941 SCH R Allocation Schedule for Aggregrate Form 941 Filers

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Allocation Schedule for Aggregate Form 941 Filers

(Rev. March 2024)

Department of the Treasury — Internal Revenue Service

Employer identification number (EIN)

Report for calendar year:

OMB No. 1545-0029

Check the quarter (same as Form 941):

—

1: January, February, March

Name as shown on Form 941

Section 3504 Agent

CPEO

Other Third Party

Read the instructions before you complete Schedule R. Type or print within the boxes. Complete a separate line for the amounts
allocated to each of your clients. The term “client” as used on this form includes the term “customer.” See the instructions.
(a) Client’s EIN

(b) Type of wages
(CPEO only)

(c) Form 941, line 1

(d) Form 941, line 2

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6 Subtotals for clients. Add lines 1 through 5
7 Enter the combined subtotal from line 9 of
all Continuation Sheets for Schedule R

8 Enter Form 941 amounts for your employees
9 Totals. Add lines 6, 7, and 8.
(j) Form 941, line 5f

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(r) Form 941, line 13

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9

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This Schedule R is
attached to:

2: April, May, June

Type of filer (check one):

(k) Form 941, line 11

(l) Form 941-X, lines 17
and 25, column 1, total

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(s) Reserved for
future use

950424

TREASURY/IRS
AND OMB USE
ONLY DRAFT
October 26, 2023
DO NOT FILE

Schedule R (Form 941):

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(t) Reserved for
future use

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For Paperwork Reduction Act Notice, see the separate instructions.

(e) Form 941, line 3

3: July, August, September

Form 941

4: October, November, December

Form 941-X

(f) Form 941-X, lines 9 (g) Form 941, lines 5a (h) Form 941, line 5c,
and 10, column 1, total and 5b, column 2, total
column 2

(i) Form 941, line 5e

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(m) Reserved for
future use

(n) Form 941-X, lines 18b (o) Form 941-X, lines 18c (p) Form 941-X, line 18d,
and 26b, column 1, total and 26c, column 1, total
column 1

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(u) Form 941-X, lines 28
and 29, column 1, total

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(v) Reserved for
future use

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www.irs.gov/Form941

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(q) Form 941, line 12

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(w) Form 941-X, lines 35 (x) Form 941-X, lines 36 (y) Form 941-X, lines 38
and 37, column 1, total and 39, column 1, total and 40, column 1, total

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Cat. No. 49301K

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Schedule R (Form 941) (Rev. 3-2024)

Page

of

(Rev. March 2024)

Employer identification number (EIN)

Report for calendar year:

Check the quarter (same as Form 941):

—

1: January, February, March

Name as shown on Form 941
Type of filer (check one):

(a) Client’s EIN

(b) Type of wages
(CPEO only)

CPEO

(c) Form 941, line 1

Other Third Party

(d) Form 941, line 2

(e) Form 941, line 3

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This Schedule R is
attached to:

2: April, May, June

Section 3504 Agent

950524

TREASURY/IRS
AND OMB USE
ONLY DRAFT
October 26, 2023
DO NOT FILE

Continuation Sheet for Schedule R (Form 941)

3: July, August, September

Form 941

4: October, November, December

Form 941-X

(f) Form 941-X, lines 9 (g) Form 941, lines 5a (h) Form 941, line 5c,
and 10, column 1, total and 5b, column 2, total
column 2

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(i) Form 941, line 5e

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9 Subtotals for clients. Add lines 1 through 8.
Include the subtotals from this line on
Schedule R, Page 1, line 7.

(j) Form 941, line 5f

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9

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(r) Form 941, line 13

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(k) Form 941, line 11

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(s) Reserved for
future use

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(l) Form 941-X, lines 17
and 25, column 1, total

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(t) Reserved for
future use

(m) Reserved for
future use

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(u) Form 941-X, lines 28
and 29, column 1, total

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(n) Form 941-X, lines 18b (o) Form 941-X, lines 18c (p) Form 941-X, line 18d,
and 26b, column 1, total and 26c, column 1, total
column 1

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(v) Reserved for
future use

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(q) Form 941, line 12

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(w) Form 941-X, lines 35 (x) Form 941-X, lines 36 (y) Form 941-X, lines 38
and 37, column 1, total and 39, column 1, total and 40, column 1, total

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Schedule R (Form 941) (Rev. 3-2024)