Schedule R (Form 941) - Allocation Schedule For Aggregate Form 941 Filers - 2011 Page 2
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1
2
3950511
Page
of
Continuation Sheet for Schedule R (Form 941)
Report for calendar year:
(Rev. January 2011)
Check the quarter (same as Form 941):
1: January, February, March
Employer identification number
—
(EIN)
2: April, May, June
Name as shown on
Form 941
3: July, August, September
4: October, November, December
(a)
(b)
(c)
(d)
(e)
(f)
(g)
Client’s Employer
Wages, tips, and
Total income tax
Total social security
Total taxes after
Advance EIC
Total deposits and
adjustments
payments
Identification
other compensation
withheld from wages,
and Medicare taxes
COBRA payments
allocated to the
allocated to the
Number (EIN)
tips, and other
allocated to the listed
allocated to the
from line 13 of
listed client EIN
listed client EIN
client EIN from line 2
compensation
listed client EIN
Form 941 plus any
from line 10 (line 8 for
from line 9
of Form 941
allocated to the listed
from line 5d
payments made with
quarters ending before
(for quarters ending
client EIN from line 3
of Form 941
the return allocated
January 1, 2011) of
before January 1,
of Form 941
to the listed client EIN
Form 941
2011) of Form 941
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26
Subtotals for clients.
Add lines 1 through 25.
Include the subtotals
from line 26 on line 17
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of Schedule R
(Form 941)
Schedule R (Form 941) (Rev. 1-2011)
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