Form 944-X Adjusted Employer's Annual Federal Tax Return or Claim f

Employer's Annual Employment Tax Return

f944-x--2022-02-00_draft

Form 944-X - Adjusted Employer's ANNUAL Federal Tax Return or Claim for Refund

OMB: 1545-2007

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Form

944-X:

(Rev. February 2022)

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

Employer identification number (EIN)

OMB No. 1545-2007

Return You’re Correcting ...

—

Enter the calendar year of the return
you’re correcting:

DRAFT AS OF
November 9, 2021
DO NOT FILE

Name (not your trade name)

(YYYY)

Trade name (if any)

Enter the date you discovered errors:

Address

Number

Street

City

Suite or room number

State

Foreign country name

Foreign province/county

/
/
(MM / DD / YYYY)

ZIP code

Foreign postal code

Read the separate instructions before completing this form. Use this form to correct errors you made on Form 944, Employer’s
ANNUAL Federal Tax Return. Use a separate Form 944-X for each year that needs correction. Type or print within the boxes. You
MUST complete all five pages. Don’t attach this form to Form 944 unless you’re reclassifying workers; see the instructions for line 42.

Part 1:

Select ONLY one process. See page 6 for additional guidance, including information on how to treat
employment tax credits and social security tax deferrals.

1. Adjusted employment tax return. Check this box if you underreported tax amounts. Also check this box if you overreported tax amounts
and you would like to use the adjustment process to correct the errors. You must check this box if you’re correcting both underreported and
overreported tax amounts on this form. The amount shown on line 27, if less than zero, may only be applied as a credit to your Form 944,
Form 941, or Form 941-SS for the tax period in which you’re filing this form.

2. Claim. Check this box if you overreported tax amounts only and you would like to use the claim process to ask for a refund or abatement of
the amount shown on line 27. Don’t check this box if you’re correcting ANY underreported tax amounts on this form.

Part 2:

Complete the certifications.

3. I certify that I’ve filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement, as
required.
Note: If you’re correcting underreported tax amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you’re correcting overreported tax
amounts, for purposes of the certifications on lines 4 and 5, Medicare tax doesn’t include Additional Medicare Tax. Form 944-X can’t be used
to correct overreported amounts of Additional Medicare Tax unless the amounts weren’t withheld from employee wages.
4. If you checked line 1 because you’re adjusting overreported federal income tax, social security tax, Medicare tax, or Additional
Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I have a
written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and won’t claim a
refund or credit for the overcollection.
b. The adjustments of social security tax and Medicare tax are for the employer’s share only. I couldn’t find the affected employees or
each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t claim
a refund or credit for the overcollection.
c. The adjustment is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
employee wages.
5. If you checked line 2 because you’re claiming a refund or abatement of overreported federal income tax, social security tax,
Medicare tax, or Additional Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I have a
written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and won’t claim a
refund or credit for the overcollection.
b. I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social security tax
and Medicare tax overcollected in prior years. I also have a written statement from each affected employee stating that he or she
hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
c. The claim for social security tax and Medicare tax is for the employer’s share only. I couldn’t find the affected employees; or each
affected employee didn’t give me a written consent to file a claim for the employee’s share of social security tax and Medicare tax;
or each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
claim a refund or credit for the overcollection.
d. The claim is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
employee wages.
For Paperwork Reduction Act Notice, see the separate instructions.

www.irs.gov/Form944X

Cat. No. 20335M

Next ■▶

Form 944-X (Rev. 2-2022)

Name (not your trade name)

Part 3:

Employer identification number (EIN)

Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank.
Column 1

Column 2

Total corrected
amount (for ALL
employees)

6.

7.

8.

Correcting Calendar Year (YYYY)

Amount originally
— reported or as
previously corrected
(for ALL employees)

=

—

=

Column 3

Column 4

Difference
(If this amount is a
negative number,
use a minus sign.)

Tax correction

DRAFT AS OF
November 9, 2021
DO NOT FILE
Wages, tips, and other
compensation (Form 944, line 1)

Federal income tax withheld from
wages, tips, and other
compensation (Form 944, line 2)
Taxable social security wages
(Form 944, line 4a, Column 1)

.

.

.

—

—

.

.

.

=
=

.

.

.

Use the amount in Column 1
when you prepare your Forms
W-2 or Forms W-2c.
Copy
Column 3
▶
here

× 0.124* =

.

.

*If you’re correcting your employer share only, use 0.062. See instructions.

9.

Qualified sick leave wages*
(Form 944, line 4a(i), Column 1)

.

—

.

=

.

× 0.062 =

.

*Use line 9 only for qualified sick leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

10.

Qualified family leave wages*
(Form 944, line 4a(ii), Column 1)

.

—

.

=

.

× 0.062 =

.

*Use line 10 only for qualified family leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

11.

Taxable social security tips
(Form 944, line 4b, Column 1)

.

—

.

=

.

× 0.124* =

.

*If you’re correcting your employer share only, use 0.062. See instructions.

12.

Taxable Medicare wages & tips
(Form 944, line 4c, Column 1)

.

—

.

=

.

× 0.029* =

.

*If you’re correcting your employer share only, use 0.0145. See instructions.

13.

14.

Taxable wages & tips subject to
Additional Medicare Tax withholding
(Form 944, line 4d, Column 1)
Tax adjustments (Form 944,
line 6)

15.

Qualified small business payroll
tax credit for increasing research
activities (Form 944, line 8a; you
must attach Form 8974)

16.

Nonrefundable portion of credit
for qualified sick and family
leave wages for leave taken
before April 1, 2021 (Form 944,
line 8b)

17a.

17b.

17c.

Nonrefundable portion of
employee retention credit (Form
944, line 8c)
Nonrefundable portion of credit
for qualified sick and family
leave wages for leave taken
after March 31, 2021 (Form 944,
line 8d)
Nonrefundable portion of
COBRA premium assistance
credit (Form 944, line 8e)

17d.

Number of individuals provided
COBRA premium assistance
(Form 944, line 8f)

18.

Special addition to wages for
federal income tax

.

—

.

=

.

× 0.009* =

.

*Certain wages & tips reported in Column 3 shouldn’t be multiplied by 0.009. See instructions.

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—

—

—

—

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—

=

=

=

=

=

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Copy
Column 3
▶
here

.

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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=

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=

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=

Next ■▶
Page 2

Form 944-X (Rev. 2-2022)

Name (not your trade name)

Part 3:

Employer identification number (EIN)

Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank. (continued)
Column 1

Column 2

Total corrected
amount (for ALL
employees)

19.

20.

21.

22.
23.

24.

Correcting Calendar Year (YYYY)

Amount originally
— reported or as
previously corrected
(for ALL employees)

=

—

=

Column 3

Column 4

Difference
(If this amount is a
negative number,
use a minus sign.)

Tax correction

DRAFT AS OF
November 9, 2021
DO NOT FILE

25.

26a.

26b.

26c.

27.

Special addition to wages for
social security taxes

.

Special addition to wages for
Medicare taxes

.

Special addition to wages for
Additional Medicare Tax

.

—

Deferred amount of the
employee share of social
security tax* (Form 944, line 10c)

.

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.

.

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—

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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See
instructions

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=

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See
instructions

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—

=

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*Line 24 can only be used if correcting a 2020 Form 944.

.

Refundable portion of
employee retention credit
(Form 944, line 10e)

.

Refundable portion of COBRA
premium assistance credit
(Form 944, line 10g)

=

.

.

*Line 23 can only be used if correcting a 2020 Form 944.

Refundable portion of credit for
qualified sick and family leave
wages for leave taken before
April 1, 2021 (Form 944, line 10d)

Refundable portion of credit for
qualified sick and family leave
wages for leave taken after
March 31, 2021 (Form 944, line
10f)

=

.

—

Subtotal. Combine the amounts on lines 7 through 21 of Column 4
Deferred amount of the employer
share of social security tax* (Form
944, line 10b)

.

.

.

—

—

=

.

—

=

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—

Total. Combine the amounts on lines 22 through 26c of Column 4

=

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=

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If line 27 is less than zero:
• If you checked line 1, this is the amount you want applied as a credit to your Form 944 for the tax period in which you’re filing this form.
(If you’re currently filing a Form 941 or Form 941-SS, Employer’s QUARTERLY Federal Tax Return, see the instructions.)
• If you checked line 2, this is the amount you want refunded or abated.
If line 27 is more than zero, this is the amount you owe. Pay this amount by the time you file this return. For information on how to pay,
see Amount you owe in the instructions.
28.

29.

30.

Qualified health plan expenses
allocable to qualified sick leave
wages for leave taken before
April 1, 2021 (Form 944, line 15)

.

Qualified health plan expenses
allocable to qualified family leave
wages for leave taken before
April 1, 2021 (Form 944, line 16)

.

Qualified wages for the employee
retention credit (Form 944, line 17)

.

—

—

—

.

.

.

=

=

=

.

.

.

Next ■▶
Page 3

Form 944-X (Rev. 2-2022)

Name (not your trade name)

Part 3:

Employer identification number (EIN)

Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank. (continued)
Column 1

Column 2

Total corrected
amount (for ALL
employees)

31.

32.

Correcting Calendar Year (YYYY)

Column 3

Amount originally
— reported or as
previously corrected
(for ALL employees)

=

—

=

Difference
(If this amount is a
negative number,
use a minus sign.)

DRAFT AS OF
November 9, 2021
DO NOT FILE
Qualified health plan expenses
for the employee retention
credit (Form 944, line 18)

Credit from Form 5884-C, line 11,
for the year* (Form 944, line 19)

.

.

—

.

.

=

.

.

*Line 32 can only be used if correcting a 2020 Form 944.

Caution: Lines 33-40 don’t apply to years beginning before January 1, 2021.
33.

34.

35.

36.

37.

38.

39.

40.

Qualified sick leave wages for
leave taken after March 31,
2021 (Form 944, line 19)

.

Qualified health plan expenses
allocable to qualified sick leave
wages for leave taken after
March 31, 2021 (Form 944, line 20)

.

Amounts under certain
collectively bargained
agreements allocable to
qualified sick leave wages for
leave taken after March 31,
2021 (Form 944, line 21)

Qualified family leave wages for
leave taken after March 31,
2021 (Form 944, line 22)
Qualified health plan expenses
allocable to qualified family
leave wages for leave taken
after March 31, 2021 (Form 944,
line 23)
Amounts under certain
collectively bargained
agreements allocable to qualified
family leave wages for leave
taken after March 31, 2021 (Form
944, line 24)
If you’re eligible for the employee
retention credit in the third
quarter of 2021 solely because
your business is a recovery
startup business, enter the total
of any amounts included on Form
944, lines 8c and 10e (or, if
corrected, Form 944-X, lines 17a
and 26a), for the third quarter of
2021 (Form 944, line 25)
If you’re eligible for the employee
retention credit in the fourth
quarter of 2021 solely because
your business is a recovery
startup business, enter the total
of any amounts included on
Form 944, lines 8c and 10e (or, if
corrected, Form 944-X, lines 17a
and 26a), for the fourth quarter of
2021 (Form 944, line 26)

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=

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Next ■▶
Page 4

Form 944-X (Rev. 2-2022)

Name (not your trade name)

Part 4:

Employer identification number (EIN)

Correcting Calendar Year (YYYY)

Explain your corrections for the calendar year you’re correcting.

41.

Check here if any corrections you entered on a line include both underreported and overreported amounts.
Explain both your underreported and overreported amounts on line 43.

42.

Check here if any corrections involve reclassified workers. Explain on line 43.

43.

You must give us a detailed explanation of how you determined your corrections. See the instructions.

DRAFT AS OF
November 9, 2021
DO NOT FILE

Part 5:

Sign here. You must complete all five pages of this form and sign it.

Under penalties of perjury, I declare that I have filed an original Form 944 and that I have examined this adjusted return or claim, including
accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer
(other than taxpayer) is based on all information of which preparer has any knowledge.

✗

Print your
name here

Sign your
name here
Date

Print your
title here

/

/

Best daytime phone

Paid Preparer Use Only

Check if you’re self-employed .

Preparer’s name

PTIN

Preparer’s signature

Date

Firm’s name (or yours if
self-employed)

EIN

Address

Phone

City
Page 5

State

/

.

.

/

ZIP code
Form 944-X (Rev. 2-2022)

Form 944-X: Which process should you use?

Type of errors
you’re correcting

Unless otherwise specified in the separate instructions, an underreported employment tax credit or social security tax
deferral should be treated like an overreported tax amount. An overreported employment tax credit or social security tax
deferral should be treated like an underreported tax amount. For more information, including which process to select on
lines 1 and 2, see Correcting an employment tax credit or social security tax deferral in the separate instructions.

DRAFT AS OF
November 9, 2021
DO NOT FILE

Underreported
tax amounts
ONLY

Use the adjustment process to correct underreported tax amounts.
• Check the box on line 1.
• Pay the amount you owe from line 27 by the time you file Form 944-X.

Overreported
tax amounts
ONLY

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

If you’re filing Form 944-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 944 expires...

Choose either the adjustment process or the claim
process to correct the overreported tax amounts.

Choose the adjustment process if you want the
amount shown on line 27 credited to your Form 944,
941, or 941-SS for the period in which you file Form
944-X. Check the box on line 1.
OR

Choose the claim process if you want the amount
shown on line 27 refunded to you or abated. Check
the box on line 2.

BOTH
underreported
and overreported
tax amounts

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

If you’re filing Form 944-X WITHIN
90 days of the expiration of the
period of limitations on credit or
refund for Form 944...

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

If you’re filing Form 944-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 944 expires...

Choose either the adjustment process or both the
adjustment process and the claim process when you
correct both underreported and overreported tax
amounts.
Choose the adjustment process if combining your
underreported tax amounts and overreported tax
amounts results in a balance due or creates a credit
that you want applied to Form 944, 941, or 941-SS.
• File one Form 944-X, and
• Check the box on line 1 and follow the instructions
on line 27.
OR
Choose both the adjustment process and the
claim process if you want the overreported tax
amount refunded to you or abated.
File two separate forms.
1. For the adjustment process, file one Form 944-X
to correct the underreported tax amounts. Check
the box on line 1. Pay the amount you owe from
line 27 by the time you file Form 944-X.
2. For the claim process, file a second Form 944-X
to correct the overreported tax amounts. Check the
box on line 2.

If you’re filing Form 944-X WITHIN
90 days of the
expiration of the period of
limitations on credit or refund
for Form 944...

You must use both the adjustment process and
the claim process.
File two separate forms.
1. For the adjustment process, file one Form 944-X
to correct the underreported tax amounts. Check
the box on line 1. Pay the amount you owe from
line 27 by the time you file Form 944-X.
2. For the claim process, file a second Form 944-X
to correct the overreported tax amounts. Check the
box on line 2.

Page 6

Form 944-X (Rev. 2-2022)


File Typeapplication/pdf
File TitleForm 944-X (Rev. February 2022)
SubjectFillable
AuthorSE:W:CAR:MP
File Modified2021-11-09
File Created2021-10-25

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