Form 943-X -Adjusted Employer’s Annual Federal Tax Return for Agricultural Employees or Claim for Refund

Instructions for Form 943-X
(Rev. February 2015)

Department of the Treasury
Internal Revenue Service

Adjusted Employer's Annual Federal Tax Return for Agricultural Employees or
Claim for Refund
Section references are to the Internal Revenue Code unless
otherwise noted.

Future Developments

For the latest information about developments related to
Form 943-X and its instructions, such as legislation enacted
after they were published, go to www.irs.gov/form943x.

What's New
Employee consents to support a claim for refund.
Notice 2015-15 provides guidance to employers on the
requirements for employee consents used by an employer to
support a claim for refund of overcollected social security tax
and Medicare tax. The notice and proposed revenue
procedure clarifies the basic requirements for a request for a
consent and for the employee consent itself, and permits a
consent to be requested, furnished, and retained in an
electronic format as an alternative to a paper format. The
notice also requests comments and contains guidance
concerning what constitutes “reasonable efforts” if a consent
is not secured to permit the employer to claim a refund of the
employer share of overcollected social security tax and
Medicare tax. For more information, see Notice 2015-15,
2015-9 I.R.B. 687, available at www.irs.gov/irb/2015–9_IRB/
ar07.html.
Claiming the COBRA premium assistance credit. The
COBRA premium assistance credit was available to an
employer for premiums paid on behalf of employees who
were involuntarily terminated from employment between
September 1, 2008, and May 31, 2010. The COBRA
premium assistance credit is not available for individuals who
were involuntarily terminated after May 31, 2010. Therefore,
only in rare circumstances, such as instances where COBRA
eligibility was delayed as a result of employer provided health
insurance coverage following termination, will the credit be
available. If you are eligible to claim the credit, use Form
943-X, lines 16a and 16b. Form 943-X should be filed after
filing your Form 943. Filing a Form 943-X before filing a Form
943 may result in errors or delays in processing your Form
943-X. For more information, visit IRS.gov and enter
"COBRA" in the search box.
If you are entitled to claim the COBRA premium
assistance credit, but are not otherwise required to
file Form 943, file a Form 943 with -0- entered on
line 15 before filing a Form 943-X to claim the credit.

TIP

Period of limitations to make certain corrections expired. Generally, you may correct overreported taxes on a
previously filed Form 943 if you file Form 943-X within 3
years of the date Form 943 was filed or 2 years from the date
you paid the tax reported on Form 943, whichever is later.
For purposes of the period of limitations, Form 943 is
considered filed on April 15 of the succeeding year if filed
before that date.
The period of limitations to correct the qualified employer's
tax exemption on wages paid to qualified employees; the
Mar 02, 2015

qualified employer's tax credit on wages paid to qualified
employees March 19–31, 2010; and advance earned income
credit (EIC) payments expired on April 15, 2014, for most
employers. The lines formerly used for these corrections
were removed from Form 943-X. If the period of limitations
for any of these corrections is still open, you will need to file
the February 2014 revision of Form 943-X. The February
2014 revision of Form 943-X is available on IRS.gov.
Retroactive increase in excludible transit benefits. The
Tax Increase Prevention Act of 2014 increased the monthly
transit benefit exclusion from $130 per participating
employee to $250 per participating employee for the period
of January 1, 2014, through December 31, 2014. Employers
were provided instructions on how to correct the social
security and Medicare taxes on the excess transit benefits in
Notice 2015-2, 2015-4 I.R.B. 334, available at www.irs.gov/
irb/2015-4_IRB/ar06.html.

Reminders
Correcting Additional Medicare Tax withholding.
Beginning in 2013, wages subject to Additional Medicare Tax
withholding are reported on Form 943, line 6, and the
withholding is reported on line 7. Any errors discovered on a
previously filed Form 943 are corrected on Form 943-X,
line 8. For more information about Additional Medicare Tax
withholding, see the Instructions for Form 943 and go to
IRS.gov and enter "Additional Medicare Tax" in the search
box. See the instructions for line 8, later, for more information
on the types of errors that can be corrected and how the
correction is reported on Form 943-X.
Social security tax rate for 2011 and 2012. In 2011 and
2012, the employee social security tax rate was 4.2% and the
employer social security tax rate was 6.2% (10.4% total). Be
sure to use the correct rate when reporting corrections on
line 6.
Correcting the COBRA premium assistance credit. For
tax periods ending before January 1, 2014, employers who
made COBRA premium assistance payments for assistance
eligible individuals were allowed a credit on their Form 943.
Any errors discovered on a previously filed Form 943 for this
credit are corrected on Form 943-X, lines 16a and 16b.
Effective for tax periods beginning after December 31, 2013,
Form 943-X is used to both report the total COBRA premium
assistance credit an employer is entitled to claim and correct
any previously reported credit. For more information, see the
instructions for lines 16a and 16b, later.

Cat. No. 20333Q

employment taxes and are requesting a refund or abatement
of the overreported amount. Follow the chart on the back of
Form 943-X for help in choosing whether to use the
adjustment process or the claim process. Be sure to give us
a detailed explanation on line 20 for each correction that you
show on Form 943-X.

General Instructions:
Understanding Form 943-X
What Is the Purpose of Form 943-X?
For tax periods beginning after December 31, 2013,
Form 943 will no longer be used to claim the credit
CAUTION
for COBRA premium assistance payments. Instead
use Form 943-X. For more information, see the instructions
for lines 16a and 16b, later.

Continue to report current year adjustments for fractions of
cents, third-party sick pay, and group-term life insurance on
Form 943, line 10.

!

You have additional requirements to complete when filing
Form 943-X, such as certifying that you filed (or will file) all
applicable Forms W-2, Wage and Tax Statement, and Forms
W-2c, Corrected Wage and Tax Statement. For corrections
of overreported federal income tax, social security tax, or
Medicare tax, you must make any certifications that apply to
your situation.

Use Form 943-X to correct errors on a previously filed
Form 943. Use Form 943-X to correct:
Income tax withheld from wages,
Taxable social security wages,
Taxable Medicare wages,
Total wages subject to Additional Medicare Tax
withholding, and
Credits for COBRA premium assistance payments.

Do not use Form 943-X to correct Form CT-1, 941,
941-SS, 944, or 945. Instead, use the “X” form that
CAUTION
corresponds to those forms (Form CT-1 X, 941-X,
944-X, or 945-X).

!

Use Form 843, Claim for Refund and Request for
Abatement, to request a refund or abatement of assessed
interest or penalties. Do not request a refund or abatement
of assessed interest or penalties on Form 943 or Form
943-X.

Where Can You Get Help?
For help filing Form 943-X or for questions about federal
employment taxes and tax corrections, you can:
Visit the IRS website at www.irs.gov/businesses and click
on the Employment Taxes link under Businesses Topics,
See Pub. 51 (Circular A), Agricultural Employer's Tax
Guide, or
Call the IRS Business and Specialty Tax Line toll free at
1-800-829-4933 or 1-800-829-4059 (TDD/TTY for persons
who are deaf, hard of hearing, or have a speech disability)
Monday–Friday from 7:00 a.m.– 7:00 p.m. local time (Alaska
and Hawaii follow Pacific time).

We use the terms “correct” and “corrections” on
Form 943-X and in these instructions to include
interest-free adjustments under sections 6205 and
6413 and claims for refund and abatement under sections
6402, 6414, and 6404. See Rev. Rul. 2009-39 for examples
of how the interest-free adjustment and claim for refund rules
apply in 10 different situations. You can find Rev. Rul.
2009-39, 2009-52 I.R.B. 951, at www.irs.gov/irb/
2009-52_IRB/ar14.html.

TIP

See also How Can You Order Forms, Instructions, and
Publications from the IRS, later.

When you discover an error on a previously filed Form
943, you must:
Correct that error using Form 943-X,
File a separate Form 943-X for each Form 943 that you are
correcting, and
File Form 943-X separately. Do not file Form 943-X with
Form 943.

When Should You File Form 943-X?
File Form 943-X when you discover an error on a previously
filed Form 943.
However, if your only errors on Form 943 relate to the
number of employees (Form 943, line 1) or to federal tax
liabilities reported on your Monthly Summary of Federal Tax
Liability on Form 943 or on Form 943-A, Agricultural
Employer's Record of Federal Tax Liability, do not file Form
943-X. For more information about correcting federal tax
liabilities reported on your Monthly Summary of Federal Tax
Liability on Form 943 or on Form 943-A, see the Form 943-A
instructions.

If you did not file a Form 943 for one or more years, do
not use Form 943-X. Instead, file Form 943 for each of those
years. See also When Should You File Form 943-X, later.
However, if you did not file Forms 943 because you
improperly treated workers as independent contractors or
nonemployees and are now reclassifying them as
employees, see the instructions for line 19, later.
Report the correction of underreported and overreported
amounts for the same year on a single Form 943-X, unless
you are requesting a refund or abatement. If you are
requesting a refund or abatement and you are correcting
both underreported and overrreported amounts, file one
Form 943-X correcting the underreported amounts only and
a second Form 943-X correcting the overreported amounts.

Due dates. The due date for filing Form 943-X depends on
when you discover an error and if you underreported or
overreported tax. If you underreported tax, see
Underreported tax, later. For overreported amounts, you may
choose to either make an interest-free adjustment or file a
claim for refund or abatement. If you are correcting
overreported amounts, see Overreported tax—adjustment
process and Overreported tax—claim process, later.
If any due date falls on a Saturday, Sunday, or legal
holiday, you may file Form 943-X on the next business day. If
we receive Form 943-X after the due date, we will treat Form
943-X as filed on time if the envelope containing Form 943-X
is properly addressed, contains sufficient postage, and is
postmarked by the U.S. Postal Service on or before the due

You will use the adjustment process if you underreported
employment taxes and are making a payment, or if you
overreported employment taxes and will be applying the
credit to Form 943 for the period during which you file Form
943-X. However, see the Caution under Is There a Deadline
for Filing Form 943-X, later, if you are correcting overreported
amounts during the last 90 days of a period of limitations.
You will use the claim process if you overreported
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Instructions for Form 943-X (Rev. 2-2015)

abatement on Form 943-X any time before the period of
limitations on the credit or refund expires. If you also need to
correct any underreported amounts, you must file another
Form 943-X reporting only corrections to the underreported
amounts. See Is There a Deadline for Filing Form 943-X,
later.

date, or sent by an IRS-designated private delivery service
on or before the due date. If you do not follow these
guidelines, we will consider Form 943-X filed when it is
actually received. See Pub. 51 (Circular A) for more
information on legal holidays and IRS-designated private
delivery services.
Underreported tax. If you are correcting underreported tax,
you must file Form 943-X by the due date of the return for the
return period in which you discovered the error (January 31
of the following year) and pay the amount you owe by the
time you file. Doing so will generally ensure that your
correction is interest free and not subject to failure-to-pay or
failure-to-deposit (FTD) penalties. See What About Penalties
and Interest, later. For details on how to make a payment,
see the instructions for line 17, later.
If Form 943-X is filed late (after the due date of the return
for the return period in which you discovered the error), you
must attach an amended Form 943-A to Form 943-X.
Otherwise, the IRS may assess an “averaged” FTD penalty.
The total tax reported on Form 943-A, line M, must match the
corrected tax (Form 943, line 11 (line 9 for calendar years
2011 and 2012), combined with any correction reported on
Form 943-X, line 15) for the year, less any previous
abatements and interest-free tax assessments.

!

CAUTION

Is There a Deadline for Filing Form
943-X?
Generally, you may correct overreported taxes on a
previously filed Form 943 if you file Form 943-X within 3
years of the date Form 943 was filed or 2 years from the date
you paid the tax reported on Form 943, whichever is later.
You may correct underreported taxes on a previously filed
Form 943 if you file Form 943-X within 3 years of the date the
Form 943 was filed. We call each of these time frames a
“period of limitations.” For purposes of the period of
limitations, Form 943 is considered filed on April 15 of the
succeeding calendar year if filed before that date.
Example. You filed your 2012 Form 943 on January 25,
2013, and payments were timely made. The IRS treats the
return as if it were filed on April 15, 2013. On January 22,
2016, you discovered that you overreported social security
and Medicare wages on that form by $10,000. To correct the
error, you must file Form 943-X by April 18, 2016, which is
the end of the period of limitations, and use the claim
process.

Example—You owe tax. On February 11, 2014, you
discovered that you underreported $1,000 of social security
and Medicare wages on your 2013 Form 943. File Form
943-X and pay the amount you owe by February 2, 2015,
because you discovered the error in 2014 and February 2,
2015, is the due date for that year. If you file Form 943-X
before February 2, 2015, pay the amount you owe when you
file.

!

CAUTION

wages.

If you file Form 943-X to correct overreported
amounts in the last 90 days of a period of limitations,
CAUTION
you must use the claim process. You cannot use the
adjustment process. If you are also correcting underreported
amounts, you must file another Form 943-X to correct the
underreported amounts using the adjustment process and
pay any tax due.

Form 943-X cannot be used to correct
underreported amounts of Additional Medicare Tax
unless the amounts were withheld from employee

!

Overreported tax—adjustment process. If you
overreported tax and choose to apply the credit to Form 943,
file an adjusted return on Form 943-X soon after you discover
the error but more than 90 days before the period of
limitations on the credit or refund for Form 943 expires. See
Is There a Deadline for Filing Form 943-X, later.

!

CAUTION

Where Should You File Form 943-X?
Send your completed Form 943-X to the address shown
below.

Form 943-X cannot be used to correct overreported
amounts of Additional Medicare Tax unless the
amounts were not withheld from employee wages.

IF you are in . . .

Example—You want your credit applied to Form 943.
You filed your 2014 Form 943 on February 2, 2015, and
payments were timely made. On May 1, 2015, you discover
that you overreported tax on your 2014 Form 943. You file
Form 943-X on June 2, 2015. The IRS treats your credit as a
tax deposit made on January 1, 2015. When you file your
2015 Form 943, include the amount from Form 943-X,
line 17, on the “Total deposits” line of your 2015 Form 943.
If you reduced your deposits by the amount of the
COBRA premium assistance credit that will be
CAUTION
reflected on your Form 943-X, do not use the
adjustment process to claim the COBRA premium assistance
credit. Use the claim process. See the instructions for lines
16a and 16b, later.

!

Overreported tax—claim process. If you overreported tax
on Form 943, you may choose to file a claim for refund or
Instructions for Form 943-X (Rev. 2-2015)

You may not file a refund claim to correct federal
income tax or Additional Medicare Tax actually
withheld from employees.

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THEN use this address . . .

Connecticut, Delaware, District of
Columbia, Florida, Georgia, Illinois,
Indiana, Kentucky, Maine,
Maryland, Massachusetts,
Michigan, New Hampshire, New
Jersey, New York, North Carolina,
Ohio, Pennsylvania, Rhode Island,
South Carolina, Tennessee,
Vermont, Virginia, West Virginia,
Wisconsin

Department of the Treasury
Internal Revenue Service
Cincinnati, OH 45999-0008

Alabama, Alaska, Arizona,
Arkansas, California, Colorado,
Hawaii, Idaho, Iowa, Kansas,
Louisiana, Minnesota, Mississippi,
Missouri, Montana, Nebraska,
Nevada, New Mexico, North
Dakota, Oklahoma, Oregon, South
Dakota, Texas, Utah, Washington,
Wyoming

Department of the Treasury
Internal Revenue Service
Ogden, UT 84201-0008

IF you are in . . .
No legal residence or principal place
of business in any state
Special filing addresses for
exempt organizations; federal, state,
and local governmental entities; and
Indian tribal governmental entities;
regardless of location

you to use parentheses to report negative amounts, you may
use them.

THEN use this address . . .
Internal Revenue Service
P.O. Box 409101
Ogden, UT 84409

How Should You Make Entries on Form 943-X?

You can help the IRS process Form 943-X timely and
accurately if you follow these guidelines.
Type or print your entries.
Use Courier font (if possible) for all typed or
computer-generated entries.
Omit dollar signs. You may use commas and decimal
points, if desired. Enter dollar amounts to the left of any
preprinted decimal point and cents to the right of it.
Always show an amount for cents. Do not round entries to
whole dollars.
Complete all three pages and sign Form 943-X on page 3.
Staple multiple sheets in the upper-left corner.

Department of the Treasury
Internal Revenue Service
Ogden, UT 84201-0008

How Should You Complete Form
943-X?
Use a Separate Form 943-X for Each Year You
Are Correcting

What About Penalties and Interest?

Use a separate Form 943-X for each Form 943 that you are
correcting. For example, if you found errors on your Forms
943 for 2013 and 2014, file one Form 943-X to correct the
2013 Form 943. File a second Form 943-X to correct the
2014 Form 943.

Generally, your correction of an underreported amount will
not be subject to a failure-to-pay penalty, FTD penalty, or
interest if you:
File on time (by the due date of Form 943 for the year in
which you discover the error),
Pay the amount shown on line 17 by the time you file
Form 943-X,
Enter the date you discovered the error, and
Explain in detail the grounds and facts relied on to support
the correction.

EIN, Name, and Address

Enter your EIN, name, and address in the spaces provided.
Also enter your name and EIN on the top of pages 2 and 3,
and on any attachments. If your address has changed since
you filed your Form 943, enter the corrected information and
the IRS will update your address of record. Be sure to write
your name, EIN, “Form 943-X,” and the calendar year you are
correcting on the top of any attachments.

No correction will be eligible for interest-free treatment if
any of the following apply.
The amounts underreported relate to an issue that was
raised in an examination of a prior period.
You knowingly underreported your employment tax
liability.
You received a notice and demand for payment.
You received a Notice of Determination of Worker
Classification.

Return You Are Correcting

Enter the calendar year of the Form 943 you are correcting in
the box at the top of page 1. Enter the calendar year on
pages 2 and 3, and on any attachments. Be sure to write your
name, EIN, “Form 943-X,” and the calendar year you are
correcting on the top of any attachments.

If you receive a notice about a penalty after you file this
return, reply to the notice with an explanation and we will
determine if you meet reasonable-cause criteria. Do not
attach an explanation when you file your return.

Enter the Date You Discovered Errors

You must enter the date you discovered errors. You discover
an error when you have enough information to be able to
correct it. If you are reporting several errors that you
discovered at different times, enter the earliest date you
discovered them here. Report any subsequent dates and
related errors on line 20.

Overview of the Process
The process to correct a previously filed Form 943 or to file a
claim is outlined below.
If you underreported the tax. If you underreported the
tax on a previously filed Form 943, check the box on line 1
and pay any additional amount you owe by the time you file
Form 943-X. For details on how to make a payment, see the
instructions for line 17, later.

Must You Make an Entry on Each Line?

You must provide all of the information requested at the top
of page 1 of Form 943-X. You must check one box (but not
both) in Part 1. In Part 2, you must check the box on line 3
and any applicable boxes on lines 4 and 5. In Part 3, if any
line does not apply, leave it blank. Complete Parts 4 and 5 as
instructed.

Example—You underreported employment taxes. On
June 20, 2014, you discovered an error that results in
additional tax on your 2013 Form 943. File Form 943-X by
February 2, 2015, and pay the amount you owe by the time
you file. See When Should You File Form 943-X, earlier. Do
not attach Form 943-X to your 2014 Form 943.

How Should You Report Negative Amounts?

Form 943-X uses negative numbers to show reductions in tax
(credits) and positive numbers to show additional tax
(amounts you owe).

If you overreported the tax. If you overreported the tax
on a previously filed Form 943, you may choose one of the
following options.
Use the adjustment process. Check the box on line 1 to
apply any credit (negative amount) from line 17 to Form 943
for the year during which you file Form 943-X.

When reporting a negative amount in columns 3 and 4,
use a minus sign instead of parentheses. For example, enter
“–10.59” instead of “(10.59).” However, if you are completing
the return on your computer and your software only allows
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Instructions for Form 943-X (Rev. 2-2015)

Instead, in either case, check the box on line 2 to file a Form
943-X under the claim process. See Is There a Deadline for
Filing Form 943-X, earlier. See the instructions for lines 16a
and 16b, later.

Use the claim process. Check the box on line 2 to file a
claim on Form 943-X requesting a refund or abatement of the
amount shown on line 17.
To ensure that the IRS has enough time to process a
credit for an overreporting adjustment in the year
during which you file Form 943-X, you are
encouraged to file Form 943-X correcting the overreported
amount in the first 11 months of a year. For example, if you
discover an overreported amount in December, you may
want to file Form 943-X during the first 11 months of the next
year. This should ensure that the IRS will have enough time
to process Form 943-X so the credit will be posted before
you file Form 943, thus avoiding an erroneous balance due
notice from the IRS. See the example below.

Check the box on line 2 to use the claim process if you are
correcting overreported amounts only and you are
claiming a refund or abatement for the negative amount
(credit) shown on line 17. Do not check this box if you are
correcting any underreported amounts on this form.

Example—You want your overreported tax applied as
a credit to Form 943. On December 18, 2015, you discover
you overreported your tax on your 2014 Form 943 and want
to make a correction using the adjustment process. To allow
the IRS enough time to process the credit, you file Form
943-X on January 4, 2016, and take the credit on your 2016
Form 943.

The IRS usually processes claims shortly after they are
filed. The IRS will notify you if your claim is denied, accepted
as filed, or selected to be examined. See Pub. 556,
Examination of Returns, Appeal Rights, and Claims for
Refund, for more information.

TIP

2. Claim

You must check the box on line 2 if you have a credit and
the period of limitations on credit or refund for Form 943 will
expire within 90 days of the date you file Form 943-X. See Is
There a Deadline for Filing Form 943-X, earlier.

Unless the IRS corrects Form 943-X during processing or
you owe other taxes, penalties, or interest, the IRS will refund
the amount shown on line 17, plus any interest that applies.

Specific Instructions:
Part 1: Select ONLY One Process

!

Because Form 943-X may be used to file either an adjusted
employment tax return or a claim for refund or abatement,
you must check one box on either line 1 or line 2. Do not
check both boxes.

CAUTION

You may not file a refund claim to correct federal
income tax or Additional Medicare Tax actually
withheld from employees.

Part 2: Complete the Certifications

1. Adjusted Employment Tax Return

You must complete all certifications that apply by checking
the appropriate boxes. If all of your corrections relate to
underreported amounts, complete line 3 only; skip lines 4
and 5 and go to Part 3.

If you are correcting both underreported amounts and
overreported amounts on this form, you must check this box.
If you check this box, any negative amount shown on line 17
will be applied as a credit (tax deposit) to your Form 943 for
the year in which you are filing this form. See Example—You
want your overreported tax applied as a credit to Form 943,
earlier.

If your corrections relate to overreported amounts, you
have a duty to ensure that your employees' rights to recover
overpaid employee social security and Medicare taxes that
you withheld are protected. The certifications on lines 4 and 5
address the requirement to:
Repay or reimburse your employees for the overcollection
of employee social security and Medicare taxes, or
Obtain consents from your employees to file a claim on
their behalf. See Notice 2015–15 for guidance on consents.

Check the box on line 1 if you are correcting underreported
amounts or overreported amounts and you would like to use
the adjustment process to correct the errors.

If you owe tax. Pay the amount shown on line 17 by the
time you file Form 943-X. Generally, you will not be charged
interest if you file on time, pay on time, enter the date you
discovered the error, and explain the correction on line 20.

3. Filing Forms W-2 or Forms W-2c

Check the box on line 3 to certify that you filed or will file
Forms W-2 or Forms W-2c, as required, showing your
employees' correct wage and tax amounts. See the General
Instructions for Forms W-2 and W-3 for detailed information
about filing requirements. References to Form W-2 on Form
943-X and in these instructions also apply to Forms W-2AS,
W-2CM, W-2GU, and W-2VI unless otherwise noted.

If you have a credit. You overreported employment taxes
(you have a negative amount on line 17) and want the IRS to
apply the credit to Form 943 for the period during which you
filed Form 943-X. The IRS will apply your credit on the first
day of the Form 943 year during which you filed Form 943-X.
However, the credit you show on Form 943-X, line 17, may
not be fully available on your Form 943 if the IRS corrects it
during processing or you owe other taxes, penalties, or
interest. The IRS will notify you if your claimed credit changes
or if the amount available as a credit on Form 943 was
reduced because of unpaid taxes, penalties, or interest.

You must check the box on line 3 to certify that you filed
Forms W-2 or Forms W-2c even if your corrections on Form
943-X do not change amounts shown on those forms. For
example, if your only correction to Form 943 involves
misstated tax adjustments (see the instructions for line 10),
check the box on line 3 to certify that you already filed all
required Forms W-2 and W-2c with the Social Security
Administration (SSA).

Do not check the box on line 1 if you are either: (a)
correcting overreported amounts and the period of
CAUTION
limitations on credit or refund for Form 943 will
expire within 90 days of the date you file Form 943-X, or (b)
claiming a credit for COBRA premium assistance payments
and you reduced your deposits in anticipation of the credit.

!

Instructions for Form 943-X (Rev. 2-2015)

4. Certifying Overreporting Adjustments

If you overreported federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax and checked the

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In certain situations, you may not have repaid or
reimbursed your employees or obtained their consents prior
to filing a claim, such as in cases where the period of
limitations on credit or refund is about to expire. In those
situations, file Form 943-X, but do not check a box on line 5.
Tell us on line 20 that you have not repaid or reimbursed
employees or obtained consents at the time you file the
claim. However, you must repay or reimburse your
employees and certify that you have done so before the IRS
can allow the claim.

box on line 1, check the appropriate box on line 4. You may
need to check more than one box. If you obtained written
statements from some employees but you could not locate
employees or secure the statements of the remaining
employees, check all applicable boxes. Provide a summary
on line 20 of the amount of the corrections for the employees
who provided written statements and for those who did not.
You may not use Form 943-X to correct
overreported amounts of Additional Medicare Tax
CAUTION
unless the amounts were not withheld from
employee wages.

!

5c. Check the box on line 5c to certify that your overreported
tax is only for the employer share of social security and
Medicare tax. This applies when affected employees did not
give you consent to file a claim for refund for the employee
share of social security and Medicare tax, they could not be
found, or they did not give you a statement described on
line 5b.

4a. Check the box on line 4a if your overreported amount
includes each affected employee share of overcollected
taxes. You are certifying that you repaid or reimbursed the
employee share of prior year taxes and you received written
statements from the employees stating that they did not and
will not receive a refund or credit for the prior year taxes. Do
not send these statements to the IRS. Keep them for your
records. Generally, all employment tax records must be kept
for at least 4 years.

5d. Check the box on line 5d to certify that your overreported
amount is only for federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax that you did not
withhold from your employees.

4b. Check the box on line 4b to certify that your overreported
amount is only for the employer share of taxes on those
employees who you were unable to find or those who did not
give you a statement described on line 4a.

Part 3: Enter the Corrections for the
Calendar Year You Are Correcting
What Amounts Should You Report in Part 3?

4c. Check the box on line 4c to certify that your overreported
amount is only for federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax that you did not
withhold from your employees.

On lines 6–9, columns 1 and 2, show amounts for all of your
employees, not just for those employees whose amounts you
are correcting.

5. Certifying Claims

If a correction that you report in column 4 includes both
underreported and overreported amounts (see the
instructions for line 18), give us details for each error on
line 20.

If you are filing a claim for refund or abatement of
overreported federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax and checked the
box on line 2, check the appropriate box on line 5. You may
need to check more than one box. If you obtained written
statements or consents from some employees but you could
not locate employees or secure the statements of the
remaining employees, check all applicable boxes. Provide a
summary on line 20 of the amount of the corrections for the
employees who provided statements or consents and for
those who did not.

!

CAUTION

Because special circumstances apply for lines 10–14,
16a, and 16b, read the instructions for each line carefully
before entering amounts in the columns.
If you previously adjusted or amended Form 943
using Form 943-X or because of an IRS examination
CAUTION
change, show amounts in column 2 that include
those previously reported corrections.

!

You may not file a refund claim to correct federal
income tax or Additional Medicare Tax actually
withheld from employees.

6. Total Wages Subject to Social Security Tax

5a. Check the box on line 5a if your overreported tax
includes each affected employee share of prior year social
security and Medicare tax. You are certifying that you repaid
or reimbursed to the employees their share of prior year
social security and Medicare tax and you received written
statements from those employees stating that they did not
and will not receive a refund or credit for the prior year taxes.

!

The 2011 and 2012 employee tax rate for social
security was 4.2%.

CAUTION

If you are correcting the taxable social security wages you
reported on Form 943, line 2, enter the total corrected
amount in column 1. In column 2, enter the amount you
originally reported or as previously corrected. In column 3,
enter the difference between columns 1 and 2.

5b. Check the box on line 5b if your overreported tax
includes each affected employee share of prior year social
security and Medicare tax and you have not yet repaid or
reimbursed the employee share of taxes. You are certifying
that you received consent from each affected employee to
file a claim on the employee share of those taxes and you
received written statements from those employees stating
that they did not and will not receive a refund or credit for the
prior year taxes. Do not send these statements and
consents to the IRS. Keep them for your records. Generally,
all employment tax records must be kept for at least 4 years.

line 6 (column 1)
- line 6 (column 2)
line 6 (column 3)

If the amount in column 2 is larger than the
amount in column 1, use a minus sign in
column 3.

Multiply the amount in column 3 by .124 (.104 for
corrections to a 2011 or 2012 return) and enter that result in
column 4.
-6-

Instructions for Form 943-X (Rev. 2-2015)

line 6 (column 3)
x .124
line 6 (column 4)

Note. If you are correcting only the employer share of tax on
a decrease to Medicare wages, use .0145 (1.45%) when
multiplying the amount in column 3. If you are correcting both
shares of tax for some employees and only the employer
share for other employees, enter the properly calculated
amount in column 4. Be sure to explain your calculations on
line 20.

(Use .104 for corrections to a 2011 or
2012 return.)
If the amount in column 3 used a minus sign,
also use a minus sign in column 4.

Example—Medicare wages decreased. Following
Example—Social security wages decreased in the
instructions for line 6, the wages that you counted twice were
also taxable Medicare wages. To correct the error, figure the
difference on Form 943-X as shown.

Note. If you are correcting only the employer share of tax on
a decrease to social security wages, use .062 (6.2%) when
multiplying the amount shown in column 3. If you are
correcting both shares of tax for some employees and only
the employer share for other employees, enter the properly
calculated amount in column 4. Be sure to show your
calculations on line 20.
Example—Social security wages decreased. You
reported $9,000 as social security wages on your 2014 Form
943, line 2. In December of 2015, you discover that you
included $2,000 in social security wages for one of your
employees twice. To correct the error, figure the difference
on Form 943-X as shown.
Column 1 (corrected amount)
Column 2 (Form 943, line 2)

7,000.00
- 9,000.00

Column 3 (difference)

- 2,000.00

Column 4 (tax correction)

-2,000.00
x .029
-58.00

Be sure to explain the reasons for this correction on
line 20.

8. Total Wages Subject to Additional Medicare
Tax Withholding

-2,000.00
x .124

Generally, you may correct errors to Additional Medicare Tax
withholding only if you discovered the errors in the same
calendar year the wages were paid to employees. However,
you may correct errors to Additional Medicare Tax
withholding for prior years if the amount reported on Form
943, line 7, does not agree with the amount you actually
withheld. This type of error is an administrative error. You
may also correct errors to Additional Medicare Tax
withholding for prior years if section 3509 rates apply. If
section 3509 rates apply, see the instructions for line 14,
later.

-248.00

7. Total Wages Subject to Medicare Tax

If you are correcting the taxable Medicare wages you
reported on Form 943, line 4, enter the total corrected
amount in column 1. In column 2, enter the amount you
originally reported or as previously corrected. In column 3,
enter the difference between columns 1 and 2.

If a prior year error was a nonadminstrative error, you may
correct only the wages subject to Additional Medicare Tax
withholding that were originally reported on Form 943, line 6,
or previously corrected on Form 943-X. You cannot correct
the tax reported on Form 943, line 7.
Prior year administrative errors. If you are correcting the
wages subject to Additional Medicare Tax withholding that
you reported on Form 943, line 6, enter the total corrected
amount in column 1. In column 2, enter the amount you
originally reported or as previously corrected. In column 3,
enter the difference between columns 1 and 2.

line 7 (column 1)
- line 7 (column 2)
If the amount in column 2 is larger than the
amount in column 1, also use a minus sign in
column 3.

line 8 (column 1)
- line 8 (column 2)

Multiply the amount in column 3 by .029 (2.9% tax rate)
and enter that result in column 4.

line 8 (column 3)

line 7 (column 3)
x .029
If the amount in column 3 used a minus sign,
also use a minus sign in column 4.

Instructions for Form 943-X (Rev. 2-2015)

- 2,000.00

Column 4 (tax correction)

Note. If the example above was for a correction to a 2011 or
2012 return, the amount in column 3 would be multiplied
by .104.

line 7 (column 4)

Column 3 (difference)

Column 3 (difference)
Tax rate (2.9%)

Be sure to explain the reasons for this correction on
line 20.

line 7 (column 3)

7,000.00
- 9,000.00

Use the difference in column 3 to determine your tax
correction.

Use the difference in column 3 to determine your tax
correction.
Column 3 (difference)
Tax rate (12.4%)

Column 1 (corrected amount)
Column 2 (Form 943, line 4)

If the amount in column 2 is larger than the
amount in column 1, also use a minus sign in
column 3.

Multiply the amount in column 3 by .009 (0.9% tax rate)
and enter that result in column 4.
-7-

Tax withheld (column 4) because the error involves a
previous year and the amount previously reported for the
employee represents the actual amount withheld from the
employee during 2014.

line 8 (column 3)
x .009
line 8 (column 4)

If the amount in column 3 used a minus sign,
also use a minus sign in column 4.

Combination of prior year administrative and nonadministrative errors. If you are reporting both administrative
errors and nonadministrative errors for the same prior year,
enter the total corrected amount in column 1. In column 2,
enter the amount you originally reported or as previously
corrected. In column 3, enter the difference between columns
1 and 2. However, multiply only the amount of wages
reported in column 3 that are related to administrative errors
by .009 (0.9% tax rate). Do not multiply any wages reported
in column 3 that are related to nonadministrative errors
by .009 (0.9% tax rate). Use line 20 to explain in detail your
corrections. The explanation must include the reasons for the
corrections and a breakdown of the amount reported in
column 3 into the amounts related to administrative errors
and nonadministrative errors.

Example—Prior year administrative error (incorrectly
reported amount of Additional Medicare Tax actually
withheld). Employee A's wages exceeded the $200,000
withholding threshold for Additional Medicare Tax in
November 2014. The total wages paid to Employee A for
2014 were $230,000. You withheld $270 ($30,000 x .009)
from the employee's wages. However, on your 2014 Form
943 you mistakenly reported $3,000 on line 6, and Additional
Medicare Tax withheld of $27 on line 7. You discover the
error on March 16, 2015. This is an example of an
administrative error that may be corrected in a later calendar
year because the amount actually withheld differs from the
amount reported on your 2014 Form 943. Use Form 943-X,
line 8, to correct the error as shown below.
Column 1 (corrected amount)
Column 2 (Form 943, line 6)

30,000.00
- 3,000.00

Column 3 (difference)

27,000.00

Example—Combination of prior year administrative
and nonadministrative errors. Employee A's wages
exceeded the $200,000 withholding threshold for Additional
Medicare Tax in November 2014. The total wages paid to
Employee A for 2014 were $230,000. You withheld $270
($30,000 x .009) from the employee's wages. However, on
your 2014 Form 943 you mistakenly reported $3,000 on
line 6, and Additional Medicare Tax withheld of $27 on line 7.
The difference in wages subject to Additional Medicare Tax
related to this administrative error is $27,000 ($30,000 –
$3,000).
Employee B's wages exceeded the $200,000 withholding
threshold for Additional Medicare Tax in December 2014.
The total wages paid to Employee B for 2014 were $220,000.
You were required to withhold $180 ($20,000 x .009) but you
withheld nothing and did not report Employee B’s $20,000 in
wages subject to Additional Medicare Tax withholding on
line 6 of your 2014 Form 943.

Use the difference in column 3 to determine your tax
correction.
Column 3 (difference)
Tax rate (0.9%)
Column 4 (tax correction)

27,000.00
x .009
243.00

Be sure to explain the reasons for this correction on
line 20.
Prior year nonadministrative errors. You may correct
only the taxable wages subject to Additional Medicare Tax
withholding that you reported on Form 943, line 6. Enter the
total corrected amount in column 1. In column 2, enter the
amount you originally reported or as previously corrected. In
column 3, enter the difference between columns 1 and 2.

You discover both errors on March 16, 2015. Use Form
943-X, line 8, to correct the errors as shown below.

line 8 (column 1)
- line 8 (column 2)
line 8 (column 3)

If the amount in column 2 is larger than the
amount in column 1, use a minus sign in
column 3.

Column 1 (corrected amount)
Column 2 (Form 943, line 6)

50,000.00
- 3,000.00

Column 3 (difference)

47,000.00

Determine the portion of wages reported in column 3 that
is related to the administrative error ($47,000 - $20,000
(nonadministrative error) = $27,000 (administrative error)).
Multiply this portion of column 3 by .009 (0.9% tax rate) to
determine your tax correction.

Do not multiply the amount in column 3 by .009 (0.9% tax
rate). Leave column 4 blank and explain the reasons for this
correction on line 20.

Difference related to administrative error
Tax rate (0.9%)

Example—Prior year nonadministrative error (failure
to withhold Additional Medicare Tax when required).
Employee B's wages exceeded the $200,000 withholding
threshold for Additional Medicare Tax in December 2014.
The total wages paid to Employee B for 2014 were $220,000.
You were required to withhold $180 ($20,000 x .009) but you
withheld nothing and did not report an amount on line 6 or
line 7 of your 2014 Form 943. You discover the error on
March 16, 2015. File Form 943-X to correct the wages
subject to Additional Medicare Tax withholding for your 2014
Form 943, but you may not correct the Additional Medicare

Column 4 (tax correction)

27,000.00
x .009
243.00

Be sure to explain the reasons for these corrections on
line 20. You must also report that $20,000 of the amount
shown in column 3 was related to the correction of a prior
year nonadministrative error and $27,000 of the amount
shown in column 3 was related to the correction of an
administrative error.

-8-

Instructions for Form 943-X (Rev. 2-2015)

9. Federal Income Tax Withheld

10. Tax Adjustments

If you are correcting the federal income tax withheld from
wages that you reported on Form 943, line 8 (line 6 for years
ending before January 1, 2013), enter the total corrected
amount in column 1. In column 2, enter the amount you
originally reported or as previously corrected. In column 3,
enter the difference between columns 1 and 2.

Do not enter an amount on line 10 unless you need to
correct any adjustments reported on Form 943, line 10
(line 8 for years ending before January 1, 2013). Amounts
reported on line 10 reflect corrections of amounts misstated
on Form 943, line 10 (line 8 for years ending before January
1, 2013). See Example—Adjustment for third-party sick pay
underreported below.

line 9 (column 1)
- line 9 (column 2)
line 9 (column 3)

Enter the corrected amount for tax adjustments in column
1. Enter the originally reported or previously corrected
amount from Form 943, line 10 (line 8 for years ending before
January 1, 2013), in column 2. In column 3, enter the
difference between columns 1 and 2.

If the amount in column 2 is larger than the
amount in column 1, use a minus sign in
column 3.

line 10 (column 1)
- line 10 (column 2)

Copy the amount in column 3 to column 4. Include any
minus sign shown in column 3.

line 10 (column 3)

Generally, you may correct federal income tax
withholding errors only if you discovered the errors
CAUTION
in the same calendar year you paid the wages.
However, you may correct errors to federal income tax
withholding for prior years if the amount reported on Form
943 does not agree with the amount you actually withheld.
This type of error is an administrative error. You may also
correct errors to federal income tax withholding for prior
years if section 3509 rates apply. See section 9 of Pub. 51
(Circular A) for more information about corrections during the
calendar year and about administrative errors. If section 3509
rates apply, see the instructions for line 11, later.

!

You may need to report negative numbers in any
column. Make sure that the difference you enter in
column 3 accurately represents the change to
adjustments originally reported or previously corrected on
Form 943, line 10 (line 8 for years ending before January 1,
2013).

TIP

Copy the amount in column 3 to column 4. Include any
minus sign shown in column 3.
On line 20, describe what you misreported on Form 943.
Tell us if your adjustment is for fractions of cents, third-party
sick pay, or group-term life insurance.

Example—Failure to withhold income tax when
required. You were required to withhold $400 of federal
income tax from an employee bonus that was paid in
December of 2014 but you withheld nothing. You discovered
the error on March 17, 2015. You cannot file Form 943-X to
correct your 2014 Form 943 because the error involves a
previous year and the amount previously reported for the
employee represents the actual amount withheld from the
employee during 2014.

Example—Adjustment for third-party sick pay
underreported. You reported $6,900 (shown as
“–6,900.00”) as a third-party sick pay adjustment (reduction
to tax) on your 2014 Form 943, line 10. Your third-party sick
pay adjustment should have been $9,600 (shown as “–
9,600.00”) because your third-party sick pay payer withheld
that amount of social security and Medicare taxes from your
employees. You discovered the error in April of 2015. To
correct the error, figure the difference on Form 943-X as
shown.

Example—Administrative error reporting income tax.
You had three employees. In 2014, you withheld $1,000 of
federal income tax from Employee A, $2,000 from Employee
B, and $6,000 from employee C. The total amount of federal
income tax you withheld was $9,000. You mistakenly
reported $6,000 on your 2014 Form 943, line 8. You
discovered the error on March 17, 2015. This is an example
of an administrative error that may be corrected in a later
calendar year because the amount actually withheld from
employees' wages differs from the amount reported on Form
943. Use Form 943-X to correct the error. Enter $9,000 in
column 1 and $6,000 in column 2. Subtract the amount in
column 2 from the amount in column 1.
Column 1 (corrected amount)
Column 2 (Form 943, line 8)
Column 3 (difference)

Column 1 (corrected amount)
Column 2 (Form 943, line 10)
Column 3 (difference)

-2,700.00

Here is how you would enter the numbers on Form 943-X.
Column 1
(corrected amount)
-9,600.00

9,000.00
- 6,000.00
3,000.00

Column 2
(Form 943, line 10)
-6,900.00

Column 3
(difference)
-2,700.00

Report “–2,700.00” as your correction in column 4.
In this example, you are claiming a credit for $2,700 in
overreported tax for your 2014 Form 943. Always enter the
same amount in column 4 (including any minus sign) that you
enter in column 3.
Be sure to explain the reasons for this correction on
line 20.

Report the 3,000.00 as a tax correction in column 4.
Be sure to explain the reasons for this correction on
line 20.

Instructions for Form 943-X (Rev. 2-2015)

-9,600.00
- (6,900.00)

-9-

previously reported. See the instructions for line 19 for more
information.

Note. If the example above was for a correction to a year
ending before January 1, 2013, the references to line 10
change to line 8.

15. Subtotal

Only use line 10 to correct adjustments for fractions
of cents, third-party sick pay, or group-term life
CAUTION
insurance previously reported. File a separate Form
943-X for each year being corrected.

Combine the amounts from column 4 on lines 6–14 and enter
the result on line 15.

!

Example. You entered “-500.00” in column 4 of line 6,
“-100.00” in column 4 of line 7, and “1,400.00” in column 4 of
line 10. Combine these amounts and enter “800.00” in
column 4 of line 15.

11–14. Special Additions to Wages for Federal
Income Tax, Social Security Tax, Medicare Tax,
and Additional Medicare Tax

Line 6
Line 7
Line 10
Line 15

Section 3509 provides special rates for the employee share
of social security tax, Medicare tax, Additional Medicare Tax,
and income tax withholding when workers are reclassified as
employees in certain circumstances. The applicable rate
depends on whether you filed required information returns.
An employer cannot recover any tax paid under this provision
from the employees. The full employer share of social
security and Medicare tax is due for all reclassifications.

-500.00
-100.00
+1,400.00
800.00

16a. Claiming or Correcting the COBRA
Premium Assistance Credit
The COBRA premium assistance credit was
available to an employer for premiums paid on
CAUTION
behalf of employees who were involuntarily
terminated from employment between September 1, 2008,
and May 31, 2010. The COBRA premium assistance credit is
not available for individuals who were involuntarily terminated
after May 31, 2010. Therefore, only in rare circumstances,
such as instances where COBRA eligibility was delayed as a
result of employer provided health insurance coverage
following termination, will the credit be available.

Note. Section 3509 rates are not available if you
intentionally disregarded the requirements to withhold taxes
from the employee, or if you withheld income tax but did not
withhold social security and Medicare tax. Section 3509 rates
are also not available for certain statutory employees.

!

On lines 11–14, enter only corrections to wages resulting
from reclassifying certain workers as employees when
section 3509 rates are used to calculate the taxes.
If the employer issued the required information returns,
use the section 3509 rates as follows.
For social security taxes, use the employer rate of 6.2%
plus 20% of the employee rate of 6.2% (4.2% for 2011 and
2012), for a total rate of 7.44% (7.04% for 2011 and 2012) of
wages.
For Medicare taxes, use the employer rate of 1.45% plus
20% of the employee rate of 1.45%, for a total rate of 1.74%
of wages.
For Additional Medicare Tax, 0.18% (20% of the employee
rate of 0.9%) of wages subject to Additional Medicare Tax.
For income tax withholding, the rate is 1.5% of wages.

Enter 65% of the total COBRA premium assistance
payments for all assistance eligible individuals in column 1.
Report the premium assistance payments 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 paid 35% of the COBRA premium. Do not
include the assistance eligible individual's 35% of the
premium in the amount entered on this line.
For tax periods ending before January 1, 2014, enter any
COBRA premium assistance payments previously claimed
on Form 943, line 13a (line 11a for calendar years 2011 and
2012), in column 2. For tax periods beginning after
December 31, 2013, enter -0- in column 2, unless you are
correcting a COBRA premium assistance payment
previously reported on a Form 943-X. If you or the IRS
previously corrected the amount reported, the amount
entered in column 2 should take into account all previous
corrections.

If the employer did not issue the required information
returns, use the section 3509 rates as follows.
For social security taxes, use the employer rate of 6.2%
plus 40% of the employee rate of 6.2% (4.2% for 2011 and
2012), for a total rate of 8.68% (7.88% for 2011 and 2012) of
wages.
For Medicare taxes, use the employer rate of 1.45% plus
40% of the employee rate of 1.45%, for a total rate of 2.03%
of wages.
For Additional Medicare Tax, 0.36% (40% of the employee
rate of 0.9%) of wages subject to Additional Medicare Tax.
For income tax withholding, the rate is 3.0% of wages.

Enter the difference between column 1 and 2 in column 3.
Copy the amount in column 3 to column 4. However, to
properly show the amount as a credit or balance due item,
enter a positive number in column 3 as a negative number in
column 4 or a negative number in column 3 as a positive
number in column 4.

Unlike other lines on Form 943-X, enter in column 1 only
the corrected wages for workers being reclassified, not the
amount paid to ALL employees. Enter in column 2 previously
reported wages (if any) to reclassified employees. To get the
amount for column 4, use the applicable section 3509 rates.
If you filed the required information returns for some
employees but did not file them for other employees, be sure
to use the applicable rates for each employee when
calculating the amounts in column 4 and show your
calculations on line 20. The tax correction in column 4 will be
a positive number if you increased the amount of wages you

The COBRA premium assistance credit is treated as
a credit on the first day of the return period (that is,
CAUTION
January 1). However, because the credit is now
claimed on Form 943-X filed AFTER submission of the Form
943, an employer that reduces its required deposits in
anticipation of the credit will receive a system-generated
notice reflecting a balance due and associated penalties and

!

-10-

Instructions for Form 943-X (Rev. 2-2015)

Form 943-A. Do not include the tax increase reported on
Form 943-X on any amended Form 943-A you file.
If you owe tax and are filing a late Form 943-X, that is,
after the due date for the return period in which you
discovered the error, you must file an amended Form 943-A
with the Form 943-X. Otherwise, the IRS may assess an
“averaged” FTD penalty. The total tax reported on Form
943-A, line M, must match the corrected tax (Form 943,
line 11 (line 9 for calendar years 2011 and 2012), combined
with any correction reported on Form 943-X, line 15) for the
year, less any previous abatements and interest-free tax
assessments.

interest, if applicable. The balance due, including any related
penalties and interest, resulting from the reduction in
deposits in anticipation of the credit will be abated when the
credit is applied. Such abatement will generally occur without
any further action from the employer. Alternatively, to prevent
triggering a system-generated balance due notice, the
employer can make its deposits without a reduction in
anticipation of the COBRA premium assistance credit and
follow these instructions for claiming the COBRA premium
assistance credit.
For more information on the COBRA premium subsidy,
visit IRS.gov and enter “COBRA” in the search box.

Payment methods. You may pay the amount you owe on
line 17 electronically using the Electronic Federal Tax
Payment System (EFTPS), by credit card or debit card, or by
a check or money order.

16b. Number of Individuals Provided COBRA
Premium Assistance on Line 16a

Enter the total number of assistance eligible individuals
provided COBRA premium assistance in column 1. Count
each assistance eligible individual who paid a reduced
COBRA premium 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 16b for the premium
assistance entered on line 16a. Further, each individual is
reported only once. For example, an assistance eligible
individual who made monthly premium payments would only
be reported as one individual on line 16b.

The preferred method of payment is EFTPS. For more
information, visit www.eftps.gov, call EFTPS Customer
Service at 1-800-555-4477 or 1-800-733-4829 (TDD) toll
free, or see Pub. 966, Electronic Federal Tax Payment
System: A Guide To Getting Started.
To pay by credit or debit card, visit the IRS website
www.irs.gov/e-pay.
If you pay by check or money order, make it payable to
“United States Treasury.” On your check or money order, be
sure to write your EIN, “Form 943-X,” and the year corrected.
You do not have to pay if the amount you owe is less than
$1.
Previously assessed FTD penalty. If line 17 reflects
overreported tax and the IRS previously assessed a FTD
penalty, you may be able to reduce the penalty. For more
information, see the Form 943-A instructions.

For tax periods ending before January 1, 2014, enter the
number of assistance eligible individuals provided COBRA
premium assistance previously reported on Form 943, line
13b (line 11b for calendar years 2011 and 2012), in column
2. For tax periods beginning after December 31, 2013,
enter -0- in column 2, unless you are correcting a previously
filed Form 943-X. If you or the IRS previously corrected the
number of individuals reported, the number entered in
column 2 should take into account all previous corrections.

Part 4: Explain Your Corrections for
the Calendar Year You Are Correcting
18. Correction of Both Underreported and
Overreported Amounts

17. Total

Check the box on line 18 if any corrections you entered on
lines 6–14 and 16a and 16b in column 3 reflect both
underreported and overreported amounts.

Combine lines 15 and 16a of column 4, and enter the result
on line 17.
Your credit. If the amount entered on line 17 is less than
zero, for example, “-115.00,” you have a credit because you
overreported your federal employment taxes.
If you checked the box on line 1, include this amount on
the "Total Deposits" line of Form 943 for the year during
which you filed Form 943-X. Do not make any changes to
your Monthly Summary of Federal Tax Liability on Form 943
or on Form 943-A. The amounts reported in your Monthly
Summary of Federal Tax Liability or on Form 943-A should
reflect your actual tax liability for the period.
If you checked the box on line 2, you are filing a claim for
refund or abatement of the amount shown.
If your credit is less than $1, we will send a refund or apply
it only if you ask us in writing to do so.

Example. If you had an increase to social security wages
of $15,000 for Employee A and a decrease to social security
wages of $5,000 for Employee B, you would enter $10,000
on line 6, column 3. That $10,000 represents the net change
from corrections.
On line 20, you must explain the reason for both the
$15,000 increase and the $5,000 decrease.

19. Did You Reclassify Any Workers

Check the box on line 19 if you reclassified any workers to be
independent contractors or nonemployees. Also check this
box if the IRS (or you) determined that workers you treated
as independent contractors or nonemployees should be
classified as employees. On line 20, give us a detailed
reason why any worker was reclassified and, if you used
section 3509 rates on lines 11–14 for any worker reclassified
as an employee, explain why section 3509 rates apply and
what rates you used.

Amount you owe. If the amount on line 17 is a positive
number, you must pay the amount you owe by the time you
file Form 943-X. You may not use any credit that you show on
another Form 943-X to pay the amount you owe, even if you
filed for the amount you owe and the credit at the same time.
If you owe tax and are filing a timely Form 943-X, do not
file an amended Form 943-A unless you were assessed an
FTD penalty caused by an incorrect, incomplete, or missing
Instructions for Form 943-X (Rev. 2-2015)

Return not filed because you did not treat any workers
as employees. If you did not previously file Form 943
because you mistakenly treated all workers as independent
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Part 5. Sign Here

contractors or as nonemployees, file a Form 943 for each
delinquent year.
On each Form 943 for which you are entitled to use
section 3509 rates, complete the following steps.
Write “Misclassified Employees” in bold letters across
the top margin of page 1.
Enter a zero on the line for “Total taxes after adjustments.”
Complete the signature area.
Attach a completed Form 943-X (see instructions below).
On each attached Form 943-X, complete the following
steps.
Complete the top of Form 943-X, including the date you
discovered the error.
Enter the wage amounts on lines 11–14, column 1.
Enter zeros on lines 11–14, column 2.
Complete columns 3 and 4 as instructed in Part 3.
Provide a detailed statement on line 20.
Complete the signature area.

You must complete all three pages of Form 943-X and sign it.
If you do not sign it on page 3, processing of Form 943-X will
be delayed.
Who must sign the Form 943-X? The following persons
are authorized to sign the return for each type of business
entity.
Sole proprietorship—The individual who owns the
business.
Corporation (including limited liability company
(LLC) treated as a corporation)—The president, vice
president, or other principal officer duly authorized to sign.
Partnership (including LLC treated as a partnership)
or unincorporated organization—A responsible and duly
authorized partner, 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 943-X may also be signed by a duly authorized
agent of the taxpayer if a valid power of attorney has been
filed.

If you cannot use section 3509 rates (for example,
because the workers you treated as nonemployees
CAUTION
were certain statutory employees), file a Form 943
for each delinquent year. Write “Misclassified Employees”
in bold letters across the top margin of page 1 of each Form
943. Complete Form 943 using the Instructions for Form 943.
Attach a Form 943-X to each Form 943. Complete the top of
Form 943-X, including the date you discovered the error, and
provide a detailed explanation on line 20.

!

Alternative signature method. Corporate officers or duly
authorized agents may sign Form 943-X by rubber stamp,
mechanical device, or computer software program. For
details and required documentation, see Rev. Proc. 2005-39.
You can find Rev. Proc. 2005-39 on page 82 of Internal
Revenue Bulletin 2005-28 at www.irs.gov/irb/2005-28_IRB/
ar16.html.

20. Explain Your Corrections

Treasury regulations require you to explain in detail the
grounds and facts relied upon to support each correction. On
line 20, describe in detail each correction you entered in
column 4 on lines 6–14 and 16a. Also explain any correction
made on line 16b. If you need more space, attach additional
sheets, but be sure to write your name, EIN, “Form 943-X,”
and the calendar year you are correcting.

Paid Preparer Use Only

A paid preparer must sign Form 943-X and provide the
information in the Paid Preparer Use Only section of Part 5 if
the preparer was paid to prepare Form 943-X 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.

You must describe the events that caused the
underreported or overreported amounts. Explanations such
as “social security and Medicare wages were overstated” or
“administrative/payroll errors were discovered” are
insufficient and may delay processing your Form 943-X
because the IRS may need to ask for a more complete
explanation.

If you are a paid preparer, enter your Preparer Tax
Identification Number (PTIN) in the space provided. Include
your complete address. If you work for a firm, enter the firm's
name and the EIN of the firm. You can apply for a PTIN
online or by filing Form W-12, IRS Paid Preparer Tax
Identification Number (PTIN) Application and Renewal. For
more information about applying for a PTIN online, visit the
IRS website at www.irs.gov/ptin. You cannot use your PTIN
in place of the EIN of the tax preparation firm.

Provide the following information in your explanation for
each correction.
Form 943-X line number(s) affected.
Date you discovered the error.
Difference (amount of the error).
Cause of the error.

Generally, you are not required to 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.

You may report the information in paragraph form. The
following paragraph is an example.
“The $1,000 difference shown in column 3 of lines 6 and 7
was discovered on May 15, 2014, during an internal audit.
We discovered that we included $1,000 of wages for one of
the employees twice. This correction removes the reported
wages that were never paid.”
For corrections shown on lines 11–14, explain why the
correction was necessary and attach any notice you received
from the IRS.
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Instructions for Form 943-X (Rev. 2-2015)

How Can You Order Forms,
Instructions, and Publications from
the IRS?

Paperwork Reduction Act Notice. We ask for the
information on Form 943-X 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,
including federal income tax withholding, on wages. This
form is used to determine the amount of taxes you owe.
Section 6011 requires you to provide the requested
information if the tax applies to you.

Visit the IRS website at www.irs.gov/formspubs.

Call the IRS at 1-800-TAX-FORM (1-800-829-3676).

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.

Additional Information
You may find the following forms, instructions, and
publications helpful when using Form 943-X.
Form W-2, Wage and Tax Statement
Form W-3, Transmittal of Wage and Tax Statements
General Instructions for Forms W-2 and W-3
Form W-2AS, American Samoa Wage and Tax Statement
Form W-2CM, Wage and Tax Statement (Northern
Mariana Islands)
Form W-2GU, Guam Wage and Tax Statement
Form W-2VI, U.S. Virgin Islands Wage and Tax Statement
Form W-3SS, Transmittal of Wage and Tax Statements
Form W-2c, Corrected Wage and Tax Statement
Form W-3c, Transmittal of Corrected Wage and Tax
Statements
Form 943-A, Agricultural Employer's Record of Federal
Tax Liability
Instructions for Form 843
Instructions for Form 943
Pub. 15 (Circular E), Employer's Tax Guide
Pub. 51 (Circular A), Agricultural Employer's Tax Guide
Pub. 80 (Circular SS), Federal Tax Guide for Employers in
the U.S. Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands
Pub. 966, Electronic Federal Tax Payment System: A
Guide To Getting Started

Instructions for Form 943-X (Rev. 2-2015)

The time needed to complete and file Form 943-X will vary
depending on individual circumstances. The estimated
average time is:
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . .
Learning about the law or the form . . . . . . . . . . .
Preparing and sending the form to the IRS . . . . . .

14 hr., 6 min.
52 min.
2 hr., 20 min.

If you have comments concerning the accuracy of these
time estimates or suggestions for making this form simpler,
we would be happy to hear from you. You can send us
comments from www.irs.gov/formspubs. Click on More
Information and then click on Give us feedback. Or you can
write to the Internal Revenue Service, Tax Forms and
Publications Division, 1111 Constitution Ave. NW, IR-6526,
Washington, DC 20224. Do not send Form 943-X to this
address. Instead, see Where Should You File Form 943-X,
earlier.

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