Employer's Monthly Federal Tax Return

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Instructions for Form 941-M

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10:42 - 10-MAY-2010

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Instructions for Form 941-M

Department of the Treasury
Internal Revenue Service

(Rev. April 2010)
Employer’s MONTHLY Federal Tax Return
Section references are to the Internal Revenue Code unless
otherwise noted.

Delete "es"

What’s New

Delete "of"

Qualified employer’s social security tax credit. Qualified
employers are allowed a credit in April of 2010 for their share
(6.2%) of social security taxes on wages/tips paid to qualified
employees after March 18, 2010, and before April 1, 2010. See
the instructions for lines 12c through 12e on page 4. For more
information regarding the employer’s social security tax
Delete
exemption visit the IRS website at www.IRS.gov and enter the
last
sentence keywords “HIRE Act” in the search box.
Qualified employer’s social security tax exemption.
Qualified employers are allowed an exemption for their share
(6.2%) of social security taxes on wages/tips paid to qualified
employees after March 31, 2010, and before January 1, 2011.
See the instructions for lines 6a through 6d on page 3. For
Delete
more information regarding the employer’s social security tax
last
exemption visit the IRS website at
sentence www.IRS.gov and enter the keywords “HIRE Act” in the search
box.
COBRA premium assistance credit extended. The credit for
COBRA premium assistance payments has been extended. It
now applies to premiums paid for employees involuntarily
terminated between September 1, 2008, and May 31, 2010,
and to premiums paid for up to 15 months. Congress may take
additional legislative action that extends the credit. To find out if
additional legislation is enacted, monitor the news media or visit
the IRS website at www.irs.gov and enter the keyword COBRA.
See Line 12a, COBRA premium assistance payments on page
4.
3.
Social security wage base for 2010. Do not withhold or pay
social security tax after an employee reaches $106,800 in
social security wages in 2010.

Reminders
Disregarded entities and qualified subchapter S
subsidiaries (QSubs). The IRS has published final
regulations (Treasury Decision 9356) under which QSubs and
eligible single-owner disregarded entities are treated as
separate entities for employment tax purposes. The final
regulations apply beginning January 1, 2009. For more
information, see Disregarded entities and qualified subchapter
S subsidiaries in the introduction to Publication 15 (Circular E),
Employer’s Tax Guide.
Paid preparers must sign Form 941-M. Paid preparers must
complete and sign the paid preparer’s section of Form 941-M.
Telephone help. If you have questions about completing Form
941-M, call the IRS Business and Specialty Tax Line toll free at
1-800-829-4933 on Monday through Friday from 7 a.m. to 10
p.m. local time (Alaska and Hawaii follow Pacific time).

General Instructions
Purpose of form. Use Form 941-M to report monthly: (a)
federal income tax you withheld from wages, tips, distributions
from nonqualified pension plans (including nongovernmental
section 457(b) plans), supplemental unemployment
compensation benefits, and third-party payments of sick pay;

and (b) social security and Medicare taxes. If you report just
one kind of tax, complete only the lines that apply.

!

CAUTION

Form 941-M is not for general public use and should
only be filed directly with an IRS compliance
representative.

Who must file. File Form 941-M if you must report federal
income tax withheld, social security taxes, and Medicare taxes
on a monthly basis to an IRS compliance representative. The
IRS may require monthly returns on Form 941-M and payments
of tax from any employer who has not complied with the
requirements for the filing of returns or the paying or depositing
of taxes reported on quarterly or annual returns. Do not file
monthly returns unless you received written notification from the
IRS to do so. A preaddressed return envelope and blank Form
941-M will be mailed to you before your first monthly return is
due and for each month thereafter. If you no longer expect to
pay amounts subject to tax reportable on Form 941-M, check
the box on line 18 and enter the date you last paid wages.
When to file. Form 941-M for any month is due by the 15th
day of the following month. If the due date for filing a return falls
on a Saturday, Sunday, or legal holiday, you may file the return
on the next business day.
Where to file. File Form 941-M, with any payment due, using
the preaddressed envelope furnished to you. Keep a duplicate
Form 941-M for your records.
Form W-5. Each eligible employee wishing to receive any
advance earned income credit (EIC) payments must give you a
completed Form W-5, Earned Income Credit Advance Payment
Certificate. Your requirement to notify certain employees about
the EIC can be met by giving each eligible employee Notice
797, Possible Federal Tax Refund Due to the Earned Income
Credit (EIC). See section 10 of Pub. 15 (Circular E), Employer’s
Tax Guide, and Pub. 596, Earned Income Credit (EIC), for more
information.
Form W-2. By January 31, furnish Form W-2, Wage and Tax
Statement, to employees who worked for you during the
previous year. If an employee stops working for you before the
end of the year, furnish Form W-2 to the employee any time
after employment ends but no later than January 31 of the
following year. However, if the employee asks you for Form
W-2, furnish the completed form within 30 days after the
request or the final wage payment, whichever is later. Send
Copy A of all Forms W-2 issued for the year with a Form W-3,
Transmittal of Wage and Tax Statements, filed on paper, to the
Social Security Administration (SSA) by the last day of
February. If you file Forms W-2 electronically, file them with the
SSA by the last day of March.
If you file a final return on Form 941-M, you must furnish
Form W-2 to your employees by the last day of the
CAUTION month in which the final Form 941-M is due. File Copy A
of Forms W-2 and Form W-3 with the Social Security
Administration by the last day of the month following the month
your final Form 941-M was due. See the Instructions for Forms
W-2 and W-3 for details.
Penalties and interest. There are penalties for filing a return
late and paying or depositing taxes late, unless there is
reasonable cause. There are also penalties for failure to: (a)
furnish Forms W-2 to employees and file copies with the SSA
and (b) deposit taxes when required. Do not attach an
explanation of why the return is late to Forms W-2 sent to the
SSA. In addition, there are penalties for willful failure to file
returns and pay taxes when due and for filing false returns or
submitting bad checks. Interest is charged on taxes paid late at

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Instructions for Form 941-M

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instructions for line 5c for
more information about
the rate set by law. See Pub. 15 (Circular E) for additional
information.

benefits. Also include here any excise taxes you were required
to withhold on golden parachute payments (section 4999).

A trust fund recovery penalty may apply if federal
income, social security, and Medicare taxes that must
CAUTION be withheld are not withheld or are not paid. This
penalty is the full amount of any unpaid trust fund tax. This
penalty may apply to you if these unpaid taxes cannot be
immediately collected from the employer or business. The trust
fund recovery penalty may be imposed on all persons who are
determined by the IRS to be responsible for collecting,
accounting for, and paying over these taxes, and who acted
willfully in not doing so.
A responsible person can be an officer or employee of a
corporation, a partner or employee of a partnership, an
accountant, a volunteer director/trustee, or any employee of a
sole proprietorship. A responsible person also may include one
who signs checks for the business or otherwise has authority to
cause the spending of business funds. Willfully means
voluntarily, consciously, and intentionally.
Related publications. Pub. 15 (Circular E) explains the rules
for withholding, paying, depositing, and reporting federal
income tax, social security, and Medicare taxes, and federal
unemployment (FUTA) tax on wages. See Pub. 15-A,
Employer’s Supplemental Tax Guide, for information on sick
pay paid by third-party payers. Pub. 51 (Circular A), Agricultural
Employer’s Tax Guide, explains rules for employers of
farmworkers. These publications are available on the IRS
website at www.irs.gov or by calling 1-800-TAX-FORM
(1-800-829-3676). See Pub. 15 (Circular E) for additional
methods of obtaining forms and publications.
Reconciliation of Forms 941-M and W-3. Certain amounts
reported on the monthly Forms 941-M for the year should agree
with the Form W-2 totals reported on Form W-3. The following
amounts are reconciled: federal income tax withholding,
social security wages, social security tips, Medicare wages and
tips, and advance earned income credit (EIC) payments.
If the amounts do not agree, the IRS may require you to
explain the differences and correct any errors. See section 12
of Pub. 15 (Circular E) for details.

4. If no wages, tips, and other compensation are
subject to social security or Medicare tax. Delete period

!

If no wages, tips, and other compensation on line 2 are subject
to social security or Medicare tax, check the box on line 4. If this
question does not apply to you, leave the box blank. For more
information about exempt wages, see section 15 of Pub. 15
(Circular E) and sections 3 and 4 of Pub. 15-A.

5. Taxable social security and Medicare wages
and tips
5a. Taxable social security wages. Enter the total wages
subject to social security taxes you paid to your employees
during the month. Also include any sick pay and taxable fringe
benefits subject to social security taxes. Enter the amount
before deductions. Do not include tips on this line. Stop
reporting for any employee whose wages (including tips) reach
$106,800 for 2010. However, continue to withhold income and
Medicare taxes for the whole year on wages and tips even
when the limit of $106,800 is reached. See the Line 5c
instructions for Medicare wages and tips.

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CAUTION

5b. Taxable social security tips. Enter all tips your
employees reported during the month until tips and wages for
an employee reach $106,800 in 2010. Do this even if you were
not able to withhold the employee tax (6.2%). Report the
uncollected employee’s share of social security tax on line 7c.
Also see section 6 of Pub. 15 (Circular E).
An employee must report to you cash tips, including tips you
paid the employee for charge customers, totaling $20 or more
in a month by the 10th day of the next month. The employee
may use Form 4070, Employee’s Report of Tips to Employer, or
give you a written statement.
Do not include allocated tips on this line. Instead, report
them on Form 8027, Employer’s Annual Information Return of
Tip Income and Allocated Tips. Allocated tips are not reportable
on Form 941-M and are not subject to withholding of federal
income, social security, or Medicare tax.

Specific Instructions

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Part 1: Answer these questions for this
Number of employees who
month

CAUTION

Do not reduce the amount reported on line 5b by any
amount paid to qualified new employees. Your liability
for exempt wages/tips will be reduced on line 6d.

5c. Taxable Medicare wages & tips. Report all wages
and tips subject to Medicare tax. Also include any sick pay and
taxable fringe benefits subject to Medicare tax. See section 5 in
Pub. 15 (Circular E) for information on types of wages subject
to Medicare tax. If none of the payments are subject to
Medicare tax, enter “-0-.”
Include all tips your employees reported during the month,
even if you were not able to withhold the employee tax (1.45%).
Report the uncollected employee’s share of Medicare tax on
line 7c. Also see section 6 of Pub. 15 (Circular E).
Delete "the"

received wages, tips, or other
1. Number of employees.
compensation

For March, June, September, and December, report the
number of employees on your payroll for the pay period that
includes the 12th of the month. Leave line 1 blank for all other
months. Do not include household employees, employees in
nonpay status during the pay period, pensioners, or active
members of the Armed Forces. An entry of 250 or more on line
1 indicates you must file Forms W-2 electronically. For more
information, call the SSA at 1-800-772-6270 or visit the SSA’s
Employer W-2 Filing Instructions and Information webpage at
www.socialsecurity.gov/employer. Delete period

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CAUTION

2. Wages, tips, and other compensation.

Do not reduce the amount reported on line 5a by any
amount paid to qualified new employees. The tax
exemption does not apply to the Medicare tax.

5d. Total social security and Medicare taxes. Add the
social security tax (line 5a), social security tips tax (line 5b), and
Medicare tax (line 5c) and enter the result on line 5d.

Enter amounts on line 2 that would also be included in box 1 of
your employees’ Forms W-2. See the Instructions for Forms
W-2 and W-3 for details.
If you get timely notice from your insurance carrier
concerning the amount of third-party sick pay it paid to your
employees, include the sick pay on line 2.

6. Employer’s social security tax exemption
Complete lines 6a – 6d to figure the payroll tax exemption for the
employer’s share (6.2%) of social security tax on wages/tips
paid to one or more qualified employees.
An employer must be a qualified employer to be eligible for
the employer’s social security tax exemption. A qualified
employer is any employer other than Federal, State, and any
related government entities. All public institutions of higher

3. Total income tax withheld from wages, tips,
and other compensation.
Delete period
Enter the federal income tax you withheld (or were required to
withhold) on wages, tips, taxable fringe benefits, sick pay, other
compensation, and supplemental unemployment compensation

Income

Do not reduce the amount reported on line 5a by any
amount paid to qualified new employees. Your liability
for exempt wages/tips will be reduced on line 6d.

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endash
education and Indian tribal governments are also qualified
employers.
An employer may elect not to apply the social security tax
exemption with respect to a qualified employee. The election is
made by not including that employee or that employee’s wages
on lines 6a-6d and lines 12c-12e. An election not to apply the
social security tax exemption for a qualified employee may
allow a qualified employer to claim the Work Opportunity Credit
for that employee. A qualified employer cannot apply both the
social security tax exemption on Form 941-M and claim the
Work Opportunity Credit for the same employee. For more
information, see Form 5884, Work Opportunity Credit.
For more information about the employer’s social security
tax exemption visit the IRS website at www.IRS.gov and enter
the keywords “HIRE Act” in the search box.
irs
6a. Number of qualified employees first paid exempt
wages/tips this month.
A qualified employee is an employee who:
• Begins employment with you after February 3, 2010, and
before January 1, 2011;
• Certifies by signed affidavit (Form W-11, Hiring Incentives to
Restore Employment (HIRE) Act Employee Affidavit), or similar
statement under penalties of perjury, that he or she has not
been employed for more than 40 hours during the 60-day
period (including 2009) ending on the date the employee begins
employment with you;
• Is not employed by you to replace another employee unless
the other employee separated from employment voluntarily or
for cause (including downsizing); and
• Is not related to you. An employee is related to you if he or
she is your child or a descendant of your child, your sibling or
stepsibling, your parent or ancestor of your parent, your
stepparent, your niece or nephew, your aunt or uncle, or your
in-law. An employee is also related to you if he or she is related
to anyone who owns more than 50% of your outstanding stock
or capital and profits interest or is your dependent or a
dependent of anyone who owns more than 50% of your
outstanding stock or capital and profits interest.
If you are an estate or trust, see section 51(i)(1) and section
152(d)(2) for more details.
Exempt wages/tips are the wages/tips paid to qualified
employees for which the employer is exempt from paying the
employer’s 6.2% share of social security tax. Enter on line 6a
Make
the number of qualified employees first paid wages/tips to which
green
you applied the social security tax exemption in this month. Do
highlight not include on line 6a qualified employees that are included on
ed text
line 12c.
bold
6b. Number of qualified employees paid exempt wages/
tips this quarter. Enter on line 6b the total number of qualified
employees paid exempt wages/tips to which you applied the
social security tax exemption in this month. Qualified
employees included on line 6a will also be included on line 6b.
Qualified employees included on line 12c may also be included
month on line 6b. See line 6a for definition of qualified employees.
.
6c. Exempt wages/tips paid to qualified employees this
quarter. Enter the amount of exempt wages/tips paid this
month to all qualified employees reported on line 6b. See line
6a for definition of exempt wages/tips.
Delete "s"
6d. Social security tax exemption. Multiply the amount
of exempt wages/tips reported on line 6c by .062 and enter the
the
result on line 6d. See the instructions for Line 17 in applying this
exemption to your tax liability.
line 17 on
6e. Total taxes before adjustments. Add the total federal
income tax withheld from wages, tips, and other compensation
(line 3) and the total social security and Medicare taxes before
adjustments (line 5d), and subtract the qualified employer’s
social security tax exemption (line 6d). Enter the result on line
6e.

7. TAX ADJUSTMENTS.

Delete period

Enter tax amounts on lines 7a through 7c that result from
current or prior period adjustments. Use a minus sign (if

Caution icon. The amount reported on line 12a is treated as a
-3deposit of taxes on the first day of your return period and must not
be used to adjust the tax laibility reported on line 16a.

possible) to show an adjustment that decreases the total taxes
shown on line 6e. Otherwise, use parentheses.
Current period adjustments. In certain cases, amounts
reported as social security and Medicare taxes on lines 5a, 5b,
and 5c must be adjusted to arrive at your correct tax liability.
See section 13 of Pub. 15 (Circular E) for information on the
following adjustments.
• Fractions-of-cents adjustment.
• Adjustment for the employee share of social security and
Medicare taxes withheld by a third-party sick pay payer.
• Adjustment for the uncollected employee share of social
security and Medicare taxes on tips.
• Adjustment for the employee share of social security and
Medicare taxes on group-term life insurance premiums paid for
former employees.

!

CAUTION

For errors discovered after December 31, 2008, make
corrections to a previously filed Form 941-M using Form
941-X. Form 941c will no longer be used.

9. Advance earned income credit (EIC)
payments made to employees.

Delete period

Enter advance EIC payments made to employees. Your eligible
employees may elect to receive part of the EIC as an advance
payment. Eligible employees who have a qualifying child must
give you a completed Form W-5 stating they qualify for the EIC.
Once the employee gives you a signed and completed Form
W-5, you must make the advance EIC payments. Advance EIC
payments are generally made from withheld federal income tax
and employee and employer social security and Medicare
taxes. See section 10 of Pub. 15 (Circular E) and Pub. 596 for
more information on advance EIC payments and eligibility
requirements.
If the amount of your advance EIC payments exceeds your
total taxes (line 8) for the month, you may claim a refund of the
overpayment or elect to have the credit applied to your return
for the following month. Provide a statement with your return
identifying the amount of excess payment(s) and the pay
period(s) in which it was paid. See section 10 of Pub. 15
(Circular E).

Delete period

12a. COBRA premium assistance payments.
Report on this line 65% of the COBRA premiums for assistance
eligible individuals. Take the COBRA premium assistance credit
on this line only after the assistance eligible individual’s 35%
share of the premium has been paid. For COBRA coverage
provided under a self-insured plan, COBRA premium
assistance is treated as having been made for each assistance
eligible individual who pays 35% of the COBRA premium. Do
not include the assistance eligible individual’s 35% of the
premium in the amount entered on this line.

12b. Number of individuals provided COBRA
premium assistance.
Delete period
Enter the total number of assistance eligible individuals
provided COBRA premium assistance reported on line 12a.
Each individual is reported only once per quarter. If an
assistance eligible individual is counted in a prior month of the
current quarter do not count them in the current month. Count
each assistance eligible individual who paid a reduced COBRA
premium in the month as one individual, whether or not the
reduced premium was for insurance that covered more than
one assistance eligible individual. For example, if the reduced
COBRA premium was for coverage for a former employee,
spouse, and two children, you would include one individual in
the number entered on line 12b for the premium assistance if
the eligible individual was not already counted in a prior month
in the current quarter.
Lines 12c – 12e only apply to April 2010. These lines are
used to determine the number of qualified employees,
CAUTION amount of exempt wages/tips, and amount of employer
social security tax exemption as if the exemption were allowed
for March 2010. An employer is allowed to treat this exemption
as a payment credited against deposit requirements for

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Instructions for Form 941-M

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Delete bold

endash

employment taxes due April 2010. If any of these lines are
completed for any month other than April 2010, Form 941-M
may be considered incomplete and subject to correction and
penalties.
comma

12c. Number of qualified employees paid
exempt wages/tips March 19-31

Federal tax deposits. If you are not required to have a special
deposit account, in general, you must deposit your tax liability at
an authorized financial institution with Form 8109 or by using
EFTPS. For more information on the deposit rules and the
electronic deposit requirements, see section 11 of Pub. 15
(Circular E).

the

16. Record of Federal Tax Liability and
Deposits.

Complete this line when filing Form 941-M for April 2010 only.
Enter on line 12c the number of qualified employees paid
exempt wages/tips from March 19, 2010, through March 31,
2010. Include only qualified employees for which you are
claiming the social security tax exemption. For definition of
qualified employee see the instructions for line 6a on page 3.

the

12d. Exempt wages/tips paid to qualified
endash
employees March 19-31

If you must deposit taxes using the Federal Tax Deposit
System, complete both columns of the record. In the tax liability
column, include federal income tax withheld plus both the
employer and employee shares of social security and Medicare
taxes minus advance EIC payment (if any) for each date of
payment (payday). Enter each deposit amount in the numbered
entry space corresponding to the date of deposit.

Complete this line when filing Form 941-M for April 2010 only.
Enter the amount of exempt wages/tips paid March 19, 2010,
through March 31, 2010, to all qualified employees reported on
line 12c. For definition of exempt wages/tips see the
comma
instructions for line 6a on page 3.

The amount of this line must equal line 10 (total taxes after
adjustment for advance EIC). Otherwise, you may be subject to
a penalty for failure to make deposits of taxes.

16a. Total tax liability for the month.

12e. Social security tax exemption for March
delete bold
endash
19-31

d

Adjusting tax liability for employer’s social security tax
exemption reported on line 6d. Monthly schedule depositors
and semiweekly schedule depositors must account for the
Multiply the amount of exempt wages/tips reported on line 12d
employer’s social security tax exemption (line 6d) when
by .062 and enter the result on line 12e.
reporting their tax liability on line 17. The total liability for the
month must equal the amount reported on line 10. Failure to
The amount reported on line 12e is treated as a deposit
account for the social security tax exemption on line 17 may
of taxes on April 1, 2010, and must not be used to adjust
CAUTION line 17 or Schedule B (Form 941).
cause line 10 to be less than the total tax liability reported on
line 17. Do not reduce the tax liability reported on line 17 below
the tax liability zero.
13. Total deposits and credits.
reported on
Replace all reference to line 17 with 16a
Add lines 11, 12a, and 12e.

!

14. Balance due.

Delete period

line 16a

Part 3: Tell us about your business

If line 10 is more than line 13, write the difference in line 14.
Otherwise, see Line 15 — Overpayment below. You do not have
to pay if line 14 is under $1.

!

CAUTION

In Part 3, answer only those questions that apply to your
business. If a question does not apply, leave it blank and go to
Part 4.

If you fail to make deposits as required and instead pay
the taxes with Form 941-M, you may be subject to a
penalty.

15. Overpayment.

18. If your business has closed . . .
If you go out of business or stop paying wages, you must file a
final payroll tax return. To tell the IRS a particular Form 941-M
is your final return, check the box on line 18 and enter the date
you last paid wages in the space provided.

Make sentence bold

If line 13 is more than line 10, write the difference in line 15.
Never make an entry in both lines 14 and 15.
If you deposited more than the correct amount for a month,
you can have the overpayment refunded (applies only to March,
June, September, and December Forms 941-M) or applied to
your next return. If you choose to apply the overpayment on
your next return, report the overpayment on line 16 of your next
return.
If line 15 is under $1, we will send a refund or apply it to your
next return only on written request.

19. If you are a seasonal employer . . .
If you hire employees seasonally — such as for the summer or
winter only — check the box on line 19. Checking the box tells
the IRS not to expect Form 941-M from you every month
because you have not paid wages regularly. However, you
must check the box every time you file a Form 941-M. Also, be
sure to check the box in the upper right corner of page 1 of
Form 941-M that corresponds to the month being reported.

Part 4: May we speak with your
third-party designee?

Part 2: Tell us about your tax liability
and deposits for this month

If you want to allow an employee, a paid tax preparer, or
another person to discuss your Form 941-M with the IRS, check
the “Yes” box in Part 4. Then tell us the name, phone number,
and five-digit personal identification number (PIN) of the specific
person to speak with — not the name of the firm who prepared
your tax return. The designee may choose any five numbers as
his or her PIN.

Special deposit account. Do not make deposits using the
Electronic Federal Tax Payment System (EFTPS) or Form
8109, Federal Tax Deposit Coupon, and do not complete line
16, Record of Federal Tax Liability and Deposits, if you are
required to have a special deposit account under section
7512(b). If you have received, by hand delivery, Form 2481,
Notice To Make Special Deposits of Taxes, you must deposit in
a separate bank account any taxes collected or required by law
to be collected. Your deposit must not be made later than the
end of the second banking day after any taxes were required to
be collected from your employees. The taxes deposited must
be kept in the account until paid with any employer tax that may
be due. The account must be designated as a special fund in
trust for the United States, payable to the “United States
Treasury” by you as trustee. For the definition of the term
“bank,” see Form 2481.

By checking “Yes,” you authorize the IRS to talk to the
person you named (your designee) about any questions we
may have while we process your return. You also authorize
your designee to:

• give us any information that is missing from your return,
• call us for information about processing your return, and
• respond to certain IRS notices you have shared with your

designee about math errors and return preparation. The IRS will
not send notices to your designee.

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You are not authorizing your designee to bind you to
anything (including additional tax liability) or to otherwise
represent you before the IRS. If you want to expand your
designee’s authorization, see Pub. 947, Practice Before the IRS
and Power of Attorney.
The authorization will automatically expire 1 year from the
due date for filing your Form 941-M. If you or your designee
want to terminate the authorization, write to the IRS office for
your locality using the “Without a payment” address under
Where Should You File on page 4 in the Instructions for Form
941.

How to Order Forms and Publications
from the IRS
Call 1-800-829-3676.

Visit the IRS website at www.irs.gov.

Part 5: Sign here

Privacy Act and Paperwork Reduction
Act Notice

Complete all information in Part 5 and sign Form 941-M as
follows.
• Sole proprietorship — The individual who owns the
business.
• Corporation (including a limited liability company (LLC)
treated as a corporation) — The president, vice president, or
other principal officer duly authorized to sign.
• Partnership (including an LLC treated as a partnership)
or unincorporated organization — A responsible and duly
authorized member or officer having knowledge of its affairs.
• Single member LLC treated as a disregarded entity for
federal income tax purposes — The owner of the LLC or a
principal officer duly authorized to sign.
• Trust or estate — The fiduciary.
Form 941-M may also be signed by a duly authorized agent
of the taxpayer if a valid power of attorney has been filed.
Alternative signature method. Corporate officers or duly
authorized agents may sign Form 941-M by rubber stamp,
mechanical device, or computer software program. For details
and required documentation, see Rev. Proc. 2005-39, 2005-28
I.R.B. 82, at
www.irs.gov/irb/2005-28_IRB/ar16.html.

We ask for the information on Form 941-M to carry out the
Internal Revenue laws of the United States. We need it to figure
and collect the right amount of tax. Subtitle C, Employment
Taxes, of the Internal Revenue Code imposes employment
taxes on wages, including income tax withholding. Form 941-M
is used to determine the amount of the taxes you owe. Section
6011 requires you to provide the requested information if the
tax is applicable to you. Section 6109 requires filers and paid
preparers to provide their identifying numbers. If you fail to
provide this information in a timely manner, you may be subject
to penalties and interest.
You are not required to provide the information requested on
a form that is subject to the Paperwork Reduction Act unless
the form displays a valid OMB control number. Books and
records relating to a form or its instructions must be retained as
long as their contents may become material in the
administration of any Internal Revenue law.
Generally, tax returns and return information are confidential,
as required by section 6103. However, section 6103 allows or
requires the IRS to disclose or give the information shown on
your tax return to others as described in the Code. For
example, we may disclose your tax information to the
Department of Justice for civil and criminal litigation, and to
cities, states, the District of Columbia, and U.S.
commonwealths and possessions for use in administering their
tax laws. We may also disclose this information to other
countries under a tax treaty, to federal and state agencies to
enforce federal nontax criminal laws, or to federal law
enforcement and intelligence agencies to combat terrorism.
The time needed to complete and file Form 941-M will vary
depending on individual circumstances. The estimated average
time is: Recordkeeping, 14 hrs., 35
6 min.; Learning about the law
or the form, 1 hr.,
470 min.; Preparing, copying, assembling, and
sending the form to the IRS, 1 hr., 16
3 min. If you have
comments concerning the accuracy of these time estimates or
suggestions for making Form 941-M simpler, we would be
happy to hear from you. You can write to: Internal Revenue
Service, Tax Products Coordinating Committee,
SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224.
Do not send Form 941-M to this address. Instead, use the
preaddressed envelope furnished to you.

Paid Preparer’s Use Only
A paid preparer must sign Form 941-M and provide the
information in the Paid preparer’s use only section of Part 5 if
the preparer was paid to prepare Form 941-M and is not an
employee of the filing entity. Paid preparers must sign paper
returns with a manual signature. The preparer must give you a
copy of the return in addition to the copy to be filed with the
IRS.
If you are a paid preparer, write your SSN or your Preparer
Tax Identification Number (PTIN) in the space provided. Include
your complete address. If you work for a firm, write the firm’s
name and the EIN of the firm. You can apply for a PTIN using
Form W-7P, Application for Preparer Tax Identification Number.
You cannot use your PTIN in place of the EIN of the tax
preparation firm.
Generally, do not complete this section if you are filing the
return as a reporting agent and have a valid Form 8655,
Reporting Agent Authorization, on file with the IRS. However, a
reporting agent must complete this section if the reporting agent
offered legal advice, for example, advising the client on
determining whether its workers are employees or independent
contractors for Federal tax purposes.

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