For details on
number, you must pay the amount you owe by the time how to complete line 31b, see the instructions for line 31b,
you file Form 941-X. You may not use any credit that you later. Be sure to explain the reasons for your corrections
show on another Form 941-X to pay the amount you owe, on line 43.
even if you filed for the amount you owe and the credit at
the same time. 28. Qualified Health Plan Expenses Allocable to
If you owe tax and are filing a timely Form 941-X, don’t Qualified Sick Leave Wages for Leave Taken
file an amended Schedule B (Form 941) unless you were After March 31, 2020, and Before April 1, 2021
assessed an FTD penalty caused by an incorrect,
incomplete, or missing Schedule B (Form 941). Don’t Generally, the period of limitations for correcting
include the tax increase reported on Form 941-X on any ! qualified health plan expenses allocable to
amended Schedule B (Form 941) you file. CAUTION qualified sick leave wages paid in the second,
third, and fourth quarters of 2020 expired on April 15,
If you owe tax and are filing a late Form 941-X, that is,
2024, for most employers. For more information about the
after the due date for Form 941 for the quarter in which
period of limitations, see Is There a Deadline for Filing
you discovered the error, you must file an amended
Form 941-X, earlier.
Schedule B (Form 941) with the Form 941-X. Otherwise,
the IRS may assess an “averaged” FTD penalty. The total If you’re correcting the qualified health plan expenses
tax reported on the “Total liability for the quarter” line of allocable to qualified sick leave wages for leave taken after
Schedule B (Form 941) must match the corrected tax March 31, 2020, and before April 1, 2021, that you
(Form 941, line 12, combined with any correction reported reported on Form 941, line 19, enter the total corrected
on Form 941-X, line 23) for the quarter, less any previous amount for all employees in column 1. In column 2, enter
abatements and interest-free tax assessments. the amount you originally reported or as previously
Payment methods. You may pay the amount you owe corrected. In column 3, enter the difference between
on line 27 electronically using the Electronic Federal Tax columns 1 and 2. Enter the corrected amount from column
Payment System (EFTPS), by credit or debit card, or by a 1 on Worksheet 1, Step 2, line 2b.
check or money order.
• The preferred method of payment is EFTPS. For more
information, go to EFTPS.gov or call 800-555-4477
(800-244-4829 (Spanish) or 303-967-5916 if you're
outside the United States (toll call)). To contact EFTPS
using Telecommunications Relay Services (TRS) for

Instructions for Form 941-X (Rev. 4-2024) 23

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29. Qualified Health Plan Expenses Allocable to 1 on Worksheet 2, Step 2, line 2b, for qualified health plan
Qualified Family Leave Wages for Leave Taken expenses allocable to qualified wages paid after March
After March 31, 2020, and Before April 1, 2021 12, 2020, and before July 1, 2021. Enter the corrected
amount from column 1 on Worksheet 4, Step 2, line 2b, for
Generally, the period of limitations for correcting qualified health plan expenses allocable to qualified
! qualified health plan expenses allocable to wages paid after June 30, 2021, and before January 1,
CAUTION qualified family leave wages paid in the second, 2022.
third, and fourth quarters of 2020 expired on April 15,
2024, for most employers. For more information about the 31b. Recovery Startup Business Checkbox
period of limitations, see Is There a Deadline for Filing For the fourth quarter of 2021, only a recovery
Form 941-X, earlier. ! startup business may claim the employee
If you’re correcting the qualified health plan expenses CAUTION retention credit.
allocable to qualified family leave wages for leave taken Whether you check the box on line 31b to tell us if
after March 31, 2020, and before April 1, 2021, that you you're eligible for the employee retention credit in the third
reported on Form 941, line 20, enter the total corrected or fourth quarter of 2021 solely because your business is
amount for all employees in column 1. In column 2, enter a recovery startup business depends on its applicability
the amount you originally reported or as previously and how you originally answered the question on Form
corrected. In column 3, enter the difference between 941, line 18b.
columns 1 and 2. Enter the corrected amount from column If you checked the box on line 18b on your originally
•
1 on Worksheet 1, Step 2, line 2f. filed Form 941 and you still qualify for the employee
30. Qualified Wages for the Employee Retention retention credit solely because your business is a
recovery startup business, check the box on line 31b.
Credit If you checked the box on line 18b on your originally
•
Generally, the period of limitations for correcting filed Form 941 but that response is no longer accurate,
don't check the box on line 31b. However, explain in detail
! qualified wages for the employee retention credit
CAUTION in the second, third, and fourth quarters of 2020 on line 43 why you no longer think that you're a recovery
expired on April 15, 2024, for most employers. For more startup business and, if correcting the third quarter of
information about the period of limitations, see Is There a 2021, the reasons that you still qualify for the employee
Deadline for Filing Form 941-X, earlier. retention credit.
• If you didn't check the box on line 18b on your originally
Use line 30 only for corrections to quarters beginning
filed Form 941 and this question still doesn't apply, don't
after March 31, 2020, and before January 1, 2022.
check the box on line 31b.
If you’re correcting the qualified wages for the employee • If you didn't check the box on line 18b on your originally
retention credit that you reported on Form 941, line 21, filed Form 941 but you're now claiming the employee
enter the total corrected amount for all employees in retention credit as a recovery startup business, check the
column 1. In column 2, enter the amount you originally box on line 31b.
reported or as previously corrected. In column 3, enter the
difference between columns 1 and 2. Enter the corrected Recovery startup business. For the third quarter of
amount from column 1 on Worksheet 2, Step 2, line 2a, for 2021, a recovery startup business is an employer that:
qualified wages paid after March 12, 2020, and before • Began carrying on a trade or business after February
July 1, 2021. Enter the corrected amount from column 1 15, 2020;
on Worksheet 4, Step 2, line 2a, for qualified wages paid • Had average annual gross receipts of $1 million or less
after June 30, 2021, and before January 1, 2022. for the 3 tax years ending with the tax year before the
calendar quarter in which the employee retention credit is
31a. Qualified Health Plan Expenses for the claimed; and
Employee Retention Credit • Isn't otherwise eligible for the employee retention credit
because business operations aren't fully or partially
Generally, the period of limitations for correcting suspended due to a governmental order or because gross
! qualified health plan expenses allocable to wages receipts (within the meaning of section 448(c) or, if you're
CAUTION for the employee retention credit in the second, a tax-exempt organization, section 6033) aren't less than
third, and fourth quarters of 2020 expired on April 15, 80% of the gross receipts for the same calendar quarter in
2024, for most employers. For more information about the calendar year 2019. The employee retention credit isn't
period of limitations, see Is There a Deadline for Filing available in the second quarter of 2021 on the basis of
Form 941-X, earlier. being a recovery startup business.
Use line 31a only for corrections to quarters beginning For the fourth quarter of 2021, a recovery startup
after March 31, 2020, and before January 1, 2022. business is an employer that began carrying on a trade or
If you’re correcting the qualified health plan expenses business after February 15, 2020, and had average
allocable to wages reported on Form 941, line 21, that you annual gross receipts of $1 million or less for the 3 tax
reported on Form 941, line 22, enter the total corrected years ending with the tax year before the calendar quarter
amount for all employees in column 1. In column 2, enter in which the employee retention credit is claimed.
the amount you originally reported or as previously
corrected. In column 3, enter the difference between
columns 1 and 2. Enter the corrected amount from column

24 Instructions for Form 941-X (Rev. 4-2024)

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Recovery startup businesses are limited to a 37. Amounts Under Certain Collectively
! maximum employee retention credit of $50,000 Bargained Agreements Allocable to Qualified
CAUTION per quarter. If you check the box on line 31b, don't
Sick Leave Wages for Leave Taken After March
enter more than $50,000 per quarter in total on lines 18a
and 26a. 31, 2021, and Before October 1, 2021
If you’re correcting the amounts under certain collectively
bargained agreements allocable to qualified sick leave
32. Credit From Form 5884-C, Line 11, for This
wages for leave taken after March 31, 2021, and before
Quarter October 1, 2021, that you reported on Form 941, line 25,
Use line 32 only for corrections to quarters beginning after enter the total corrected amount for all employees in
March 31, 2020, and before April 1, 2021. column 1. In column 2, enter the amount you originally
If you’re correcting the credit from Form 5884-C, reported or as previously corrected. In column 3, enter the
line 11, for the second, third, or fourth quarter of 2020, or difference between columns 1 and 2. Enter the corrected
the first quarter of 2021, that you reported on Form 941, amount from column 1 on Worksheet 3, Step 2, line 2c.

line 23, enter the total corrected amount in column 1. In Be sure to explain the reasons for this correction on
column 2, enter the amount you originally reported or as line 43.
previously corrected. In column 3, enter the difference
between columns 1 and 2. Enter the corrected amount 38. Qualified Family Leave Wages for Leave
from column 1 on Worksheet 1, Step 1, line 1j. Entering an Taken After March 31, 2021, and Before October
amount here is strictly for purposes of figuring the credit
for qualified sick and family wages for leave taken after 1, 2021
March 31, 2020, and before April 1, 2021, on Worksheet If you’re correcting the qualified family leave wages for
1. For purposes of figuring the employee retention credit leave taken after March 31, 2021, and before October 1,
for qualified wages paid after March 12, 2020, and before 2021, that you reported on Form 941, line 26, enter the
July 1, 2021, enter the corrected amount from column 1 total corrected amount in column 1. In column 2, enter the
on Worksheet 2, Step 1, line 1k, unless you also amount you originally reported or as previously corrected.
completed Worksheet 1 and you're bringing the amount In column 3, enter the difference between columns 1 and
from Worksheet 1, Step 1, line 1l, forward to Worksheet 2, 2. Enter the corrected amount from column 1 on
Step 1, line 1a. Reporting a correction on this line doesn't Worksheet 3, Step 2, line 2g.
correct the credit claimed on Form 5884-C.
Be sure to explain the reasons for this correction on
35. Qualified Sick Leave Wages for Leave Taken line 43.

After March 31, 2021, and Before October 1, 39. Qualified Health Plan Expenses Allocable to
2021 Qualified Family Leave Wages for Leave Taken
If you’re correcting the qualified sick leave wages for leave After March 31, 2021, and Before October 1,
taken after March 31, 2021, and before October 1, 2021,
2021
that you reported on Form 941, line 23, enter the total
corrected amount in column 1. In column 2, enter the If you’re correcting the qualified health plan expenses
amount you originally reported or as previously corrected. allocable to qualified family leave wages for leave taken
In column 3, enter the difference between columns 1 and after March 31, 2021, and before October 1, 2021, that
2. Enter the corrected amount from column 1 on you reported on Form 941, line 27, enter the total
Worksheet 3, Step 2, line 2a. corrected amount for all employees in column 1. In column
2, enter the amount you originally reported or as
Be sure to explain the reasons for this correction on previously corrected. In column 3, enter the difference
line 43. between columns 1 and 2. Enter the corrected amount
from column 1 on Worksheet 3, Step 2, line 2h.
36. Qualified Health Plan Expenses Allocable to
Qualified Sick Leave Wages for Leave Taken Be sure to explain the reasons for this correction on
After March 31, 2021, and Before October 1, line 43.
2021
40. Amounts Under Certain Collectively
If you’re correcting the qualified health plan expenses
Bargained Agreements Allocable to Qualified
allocable to qualified sick leave wages for leave taken after
March 31, 2021, and before October 1, 2021, that you Family Leave Wages for Leave Taken After
reported on Form 941, line 24, enter the total corrected March 31, 2021, and Before October 1, 2021
amount for all employees in column 1. In column 2, enter If you’re correcting the amounts under certain collectively
the amount you originally reported or as previously bargained agreements allocable to qualified family leave
corrected. In column 3, enter the difference between wages for leave taken after March 31, 2021, and before
columns 1 and 2. Enter the corrected amount from column October 1, 2021, that you reported on Form 941, line 28,
1 on Worksheet 3, Step 2, line 2b. enter the total corrected amount for all employees in
column 1. In column 2, enter the amount you originally
Be sure to explain the reasons for this correction on
reported or as previously corrected. In column 3, enter the
line 43.
difference between columns 1 and 2. Enter the corrected
amount from column 1 on Worksheet 3, Step 2, line 2i.

Instructions for Form 941-X (Rev. 4-2024) 25

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Be sure to explain the reasons for this correction on 43. Explain Your Corrections
line 43. Treasury regulations require you to explain in detail the
grounds and facts relied upon to support each correction.
Part 4: Explain Your Corrections for
On line 43, describe in detail each correction you entered
This Quarter in column 4 on lines 7–22, and lines 25–26c. Also use
line 43 to describe corrections made on line 6, lines 28–
41. Corrections of Both Underreported and 32, and lines 35–40. If you need more space, attach
Overreported Amounts additional sheets, but be sure to write your name, EIN,
Check the box on line 41 if any corrections you entered on “Form 941-X,” the quarter you’re correcting (for example,
lines 7–22, 25–26c, 28–31a, 32, or 35–40, column 3, “Quarter 2”), and the calendar year of the quarter you’re
reflect both underreported and overreported amounts. correcting on the top of each sheet.

Example. If you had an increase to social security You must describe the events that caused the
wages of $15,000 for Xavier Black and a decrease to underreported or overreported amounts. Explanations
social security wages of $5,000 for Sophie Rose, you such as “social security and Medicare wages were
would enter $10,000 on line 8, column 3. That $10,000 overstated” or “administrative/payroll errors were
represents the net change from corrections. discovered” or “taxes were not withheld” are insufficient
On line 43, you must explain the reasons for both the and may delay processing your Form 941-X because the
$15,000 increase and the $5,000 decrease. IRS may need to ask for a more complete explanation.

42. Did You Reclassify Any Workers? Provide the following information in your explanation for
Check the box on line 42 if you reclassified any workers to each correction.
be independent contractors or nonemployees. Also check • Form 941-X line number(s) affected.
this box if the IRS (or you) determined that workers you • Date you discovered the error.
treated as independent contractors or nonemployees • Difference (amount of the error).
should be classified as employees. On line 43, give us a • Cause of the error.
detailed reason why any worker was reclassified and, if You may report the information in paragraph form. The
you used section 3509 rates on lines 19–22 for any worker following paragraph is an example.

reclassified as an employee, explain why section 3509 “The $1,000 difference shown in column 3 on lines 6, 8,
rates apply and what rates you used. and 12 was discovered on May 13, 2024, during an
Return not filed because you didn’t treat any workers internal payroll audit. We discovered that we included
as employees. If you didn’t previously file Form 941 $1,000 of wages for one of our employees twice. This
because you mistakenly treated all workers as correction removes the reported wages that were never
independent contractors or nonemployees, file a Form paid.”
941 for each delinquent quarter.
For corrections shown on lines 19–22, explain why the
On each Form 941 for which you’re entitled to use
correction was necessary and attach any notice you
section 3509 rates, complete the following steps.
received from the IRS.
• Write “Misclassified Employees” in bold letters
across the top margin of page 1. Part 5: Sign Here
• Enter a zero on line 12.
• Complete the signature area. You must complete all five pages of Form 941-X and sign
• Attach a completed Form 941-X (see instructions next). it on page 5. If you don’t sign, processing of Form 941-X
On each Form 941-X, complete the following steps. will be delayed.
• Complete the top of Form 941-X, including the date you Who must sign the Form 941-X? The following persons
discovered the error. are authorized to sign the return for each type of business
• Enter the wage amounts on lines 19–22, column 1. entity.
• Enter zeros on lines 19–22, column 2. • Sole proprietorship—The individual who owns the
• Complete columns 3 and 4 as instructed in Part 3. business.
• Provide a detailed statement on line 43. • Corporation (including a limited liability company
• Complete the signature area. (LLC) treated as a corporation)—The president, vice
If you can’t use section 3509 rates (for example, president, or other principal officer duly authorized to sign.
• Partnership (including an LLC treated as a
! because the workers you treated as partnership) or unincorporated organization—A
CAUTION nonemployees were certain statutory employees),
file a Form 941 for each delinquent quarter. Write responsible and duly authorized member, partner, or
“Misclassified Employees” in bold letters across the top officer having knowledge of its affairs.
margin of page 1 of each Form 941. Complete Form 941 • Single-member LLC treated as a disregarded entity
using the Instructions for Form 941. Attach a Form 941-X for federal income tax purposes—The owner of the
to each Form 941. Complete the top of Form 941-X, LLC or a principal officer duly authorized to sign.
including the date you discovered the error, and provide a • Trust or estate—The fiduciary.
detailed explanation on line 43. Form 941-X may also be signed by a duly authorized
agent of the taxpayer if a valid power of attorney has been
filed.

26 Instructions for Form 941-X (Rev. 4-2024)

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Alternative signature method. Corporate officers or If you’re a paid preparer, enter your Preparer Tax
duly authorized agents may sign Form 941-X by rubber Identification Number (PTIN) in the space provided.
stamp, mechanical device, or computer software program. Include your complete address. If you work for a firm,
For details and required documentation, see Rev. Proc. enter the firm's name and the EIN of the firm. You can
2005-39. You can find Rev. Proc. 2005-39, 2005-28 I.R.B. apply for a PTIN online or by filing Form W-12. For more
82, at IRS.gov/irb/2005-28_IRB#RP-2005-39. information about applying for a PTIN online, go to
IRS.gov/PTIN. You can’t use your PTIN in place of the EIN
Paid Preparer Use Only of the tax preparation firm.
A paid preparer must sign Form 941-X and provide the Generally, you’re not required to complete this section if
information in the Paid Preparer Use Only section of Part 5 you’re filing the return as a reporting agent and have a
if the preparer was paid to prepare Form 941-X and isn’t valid Form 8655 on file with the IRS. However, a reporting
an employee of the filing entity. Paid preparers must sign agent must complete this section if the reporting agent
paper returns with a manual signature. The preparer must offered legal advice, for example, advising the client on
give you a copy of the return in addition to the copy to be determining whether its workers are employees or
filed with the IRS. independent contractors for federal tax purposes.

Instructions for Form 941-X (Rev. 4-2024) 27

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Worksheet 1. Adjusted Credit for Qualified Sick and Family Leave 
Wages for Leave Taken After March 31, 2020, and Before April 1, 
2021                                                                                                                                          Keep for Your Records
You must use this worksheet if you claimed the credit for qualified sick and family leave wages for leave taken after March 31, 2020, and 
before April 1, 2021, on your original Form 941 and you correct any amounts used to figure the credit for qualified sick and family leave 
wages for leave taken after March 31, 2020, and before April 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it 
for the first time on Form 941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a 
client-by-client basis. 
Step 1.       Determine the corrected employer share of social security tax this quarter after it is reduced by any credit 
              claimed on Form 8974, Form 5884-C, and/or Form 5884-D
        1a    Enter the amount of social security wages from Form 941, Part 1, line 5a, column 1, 
              or, if corrected, the amount from Form 941-X, line 8, column 1 . . . . . . . . . . . . . . . . .                             1a       
        1b    Enter the amount of social security tips from Form 941, Part 1, line 5b, column 1, or, 
              if corrected, the amount from Form 941-X, line 11, column 1 . . . . . . . . . . . . . . . . . . .                            1b       
        1c    Add lines 1a and 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      1c       
        1d    Multiply line 1c by 6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           1d       
        1e    If you're a third-party payer of sick pay that isn't an agent and you're claiming credits 
              for amounts paid to your employees, enter the employer share of social security tax 
              included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer 
              share of social security tax on sick pay that you included on Form 941-X, line 15, 
              column 1 (enter as a negative number)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   1e       
        1f    Employer share of social security tax included on Form 941-X, line 20, 
              column 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1f       
        1g    If you received a Section 3121(q) Notice and Demand during the quarter, enter the 
              amount of the employer share of social security tax from the notice  . . . . . . . . . . . . .                               1g       
        1h    Employer share of social security tax. Combine lines 1d, 1e, 1f, and 1g . . . . . . .                                                 1h              
        1i    Enter the amount from Form 8974, line 12 (including any amended Form 8974 
              attached to Form 941-X) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          1i       
        1j    Enter the amount from Form 5884-C, line 11, for this quarter (for quarters ending 
              before April 1, 2021, this amount was also included on Form 941, Part 3, line 23, or, 
              if corrected, the amount from Form 941-X, line 32, column 1) . . . . . . . . . . . . . . . . . .                             1j       
        1j(i) Enter the amount from Form 5884-D, line 12, for this quarter  . . . . . . . . . . . . . . . . . .                            1j(i)    
        1k    Total nonrefundable credits already used against the employer share of 
              social security tax. Add lines 1i, 1j, and 1j(i) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                          1k  
        1l    Employer share of social security tax remaining. Subtract line 1k 
              from line 1h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          1l  

Step 2.       Figure the sick and family leave credit
        2a    Qualified sick leave wages reported on Form 941, Part 1, line 5a(i), column 1, or, if 
              corrected, the amount from Form 941-X, line 9, column 1 . . . . . . . . . . . . . . . . . . . . .                            2a       
        2a(i) Qualified sick leave wages included on Form 941, Part 1, line 5c, or, if corrected, the 
              amount from Form 941-X, line 12, column 1, but not included on Form 941, Part 1, 
              line 5a(i), column 1, or Form 941-X, line 9, column 1, because the wages reported 
              on that line were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . .                         2a(i)    
        2a(ii)  Total qualified sick leave wages. Add lines 2a and 2a(i) . . . . . . . . . . . . . . . . . . . . . . .                     2a(ii)   
        2a(iii) Qualified sick leave wages excluded from the definition of employment under 
              sections 3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2a(iii)  
        2b    Qualified health plan expenses allocable to qualified sick leave wages (Form 941, 
              Part 3, line 19, or, if corrected, Form 941-X, line 28, column 1) . . . . . . . . . . . . . . . . .                          2b       
        2c    Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 
              1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     2c       
        2d    Credit for qualified sick leave wages. Add lines 2a(ii), 2a(iii), 2b, and 2c . . . . . . .                                            2d  
        2e    Qualified family leave wages reported on Form 941, Part 1, line 5a(ii), column 1, or, if 
              corrected, the amount from Form 941-X, line 10, column 1 . . . . . . . . . . . . . . . . . . . .                             2e       
        2e(i)  Qualified family leave wages included on Form 941, Part 1, line 5c, or, if corrected, 
              the amount from Form 941-X, line 12, column 1, but not included on Form 941, Part 
              1, line 5a(ii), column 1, or Form 941-X, line 10, column 1, because the wages 
              reported on that line were limited by the social security wage base . . . . . . . . . . . . . .                              2e(i)    
        2e(ii) Total qualified family leave wages. Add lines 2e and 2e(i) . . . . . . . . . . . . . . . . . . . . .                        2e(ii)   
        2e(iii) Qualified family leave wages excluded from the definition of employment under 
              sections 3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2e(iii)  
        2f    Qualified health plan expenses allocable to qualified family leave wages (Form 941, 
              Part 3, line 20, or, if corrected, Form 941-X, line 29, column 1) . . . . . . . . . . . . . . . . .                          2f       
        2g    Employer share of Medicare tax on qualified family leave wages. Multiply line 2e(ii) 
              by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      2g       
        2h    Credit for qualified family leave wages. Add lines 2e(ii), 2e(iii), 2f, and 2g . . . . . .                                            2h  
        2i    Credit for qualified sick and family leave wages. Add lines 2d and 2h . . . . . . . .                                                 2i  
        2j    Nonrefundable portion of credit for qualified sick and family leave wages for 
              leave taken after March 31, 2020, and before April 1, 2021. Enter the smaller of 
              line 1l or line 2i. Enter this amount on Form 941-X, line 17, column 1 . . . . . . . . . . . .                                        2j
        2k    Refundable portion of credit for qualified sick and family leave wages for 
              leave taken after March 31, 2020, and before April 1, 2021. Subtract line 2j from 
              line 2i and enter this amount on Form 941-X, line 25, column 1 . . . . . . . . . . . . . . . . .                                      2k

28                                                                                          Instructions for Form 941-X (Rev. 4-2024)

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Worksheet 2. Adjusted Employee Retention Credit for Qualified 
Wages Paid After March 12, 2020, and Before July 1, 2021                                                                                     Keep for Your Records
You must use this worksheet if you claimed the employee retention credit for qualified wages paid after March 12, 2020, and before July 1, 
2021, on your original Form 941 and you correct any amounts used to figure the employee retention credit for qualified wages paid after 
March 12, 2020, and before July 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 
941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis. 
Step 1.    Determine the corrected employer share of social security tax this quarter after it is reduced by any credit 
           claimed on Form 8974, Form 5884-C, and/or Form 5884-D
        1a If you completed Worksheet 1 to claim a credit for qualified sick and family leave 
           wages for leave taken after March 31, 2020, and before April 1, 2021, for a quarter in 
           which you're also claiming the employee retention credit, enter the amount from 
           Worksheet 1, Step 1, line 1l, and go to Step 2. Otherwise, complete lines 1b–1n 
           below and then go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                1a                   
        1b Enter the amount of social security wages from Form 941, Part 1, line 5a, column 1, 
           or, if corrected, the amount from Form 941-X, line 8, column 1 . . . . . . . . . . . . . . . . .                               1b  
        1c Enter the amount of social security tips from Form 941, Part 1, line 5b, column 1, or, 
           if corrected, the amount from Form 941-X, line 11, column 1 . . . . . . . . . . . . . . . . . . .                              1c  
        1d Add lines 1b and 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        1d  
        1e Multiply line 1d by 6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             1e  
        1f If you're a third-party payer of sick pay that isn't an agent and you're claiming credits 
           for amounts paid to your employees, enter the employer share of social security tax 
           included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer 
           share of social security tax on sick pay that you included on Form 941-X, line 15, 
           column 1 (enter as a negative number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                      1f  
        1g Employer share of social security tax included on Form 941-X, line 20, 
           column 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1g  
        1h If you received a Section 3121(q) Notice and Demand during the quarter, enter the 
           amount of the employer share of social security tax from the notice  . . . . . . . . . . . . .                                 1h  
        1i Employer share of social security tax. Combine lines 1e, 1f, 1g, and 1h . . . . . . .                                              1i                   
        1j Enter the amount from Form 941, Part 1, line 11a, or, if corrected, the amount from 
           Form 941-X, line 16, column 1 (credit from Form 8974) . . . . . . . . . . . . . . . . . . . . . . .                            1j  
        1k Enter the amount from Form 5884-C, line 11, for this quarter (for quarters ending 
           before April 1, 2021, this amount was also included on Form 941, Part 3, line 23, or, 
           if corrected, the amount from Form 941-X, line 32, column 1) . . . . . . . . . . . . . . . . . .                               1k  
        1l Enter the amount from Form 5884-D, line 12, for this quarter  . . . . . . . . . . . . . . . . . .                              1l  
        1m Total nonrefundable credits already used against the employer share of 
           social security tax. Add lines 1j, 1k, and 1l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                        1m  
        1n Employer share of social security tax remaining. Subtract line 1m 
           from line 1i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     1n  

Step 2.    Figure the employee retention credit
           Caution: For qualified wages paid before January 1, 2021, the cumulative total for 
           all quarters of 2020 that can be claimed on lines 2a, 2b, 2c, and 2d can't exceed 
           $10,000 per employee. For qualified wages paid after December 31, 2020, the total 
           amount included on lines 2a and 2b can't exceed $10,000 per employee each 
           quarter.
        2a Qualified wages (excluding qualified health plan expenses) for the employee 
           retention credit (Form 941, Part 3, line 21, or, if corrected, Form 941-X, line 30, 
           column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2a  
        2b Qualified health plan expenses allocable to qualified wages for the employee 
           retention credit (Form 941, Part 3, line 22, or, if corrected, Form 941-X, line 31a, 
           column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2b  
        2c Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          2c  
        2d Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          2d  
        2e Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2e  
        2f Retention credit. If you're correcting the second, third, or fourth quarter of 2020, 
           multiply line 2e by 50% (0.50). If you're correcting the first or second quarter of 
           2021, multiply line 2e by 70% (0.70) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     2f  
        2g Enter the amount of the employer share of social security tax from Step 1, line 1a, or, 
           if applicable, Step 1, line 1n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2g  
        2h Enter the amount of the nonrefundable portion of the credit for qualified sick and 
           family leave wages for leave taken after March 31, 2020, and before April 1, 2021 
           (this amount may come from Worksheet 1, Step 2, line 2j, in these instructions if 
           you're correcting that credit for the quarter, or you may need to enter the credit 
           claimed on your original Form 941 for the quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . .                       2h  
        2i Subtract line 2h from line 2g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          2i  
        2j Nonrefundable portion of employee retention credit. Enter the smaller of line 2f 
           or line 2i. Enter this amount on Form 941-X, line 18a, column 1 . . . . . . . . . . . . . . . .                                    2j
        2k Refundable portion of employee retention credit. Subtract line 2j from line 2f 
           and enter this amount on Form 941-X, line 26a, column 1 . . . . . . . . . . . . . . . . . . . . .                                  2k

Instructions for Form 941-X (Rev. 4-2024)                                                                                                                         29

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Worksheet 3. Adjusted Credit for Qualified Sick and Family Leave 
Wages for Leave Taken After March 31, 2021, and Before October 1, 
2021                                                                                                                                                   Keep for Your Records
You must use this worksheet if you claimed the credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before October 1, 2021, on 
your original Form 941 and you correct any amounts used to figure the credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before 
October 1, 2021. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 941-X. If you're a third-party payer, you must complete 
this worksheet for each client for which it is applicable, on a client-by-client basis. 
Step 1.         Determine the corrected employer share of Medicare tax
        1a      Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if corrected, the                                        
                amount from Form 941-X, line 12, column 1 .             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1a
        1b      Multiply line 1a by 1.45% (0.0145)        . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1b      
        1c      If you're a third-party payer of sick pay that isn't an agent and you're claiming credits for amounts paid 
                to your employees, enter the employer share of Medicare tax included on Form 941, Part 1, line 8, or, 
                if corrected, the amount of the employer share of Medicare tax on sick pay that you included on Form                                      
                941-X, line 15, column 1 (enter as a negative number) .               . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1c
        1d      Employer share of Medicare tax included on Form 941-X, line 21, column 4                        . . . . . . . . . . . . . . . .   1d      
        1e      If you received a Section 3121(q) Notice and Demand during the quarter, enter the amount of the                                           
                employer share of Medicare tax from the notice .            . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   1e
        1f      Employer share of Medicare tax. Combine lines 1b, 1c, 1d, and 1e                        . . . . . . . . . . . . . . . . . . . .           1f                    
        1g      For corrections to quarters beginning after December 31, 2022, only, enter the amount from Form                                           
                8974, line 16 (including any amended Form 8974 attached to Form 941-X) .                        . . . . . . . . . . . . . . . .   1g
        1h      Employer share of Medicare tax remaining. Subtract line 1g from line 1f                         . . . . . . . . . . . . . . . .           1h                    
Step 2.         Figure the sick and family leave credit
        2a      Qualified sick leave wages for leave taken after March 31, 2021, and before October 1, 2021, 
                reported on Form 941, Part 3, line 23, or, if corrected, the amount from Form 941-X, line 35,                                             
                column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2a
        2a(i)   Qualified sick leave wages included on Form 941, Part 3, line 23, or, if corrected, the amount from 
                Form 941-X, line 35, column 1, that were not included as wages reported on Form 941, Part 1, lines 
                5a and 5c, or, if corrected, the amount from Form 941-X, lines 8 and 12, column 1, because the 
                qualified sick leave wages were excluded from the definition of employment under sections 3121(b)                                         
                (1)–(22)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(i)
        2a(ii)  Subtract line 2a(i) from line 2a .    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2a(ii)  
        2a(iii) Qualified sick leave wages included on Form 941, Part 3, line 23, or, if corrected, the amount from 
                Form 941-X, line 35, column 1, that were not included as wages reported on Form 941, Part 1, 
                line 5a, or, if corrected, the amount from Form 941-X, line 8, column 1, because the qualified sick                                       
                leave wages were limited by the social security wage base                 . . . . . . . . . . . . . . . . . . . . . . . . . . .   2a(iii)
        2a(iv)  Subtract line 2a(iii) from line 2a(ii) .  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2a(iv)  
        2b      Qualified health plan expenses allocable to qualified sick leave wages for leave taken after March 31, 
                2021, and before October 1, 2021, reported on Form 941, Part 3, line 24, or, if corrected, the amount                                     
                from Form 941-X, line 36, column 1          . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2b
        2c      Amounts under certain collectively bargained agreements allocable to qualified sick leave wages for 
                leave taken after March 31, 2021, and before October 1, 2021, reported on Form 941, Part 3, line 25,                                      
                or, if corrected, the amount from Form 941-X, line 37, column 1                 . . . . . . . . . . . . . . . . . . . . . . . .   2c
        2d      Employer share of social security tax on qualified sick leave wages. Multiply line 2a(iv) by 6.2%                                         
                (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
        2e      Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 1.45%                                               
                (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2e
        2f      Credit for qualified sick leave wages. Add lines 2a, 2b, 2c, 2d, and 2e .                     . . . . . . . . . . . . . . . . .           2f  
        2g      Qualified family leave wages for leave taken after March 31, 2021, and before October 1, 2021, 
                reported on Form 941, Part 3, line 26, or, if corrected, the amount from Form 941-X, line 38,                                             
                column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2g
        2g(i)   Qualified family leave wages included on Form 941, Part 3, line 26, or, if corrected, the amount from 
                Form 941-X, line 38, column 1, that were not included as wages reported on Form 941, Part 1, lines 
                5a and 5c, or, if corrected, the amount from Form 941-X, lines 8 and 12, column 1, because the 
                qualified family leave wages were excluded from the definition of employment under sections 3121(b)                                       
                (1)–(22)  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g(i)
        2g(ii)  Subtract line 2g(i) from line 2g .    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2g(ii)  
        2g(iii) Qualified family leave wages included on Form 941, Part 3, line 26, or, if corrected, the amount from 
                Form 941-X, line 38, column 1, that were not included as wages reported on Form 941, Part 1, 
                line 5a, or, if corrected, the amount from Form 941-X, line 8, column 1, because the qualified family                                     
                leave wages were limited by the social security wage base                 . . . . . . . . . . . . . . . . . . . . . . . . . . .   2g(iii)
        2g(iv)  Subtract line 2g(iii) from line 2g(ii)    . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2g(iv)  
        2h      Qualified health plan expenses allocable to qualified family leave wages for leave taken after March 
                31, 2021, and before October 1, 2021, reported on Form 941, Part 3, line 27, or, if corrected, the                                        
                amount from Form 941-X, line 39, column 1 .             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2h
        2i      Amounts under certain collectively bargained agreements allocable to qualified family leave wages 
                for leave taken after March 31, 2021, and before October 1, 2021, reported on Form 941, Part 3,                                           
                line 28, or, if corrected, the amount from Form 941-X, line 40, column 1 .                  . . . . . . . . . . . . . . . . . .   2i
        2j      Employer share of social security tax on qualified family leave wages. Multiply line 2g(iv) by 6.2%                                       
                (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2j
        2k      Employer share of Medicare tax on qualified family leave wages. Multiply line 2g(ii) by 1.45%                                             
                (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2k
        2l      Credit for qualified family leave wages. Add lines 2g, 2h, 2i, 2j, and 2k                     . . . . . . . . . . . . . . . . .           2l  
        2m      Credit for qualified sick and family leave wages. Add lines 2f and 2l .                     . . . . . . . . . . . . . . . . . .           2m  
        2n      For second quarter of 2021 only, enter any employee retention credit claimed under section 2301 
                of the CARES Act (this amount may come from Worksheet 2, Step 2, line 2f, in these instructions if 
                you're correcting that credit for the second quarter of 2021, or you may need to enter the credit 
                claimed on your original Form 941 for the second quarter of 2021) with respect to any wages taken                                         
                into account for the credit for qualified sick and family leave wages for the quarter                   . . . . . . . . . . . .   2n
        2o      Enter any credit claimed under section 41 for increasing research activities with respect to any wages                                    
                taken into account for the credit for qualified sick and family leave wages .                 . . . . . . . . . . . . . . . . .   2o
        2p      Add lines 2n and 2o     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2p      
        2q      Credit for qualified sick and family leave wages after adjusting for other credits. Subtract                                                  
                line 2p from line 2m .  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2q
        2r      Nonrefundable portion of credit for qualified sick and family leave wages for leave taken 
                after March 31, 2021, and before October 1, 2021. Enter the smaller of line 1h or line 2q. Enter 
                this amount on Form 941-X, line 18b, column 1 .             . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2r
        2s      Refundable portion of credit for qualified sick and family leave wages for leave taken after 
                March 31, 2021, and before October 1, 2021. Subtract line 2r from line 2q and enter this amount 
                on Form 941-X, line 26b, column 1 .         . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2s
30                                                                                                                                    Instructions for Form 941-X (Rev. 4-2024)

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The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Worksheet 4. Adjusted Employee Retention Credit for Qualified 
Wages Paid After June 30, 2021, and Before January 1, 2022                                                                                Keep for Your Records
You must use this worksheet if you claimed the employee retention credit for qualified wages paid after June 30, 2021, and before January 
1, 2022, on your original Form 941 and you correct any amounts used to figure the employee retention credit for qualified wages paid after 
June 30, 2021, and before January 1, 2022. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 
941-X. If you're a third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis. 
Step 1.    Determine the corrected employer share of Medicare tax
        1a If you completed Worksheet 3 to claim a credit for qualified sick and family leave 
           wages for leave taken after March 31, 2021, and before October 1, 2021, for a 
           quarter in which you're also claiming the employee retention credit, enter the 
           amount from Worksheet 3, Step 1, line 1h, and go to Step 2. Otherwise, complete 
           lines 1b–1g below and then go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                       1a                   
        1b Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if 
           corrected, the amount from Form 941-X, line 12, column 1 . . . . . . . . . . . . . . . . . . .                              1b  
        1c Multiply line 1b by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              1c  
        1d If you're a third-party payer of sick pay that isn't an agent and you're claiming credits 
           for amounts paid to your employees, enter the employer share of Medicare tax 
           included on Form 941, Part 1, line 8, or, if corrected, the amount of the employer 
           share of Medicare tax on sick pay that you included on Form 941-X, line 15, column 
           1 (enter as a negative number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              1d  
        1e Employer share of Medicare tax included on Form 941-X, line 21, column 4 . . . . . .                                        1e  
        1f If you received a Section 3121(q) Notice and Demand during the quarter, enter the 
           amount of the employer share of Medicare tax from the notice . . . . . . . . . . . . . . . .                                1f  
        1g Employer share of Medicare tax. Combine lines 1c, 1d, 1e, and 1f . . . . . . . . . . .                                          1g                   

Step 2.    Figure the employee retention credit
           Caution: You must be a recovery startup business to claim the employee retention 
           credit for qualified wages paid after September 30, 2021, and before January 1, 
           2022 (fourth quarter 2021). The total amount included on lines 2a and 2b can't 
           exceed $10,000 per employee each quarter. 
        2a Qualified wages (excluding qualified health plan expenses) for the employee 
           retention credit (Form 941, Part 3, line 21, or, if corrected, Form 941-X, line 30, 
           column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a  
        2b Qualified health plan expenses allocable to qualified wages for the employee 
           retention credit (Form 941, Part 3, line 22, or, if corrected, Form 941-X, line 31a, 
           column 1) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b  
        2c Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       2c  
        2d Retention credit. Multiply line 2c by 70% (0.70). If you qualify for the employee 
           retention credit solely because your business is a recovery startup business, don't 
           enter more than $50,000 per quarter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     2d  
        2e Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if 
           applicable, Step 1, line 1g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2e  
        2f Enter the amount of the nonrefundable portion of the credit for qualified sick and 
           family leave wages for leave taken after March 31, 2021, and before October 1, 
           2021 (this amount may come from Worksheet 3, Step 2, line 2r, in these instructions 
           if you're correcting that credit or you may need to enter the credit claimed on your 
           original Form 941) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      2f  
        2g Subtract line 2f from line 2e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2g  
        2h Nonrefundable portion of employee retention credit. Enter the smaller of 
           line 2d or line 2g. Enter this amount on Form 941-X, line 18a, column 1 . . . . . . . . .                                       2h
        2i Refundable portion of employee retention credit. Subtract line 2h from line 2d 
           and enter this amount on Form 941-X, line 26a, column 1 . . . . . . . . . . . . . . . . . . . .                                 2i

Instructions for Form 941-X (Rev. 4-2024)                                                                                                                      31

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Page 32 of 32      Fileid: … ns/i941x/202404/a/xml/cycle06/source                                                                            10:11 - 16-May-2024

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Worksheet 5. Adjusted COBRA Premium Assistance Credit                                                                                        Keep for Your Records
You must use this worksheet if you claimed the COBRA premium assistance credit on your original Form 941 and you correct any amounts used to figure the 
COBRA premium assistance credit. You'll also use this worksheet to figure this credit if you're claiming it for the first time on Form 941-X. If you're a 
third-party payer, you must complete this worksheet for each client for which it is applicable, on a client-by-client basis. 
Step 1.    Determine the corrected employer share of Medicare tax
        1a If you completed Worksheet 3 or Worksheet 4 for a quarter in which you're also claiming the 
           COBRA premium assistance credit, enter the amount listed on Worksheet 3, line 1h, or 
           Worksheet 4, line 1a or 1g (as applicable). Otherwise, complete lines 1b–1i below and then go 
           to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      1a                   
        1b Enter the amount of Medicare wages from Form 941, Part 1, line 5c, column 1, or, if corrected, 
           the amount from Form 941-X, line 12, column 1 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    1b  
        1c Multiply line 1b by 1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           1c  
        1d If you're a third-party payer of sick pay that isn't an agent and you're claiming credits for 
           amounts paid to your employees, enter the employer share of Medicare tax included on Form 
           941, Part 1, line 8, or, if corrected, the amount of the employer share of Medicare tax on sick 
           pay that you included on Form 941-X, line 15, column 1 (enter as a negative 
           number) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1d  
        1e Employer share of Medicare tax included on Form 941-X, line 21, column 4 . . . . . . . . . . . .                               1e  
        1f If you received a Section 3121(q) Notice and Demand during the quarter, enter the amount of 
           the employer share of Medicare tax from the notice . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                   1f  
        1g Employer share of Medicare tax. Combine lines 1c, 1d, 1e, and 1f   . . . . . . . . . . . . . . . .                                 1g                   
        1h For corrections to quarters beginning after December 31, 2022, only, enter the amount from 
           Form 8974, line 16 (including any amended Form 8974 attached to Form 941-X) . . . . . . . .                                    1h  
        1i Employer share of Medicare tax remaining. Subtract line 1h from line 1g     . . . . . . . . . . .                                  1i                   
Step 2.    Figure the COBRA premium assistance credit
        2a Enter the COBRA premium assistance that you provided this quarter  . . . . . . . . . . . . . . . .                             2a  
        2b Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if applicable, 
           Step 1, line 1i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2b  
        2c Enter the amount of the nonrefundable portion of the credit for qualified sick and family leave 
           wages for leave taken after March 31, 2021, and before October 1, 2021 (this amount may 
           come from Worksheet 3, Step 2, line 2r, in these instructions if you're correcting that credit for 
           the quarter or you may need to enter the credit claimed on your original Form 941 for the 
           quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c  
        2d Enter the amount of the nonrefundable portion of the employee retention credit (this amount 
           may come from Worksheet 4, Step 2, line 2h, in these instructions if you're correcting that 
           credit for the quarter or you may need to enter the credit claimed on your original Form 941 for 
           the quarter) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2d  
        2e Other nonrefundable credits used against the employer share of Medicare tax. Add 
           lines 2c and 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    2e  
        2f Subtract line 2e from line 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2f  
        2g Nonrefundable portion of the COBRA premium assistance credit. Enter the smaller of 
           line 2a or line 2f. Enter this amount on Form 941-X, line 18c, column 1 . . . . . . . . . . . . . . . .                            2g
        2h Refundable portion of the COBRA premium assistance credit. Subtract line 2g from 
           line 2a and enter this amount on Form 941-X, line 26c, column 1 . . . . . . . . . . . . . . . . . . .                              2h

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and publications as soon as possible. Don't resubmit             vary depending on individual circumstances. The 
requests you've already sent us. You can get forms and           estimated burden for employers filing Form 941-X is 
publications faster online.                                      approved under OMB control number 1545-0029 and is 
                                                                 included in the estimates shown in the Instructions for 
Paperwork Reduction Act Notice. We ask for the                   Form 941.
information on Form 941-X to carry out the Internal 
Revenue laws of the United States. You are required to 
give us the information. We need it to ensure that you are 
complying with these laws and to allow us to figure and 
collect the right amount of tax.

32                                                                                                       Instructions for Form 941-X (Rev. 4-2024)

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