Information Collection

Form 941-X - Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund

IC 187187 under ICR 201310-1545-001 · OMB 1545-0029.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 1545-0029 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form 941-X Form 941-X - Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund	Form
INST_Form_941-X_APR2013.pdf	Instruction
DRAFT_Form_941-X_APR2014.pdf	Other-DRAFT_Form_941-X_APR2014
941-X Adjusted Employer's QUARTERLY Federal Tax Return or Clai Form_941-X_REV_APR2013.pdf	Form
Form 941-X brdn_busi.PDF Burden for 941-X	IC Document

IC Title:

Form 941-X - Adjusted Employer's Quarterly Federal Tax Return or Claim for Refund

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	941-X	Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund	Form_941-X_REV_APR2013.pdf	Yes	Yes	Fillable Fileable
Instruction			INST_Form_941-X_APR2013.pdf	Yes	No	Printable Only
Other-DRAFT_Form_941-X_APR2014			DRAFT_Form_941-X_APR2014.pdf	Yes	No	Fillable Fileable

Line of Business: General Government

Subfunction: Taxation Management

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 5,798,054

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 10 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	100,000	100,000
Annual IC Time Burden (Hours)	1,754,000	1,754,000
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Burden for 941-X	Form 941-X brdn_busi.PDF	11/19/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.