IRC SECTION 6011 AND CHAPTER 21
REQUIRE EMPLOYERS TO REPORT FICA EARNINGS AND TAXES TO THE IRS.
THIS FORM IS THE SPANISH VERSION OF FORM 941SS AND IS USED ONLY IN
PUERTO RICO. IRC SECTION 6011 AND CHAPTER 21 REQUIRE EMPLOYERS TO
PREPARE AND FILE A STATEMENT REPORTING THE AMOUNT OF WAGES PAID
SUBJECT TO FICA TAX AND THE AMOUNT OF FICA TAX. THIS FORM IS A
VARIATION OF FORM 941 AND IS USED BY EMPLOYERS IN VIRGIN ISLANDS,
GUAM, AND AMERICAN SAMOA.
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.