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Page 1 of 4      Instructions for Schedule D (Form 941)                                                  13:20 - 27-JUN-2011

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                                                                                                         Department of the Treasury
Instructions for                                                                                         Internal Revenue Service

Schedule D (Form 941)

(Rev. June 2011)
Report of Discrepancies Caused by Acquisitions, Statutory Mergers, or
Consolidations

Section references are to the Internal Revenue Code unless           Each party to an applicable transaction (see
otherwise noted.                                          TIP        below) files its own Schedule D (Form 941).

General Instructions
                                                          File Schedule D (Form 941) for:
Understanding Schedule D (Form 941)                       •A statutory merger,
These instructions tell you about Schedule D (Form 941),  •A consolidation, or
Report of Discrepancies Caused by Acquisitions,           •An acquisition for which you are using the alternate
Statutory Mergers, or Consolidations. Employers can use   procedure under Rev. Proc. 2004-53. See Rev. Proc.
Schedule D (Form 941), to explain certain discrepancies   2004-53, 2004-34 I.R.B. 320, available at 
(caused by acquisitions, statutory mergers, and           www.irs.gov/irb/2004–34_IRB/ar13.html.
consolidations) between Forms W-2, Wage and Tax
Statement (Copy A), and Forms 941, Employer’s             Do NOT file a Schedule D for:
QUARTERLY Federal Tax Return, for the totals of social    •An acquisition for which you are using the standard
security wages, Medicare wages and tips, social security  procedure under Rev. Proc. 2004-53, or
tips, federal income tax withheld, and advance earned     •An acquisition that is not a statutory merger or
income credit (EIC) payments (for tax years ending        consolidation and that does not qualify under the
before January 1, 2011).                                  predecessor-successor rules. See Acquisitions that
                                                          Qualify Under Predecessor-Successor Rules, on page 2,
What Is Schedule D (Form 941)?                            for a complete discussion of the predecessor-successor
                                                          rules.
Each year the Internal Revenue Service (IRS) and the
Social Security Administration (SSA) compare the totals   Types of Mergers and Acquisitions
on your Forms 941 with the totals from your Forms W-2
                                                          Mergers, acquisitions, and other reorganizations
(Copy A), to verify the following.
                                                          generally fall into one of three categories for purposes of
•The wages you reported on Forms 941 match those
                                                          reporting employment taxes.
you reported on Forms W-2 (Copy A) so that your
                                                          •Statutory mergers and consolidations.
employees’ social security earnings records are complete
                                                          •Acquisitions that qualify under the
for benefit purposes.
                                                          predecessor-successor rules (see Acquisitions that
•You have paid the appropriate taxes.
                                                          Qualify Under Predecessor-Successor Rules on
 Generally, the totals of all your Forms W-2 (Copy A)     page 2).
should equal the aggregate quarterly totals you reported  •Other acquisitions that are not statutory mergers or
on Forms 941. Use Schedule D (Form 941) if                consolidations and that do not qualify under the
discrepancies exist between the totals you reported on    predecessor-successor rules (see Acquisitions that
those forms only as a result of an acquisition, statutory Qualify Under the Predecessor-Successor Rules on 
merger, or consolidation.                                 page 2).
       IRS uses Schedule D (Form 941) to determine if
 !     you have reported your wages and tax liabilities   Statutory Mergers and Consolidations
CAUTIONcorrectly. In many cases, the information on       If you are the surviving corporation after a statutory
Schedule D (Form 941) helps the IRS resolve               merger or consolidation, you should file Schedule D
discrepancies without contacting you.                     (Form 941) to provide:
                                                          •The date of the statutory merger or consolidation;
Who Should File Schedule D (Form 941)?                    •The name, trade name (doing business as or d/b/a),
                                                          address, and employer identification number (EIN) of the
You do not need to file a Schedule D (Form 941) for       acquired corporation; and
every merger, acquisition, or other reorganization that    An explanation of any discrepancies between Forms
                                                          •
occurs. File Schedule D (Form 941) only for those         W-2 (Copy A) and Forms 941 in the totals of social
acquisitions, statutory mergers or consolidations that    security wages, Medicare wages and tips, social security
create discrepancies between Forms W-2 (Copy A) and       tips, federal income tax withheld, and advance EIC
Forms 941 in the totals of:                               payments (only for tax years ending before January 1,
•Social security wages,                                   2011).
•Medicare wages and tips,
•Social security tips,                                     If you are the acquired corporation after a statutory
•Federal income tax withheld, and                         merger or consolidation and you are filing a final Form
•Advance EIC payments (for tax years ending before        941, you should file Schedule D (Form 941) to provide:
January 1, 2011).                                         •The date of the statutory merger or consolidation;
Jun 27, 2011                                          Cat. No. 38789M



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Page 2 of 4   Instructions for Schedule D (Form 941)                                         13:20 - 27-JUN-2011

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•The name, trade name (doing business as or d/b/a),            When Should You File?
address, and EIN of the surviving corporation; and
•An explanation of any discrepancies between Forms             If your business is continuing to operate, you should file
W-2 (Copy A) and Forms 941 in the totals of social             Schedule D (Form 941) with your Form 941 no later than
security wages, Medicare wages and tips, social security       the due date of your Form 941 for the first quarter of the
tips, federal income tax withheld, and advance EIC             year after the calendar year of the transaction.
payments (only for tax years ending before January 1,
                                                               If your business is not continuing to operate, you
2011).                                                         should file Schedule D (Form 941) with your final Form
 Rev. Rul. 62-60, 1962-1 C.B. 186, provides that, for          941.
employment tax purposes, the “resultant” corporation           For example, if the transaction occurred in the third
(now called a “surviving” corporation) resulting from a        quarter of 2010 and your business is continuing to
statutory merger or consolidation is the same employer         operate, you would file Schedule D (Form 941) with your
and taxpayer as the “absorbed” corporation (now called         Form 941 no later than the due date for the first quarter
an “acquired” corporation). The predecessor-successor          of 2011. However, if your business is not continuing to
rules described in Rev. Proc. 2004-53 do not apply to          operate during 2010, you would file Schedule D (Form
these transactions.                                            941) with your final Form 941 no later than the due date
                                                               for the third quarter of 2010.
 However, Rev. Proc. 2004-53 provides guidance for
using Schedule D (Form 941) by a surviving corporation         How Should You File?
or an acquired corporation to report information after a
statutory merger or consolidation only where there is a        Schedule D (Form 941) was designed to be filed
discrepancy. If the surviving corporation completes and        electronically with your electronic submission of Form
files Schedule D (Form 941) to explain discrepancies           941. Electronic filing of Schedule D (Form 941) enables
between the totals on Forms W-2 (Copy A) and the totals        IRS to process information on the form more efficiently
on Forms 941, filing Schedule D (Form 941) will also           and accurately.
provide notice of a statutory merger or consolidation          However, you may file Schedule D (Form 941) on
under Rev. Rul. 62-60.                                         paper if necessary. When filing on paper, do not attach
                                                               Schedule D (Form 941) to your Form 941. Instead, file
Acquisitions that Qualify Under the                            Schedule D (Form 941) separately using the following
Predecessor-Successor Rules                                    address.
Acquisitions that qualify under the                            IRS Philadelphia Campus
predecessor-successor rules are acquisitions in which a        Mail Stop 4-G08 151
successor employer:                                            2970 Market Street
•Acquires substantially all the property used in a trade       Philadelphia, PA 19104
or business of another employer (predecessor) or in a          Do not use this address to file Form 941. See Where
separate unit of a trade or business of a predecessor,         Should You File? in the Instructions for Form 941 for the
and                                                            filing address of Form 941.
•In connection with and directly after the acquisition (but
during the same calendar year) employs individuals who
immediately before the acquisition were employed in the
trade or business of the predecessor.                          Specific Instructions

 These acquisitions satisfy the conditions for                 Completing Schedule D (Form 941)
predecessor-successor status set forth in section
3121(a)(1) and Regulations section 31.3121(a)(1)-1(b).         Your Business Information
 Rev. Proc. 2004-53 contains the rules that apply to           Carefully fill in your employer identification number (EIN),
employment tax reporting in a predecessor-successor            name, trade name (doing business as or d/b/a), and
situation. Two procedures can be used in an acquisition        complete address at the top of the schedule.
that qualifies as a predecessor-successor situation.                  Always be sure the EIN on the Schedule D (Form
•Standard procedure   —Do not file Schedule D (Form            !      941) you file exactly matches the EIN the IRS
941). No discrepancies should exist between the totals of      CAUTIONassigned to your business.
the Forms W-2 (Copy A) and the totals of the Forms 941
as a result of the acquisition.                                Tax Year of DiscrepanciesAlternate procedure  —Each party in the transaction           In the box at the top of the schedule, write the tax year
should file Schedule D (Form 941). Forms W-2 (Copy A)          (not the quarter) in which the discrepancies occurred.
filed by the successor may include amounts reported on         Write the tax year using four digits. For example, if the
Forms 941 filed by the predecessor.                            transaction occurred on March 22, 2011, write “2011” in
                                                               the box.
Other Acquisitions
                                                               Make sure you fill in the correct tax year so you can
If you completed other acquisitions that are not statutory     reconcile the information appropriately. The tax year
mergers or consolidations and that do not qualify under        must be the same as the calendar year you write in Part
the predecessor-successor rules, no discrepancies              1, line 2.
should exist as a result of the acquisition. Rev. Rul. 62-60
and Rev. Proc. 2004-53 do not apply to such                           Be sure to fill in your EIN, business name, other
transactions. Do not file Schedule D (Form 941) for such       TIP    party’s EIN, and the tax year of the discrepancies
transactions.                                                         on the top of page 2 as well.
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Page 3 of 4        Instructions for Schedule D (Form 941)                               13:20 - 27-JUN-2011

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Type of Submission                                                   If no Forms W-2 (Copy A) were filed by you, write
                                                              !      “-0-” in Column B, “Amount you reported to SSA
Check the appropriate box to show whether this form is        CAUTION
                                                                     for the tax year.”
the “Original” Schedule D (Form 941) for a specific
transaction or corrects (mark “Corrected”) a Schedule D         If you are filing for one transaction only, stop here. If
(Form 941) you previously submitted.                          you are filing for more than one transaction, go to Part 3.

Part 1: Answer these background                               Part 3: Fill this part out ONLY if you
questions                                                     are filing more than one Schedule D
1. Check the appropriate box to explain the type of           (Form 941) for any calendar year
transaction for which you are submitting Schedule D           If you are filing only one Schedule D (Form 941) for the
(Form 941). See Types of Mergers and Acquisitions on          calendar year, leave this part blank.
page 1 for details.
                                                                When more than one statutory merger, consolidation,
File Schedule D (Form 941) after either:                      or acquisition occurs during a calendar year, file a
a. A statutory merger or consolidation (Check whether         separate Schedule D (Form 941) for each transaction.
you are an acquired corporation or a surviving                Complete Part 3 for each transaction. For instance, if you
corporation.), or                                             have 11 different transactions in a calendar year, you
b. An acquisition for which you are using the alternate       need to file 11 different Schedules D (Form 941). Part 2
procedure under Rev. Proc. 2004-53. (Check whether            would be the same for each schedule. Part 3 would show
you are a predecessor or a successor.)                        one of the 11 transactions. For example, the amount
2. Fill in the effective date of the transaction in the       entered in Part 2 on line 4 for Column C should equal the
box. Make sure you write the month, day, and year in this     total of all 11 entries in Part 3 on line 10 for Column C.
format: MM/DD/YYYY. The year must be the same as the          Line 9.Show the number of schedules you are filing for
calendar year you write in the box at the top of the          the year and identify which schedule this is. For example,
schedule.                                                     if you had three different transactions in a calendar year
3. Fill in the contact information about the OTHER            and you are filing a Schedule D (Form 941) to describe
PARTY in the transaction by including the other party’s       the second transaction, fill in “2” and “3” so the sentence
EIN, name, trade name (doing business as or d/b/a),           reads: “This is schedule 2 of 3. ”
complete address, and phone number. Verify the other
                                                              Lines 10–14.For purposes of Part 3, Columns A and B,
party’s EIN to make sure it is correct.
                                                              the term “employees affected by the transaction reported
                                                              on this Schedule D” means those employees who
Part 2: Tell us about the                                     received wages that were reported on Forms 941 filed by
                                                              one employer but whose wages were reported on Form
discrepancies with your returns                               W-2 (Copy A) filed by another employer as a result of this
Lines 4–8. Gather your information about the social           particular transaction. Report the totals for social security
security wages, Medicare wages and tips, social security      wages, Medicare wages and tips, social security tips,
tips, federal income tax withheld, and advance earned         federal income tax withheld, and advance earned income
income credit (EIC) payments (for tax years ending            credit (EIC) payments (for tax years ending before
before January 1, 2011) you reported. When entering           January 1, 2011).
money amounts from your Forms 941 and W-2 (Copy A)               In Column A, fill in the amount you reported to the IRS
on lines 4–14, you may round to the nearest dollar. Do        for the tax year for employees affected by the transaction
not show dollar signs but do use commas as appropriate.       reported on this Schedule D (Form 941) for each of the
Show an amount (even if it is zero) for each column of a      items. Add the totals from all your Forms 941, as
line.                                                         corrected by any Forms 941-X, and write your answers
In Column A, fill in the amount you reported to the IRS       on the appropriate lines.
for the tax year for each of the items. Add the totals from     In Column B, fill in the amount you reported to SSA for
all Forms 941, as corrected by any Forms 941-X,               the tax year for employees affected by the transaction
Adjusted Employer’s QUARTERLY Federal Tax Return              reported on this Schedule D (Form 941) for each of the
or Claim for Refund, and write your answers on the            items. Add the totals from all Forms W-2 (Copy A), as
appropriate lines.                                            corrected by any Forms W-2c (Copy A), and write your
In Column B, fill in the amount you reported to SSA for       answers on the appropriate lines.
each of the items. Add the totals from all Forms W-2            Calculate the differences between the entries in the
(Copy A), as corrected by any Forms W-2c, Corrected           columns:
Wage and Tax Statement (Copy A), and write your                                 Column A
answers on the appropriate lines.                                              –Column B
Calculate the differences between the entries in the                            Column C
columns:
                    Column A                                    Enter any negative result in parentheses, if possible.
                   –Column B                                  For example, if line 12, Column A is “-0-” and line 12,
                    Column C                                  Column B is “6,000,” write “(6,000)” on line 12, Column
                                                              C.
Enter any negative result in parentheses, if possible.               If no Forms W-2 (Copy A) were filed by you, write
For example, if line 6, Column A is “-0-” and line 6,         !      “-0-” in Column B, “Amount you reported to SSA
                                                              CAUTION
Column B is “6,000,” write “(6,000)” on line 6, Column C.            for the tax year.”
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Page 4 of 4Instructions for Schedule D (Form 941)                                      13:20 - 27-JUN-2011

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

Paperwork Reduction Act Notice.We ask for the                circumstances. The estimated average time is:
information on Schedule D (Form 941) to carry out the        Recordkeeping, 11 hr., 43 min.; Learning about the
Internal Revenue laws of the United States. You are          law or the form, 18 min.; Preparing, copying,
required to give us the information. We need it to ensure    assembling, and sending the form to the IRS, 30 min.
you are complying with these laws and to allow us to         If you have comments concerning the accuracy of this
figure and collect the right amount of tax.                  time estimate or suggestions for making Schedule D
                                                             (Form 941) simpler, we would be happy to hear from you.
You are not required to provide the information
requested on a form that is subject to the Paperwork         You can email us at: taxforms@irs.gov. Enter “Schedule
                                                             D (Form 941)” on the subject line. Or write to: Internal
Reduction Act unless the form displays a valid OMB
control number. Books or records relating to a form or its   Revenue Service, Tax Products Coordinating Committee,
                                                             SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW,
instructions must be retained as long as their contents
may become material in the administration of any Internal    IR-6526, Washington, DC 20224. Do not send Schedule
                                                             D (Form 941) to this address. Instead, see How Should
Revenue law. Generally, tax returns and return
information are confidential, as required by section 6103.   You File?, earlier.
The time needed to complete and file Schedule D
(Form 941) will vary depending on individual

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