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Department of the Treasury
Internal Revenue Service

2022 Instructions for Schedule H
Household
Employment
Taxes

Here is a list of forms that household employers need to
complete.

•
•
•

Schedule H (Form 1040) for figuring your household employment taxes.
Form W-2 for reporting wages paid to your employees.
Form W-3 for sending Copy A of Form(s) W-2 to the Social Security Administration (SSA).
For more information, see What Forms Must You File? in Pub. 926, Household
Employer's Tax Guide.

We have been asked:
Do I need to pay household employment taxes for 2022? If you have a household
employee, you need to withhold and pay social security and Medicare taxes if you
paid cash wages of $2,400 or more in 2022 to any one household employee. See Did
you have a household employee? and the Line A instructions for more information.
You need to pay federal unemployment tax if you paid total cash wages of $1,000 or
more in any calendar quarter of 2021 or 2022 to household employees. See the Part II.
Federal Unemployment (FUTA) Tax instructions for more information.
How do I file Schedule H? File Schedule H with your Form 1040, 1040-SR,
1040-NR, 1040-SS, or 1041. If you’re not filing a 2022 tax return, file Schedule H by
itself.
Do I make a separate payment? No. You pay both income and employment taxes to
the United States Treasury when you file Schedule H with your return.
When do I pay? Most filers must pay by April 18, 2023.
How many copies of Form W-3 do I send to the SSA? Send one copy of Form W-3
with Copy A of Form(s) W-2 to the SSA, and keep one copy of Form W-3 for your
records.

Important Dates
By . . . . . . . . . . . . . . . . . . . .

You must . . . . . . . . . . . . . . . . . . . . . . . . . . .

January 31, 2023

Give your employee Form W-2 and send Copy A of Form(s)
W-2 with Form W-3 to the SSA. Go to SSA.gov/employer
for details.
File Schedule H and pay your household employment taxes
with your 2022 tax return.

April 18, 2023

Contents
When and Where To File . . . . . . . . . . . . . . . . . . . .
How To Fill In Schedule H, Form W-2, and Form W-3
Schedule H . . . . . . . . . . . . . . . . . . . . . . . . . .
Worksheet 1. Credit for Late Contributions . . . . .
Worksheet 2. Household Employers in a Credit
Reduction State . . . . . . . . . . . . . . . . . . . . .
Form W-2 and Form W-3 . . . . . . . . . . . . . . . . .
Worksheet 3. Credit for Qualified Sick and Family
Leave Wages Paid in 2022 for Leave Taken After
March 31, 2020, and Before April 1, 2021 . . . . . .

Section references are to the Internal Revenue Code unless
otherwise noted.

Contents
What's New . . . . . . . . . . . . . . . . . . . . . . . . . .
Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . .
Who Needs To File Schedule H? . . . . . . . . . . . .
Who Needs To File Form W-2 and Form W-3? . .
Do You Have an Employer Identification Number
(EIN)? . . . . . . . . . . . . . . . . . . . . . . . . . .
Can Your Employee Legally Work in the United
States? . . . . . . . . . . . . . . . . . . . . . . . . . .
What About State Employment Taxes? . . . . . . . .

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Contents
Worksheet 4. Credit for Qualified Sick and Family
Leave Wages Paid in 2022 for Leave Taken After
March 31, 2021, and Before October 1, 2021 . . .
Estimated Tax Penalty . . . . . . . . . . . . . . . . . . . . .
What Records To Keep . . . . . . . . . . . . . . . . . . . .
What Is the Earned Income Credit (EIC)? . . . . . . . .
Rules for Business Employers . . . . . . . . . . . . . . . .
How To Correct Schedule H . . . . . . . . . . . . . . . . .
How To Get Forms and Publications . . . . . . . . . . .
Privacy Act and Paperwork Reduction Act Notice . . .

Page

Use Worksheet 3 to figure the credit for leave taken after
March 31, 2020, and before April 1, 2021. Use Worksheet 4 to
figure the credit for leave taken after March 31, 2021, and before October 1, 2021. For more information about the credit for
qualified sick and family leave wages, go to IRS.gov/PLC.
Qualified parking exclusion and commuter transportation
benefit. For 2022, the monthly exclusion for qualified parking
is $280 and the monthly exclusion for commuter highway vehicle transportation and transit passes is $280.
Credit reduction state. A state that hasn't repaid money it
borrowed from the federal government to pay unemployment
benefits is a “credit reduction state.” The Department of Labor
determines these states. If an employer pays wages that are
subject to the unemployment tax laws of a credit reduction
state, that employer must pay additional federal unemployment
tax.
For 2022, there are credit reduction states. If you paid any
wages that are subject to the unemployment compensation laws
of a credit reduction state, your credit against federal unemployment tax will be reduced based on the credit reduction rate
for that credit reduction state. Use Worksheet 2 to figure your
credit reduction for 2022.

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Future Developments
For the latest information about developments related to Schedule H and its instructions, such as legislation enacted after they
were published, go to IRS.gov/ScheduleH.

What's New
Social security and Medicare tax for 2022. The rate of social
security tax on taxable wages, including qualified sick leave
wages and qualified family leave wages paid in 2022 for leave
taken after March 31, 2021, and before October 1, 2021, is
6.2% each for the employer and employee or 12.4% for both.
Qualified sick leave wages and qualified family leave wages
paid in 2022 for leave taken after March 31, 2020, and before
April 1, 2021, aren't subject to the employer share of social security tax; therefore, the tax rate on these wages is 6.2%. The
social security wage base limit is $147,000.
The Medicare tax rate is 1.45% each for the employee and
employer, unchanged from 2021. There is no wage base limit
for Medicare tax.
Social security and Medicare taxes apply to the wages of
household workers you pay $2,400 or more in cash wages in
2022. For more information, see Cash wages and $2,400 test,
later.
For information about the rates and wage threshold that will
apply in 2023, see Pub. 926.
The COVID-19 related credit for qualified sick and family
leave wages is limited to leave taken after March 31, 2020,
and before October 1, 2021. Generally, the credit for qualified sick and family leave wages, as enacted under the Families
First Coronavirus Response Act (FFCRA) and amended and
extended by the COVID-related Tax Relief Act of 2020, for
leave taken after March 31, 2020, and before April 1, 2021,
and the credit for qualified sick and family leave wages under
sections 3131, 3132, and 3133 of the Internal Revenue Code,
as enacted under the American Rescue Plan Act of 2021 (the
ARP), for leave taken after March 31, 2021, and before October 1, 2021, have expired. However, employers that pay qualified sick and family leave wages in 2022 for leave taken after
March 31, 2020, and before October 1, 2021, are eligible to
claim a credit on Schedule H filed for 2022. For more information, see the instructions for line 8b, line 8c, line 8e, and
line 8f, later.

Reminders
Deferral of the employer share of social security tax expired. The CARES Act allowed employers to defer the deposit and payment of the employer share of social security tax. The
deferred amount of the employer share of social security tax
was only available for deposits due on or after March 27, 2020,
and before January 1, 2021, as well as deposits and payments
due after January 1, 2021, that were required for wages paid on
or after March 27, 2020, and before January 1, 2021. One‐half
of the employer share of social security tax was due by December 31, 2021, and the remainder is due by December 31, 2022.
Because both December 31, 2021, and December 31, 2022, are
nonbusiness days, payments made on the next business day
will be considered timely. Any payments or deposits you made
before December 31, 2021, were first applied against your payment due on December 31, 2021, and then applied against your
payment due on December 31, 2022. For more information
about the deferral of employment tax deposits, go to IRS.gov/
ETD. See Paying the deferred amount of the employer share of
social security tax and How to pay the deferred amount of the
employer share of social security tax, later, for information
about paying the deferred amount of the employer share of social security tax.
Paying the deferred amount of the employer share of social
security tax. One-half of the employer share of social security
tax was due by December 31, 2021, and the remainder is due
by December 31, 2022. Because both December 31, 2021, and
December 31, 2022, are nonbusiness days, payments made on
the next business day will be considered timely. Any payments
you made before December 31, 2021, were first applied against
your payment due on December 31, 2021, and then applied
against your payment due on December 31, 2022. For additional information, go to IRS.gov/ETD.

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Household work is work done in or around your home.
Some examples of workers who do household work are:

How to pay the deferred amount of the employer share of
social security tax. You may pay the amount you owe electronically using the Electronic Federal Tax Payment System
(EFTPS), by credit or debit card, or by a check or money order.
The preferred method of payment is EFTPS. For more information, go to EFTPS.gov, or call 800-555-4477. To contact
EFTPS using Telecommunications Relay Services (TRS) for
people who are deaf, hard of hearing, or have a speech disability, dial 711 and then provide the TRS assistant the
800-555-4477 number above or 800-733-4829. To pay the deferred amount using EFTPS, select Payment due on an IRS notice.
To pay by credit or debit card, go to IRS.gov/PayByCard. If
you pay by check or money order, make it payable to “United
States Treasury.” Enter your EIN, “Schedule H,” and the calendar year in which you originally deferred the payment (for example, “TY2020”). Payment of the deferral isn't reported on
Schedule H (Form 1040).
Bicycle commuting reimbursements. P.L. 115-97, Tax Cuts
and Jobs Act, suspends the exclusion of qualified bicycle commuting reimbursements from your employee's income for tax
years beginning after 2017 and before 2026.
Outsourcing payroll duties. You’re responsible to ensure that
tax returns are filed and deposits and payments are made, even
if you contract with a third party to perform these acts. You remain responsible if the third party fails to perform any required
action. Before you choose to outsource any of your payroll and
related tax duties (that is, withholding, reporting, and paying
over social security, Medicare, FUTA, and income taxes) to a
third-party payer, such as a payroll service provider or reporting agent, go to IRS.gov/OutsourcingPayrollDuties for helpful
information on this topic. For more information on the different
types of third-party payer arrangements, see section 16 of Pub.
15.
Paid preparers. If you use a paid preparer to complete
Schedule H, the paid preparer must complete and sign the paid
preparer’s section of the Schedule H unless you’re attaching
Schedule H to Form 1040, 1040-SR, 1040-NR, 1040-SS, or
1041. A paid preparer must sign Schedule H and provide the
information requested in the Paid Preparer Use Only section
only if the preparer was paid to prepare Schedule H and isn't
your employee. The preparer must give you a copy of the return in addition to the copy to be filed with the IRS.

Babysitters
Butlers
Caretakers
Cleaning people

Cooks
Drivers
Health aides
Housekeepers

Maids
Nannies
Private nurses
Yard workers

If a worker is your employee, it doesn't matter whether the
work is full or part time or that you hired the worker through
an agency or from a list provided by an agency or association.
Also, it doesn't matter if the wages paid are for work done
hourly, daily, weekly, or by the job.
If you’re a home care service recipient receiving home care
services through a program administered by a federal, state, or
local government agency, and the person who provides your
care is your household employee, you can ask the IRS to authorize an agent under section 3504 to report, file, and pay all
federal employment taxes, including FUTA taxes, on your behalf. See Form 2678, Employer/Payer Appointment of Agent,
for more information.
If a government agency or third-party agent reports

TIP and pays the employment taxes on wages paid to your
household employee on your behalf, you don't need to
file Schedule H to report those taxes.
Workers who aren't your employees. Workers you get from
an agency aren't your employees if the agency is responsible
for who does the work and how it is done. Self-employed
workers are also not your employees. A worker is self-employed if only the worker can control how the work is done. A
self-employed worker usually provides their own tools and offers services to the general public in an independent business.
Example. You made an agreement with a worker to care
for your lawn. The worker runs a lawn care business and offers
their services to the general public. The worker hires their own
helpers, provides their own tools and supplies, and instructs the
helpers how to do their jobs. Neither the worker nor their helpers are your employees.
For more information, see Pub. 926.

Who Needs To File Form W-2 and
Form W-3?

Who Needs To File Schedule H?

You must file Form W-2 for each household employee to
whom you paid $2,400 or more of cash wages in 2022 that are
subject to social security and Medicare taxes. To find out if the
wages are subject to these taxes, see the instructions for Schedule H, line 1a, line 3, and line 5, later. Even if the wages aren't
subject to these taxes, if you withheld federal income tax from
the wages of any household employee, you must file Form W-2
for that employee. However, when not subject to social security and Medicare taxes, leave boxes 3, 4, 5, and 6 blank on
Form W-2; only complete boxes 1 and 2. If the wages are below $2,400 for 2022 and you complete boxes 3, 4, 5, and 6 on
Form W-2, the SSA will reject your Form W-2.

You must file Schedule H if you answer “Yes” to any of the
questions on lines A, B, and C of Schedule H.
Did you have a household employee? If you hired someone
to do household work and you could control what work they
did and how they did it, you had a household employee. This is
true even if you gave the employee freedom of action. What
matters is that you had the right to control the details of how
the work was done.
Example. You paid Betty Oak to babysit your child and do
light housework 4 days a week in your home. Betty followed
your specific instructions about household and childcare duties.
You provided the household equipment and supplies Betty needed to do the work. Betty is your household employee.

If you're required to file a 2022 Form W-2 for any household employee, you must also send Form W-3 with Copy A of

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Form(s) W-2 to the SSA. You're encouraged to file your Forms
W-2 and W-3 electronically. If filing electronically via the
SSA's Form W-2 Online service, the SSA generates Form W-3
data from the electronic submission of Form(s) W-2. For more
information on electronic filing, go to the SSA's Employer W-2
Filing Instructions & Information website at SSA.gov/employer.

If you’re a calendar year taxpayer and have no house-

TIP hold employees for 2022, you don't have to file Schedule H for 2022.
If you have household employees for 2022, but you’re not
required to file a 2022 tax return (for example, because your income is below the amount that requires you to file), you must
file Schedule H by itself by April 18, 2023. Complete Schedule H and put it in an envelope with your check or money order. Don't send cash. See the list of filing addresses later in
these instructions. Mail your completed Schedule H and payment to the address listed for the place where you live. Make
your check or money order payable to “United States Treasury” for the total household employment taxes due. Enter your
name, address, SSN, daytime phone number, and “2022 Schedule H” on your check or money order. Household employers
that are tax exempt and don't have to file a tax return (for example, churches that pay a household worker to take care of a
minister's home) may also file Schedule H by itself.

Do You Have an Employer
Identification Number (EIN)?
If you have household employees, you will need an EIN to file
Schedule H. If you don't have an EIN, you may apply for one
online by going to IRS.gov/EIN. You may also apply for an
EIN by faxing or mailing Form SS-4 to the IRS. Don't use your
social security number (SSN) in place of an EIN. The Instructions for Form SS-4 explain how you can get an EIN immediately over the Internet, generally within 4 business days by fax,
or in about 4 weeks if you apply by mail. Go to IRS.gov/Forms
to get forms and publications, including Form SS-4.

Can Your Employee Legally Work in
the United States?

Form W-2 and Form W-3
You're encouraged to file your Forms W-2 and W-3 electronically. Go to the SSA's Employer W-2 Filing Instructions & Information website at SSA.gov/employer to learn about electronic filing. If filing electronically via the SSA's Form W-2 Online
service, the SSA generates Form W-3 automatically based on
your Form(s) W-2.

It is unlawful to employ a person who can't legally work in the
United States. When you hire a household employee to work
for you on a regular basis, you and the employee must each
complete part of the U.S. Citizenship and Immigration Services
(USCIS) Form I-9, Employment Eligibility Verification. You
must verify that the employee is either a U.S. citizen or a person who can legally work in the United States and you must
keep Form I-9 for your records. You can get the form and the
USCIS Handbook for Employers by going to the USCIS website at USCIS.gov/I-9-Central. You may use E-Verify at EVerify.gov to confirm the employment eligibility of newly
hired employees.

By January 31, 2023, send Copy A of all Forms W-2 with
Form W-3 to the SSA and give Copies B, C, and 2 of Form
W-2 to each employee. For paper forms, you will meet this requirement if the form is properly addressed, mailed, and postmarked no later than January 31, 2023.

What About State Employment
Taxes?

!

If you file Forms W-2 and W-3 electronically, don't
mail the paper Forms W-2 and W-3 to the SSA.

CAUTION

If filing on paper, mail Copy A of all Forms W-2 with Form
W-3 to:

If you employed a household employee in 2022, you probably
have to pay contributions to your state unemployment fund for
2022. To find out if you do, contact your state unemployment
tax agency. For a list of state unemployment tax agencies, go to
the U.S. Department of Labor's website at oui.doleta.gov/
unemploy/agencies.asp. You should also find out if you need to
pay or collect other state employment taxes or carry workers'
compensation insurance.

Social Security Administration
Direct Operations Center
Wilkes-Barre, PA 18769-0001
If you use “Certified Mail” to file, change the ZIP code to
“18769-0002.” If you use an IRS-approved private delivery
service (PDS), add “Attn: W-2 Process, 1150 E. Mountain Dr.”
to the address and change the ZIP code to “18702-7997.” Go to
IRS.gov/PDS for the current list of IRS-approved PDSs.

When and Where To File
Schedule H

Check with your state, city, or local tax department to

If you file Form 1040, 1040-SR, 1040-NR, 1040-SS, or 1041
for 2022, remember to attach Schedule H to it. Mail your return, by April 18, 2023, to the address shown in your tax return
instructions.
Exceptions. If you get an extension of time to file your return,
file your return with Schedule H by the extended due date. If
you’re a fiscal year filer, file your return and Schedule H by the
due date of your fiscal year return, including extensions.

TIP find out if you must file Copy 1 of Form W-2.
Penalties. You may have to pay a penalty if you don't give
Forms W-2 to your employees or file Copy A of the forms with
the SSA by the due dates. You may also have to pay a penalty
if you don't show your employee's SSN on Form W-2 or don't
provide correct information on the form.

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plies. Report the value of taxable noncash wages in box 1 of
Form W-2 together with cash wages. Don't show noncash wages in box 3 or in box 5 of Form W-2. See section 5 of Pub. 15
for more information on cash and noncash wages, and Pub.
15-B for more information on fringe benefits.

How To Fill In Schedule H, Form
W-2, and Form W-3
Schedule H

!

CAUTION

Transportation (commuting) benefits. If you reimburse
your employee for qualified parking, transportation in a commuter highway vehicle, or transit passes, you may be able to
exclude the cash reimbursement amounts from counting as
cash wages subject to social security and Medicare taxes.
Qualified parking is parking at or near your home or at or near
a location from which your employee commutes to your home.
It doesn't include parking at or near your employee's home. For
2022, you can reimburse your employee up to $280 per month
for qualified parking and $280 per month for combined commuter highway vehicle transportation and transit passes. See
Transportation (Commuting) Benefits in Pub. 15-B for more
information. Any cash reimbursement over these amounts is included as wages.

If you were notified that your household employee received payments from a state disability plan, see State
Disability Payments, later.

Social security number (SSN). Enter your SSN. Form 1041
filers, don't enter a number in this space. But be sure to enter
your EIN in the space provided.
Employer identification number (EIN). An EIN is a
nine-digit number assigned by the IRS. The digits are arranged
as follows: 00-0000000. Enter your EIN in the space provided.
If you don't have an EIN, see Do You Have an Employer Identification Number (EIN), earlier. If you applied for an EIN but
haven't received it, enter “Applied For” and the date you applied. Don't use your SSN as an EIN.
Line A. Did you pay any one household employee cash wages of $2,400 or more in 2022? To figure the total cash wages
you paid in 2022 to each household employee, don't include
amounts paid to any of the following individuals.
• Your spouse.
• Your child who was under age 21.
• Your parent. (See Exception for parents below.)
• Your employee who was under age 18 at any time during
2022. If the employee wasn't a student, see Exception for employees under age 18 below.

Part I. Social Security, Medicare, and
Federal Income Taxes
Social security and Medicare taxes fund retirement, survivor,
disability, and health benefits for workers and their families.
You and your employees generally pay these taxes in equal
amounts.
You’re not required to withhold federal income tax from
wages you pay a household employee. You should withhold
federal income tax only if your household employee asks you
to withhold it and you agree. The employee must give you a
completed Form W-4.

Exception for parents. Include the cash wages you paid
your parent for work in or around your home if both (1) and (2)
below apply.
1. Your child (including an adopted child or stepchild) who
lived with you was under age 18 or had a physical or mental
condition that required the personal care of an adult for at least
4 continuous weeks during the calendar quarter in which services were performed. A calendar quarter is January through
March, April through June, July through September, or October through December.
2. You were divorced and not remarried, a widow or widower, or married to and living with a person whose physical or
mental condition prevented your spouse from caring for the
child for at least 4 continuous weeks during the calendar quarter in which services were performed.

For 2022, the rate of social security tax on taxable wages,
including qualified sick leave wages and qualified family leave
wages paid in 2022 for leave taken after March 31, 2021, and
before October 1, 2021, is 6.2% each for the employer and employee or 12.4% for both. Qualified sick leave wages and
qualified family leave wages paid in 2022 for leave taken after
March 31, 2020, and before April 1, 2021, aren’t subject to the
employer share of social security tax; therefore, the tax rate on
these wages is 6.2%. The social security wage base limit is
$147,000.
The Medicare tax rate is 1.45% each for the employee and
employer, unchanged from 2021. There is no wage base limit
for Medicare tax. If you didn't deduct the employee's share
from the employee’s wages, you must pay the employee's share
of tax and your share of tax, a total of 12.4% for social security
tax and 2.9% for Medicare tax. See Form W-2 and Form W-3,
later, for more information.

Exception for employees under age 18. Include the cash
wages you paid to a person who was under age 18 and not a
student if providing household services was the employee’s
principal occupation.
Cash wages. Cash wages include wages paid by check, money
order, etc. Cash wages don't include the value of food, lodging,
clothing, transit passes, or other noncash items you give a
household employee. However, cash you give your employee
in place of these items is included in cash wages.
Noncash wages paid to household employees aren't subject
to social security taxes or Medicare taxes; however, they are
subject to federal income tax unless a specific exclusion ap-

In addition to withholding Medicare tax at 1.45%, you must
withhold a 0.9% Additional Medicare Tax from wages you pay
to an employee in excess of $200,000 in a calendar year.
You’re required to begin withholding Additional Medicare Tax
in the pay period in which you pay wages in excess of
$200,000 to an employee and continue to withhold it each pay
period until the end of the calendar year. Additional Medicare
Tax is only imposed on the employee. There is no employer
share of Additional Medicare Tax. All wages that are subject to

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Medicare tax are subject to Additional Medicare Tax withholding if paid in excess of the $200,000 withholding threshold. For
more information on Additional Medicare Tax, go to IRS.gov/
ADMT.

Line 8a. Total social security, Medicare, and federal income
taxes. Add lines 2c, 4, 6, and 7. Enter the result on line 8a.

$2,400 test. If you pay a household employee $2,400 or
more in cash wages during 2022, you must report and pay social security and Medicare taxes on all the wages, including the
first $2,400 paid to that employee. The test applies to cash wages paid in 2022 regardless of when the wages were earned.
See Pub. 926 for more information.

If you aren't claiming a credit for qualified sick or family leave
wages, enter the amount from line 8a on line 8d and skip to
line 9.

Lines 8b Through 8f

The same wages can't be treated as both qualified sick leave
wages and qualified family leave wages. For leave taken after
March 31, 2021, and before October 1, 2021, any wages taken
into account in determining the credit for qualified sick and
family leave wages can't be taken into account as wages for
purposes of the credits under sections 45A, 45P, 45S, and 51.
Emergency Paid Sick Leave Act (EPSLA). Employers with
fewer than 500 employees and, for leave taken after March 31,
2021, and before October 1, 2021, certain governmental employers without regard to number of employees (except for the
federal government and its agencies and instrumentalities unless described in section 501(c)(1)) are entitled to a credit if
they provide paid sick leave to employees that otherwise meets
the requirements of the EPSLA. Under the EPSLA, as amended for purposes of the ARP, wages are qualified sick leave
wages if paid to employees that are unable to work before October 1, 2021, because the employee:
1. Is subject to a federal, state, or local quarantine or isolation order related to COVID-19;
2. Has been advised by a health care provider to self-quarantine due to concerns related to COVID-19;
3. Is experiencing symptoms of COVID-19 and seeking a
medical diagnosis; or, for leave taken after March 31, 2021,
and before October 1, 2021, is seeking or awaiting the results
of a diagnostic test for, or a medical diagnosis of, COVID-19
(and the employee has been exposed to COVID-19 or the employee's employer has requested such test or diagnosis), or the
employee is obtaining immunizations related to COVID-19 or
recovering from an injury, disability, illness, or condition related to such immunization;
4. Is caring for an individual subject to an order described
in (1) or who has been advised as described in (2);
5. Is caring for a son or daughter because the school or
place of care for that child has been closed, or the childcare
provider for that child is unavailable, due to COVID-19 precautions; or
6. Is experiencing any other substantially similar condition
specified by the U.S. Department of Health and Human Services, which for leave taken after March 31, 2021, and before
October 1, 2021, includes to accompany an individual to obtain
immunization related to COVID-19, or to care for an individual
who is recovering from any injury, disability, illness, or condition related to the immunization.

Line 1a. Total cash wages subject to social security tax. Enter the total of cash wages (see Cash wages, earlier) paid in
2022 to each household employee who meets the $2,400 test,
explained earlier.

!

CAUTION

If you paid any household employee cash wages of
more than $147,000 in 2022, include on line 1a only
the first $147,000 of that employee's cash wages.

Qualified sick leave wages and qualified family leave
wages paid in 2022 for leave taken after March 31,
CAUTION 2020, and before April 1, 2021, are reported on
line 1b. Qualified sick leave wages and qualified family leave
wages paid in 2022 for leave taken after March 31, 2021, and
before October 1, 2021, are reported on line 1a.

!

Line 1b. Qualified sick and family leave wages paid in 2022
for leave taken after March 31, 2020, and before April 1,
2021, included on line 1a. Enter the qualified sick and family
leave wages you paid in 2022 for leave taken after March 31,
2020, and before April 1, 2021, included on line 1a. For more
information on qualified sick and family leave wages paid in
2022 for leave taken after March 31, 2020, and before April 1,
2021, see the instructions for line 8g and line 8i, later.
Line 2a. Social security tax. Multiply the amount on line 1a
by 12.4% (0.124). Enter the result on line 2a.
Line 2b. Employer share of social security tax on qualified
sick and family leave wages paid in 2022 for leave taken after March 31, 2020, and before April 1, 2021. Multiply the
amount on line 1b by 6.2% (0.062). Enter the result on line 2b.
Line 2c. Total social security tax. Subtract line 2b from
line 2a. Enter the result on line 2c.
Line 3. Total cash wages subject to Medicare tax. Enter the
total cash wages (see Cash wages, earlier) paid in 2022 to each
employee who meets the $2,400 test, explained earlier. There is
no limit on wages subject to Medicare tax.
Line 4. Medicare tax. Multiply the amount on line 3 by 2.9%
(0.029). Enter the result on line 4.
Line 5. Total cash wages subject to Additional Medicare
Tax withholding. Enter the total cash wages (see Cash wages,
earlier) paid to each employee in 2022 that exceeded $200,000.
Line 6. Additional Medicare Tax withholding. Multiply the
amount on line 5 by 0.9% (0.009). Enter the result on line 6.
Line 7. Federal income tax withheld. Enter any federal income tax you withheld from the wages you paid to your household employees in 2022. See Pub. 926 and Pub. 15 for information on withholding federal income taxes.

Son or daughter. A son or daughter must generally have
been under 18 years of age or incapable of self-care because of
a mental or physical disability. A son or daughter includes a biological child, adopted child, stepchild, foster child, legal ward,
or child for whom the employee assumes parental status and
carries out the obligations of a parent.

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Limits on qualified sick leave wages. The EPSLA, as
amended for purposes of the ARP, provides different limitations for different circumstances under which qualified sick
leave wages are paid. For paid sick leave qualifying under (1),
(2), or (3) earlier, the amount of qualified sick leave wages is
determined at the employee's regular rate of pay, but the wages
may not exceed $511 for any day (or portion of a day) for
which the individual is paid sick leave. For paid sick leave
qualifying under (4), (5), or (6) earlier, the amount of qualified
sick leave wages is determined at two-thirds the employee's
regular rate of pay, but the wages may not exceed $200 for any
day (or portion of a day) for which the individual is paid sick
leave. The EPSLA also limits each individual to a maximum of
up to 80 hours of paid sick leave in total for leave taken after
March 31, 2020, and before April 1, 2021. The ARP resets this
limit at 80 hours of paid sick leave for leave taken after March
31, 2021, and before October 1, 2021. Therefore, for leave taken after March 31, 2020, and before April 1, 2021, the maximum amount of paid sick leave wages can't exceed $5,110 for
an employee for leave under (1), (2), or (3), and it can't exceed
$2,000 for an employee for leave under (4), (5), or (6). These
maximum amounts also reset and apply to leave taken after
March 31, 2021, and before October 1, 2021.
For more information about qualified sick and family leave
wages, go to IRS.gov/PLC.
Expanded Family and Medical Leave Act (Expanded
FMLA). Employers with fewer than 500 employees and, for
leave taken after March 31, 2021, and before October 1, 2021,
certain governmental employers without regard to number of
employees (except for the federal government and its agencies
and instrumentalities unless described in section 501(c)(1)) are
entitled to a credit under the FFCRA, as amended for purposes
of the ARP, if they provide paid family leave to employees that
otherwise meets the requirements of the Expanded FMLA. For
leave taken after March 31, 2020, and before April 1, 2021,
wages are qualified family leave wages if paid to an employee
who has been employed for at least 30 calendar days when an
employee is unable to work due to the need to care for a son or
daughter under 18 years of age or incapable of self-care because of a mental or physical disability because the school or
place of care for that child has been closed, or the childcare
provider for that child is unavailable, due to a public health
emergency. See Son or daughter, earlier, for more information.
For leave taken after March 31, 2021, and before October 1,
2021, the leave can be granted for any other reason provided by
the EPSLA, as amended for purposes of the ARP.
For leave taken after March 31, 2020, and before April 1,
2021, the first 10 days for which an employee takes leave may
be unpaid. During this period, employees may use other forms
of paid leave, such as qualified sick leave, accrued sick leave,
annual leave, or other paid time off. After an employee takes
leave for 10 days, the employer provides the employee paid
leave (that is, qualified family leave wages) for up to 10 weeks.
For leave taken after March 31, 2021, and before October 1,
2021, the 10-day rule discussed above doesn't apply and the
paid leave can be provided for up to 12 weeks.

mined under the Fair Labor Standards Act of 1938), multiplied
by the number of hours the employee otherwise would have
been scheduled to work. For leave taken after March 31, 2020,
and before April 1, 2021, the total qualified family leave wages
can't exceed $200 per day or $10,000 in the aggregate per employee. For leave taken after March 31, 2021, and before October 1, 2021, the limit resets and the total qualified leave wages
can't exceed $200 per day or $12,000 in the aggregate per employee.
For more information about qualified sick and family leave
wages, go to IRS.gov/PLC.
If you paid qualified sick or family leave wages in

TIP 2022 for leave taken after March 31, 2020, and before
April 1, 2021, complete lines 8g through 8j before
completing Worksheet 3. If you paid qualified sick or family
leave wages in 2022 for leave taken after March 31, 2021, and
before October 1, 2021, complete lines 8k through 8n before
completing Worksheet 4.
Line 8b. Nonrefundable portion of credit for qualified sick
and family leave wages for leave taken after March 31,
2020, and before April 1, 2021. Enter the nonrefundable portion of the credit for qualified sick and family leave wages for
leave taken after March 31, 2020, and before April 1, 2021,
from Worksheet 3, Step 2, line 2j.

!

CAUTION

Complete line 8b only if qualified sick leave wages
and/or qualified family leave wages were paid in 2022
for leave taken after March 31, 2020, and before April

1, 2021.
Businesses, tax-exempt organizations with fewer than 500
employees, and Schedule H filers that provide paid sick leave
under the EPSLA and/or provide paid family leave under the
Expanded FMLA are eligible to claim the credit for qualified
sick and family leave wages for leave taken after March 31,
2020, and before April 1, 2021. For purposes of the credit,
qualified sick leave wages and qualified family leave wages are
wages for social security and Medicare tax purposes, determined without regard to the exclusions from the definition of
employment under sections 3121(b)(1)–(22), that an employer
pays that otherwise meet the requirements of the EPSLA or Expanded FMLA. The credit for qualified sick and family leave
wages consists of the qualified sick leave wages, the qualified
family leave wages, the qualified health plan expenses allocable to those wages, and the employer share of Medicare tax allocable to those wages. The nonrefundable portion of the credit
is limited to the employer share of social security tax reported
on Schedule H, line 2a.
Any credit in excess of the remaining amount of the employer share of social security tax is refundable and reported on
Schedule H, line 8e. For more information on the credit for
qualified sick and family leave wages, go to IRS.gov/PLC.
Qualified health plan expenses allocable to qualified sick
and family leave wages. The credit for qualified sick leave
wages and qualified family leave wages is increased to cover
the qualified health plan expenses that are properly allocable to
the qualified leave wages for which the credit is allowed. These
qualified health plan expenses are amounts paid or incurred by
the employer to provide and maintain a group health plan but

Rate of pay and limit on wages. The rate of pay must be at
least two-thirds of the employee's regular rate of pay (as deter-

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only to the extent such amounts are excluded from the employees' income as coverage under an accident or health plan. The
amount of qualified health plan expenses generally includes
both the portion of the cost paid by the employer and the portion of the cost paid by the employee with pre-tax salary reduction contributions. However, qualified health plan expenses
don't include amounts that the employee paid for with after-tax
contributions. For more information, go to IRS.gov/PLC.

Line 8d. Total social security, Medicare, and federal income taxes after nonrefundable credits. Add lines 8b and 8c
and then subtract that total from line 8a. Enter the result on
line 8d.
Line 8e. Refundable portion of credit for qualified sick and
family leave wages for leave taken After March 31, 2020,
and before April 1, 2021. Enter the refundable portion of the
credit for qualified sick and family leave wages from Worksheet 3, Step 2, line 2k.

You must include the full amount (both the nonrefund-

TIP able and refundable portions) of the credit for qualified sick and family leave wages in your gross income
for the tax year that includes the last day of any calendar quarter in which a credit is allowed.

!

CAUTION

Complete line 8e only if qualified sick leave wages
and/or qualified family leave wages were paid in 2022
for leave taken after March 31, 2020, and before April

1, 2021.

Line 8c. Nonrefundable portion of credit for qualified sick
and family leave wages for leave taken after March 31,
2021, and before October 1, 2021. Enter the nonrefundable
portion of the credit for qualified sick and family leave wages
from Worksheet 4, Step 2, line 2l.

Businesses, tax-exempt organizations with fewer than 500
employees, and Schedule H filers that provide paid sick leave
under the EPSLA and/or provide paid family leave under the
Expanded FMLA are eligible to claim the credit for qualified
sick and family leave wages. The credit for qualified sick and
family leave wages consists of the qualified sick leave wages,
the qualified family leave wages, the qualified health plan expenses allocable to those wages, and the employer share of
Medicare tax allocable to those wages. The refundable portion
of the credit is allowed after the employer share of social security tax is reduced to zero by nonrefundable credits that are applied against the employer share of social security tax.
Line 8f. Refundable portion of credit for qualified sick and
family leave wages for leave taken after March 31, 2021,
and before October 1, 2021. Enter the refundable portion of
the credit for qualified sick and family leave wages from
Worksheet 4, Step 2, line 2m.

Complete line 8c only if qualified sick leave wages
and/or qualified family leave wages were paid in 2022
CAUTION for leave taken after March 31, 2021, and before October 1, 2021.

!

Businesses, tax-exempt organizations with fewer than 500
employees, and Schedule H filers that provide paid sick leave
under the EPSLA, as amended for purposes of the ARP, and/or
provide paid family leave to employees that otherwise meets
the requirements under the Expanded FMLA, as amended for
purposes of the ARP, are eligible to claim the credit for qualified sick and family leave wages for leave taken after March
31, 2021, and before October 1, 2021. The nonrefundable portion of the credit is limited to the employer share of Medicare
tax.
For purposes of this credit, qualified sick leave wages and
qualified family leave wages are wages for social security and
Medicare tax purposes, determined without regard to the exclusions from the definition of employment under sections
3121(b)(1)–(22), that an employer pays that otherwise meet the
requirements of the EPSLA or Expanded FMLA, as enacted
under the FFCRA and amended for purposes of the ARP.
The credit for qualified sick and family leave wages consists
of the:
• Qualified sick leave wages and/or qualified family leave
wages;
• Qualified health plan expenses allocable to qualified sick
and family leave wages;
• Collectively bargained defined benefit pension plan contributions, subject to the qualified leave wage limitations, allocable to the qualified sick and family leave wages;
• Collectively bargained apprenticeship program contributions, subject to the qualified leave wages limitations, allocable
to the qualified sick and family leave wages; and
• Employer share of social security and Medicare tax allocable to the qualified sick and family leave wages.
For more information on the collectively bargained amounts
discussed above, see sections 3131 and 3132.

Complete line 8f only if qualified sick leave wages
and/or qualified family leave wages were paid in 2022
CAUTION for leave taken after March 31, 2021, and before October 1, 2021.

!

Businesses, tax-exempt organizations with fewer than 500
employees, and Schedule H filers are entitled to a credit if they
provide paid sick leave to employees that otherwise meets the
requirements of the EPSLA, as amended for purposes of the
ARP, and/or provide paid family leave to employees that otherwise meets the requirements under the Expanded FMLA, as
amended for purposes of the ARP, for leave taken after March
31, 2021, and before October 1, 2021. The refundable portion
of the credit is allowed after the employer share of Medicare
tax is reduced to zero by nonrefundable credits that are applied
against the employer share of Medicare tax.

Lines 8g Through 8n
The amounts entered on lines 8g through 8n are amounts that
you use on Worksheet 3 and Worksheet 4 at the end of these
instructions to figure certain credits. If you're claiming these
credits, you must enter the applicable amounts.

!

CAUTION

Complete lines 8g and 8h only if qualified sick leave
wages were paid in 2022 for leave taken after March
31, 2020, and before April 1, 2021.

Line 8g. Qualified sick leave wages for leave taken before
April 1, 2021. Enter the qualified taxable (subject to social

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security tax) sick leave wages you paid in 2022 to your employees for leave taken after March 31, 2020, and before April
1, 2021. Qualified sick leave wages for leave taken after March
31, 2020, and before April 1, 2021, aren't subject to the employer share of social security tax; therefore, the tax rate on
these wages is 6.2%. Stop paying social security tax on and entering an employee's wages on line 1a when the employee's
taxable wages, including qualified sick and family leave wages
reported on line 1b, reach $147,000 for the year. See the instructions for line 3, earlier, for reporting Medicare tax on
qualified sick leave wages, including the portion above the social security wage base. This amount is also entered on Worksheet 3, Step 2, line 2a.
Line 8h. Qualified health plan expenses allocable to qualified sick leave wages reported on line 8g. Enter the qualified
health plan expenses allocable to qualified sick leave wages
paid in 2022 for leave taken after March 31, 2020, and before
April 1, 2021. This amount is also entered on Worksheet 3,
Step 2, line 2b.

!

CAUTION

Line 8l. Qualified health plan expenses allocable to qualified sick leave wages reported on line 8k. Enter the qualified
health plan expenses allocable to qualified sick leave wages
paid in 2022 for leave taken after March 31, 2021, and before
October 1, 2021. This amount is also entered on Worksheet 4,
Step 2, line 2b.

!

CAUTION

Line 8m. Qualified family leave wages for leave taken after
March 31, 2021, and before October 1, 2021. Enter the
qualified family leave wages you paid in 2022 to your employees for leave taken after March 31, 2021, and before October 1,
2021, including any qualified family leave wages that were
above the social security wage base and any qualified family
leave wages excluded from the definition of employment under
sections 3121(b)(1)–(22). See the instructions for line 8c, earlier, for more information about qualified family leave wages for
leave taken after March 31, 2021, and before October 1, 2021.
This amount is also entered on Worksheet 4, Step 2, line 2f.
Line 8n. Qualified health plan expenses allocable to qualified family leave wages reported on line 8m. Enter the qualified health plan expenses allocable to qualified family leave
wages paid in 2022 for leave taken after March 31, 2021, and
before October 1, 2021. This amount is also entered on Worksheet 4, Step 2, line 2g.
Line 9. Did you pay total cash wages of $1,000 or more in
any calendar quarter of 2021 or 2022 to all household employees? Review the cash wages you paid to all your household employees for each calendar quarter of 2021 and 2022.
If the total for any quarter in 2021 or 2022 is not $1,000 or
more, check "No," stop here, and include the amount from
line 8d on Schedule 2 (Form 1040), line 9. Include the
amounts, if any, from line 8e on Schedule 3 (Form 1040),
line 13b; and from line 8f on Schedule 3 (Form 1040), line 13h.
If you don't file Form 1040, complete Schedule H, Part IV, and
follow the instructions under When and Where To File, earlier.
If the total for any quarter in 2021 or 2022 is $1,000 or
more, check "Yes" and complete Schedule H, Part II.

Complete lines 8i and 8j only if qualified family leave
wages were paid in 2022 for leave taken after March
31, 2020, and before April 1, 2021.

Line 8i. Qualified family leave wages for leave taken before
April 1, 2021. Enter the qualified taxable (subject to social security tax) family leave wages you paid in 2022 to your employees for leave taken after March 31, 2020, and before April
1, 2021. Qualified family leave wages for leave taken after
March 31, 2020, and before April 1, 2021, aren't subject to the
employer share of social security tax; therefore, the tax rate on
these wages is 6.2%. Stop paying social security tax on and entering an employee's wages on line 1a when the employee's
taxable wages, including qualified sick and family leave wages
reported on line 1b, reach $147,000 for the year. See the instructions for line 3, earlier, for reporting Medicare tax on
qualified family leave wages, including the portion above the
social security wage base. This amount is also entered on
Worksheet 3, Step 2, line 2e.
Line 8j. Qualified health plan expenses allocable to qualified family leave wages reported on line 8i. Enter the qualified health plan expenses allocable to qualified family leave
wages paid in 2022 for leave taken after March 31, 2020, and
before April 1, 2021. This amount is also entered on Worksheet
3, Step 2, line 2f.

!

CAUTION

Complete lines 8m and 8n only if qualified family
leave wages were paid in 2022 for leave taken after
March 31, 2021, and before October 1, 2021.

Part II. Federal Unemployment (FUTA) Tax
Together with state unemployment tax systems, the FUTA tax
provides funds for paying unemployment compensation to
workers who have lost their jobs. Most employers pay both a
federal and a state unemployment tax.

Complete lines 8k and 8l only if qualified sick leave
wages were paid in 2022 for leave taken after March
31, 2021, and before October 1, 2021.

The FUTA tax applies to the first $7,000 you pay to each
employee during a calendar year after subtracting any payments exempt from FUTA tax. The FUTA tax rate is 6.0% for
2022. But see Credit for contributions paid to state next. Only
employers pay FUTA tax. Don't collect or deduct FUTA tax
from your employee's wages. You must pay it from your own
funds.
Credit for contributions paid to state. You may be able to
take a credit of up to 5.4% against the FUTA tax, resulting in a
net FUTA tax rate of 0.6%. But to do so, you must pay all the
required contributions for 2022 to your state unemployment
fund by April 18, 2023. Fiscal year filers must pay all required

Line 8k. Qualified sick leave wages for leave taken after
March 31, 2021, and before October 1, 2021. Enter the
qualified sick leave wages you paid in 2022 to your employees
for leave taken after March 31, 2021, and before October 1,
2021, including any qualified sick leave wages that were above
the social security wage base and any qualified sick leave wages excluded from the definition of employment under sections
3121(b)(1)–(22). See the instructions for line 8c, earlier, for
more information about qualified sick leave wages for leave
taken after March 31, 2021, and before October 1, 2021. This
amount is also entered on Worksheet 4, Step 2, line 2a.

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contributions for 2022 by the due date of their federal income
tax returns (not including extensions).
State unemployment taxes are sometimes called contributions. Contributions are payments that a state requires you, as
an employer, to make to its unemployment fund for the payment of unemployment benefits. However, contributions don't
include:
• Any payments deducted or deductible from your employees' pay;
• Penalties, interest, or special administrative taxes; or
• Voluntary contributions you paid to get a lower state experience rate.
If you paid contributions to any credit reduction state, see
the instructions for line 23, later.
Lines 10 through 12. Answer the questions on lines 10
through 12 to see if you should complete Section A or Section B of Part II.
Fiscal year filers. If you paid all state unemployment contributions for 2022 by the due date of your return (not including extensions), check the “Yes” box on line 11. Check the
“No” box if you didn't pay all of your state contributions by the
due date of your return.
Section A
Line 13. Name of the state where you paid unemployment
contributions. Enter the two-letter abbreviation of the name
of the state (or the District of Columbia, Puerto Rico, or the
U.S. Virgin Islands) to which you paid unemployment contributions. For a list of states and their postal abbreviations, see
State Names and Postal Abbreviations, later.
Line 14. Contributions paid to your state unemployment
fund. Enter the total of contributions (defined earlier) you paid
to your state unemployment fund for 2022. If you didn't have
to make contributions because your state gave you a 0% experience rate, enter “0% rate” on line 14.
Line 15. Total cash wages subject to FUTA tax. Enter the
total of cash wages (see Cash wages, earlier) you paid in 2022
to each household employee, including employees paid less
than $1,000. However, don't include cash wages paid in 2022
to any of the following individuals.
• Your spouse.
• Your child who was under age 21.
• Your parent.
If you paid any household employee more than $7,000 in
2022, include on line 15 only the first $7,000 of that employee's cash wages.
Line 16. FUTA tax. Multiply the wages on line 15 by 0.6%
(0.006). Enter the result on line 16.
Section B

!

Complete lines 17 through 24 only if you checked a
“No” box on line 10, 11, or 12.

allowable if the contributions were paid on or before April 18,
2023.
Line 17. Complete all columns below that apply. Complete
all columns that apply. If you don't, you won't get a credit. If
you need more space, attach a statement using the same format
as line 17. Your state will provide the experience rate. If you
don't know your rate, contact your state unemployment tax
agency.
You must complete columns (a), (b), and (h), even if you
weren't given an experience rate. If you were given an experience rate of 5.4% or higher, you must also complete columns
(c) and (d). If you were given a rate of less than 5.4%, you
must complete all columns.
If you were given a rate for only part of the year, or the rate
changed during the year, you must complete a separate line for
each rate period.
Column (b). Taxable wages. Enter the taxable wages on
which you must pay taxes to the unemployment fund of the
state shown in column (a). If your experience rate is 0%, enter
the amount of wages you would have had to pay taxes on if
that rate hadn't been granted.
Column (h). Contributions paid to state unemployment
fund. Enter the total contributions (defined earlier) you paid
to the state unemployment fund for 2022 by April 18, 2023.
Fiscal year filers, enter the total contributions you paid to the
state unemployment fund for 2022 by the due date of your return (not including extensions). If you’re claiming excess credits as payments of state unemployment contributions, attach a
copy of the letter from your state.
Line 18. Totals. Add the amounts in columns (g) and (h) separately and enter the totals in the spaces provided.
Line 19. Add columns (g) and (h) of line 18. Add the
amounts shown in columns (g) and (h) of line 18. Enter the total on line 19.
Line 20. Total cash wages subject to FUTA tax. Enter the
total cash wages subject to FUTA tax. See the line 15 instructions, earlier, for details.
Line 21. Multiply line 20 by 6.0% (0.06). Multiply the wages
on line 20 by 6.0% (0.06). Enter the result on line 21.
Line 22. Multiply line 20 by 5.4% (0.054). Multiply the wages on line 20 by 5.4% (0.054). Enter the result on line 22.
Line 23. Enter the smaller of line 19 or line 22. Enter the
smaller of line 19 or 22. However, if you paid state unemployment contributions late or you're in a credit reduction state,
don't enter the smaller of line 19 or 22, as discussed next. You
paid state unemployment contributions late if you paid any
state contributions after the due date for filing Form 1040 or
1040-SR (not including extensions). You're in a credit reduction state if you’re a household employer in a state which has
an amount greater than zero in the “Reduction Rate” column of
Worksheet 2.
If you paid state unemployment contributions late, use

TIP Worksheet 1 to figure the amount to enter on line 23.

CAUTION

Credit for 2022. The credit you can take for any state unemployment fund contributions for 2022 that you pay after April
18, 2023, is limited to 90% of the credit that would have been

If you're in a credit reduction state, use Worksheet 2
to figure the amount to enter on line 23. If you paid state contributions late and you're also in a credit reduction state, com-

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Keep for Your Records

Worksheet 1. Credit for Late Contributions
1.

Enter the amount from Schedule H, line 22 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

Enter the amount from Schedule H, line 19 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3.

Subtract line 2 from line 1. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4.

Enter total contributions paid to the state(s) after the Form 1040 or 1040-SR due date . . . . . .

5.

Enter the smaller of line 3 or line 4 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

6.

Multiply line 5 by 90% (0.90) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

7.

Add lines 2 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

8.

Enter the smaller of the amount on line 1 or line 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

9.

Are you in a credit reduction state?
Yes. Enter the amount from line 8 above, on Worksheet 2, line 1. Complete that Worksheet 2 to figure the amount to
enter on Schedule H, line 23.
No. Enter the amount from line 8 on Schedule H, line 23.

State Names and Postal Abbreviations
State

Postal
Abbreviation

State

Postal
Abbreviation

State

Postal
Abbreviation

State

Postal
Abbreviation

Alabama

AL

Indiana

IN

Nevada

NV

Tennessee

TN

Alaska

AK

Iowa

IA

New Hampshire

NH

Texas

TX

Arizona

AZ

Kansas

KS

New Jersey

NJ

Utah

UT

Arkansas

AR

Kentucky

KY

New Mexico

NM

Vermont

VT

California

CA

Louisiana

LA

New York

NY

Virginia

VA

Colorado

CO

Maine

ME

North Carolina

NC

Washington

WA

Connecticut

CT

Maryland

MD

North Dakota

ND

West Virginia

WV

Delaware

DE

Massachusetts

MA

Ohio

OH

Wisconsin

WI

District of Columbia

DC

Michigan

MI

Oklahoma

OK

Wyoming

WY

Florida

FL

Minnesota

MN

Oregon

OR

Puerto Rico

PR

Georgia

GA

Mississippi

MS

Pennsylvania

PA

U.S. Virgin Islands

VI

Hawaii

HI

Missouri

MO

Rhode Island

RI

Idaho

ID

Montana

MT

South Carolina

SC

Illinois

IL

Nebraska

NE

South Dakota

SD

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plete Worksheet 1 before completing Worksheet 2. If you didn't
pay any state unemployment contributions late and you're not
in a credit reduction state, you don't need to complete Worksheet 1 or Worksheet 2.

Part III. Total Household Employment Taxes
Line 25. Enter the amount from line 8d. Enter the amount
from line 8d. If there is no entry on line 8d, enter -0-.
Line 26. Add line 16 (or line 24) and line 25. Add the
amounts on lines 16 and 25. If you were required to complete
Section B of Part II, add the amounts on lines 24 and 25 and
enter the total on line 26.
Line 27. Are you required to file Form 1040? Follow the instructions in the chart.

IF you file
Form. . .

Enter the
amount from
Schedule H,
line 8d, or, if
applicable,
line 26 on...

Enter the
amount, if
any, from
Schedule H,
line 8e, on…

Enter the
amount, if
any, from
Schedule H,
line 8f, on…

1040 or 1040-SR

Schedule 2 (Form Schedule 3
1040), line 9.
(Form 1040),
line 13b.

Schedule 3
(Form 1040),
line 13h.

1040-NR

Schedule 2 (Form Schedule 3
1040), line 9.
(Form 1040),
line 13b.

Schedule 3
(Form 1040),
line 13h.

1040-SS

Form 1040-SS,
Part I, line 4.

Form 1040-SS, Form 1040-SS,
Part I, line 11a. Part I, line 11b.

1041

Form 1041,
Schedule G, Part
I, line 7.

Form 1041,
Schedule G,
Part II, line 17.

funds. If you paid all of your employee's share of social security and Medicare taxes, without deducting the amounts from the
employee's pay, the employee's wages are increased by the
amount of that tax for income tax withholding purposes. However, the tax you paid isn't counted as social security and Medicare wages and isn't included in boxes 3 and 5 of Form W-2.
Also, don't count the tax as wages for FUTA tax purposes. Follow steps 1 through 3 below.
1. Enter the amounts you paid on your employee's behalf
in boxes 4 and 6 (don't include your share of these taxes).
2. Add the amounts in boxes 3, 4, and 6. (However, if
box 5 is greater than box 3, then add the amounts in boxes 4, 5,
and 6.)
3. Include the total in box 1. Also include in box 1 any taxable noncash wages which aren't reported in boxes 3 and 5.
On Form W-3, put an “X” in the “Hshld. emp.” box

TIP located in box b, Kind of Payer.
For information on filing Forms W-2 and W-3 electronically, go to the SSA's Employer W-2 Filing Instructions & Information website at SSA.gov/employer.

You Should Also Know
Estimated Tax Penalty

Form 1041,
Schedule G,
Part II, line 18.

If you don't file any of the above forms, complete Schedule H,
Part IV, and follow the instructions under When and Where To
File, earlier.

Paid Preparers
Paid Preparer Use Only. You must complete this part if you
were paid to prepare Schedule H, and aren't an employee of the
filing entity, and aren't attaching Schedule H to Form 1040,
1040-SR, 1040-NR, 1040-SS, or 1041. You must sign in the
space provided and give the filer a copy of Schedule H in addition to the copy to be filed with the IRS.

Form W-2 and Form W-3
If you file one or more Forms W-2, you must also file Form
W-3. We encourage you to file electronically. If filing electronically via the SSA's Form W-2 Online service, the SSA will
generate Form W-3 data from the electronic submission.
You must report both cash and noncash wages in box 1, as
well as tips and other compensation. For detailed information
on preparing these forms, see the General Instructions for
Forms W-2 and W-3.
Employee's portion of taxes paid by employer. You’re responsible for payment of your employee's share of the taxes as
well as your own. You can either withhold your employee's
share from the employee's wages or pay it from your own

You may need to increase the federal income tax withheld from
your pay, pension, annuity, etc., or make estimated tax payments to avoid an estimated tax penalty based on your household employment taxes shown on Schedule H, line 26. You
may increase your federal income tax withheld by giving your
employer a new Form W-4, or by giving the payer of your pension a new Form W-4P. Make estimated tax payments by filing
Form 1040-ES, Estimated Tax for Individuals. For more information, see Pub. 505.
Estimated tax payments must be made as the tax liability is incurred by April 18, 2022; June 15, 2022;
CAUTION September 15, 2022; and January 17, 2023. If you file
your Form 1040 or 1040-SR by January 31, 2023, and pay the
entire balance due with the form, you don't have to make the
payment due on January 17, 2023.

!

Exception. You won't be penalized for failure to make estimated tax payments if both (1) and (2) below apply for the year.
1. You won't have federal income tax withheld from wages, pensions, or any other payments you receive.
2. Your income taxes, excluding your household employment taxes, wouldn't be enough to require payment of estimated taxes.

What Records To Keep
You must keep copies of Schedule H and related Forms W-2,
W-3, and W-4 for at least 4 years after the due date for filing
Schedule H or the date the taxes were paid, whichever is later.
You must also keep records to support the information you enter on the forms you file. If you must file Form W-2, you will
need to keep a record of each employee's name, address, and

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Keep for Your Records

Worksheet 2. Household Employers in a Credit Reduction State
1. Enter the smaller of the amount from Schedule H, line 19 or line 22. (However, if you completed Worksheet 1,
enter the amount from line 8 of that Worksheet 1.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1.

2. Enter the total taxable FUTA wages from Schedule H, line 20 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2.

3. Place an “X” in the box of EVERY state in which you had to pay state unemployment tax this year. If all of the states you check have a credit
reduction rate of zero, you don't have to complete this Worksheet 2. For each state with a credit reduction rate greater than zero, enter the FUTA
taxable wages, multiply by the reduction rate, and then enter the credit reduction amount. Don't enter your state unemployment wages in the FUTA
Taxable Wages box. Also don't include in the FUTA Taxable Wages box wages that were excluded from state unemployment tax. If any states don't
apply to you, leave them blank.
Postal Abbreviation

FUTA Taxable
Wages

Reduction
Rate

Credit Reduction

Postal Abbreviation

FUTA Taxable
Wages

Reduction
Rate

Credit Reduction

AK

x 0.000

NC

x 0.000

AL

x 0.000

ND

x 0.000

AR

x 0.000

NE

x 0.000

AZ

x 0.000

NH

x 0.000

CA

x 0.003

NJ

x 0.003

CO

x 0.003

NM

x 0.000

CT

x 0.003

NV

x 0.000

DC

x 0.000

NY

x 0.003

DE

x 0.000

OH

x 0.000

FL

x 0.000

OK

x 0.000

GA

x 0.000

OR

x 0.000

HI

x 0.000

PA

x 0.003

IA

x 0.000

RI

x 0.000

ID

x 0.000

SC

x 0.000

IL

x 0.003

SD

x 0.000

IN

x 0.000

TN

x 0.000

KS

x 0.000

TX

x 0.000

KY

x 0.000

UT

x 0.000

LA

x 0.000

VA

x 0.000

MA

x 0.003

VT

x 0.000

MD

x 0.000

WA

x 0.000

ME

x 0.000

WI

x 0.000

MI

x 0.000

WV

x 0.000

MN

x 0.003

WY

x 0.000

MO

x 0.000

PR

x 0.000

MS

x 0.000

VI

x 0.039

MT

x 0.000

4. Total Credit Reduction. Add all amounts shown in the Credit Reduction boxes. Enter the total here . . . . . . . .

4.

5. Subtract line 4 of this Worksheet 2 from line 1 of this Worksheet 2 and enter the result here and on Schedule H,
line 23. If zero or less, enter -0- . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5.

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Worksheet 3. Credit for Qualified Sick and Family Leave Wages Paid in 2022
for Leave Taken After March 31, 2020, and Before April 1, 2021

Keep for Your Records

Determine how you will complete this worksheet.
If you paid qualified sick leave wages and/or qualified family leave wages in 2022 for leave taken after March 31,2020, and before April 1, 2021, complete
Step 1 and Step 2. Caution: Use Worksheet 4 to figure the credit for qualified sick and family leave wages paid in 2022 for leave taken after March 31,
2021, and before October 1, 2021.
Step 1.
Determine the employer share of social security tax this year
1a
Enter the amount of social security tax from Schedule H (Form 1040), Part I, line 2a . . . . . . 1a
1b
Multiply line 1a by 50% (0.50) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b
1c
Enter the amount of social security tax from Schedule H (Form 1040), Part I, line 2b . . . . . . 1c
1d
Employer share of social security tax. Subtract line 1c from line 1b . . . . . . . . . . . . . . . . 1d
Step 2.
Figure the sick and family leave credit
2a
Qualified sick leave wages reported on Schedule H (Form 1040), Part I, line 8g . . . . . . . . . 2a
2a(i)
Qualified sick leave wages included on Schedule H (Form 1040), Part I, line 8g, but not
included on Schedule H (Form 1040), Part I, line 1a, because the wages reported on that line
were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(i)
2a(ii) Total qualified sick leave wages. Add lines 2a and 2a(i) . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(ii)
2a(iii) Qualified sick leave wages excluded from the definition of employment under sections
3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(iii)
2b
Qualified health plan expenses allocable to qualified sick leave wages reported on
Schedule H (Form 1040), Part I, line 8h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
2c
Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 1.45%
(0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
2d
Credit for qualified sick leave wages. Add lines 2a(ii), 2a(iii), 2b, and 2c . . . . . . . . . . . . .
2d
2e
Qualified family leave wages reported on Schedule H (Form 1040), Part I, line 8i . . . . . . . . 2e
2e(i)
Qualified family leave wages included on Schedule H (Form 1040), Part I, line 8i, but not
included on Schedule H (Form 1040), Part I, line 1a, because the wages reported on that line
were limited by the social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e(i)
2e(ii) Total qualified family leave wages. Add lines 2e and 2e(i) . . . . . . . . . . . . . . . . . . . . . . . . 2e(ii)
2e(iii) Qualified family leave wages excluded from the definition of employment under sections
3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e(iii)
2f
Qualified health plan expenses allocable to qualified family leave wages reported on
Schedule H (Form 1040), Part I, line 8j . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f
2g
Employer share of Medicare tax on qualified family leave wages. Multiply line 2e(ii) by
1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g
2h
Credit for qualified family leave wages. Add lines 2e(ii), 2e(iii), 2f, and 2g . . . . . . . . . . .
2h
2i
Credit for qualified sick and family leave wages. Add lines 2d and 2h . . . . . . . . . . . . . .
2i
2j
Nonrefundable portion of credit for qualified sick and family leave wages for leave
taken after March 31, 2020, and before April 1, 2021. Enter the smaller of line 1d or
line 2i. Enter this amount on Schedule H (Form 1040), Part I, line 8b . . . . . . . . . . . . . . . . .
2j
2k
Refundable portion of credit for qualified sick and family leave wages for leave taken
after March 31, 2020, and before April 1, 2021. Subtract line 2j from line 2i and enter this
amount on Schedule H (Form 1040), Part I, line 8e . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2k

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Worksheet 4. Credit for Qualified Sick and Family Leave Wages Paid in 2022
for Leave Taken After March 31, 2021, and Before October 1, 2021

Keep for Your Records

Determine how you will complete this worksheet.
If you paid qualified sick leave wages and/or qualified family leave wages in 2022 for leave taken after March 31, 2021, and before October 1, 2021,
complete Step 1 and Step 2. Caution: Use Worksheet 3 to figure the credit for qualified sick and family leave wages paid in 2022 for leave taken after
March 31, 2020, and before April 1, 2021.
Step 1.
Determine the employer share of Medicare tax
1a
Enter the amount of Medicare tax from Schedule H (Form 1040), Part I, line 4 . . . . . . . . . . 1a
1b
Employer share of Medicare tax. Multiply line 1a by 50% (0.50) . . . . . . . . . . . . . . . . . .
1b
Step 2.
Figure the sick and family leave credit
2a
Qualified sick leave wages reported on Schedule H (Form 1040), Part I, line 8k . . . . . . . . . 2a
2a(i)
Qualified sick leave wages included on Schedule H (Form 1040), Part I, line 8k, that were
not included as wages reported on Schedule H (Form 1040), Part I, lines 3 and 4, because the
qualified sick leave wages were excluded from the definition of employment under sections
3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(i)
2a(ii) Subtract line 2a(i) from line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(ii)
2a(iii) Qualified sick leave wages included on Schedule H (Form 1040), Part I, line 8k, that were
not included as wages reported on Schedule H (Form 1040), Part I, line 1a, because the
qualified sick leave wages were limited by the social security wage base . . . . . . . . . . . . . . 2a(iii)
2a(iv) Subtract line 2a(iii) from line 2a(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2a(iv)
2b
Qualified health plan expenses allocable to qualified sick leave wages reported on
Schedule H (Form 1040), Part I, line 8l . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
2b(i) Amounts under certain collectively bargained agreements allocable to qualified sick leave
wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . . . . . . . . . 2b(i)
2c
Employer share of social security tax on qualified sick leave wages. Multiply line 2a(iv) by
6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
2d
Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 1.45%
(0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2d
2e
Credit for qualified sick leave wages. Add lines 2a, 2b, 2b(i), 2c, and 2d . . . . . . . . . . . . .
2e
2f
Qualified family leave wages reported on Schedule H (From 1040), Part I, line 8m . . . . . . . 2f
2f(i)
Qualified family leave wages included on Schedule H (Form 1040), Part I, line 8m, that were
not included as wages reported on Schedule H (Form 1040), Part I, lines 3 and 4, because the
qualified family leave wages were excluded from the definition of employment under
sections 3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f(i)
2f(ii) Subtract line 2f(i) from line 2f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f(ii)
2f(iii) Qualified family leave wages included on Schedule H (Form 1040), Part I, line 8m, that were
not included as wages reported on Schedule H (Form 1040), Part I, line 1a, because the
qualified family leave wages were limited by the social security wage base . . . . . . . . . . . . 2f(iii)
2f(iv) Subtract line 2f(iii) from line 2f(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f(iv)
2g
Qualified health plan expenses allocable to qualified family leave wages reported on
Schedule H (Form 1040), Part I, line 8n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g
2g(i) Amounts under certain collectively bargained agreements allocable to qualified family leave
wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . . . . . . . . . 2g(i)
2h
Employer share of social security tax on qualified family leave wages. Multiply line 2f(iv) by
6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2h
2i
Employer share of Medicare tax on qualified family leave wages. Multiply line 2f(ii) by
1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2i
2j
Credit for qualified family leave wages. Add lines 2f, 2g, 2g(i), 2h, and 2i . . . . . . . . . . . .
2j
2k
Credit for qualified sick and family leave wages. Add lines 2e and 2j . . . . . . . . . . . . . . .
2k
2l
Nonrefundable portion of credit for qualified sick and family leave wages for leave
taken after March 31, 2021, and before October 1, 2021. Enter the smaller of line 1b or
line 2k. Enter this amount on Schedule H (Form 1040), Part I, line 8c . . . . . . . . . . . . . . . .
2l
2m
Refundable portion of credit for qualified sick and family leave wages for leave taken
after March 31, 2021, and before October 1, 2021. Subtract line 2l from line 2k and enter
this amount on Schedule H (Form 1040), Part I, line 8f . . . . . . . . . . . . . . . . . . . . . . . . . .
2m

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SSN. Each payday, you should record and keep the dates and
amounts of:
• Cash and noncash wage payments,
• Any employee social security tax you withhold or agree
to pay for your employee,
• Any employee Medicare tax you withhold or agree to pay
for your employee,
• Any federal income tax you withhold, and
• Any state employment taxes you withhold.

What Is the Earned Income Credit
(EIC)?

The EIC is a refundable tax credit for certain workers.
Which employees must I notify about the EIC? You must
notify your household employee about the EIC if you agreed to
withhold federal income tax from the employee's wages but
didn't do so because the income tax withholding tables showed
that no tax should be withheld.
You’re encouraged to notify each employee whose

TIP wages for 2022 were less than $53,057 ($59,187 if
married filing jointly) that the employee may be eligible for the EIC for 2022.
How and when must I notify my employees? You must give
the employee one of the following items.
• The official IRS Form W-2, which has the required information about the EIC on the back of Copy B.
• A substitute Form W-2 with the same EIC information on
the back of the employee's copy that is on Copy B of the official IRS Form W-2.
• Notice 797, Possible Federal Tax Refund Due to the
Earned Income Credit (EIC).
• Your written statement with the same wording as Notice
797.
If you’re not required to give the employee a Form W-2,
you must provide the notification by February 7, 2023.
If the notification isn't given on Form W-2 in a timely manner, you must hand the notice directly to the employee or send
it by First-Class Mail to the employee's last known address.
How do my employees claim the EIC? Eligible employees
claim the EIC on their 2022 tax returns.

Rules for Business Employers
Don't use Schedule H if you chose to report employment taxes
for your household employees along with your other employ-

ees on Form 941, Employer's QUARTERLY Federal Tax Return; Form 943, Employer's Annual Federal Tax Return for
Agricultural Employees; or Form 944, Employer's ANNUAL
Federal Tax Return. If you report this way, be sure to include
your household employees' wages on your Form 940, Employer's Annual Federal Unemployment (FUTA) Tax Return.

State Disability Payments
Certain state disability plan payments to household employees
are treated as wages subject to social security and Medicare
taxes. If your employee received payments from a plan that
withheld the employee's share of social security and Medicare
taxes, include the payments on lines 1a, 3, and, if applicable, 5
of Schedule H and complete the rest of Part I through line 7.
Add lines 2c, 4, 6, and 7. From that total, subtract the amount
of these taxes withheld by the state. Enter the result on line 8a.
Also, enter “disability” and the amount subtracted on the dotted
line next to line 8a. See the notice issued by the state for more
details.

How To Correct Schedule H
If you discover an error on a Schedule H that you previously
filed with Form 1040, 1040-SR, 1040-NR, or 1040-SS, file
Form 1040-X, Amended U.S. Individual Income Tax Return,
and attach a corrected Schedule H. If you discover an error on
a Schedule H that you previously filed with Form 1041, file an
“Amended” Form 1041 and attach a corrected Schedule H.
If you discover an error on a Schedule H that you filed as a
stand-alone return, file another stand-alone Schedule H with
the corrected information. In the top margin of your corrected
Schedule H, write (in bold letters) “CORRECTED” followed
by the date you discovered the error.
If you owe tax, pay in full with your Form 1040-X, Form
1041, or stand-alone Schedule H. If you overpaid tax on a previously filed Schedule H, then, depending on whether you adjust or claim a refund, you must certify that you repaid or reimbursed the employee's share of social security and Medicare
taxes, or that you have obtained consents from your employees
to file a claim for refund for the employee tax. See Pub. 926 for
complete instructions.

How To Get Forms and Publications
To get the IRS forms and publications mentioned in these instructions (including Notice 797), go to IRS.gov/Forms.

Privacy Act and Paperwork Reduction Act Notice
We ask for the information on this form to carry out the Internal Revenue laws of the United States. You’re required to give us the
information. We need it to ensure that you’re complying with these laws and to allow us to figure and collect the right amount of
tax. If you don't provide the information we ask for, or provide false or fraudulent information, you may be subject to penalties.
You’re 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 or records relating to a form or instructions must be retained as long as their
contents may become material in the administration of any Internal Revenue law.
Subtitle C, Employment Taxes, of the Internal Revenue Code imposes employment taxes on wages and provides for income tax
withholding. This form is used to determine the amount of the taxes that you owe. Section 6011 requires you to provide the requested information if the tax is applicable to you. Section 6109 requires you to provide your identification number.

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Fileid: … 1040-sch-h/2022/a/xml/cycle04/source

The type and rule above prints on all proofs including departmental reproduction proofs. MUST be removed before printing.

Generally, tax returns and return information are confidential, as required by section 6103. However, section 6103 allows or
requires the IRS to disclose or give the information shown on your tax return to others as described in the Code. For example, we
may disclose your tax information to the Department of Justice for civil and criminal litigation, and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions to administer their tax laws. We may also disclose this information to other
countries under a tax treaty, to federal and state agencies to enforce federal nontax criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism.
The time needed to complete and file this form will vary depending on individual circumstances. The estimated burden for individual taxpayers filing this form is approved under OMB control number 1545-0074 and is included in the estimates shown in the
instructions for their individual income tax return.
The estimated burden for all other taxpayers who file this form is:
Recordkeeping . . . . . . . . . . . . . . . . . . . . . . . .
Learning about the law or the form. . . . . . . . . . . .
Preparing the form . . . . . . . . . . . . . . . . . . . . .
Copying, assembling, and sending the form to the IRS

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

1 hr., 38 min.
39 min.
1 hr., 3 min.
34 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 IRS.gov/FormComments. Or you can send your comments to Internal
Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Don't send
Schedule H (Form 1040) to this address. Instead, see When and Where To File, earlier.

Do You Have To File Form 1040, 1040-SR, 1040-NR, 1040-SS, or 1041?
Yes — Attach Schedule H to that form and mail to the address in your tax return instructions.
No — Mail your completed Schedule H and payment to the address shown below that applies to you. No street address is needed.
See When and Where To File, earlier, for the information to enter on your payment.
IF you live in...

THEN use this address...

Arizona, Florida, Louisiana, Mississippi, New Mexico, Texas

Department of the Treasury
Internal Revenue Service
Austin, TX 73301-0002

Alabama, Arkansas, Connecticut, Delaware, District of Columbia, Georgia,
Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Minnesota,
Missouri, New Hampshire, New Jersey, New York, North Carolina, Oklahoma,
Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia,
West Virginia, Wisconsin

Department of the Treasury
Internal Revenue Service
Kansas City, MO 64999-0002

Alaska, California, Colorado, Hawaii, Idaho, Kansas, Michigan, Montana,
Nebraska, Nevada, North Dakota, Ohio, Oregon, South Dakota, Utah,
Washington, Wyoming

Department of the Treasury
Internal Revenue Service
Ogden, UT 84201-0002

A foreign country, U.S. possession or territory,* or use an APO or FPO address,
or file Form 2555 or 4563, or are a dual-status alien

Department of the Treasury
Internal Revenue Service
Austin, TX 73301-0215

* If you live in American Samoa, Puerto Rico, Guam, the U.S. Virgin Islands, or the Northern Mariana Islands, see Pub. 570.

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