Form 944-X Adjusted Employer�s ANNUAL Federal Tax Return or Claim f

Form 944-X:
(January 2009)

Draft 10: 11/12/08

Adjusted Employer’s ANNUAL Federal Tax Return or Claim for Refund
Department of the Treasury — Internal Revenue Service

OMB No. 1545-2007

Return You Are Correcting …
Employer Identification Number (EIN)

–

Check the type of return you are correcting:
Name (not your trade name)

944

Trade name (if any)

944-SS

Address
Number

Street

Suite or room number

Enter the calendar year of the return you
are correcting:
(YYYY)

City

State

ZIP code

Use this form to correct errors made on Form 944 or Form 944-SS, Employer’s ANNUAL Federal
Tax Return, for one year only. Please type or print within the boxes. Do not attach this form to
Form 944 or Form 944-SS. You MUST complete all three pages. Read the instructions before
you complete this form.

Enter the date you discovered errors:

/

/

(MM / DD / YYYY)

Part 1: Select ONLY one process.
1.

Adjusted employment tax return. Check this box if you underreported amounts. Also check this box if you overreported amounts and
would like to use the adjustment process to correct the errors. You must check this box if you are correcting both underreported and
overreported amounts on this form. The amount shown on line 17, if less than 0, may only be applied as a credit to your Form 941, Form
941-SS, Form 944, or Form 944-SS for the tax period in which you are filing this form.

2.

Claim. Check this box if you overreported amounts only and you would like to use the claim process to ask for a refund or abatement of the
amount shown on line 17. Do not check this box if you are correcting ANY underreported amounts on this form.

Part 2: Complete the certifications.
3.

I certify that I have filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement, as
required.
Note: If you are correcting underreported amounts only, go to Part 3 (Skip lines 4 and 5).
4.

If you checked line 1 because you are adjusting overreported amounts, check all that apply. (Check at least one.)
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected federal income tax for the current year and the

overcollected social security and Medicare tax for current and prior years. For adjustments of employee social security
and Medicare tax overcollected in prior years, I have a written statement from each employee stating that he or she has
not claimed (or the claim was rejected) and will not claim a refund or credit for the overcollection.
b. the adjustment of social security tax and Medicare tax is for the employer’s share only. I could not find the affected

employees or each employee did not give me a written statement that he or she has not claimed (or the claim was
rejected) and will not claim a refund or credit for the overcollection.
c. the adjustment is for federal income tax, social security tax, and Medicare tax that I did not withhold from employee wages.
5.

If you checked line 2 because you are claiming a refund or abatement of overreported employment taxes, check all that apply.
(Check at least one.)
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected social security and Medicare tax. For claims of

employee social security and Medicare tax overcollected in prior years, I have a written statement from each employee
stating that he or she has not claimed (or the claim was rejected) and will not claim a refund or credit for the overcollection.
b. I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social

security and Medicare tax. For refunds of employee social security and Medicare tax overcollected in prior years, I also
have a written statement from each employee stating that he or she has not claimed (or the claim was rejected) and will
not claim a refund or credit for the overcollection.
c. the claim for social security tax and Medicare tax is for the employer’s share only. I could not find the affected

employees; or each employee did not give me a written consent to file a claim for the employee’s share of social
security and Medicare tax; or each employee did not give me a written statement that he or she has not claimed (or the
claim was rejected) and will not claim a refund or credit for the overcollection.
d. the claim is for federal income tax, social security tax, and Medicare tax that I did not withhold from employee wages.
For Paperwork Reduction Act Notice, see the instructions.

Cat. No. 20335M

Form 944-X (1-2009)

Next ·

Name (not your trade name)

Employer Identification Number (EIN)

Calendar Year (YYYY)

3: Enter the corrections for this year. If any line does not apply, leave it blank.

Draft

6. Wages, tips and other compensation
(from line 1 of Form 944)

7. Income tax withheld from wages,
tips, and other compensation
(from line 2 of Form 944)
8. Taxable social security wages
(from line 4a, Column 1 of Form 944
or Form 944-SS)

Column 1

Column 2

Total corrected
amount
(For ALL employees)

.

.
.

–

Column 3

Column 4

Amount originally
Difference
reported or as previously
= (If this amount is a
corrected
negative number, use a
(For ALL employees)
minus sign.)

–

–

–

.

.
.

=

=

=

.

.
.

Tax correction

Use the amount in Column 1 when you
prepare your Forms W-2 or Forms W-2c.

Copy
Column 3
here ff

.

X .124* =

.

*If you are correcting your employer share only, use .062. See instructions.

9. Taxable social security tips
(from line 4b, Column 1 of Form 944
or Form 944-SS)

.

–

.

=

.

X .124* =

.

*If you are correcting your employer share only, use .062. See instructions.

10. Taxable Medicare wages and tips
(from line 4c, Column 1 of Form 944
or Form 944-SS)

.

–

.

=

.

X .029* =

.

*If you are correcting your employer share only, use .0145. See instructions.

11. Tax adjustments
(from lines 6a through 6c of Form 944
or Form 944-SS)
12. Special addition to wages for
federal income tax
13. Special addition to wages for
social security taxes
14. Special addition to wages for
Medicare taxes

.
.
.
.

–

–

–

–

.
.
.
.

=

=

=

=

.
.
.
.

Copy
Column 3
here ff

.

See
instructions

.
.

See
instructions

See
instructions

.

15. Subtotal: Combine the amounts in lines 7–14 of Column 4..................................................................................................................
16. Advance earned income credit (EIC)
payments made to employees
(from line 8 of Form 944)

.

–

.

=

.

.

See
instructions

.

17. Total: Combine the amounts in lines 15 and 16 of Column 4................................................................................................................

.

If line 17 is less than 0…
• If you checked line 1, this is the amount you want applied as a credit to your Form 944 or Form 944-SS for the tax period in which you are
filing this form.
• If you checked line 2, this is the amount you want refunded or abated.

If line 17 is more than 0, this is the amount you owe. Pay this amount when you file this return. Go to Amount You Owe on page X of the instructions.
Page 2

Form

(1-2009)

Next ·

Name (not your trade name)

Employer Identification Number (EIN)

Calendar Year (YYYY)

4: Explain your corrections for this year.
18. Check here if any corrections you entered on a line include both underreported and overreported amounts. Explain both your
underreported and overreported amounts on line 20.
19. Check here if any corrections involve reclassified workers. Explain on line 20.
20. You must give us a detailed explanation of how you determined your corrections. (See the instructions.)

Part 5: Sign here. You must complete all three pages of this form and sign it.
Under penalties of perjury, I declare that I have filed an original Form 944 or Form 944-SS and that I have examined this adjusted return or claim and
any schedules or statements that are attached, and to the best of my knowledge and belief, they are true, correct, and complete. Declaration of
preparer (other than taxpayer) is based on all information of which preparer has any knowledge.



Print your
name here

Sign your
name here

Print your
title here

Date

/

/

Best daytime phone

(

)

--

Paid preparer’s use only

Check if you are self employed ....................................

Preparer’s name

Preparer’s SSN/PTIN

Preparer’s signature

Date

Firm’s name (or yours
if self-employed

EIN

Address

Phone

City
Page 3

State

/

(

/

)

--

ZIP code
Form 944-X (1-2009)

Type of errors
you are
correcting

Underreported
amounts
ONLY

Overreported
amounts
ONLY

Form 944-X: Which process should you use?

Use the adjustment process to correct underreported amounts.
• Check the box on line 1.
• Pay the amount you owe from line 17 when you file Form 944-X.
The process you
use depends on
when you file
Form 944-X.

If you are filing Form 944-X
MORE THAN 90 days before
the period of limitations on
credit or refund for Form 944
or Form 944-SS expires …

Choose either process to correct the overreported amounts.
Choose the adjustment process if you want the amount shown
on line 17 credited to your Form 944, 944-SS, 941, or Form 941SS for the period in which you file Form 944-X. Check the box on
line 1.
OR
Choose the claim process if you want the amount shown on
line 17 refunded to you or abated. Check the box on line 2.

If you are filing Form 944-X
WITHIN 90 DAYS of the
expiration of the period of
limitations on credit or
refund for Form 944 or Form
944-SS …
BOTH
underreported
and
overreported
amounts

The process you
use depends on
when you file
Form 944-X.

If you are filing Form 944-X
MORE THAN 90 days before
the period of limitations on
credit or refund for Form 944
or Form 944-SS expires …

You must use the claim process to correct the overreported
amounts. Check the box on line 2.

Choose either the adjustment process or both the adjustment
process and the claim for refund process when you correct both
underreported and overreported amounts.

Choose the adjustment process if combining your
underreported and overreported amounts results in a balance
due or creates a credit that you want applied to Form 944, 944SS, 941, or 941-SS.
• File one Form 944-X, and
• Check the box on line 1 and follow the instructions on line 17.
OR
Choose both the adjustment process and the claim process
if you want the overreported amount refunded to you or abated.
File two separate forms.
1. For the adjustment process, file one Form 944-X to correct
the underreported amounts. Check the box on line 1. Pay
the amount you owe from line 17 when you file Form 944-X.
2. For the claim process, file a second Form 944-X to correct
the overreported amounts. Check the box on line 2.

If you are filing Form 944-X
WITHIN 90 DAYS of the
expiration of the period of
limitations on credit or
refund for Form 944 or Form
944-SS…

You must use both the adjustment process and claim process.
File two separate forms.
1. For the adjustment process, file one Form 944-X to correct
the underreported amounts. Check the box on line 1. Pay
the amount you owe from line 17 when you file Form 944-X.
2. For the claim for refund process, file a second Form 944-X
to correct the overreported amounts. Check the box on line 2.
Form 944-X (1-2009)