Form 941-X - Adjusted Employer'S Quarterly Federal Tax Return Or Claim For Refund - 2013 Page 2
Download a blank fillable Form 941-X - Adjusted Employer'S Quarterly Federal Tax Return Or Claim For Refund - 2013 in PDF format just by clicking the "DOWNLOAD PDF" button.
Open the file in any PDF-viewing software. Adobe Reader or any alternative for Windows or MacOS are required to access and complete fillable content.
Complete Form 941-X - Adjusted Employer'S Quarterly Federal Tax Return Or Claim For Refund - 2013 with your personal data - all interactive fields are highlighted in places where you should type, access drop-down lists or select multiple-choice options.
Some fillable PDF-files have the option of saving the completed form that contains your own data for later use or sending it out straight away.
ADVERTISEMENT
1
2
3
4Employer identification number (EIN)
Name (not your trade name)
Correcting quarter
(1, 2, 3, 4)
Correcting calendar year (YYYY)
Part 3:
Enter the corrections for this quarter. If any line does not apply, leave it blank.
Column 2
Column 3
Column 4
Column 1
Amount originally
Difference
Total corrected
reported or as
(If this amount is a
amount (for ALL
Tax correction
employees)
previously corrected
negative number,
=
—
(for ALL employees)
use a minus sign.)
6.
Wages, tips and other
Use the amount in Column 1 when you
=
—
.
.
.
compensation (Form 941, line 2)
prepare your Forms W-2 or Forms W-2c.
7.
Income tax withheld from
Copy Column
=
wages, tips, and other
—
.
.
.
.
3 here
▶
compensation (Form 941, line 3)
Taxable social security wages
8.
=
—
(Form 941 or 941-SS, line 5a,
.
.
.
.
× .124* =
Column 1)
*If you are correcting a 2011 or 2012 return, use .104. If you are correcting your employer share only, use .062. See instructions.
Taxable social security tips (Form
9.
=
—
941 or 941-SS, line 5b, Column 1)
.
.
.
.
× .124* =
*If you are correcting a 2011 or 2012 return, use .104. If you are correcting your employer share only, use .062. See instructions.
10.
Taxable Medicare wages and tips
=
—
(Form 941 or 941-SS, line 5c, Column 1)
.
.
.
.
× .029* =
*If you are correcting your employer share only, use .0145. See instructions.
11.
Taxable wages & tips subject to
=
—
Additional Medicare Tax withholding
.
.
.
.
× .009 =
(Form 941 or 941-SS, line 5d; only for
quarters beginning after December 31, 2012)
12.
Section 3121(q) Notice and Demand —
=
Copy Column
—
.
.
.
.
Tax due on unreported tips
3 here
▶
(Form 941 or 941-SS, line 5f (line 5e for
quarters ending before January 1, 2013))
13a.
Number of qualified employees first
=
Complete lines 13a-13c only
—
paid exempt wages/tips this
for corrections to quarters
quarter (Form 941 or 941-SS, line 6a)
ending after March 31, 2010,
and before January 1, 2011.
13b.
Number of qualified employees
=
—
paid exempt wages/tips this
quarter (Form 941 or 941-SS, line 6b)
13c.
Exempt wages/tips paid to
=
—
qualified employees this quarter
.
.
.
.
× .062 =
(Form 941 or 941-SS, line 6c)
14.
Tax adjustments (Form 941 or 941-
=
—
Copy Column
SS, lines 7–9 (lines 7a–7c for quarters
.
.
.
.
3 here
▶
ending before January 1, 2011))
15.
Special addition to wages for
=
—
See
.
.
.
.
federal income tax
instructions
16.
Special addition to wages for
=
—
See
.
.
.
.
social security taxes
instructions
17.
Special addition to wages for
=
—
See
.
.
.
.
Medicare taxes
instructions
.
18.
Combine the amounts on lines 7–17 of Column 4
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
.
19.
Advance earned income credit (EIC)
=
—
See
payments made to employees
.
.
.
.
instructions
(Form 941, line 9; only for quarters
ending before January 1, 2011)
20a.
COBRA premium assistance payments
=
—
See
.
.
.
.
(Form 941 or 941-SS, line 12a)
instructions
20b.
Number of individuals provided
=
—
COBRA premium assistance
(Form 941 or 941-SS, line 12b)
20c.
Number of qualified employees paid
Complete lines 20c and 20d
=
—
exempt wages/tips March 19–31, 2010
only for corrections to the
(Form 941 or 941-SS, line 12c)
second quarter of 2010.
20d.
Exempt wages/tips paid to qualified
=
—
employees March 19–31, 2010
.
.
.
.
× .062 =
(Form 941 or 941-SS, line 12d)
.
21.
Total. Combine the amounts on lines 18–20d of Column 4. Continue on next page
.
.
.
.
.
.
.
.
.
.
.
Next
▶
■
2
941-X
Page
Form
(Rev. 4-2013)
ADVERTISEMENT
0 votes
Related Articles
Related forms
Instructions For Form 941-x - Adjusted Employer's Quarterly Federal Tax Return Or Claim For Refund - 2017
Financial
Instructions For Form 941-x - Adjusted Employer's Quarterly Federal Tax Return Or Claim For Refund - 2010
Financial
Related Categories
Parent category: Financial