943 X Adjusted Employer's Annual Federal Tax Return for Agricu

Note: The draft you are looking for begins on the next page.

Caution: DRAFT—NOT FOR FILING

This is an early release draft of an IRS tax form, instructions, or publication,
which the IRS is providing for your information. Do not file draft forms and do
not rely on draft forms, instructions, and pubs for filing. We incorporate all
significant changes to forms posted with this coversheet. However, unexpected
issues occasionally arise, or legislation is passed—in this case, we will post a
new draft of the form to alert users that changes were made to the previously
posted draft. Thus, there are never any changes to the last posted draft of a
form and the final revision of the form. Forms and instructions are subject to
OMB approval before they can be officially released, so we post drafts of them
until they are approved. Drafts of instructions and pubs usually have some
additional changes before their final release. Early release drafts are at
IRS.gov/DraftForms and remain there after the final release is posted at
IRS.gov/LatestForms. Also see IRS.gov/Forms.
Most forms and publications have a page on IRS.gov: IRS.gov/Form1040 for
Form 1040; IRS.gov/Pub501 for Pub. 501; IRS.gov/W4 for Form W-4; and
IRS.gov/ScheduleA for Schedule A (Form 1040), for example, and similarly for
other forms, pubs, and schedules for Form 1040. When typing in a link, type it
into the address bar of your browser, not a Search box on IRS.gov.
If you wish, you can submit comments to the IRS about draft or final forms,
instructions, or pubs at IRS.gov/FormsComments. Include “NTF” followed by the
form or pub number (for example, “NTF1040”, “NTFW4”, “NTF501, etc.) in the
body of the message to route your message properly. We cannot respond to all
comments due to the high volume we receive and may not be able to consider
many suggestions until the subsequent revision of the product, but we will
review each “NTF” message. If you have comments on reducing paperwork and
respondent (filer) burden, with respect to draft or final forms, please respond to
the relevant information collection through the Federal Register process; for
more info, click here.

Form

943-X:

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

(Rev. February 2024)
Employer identification number
(EIN)

OMB No. 1545-0035

Return You’re Correcting...

—

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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
Name (not your trade name)

(YYYY)

Trade name (if any)
Address

Number

Street

Suite or room number

City

Foreign country name

State

Foreign province/county

ZIP code

Enter the date you discovered errors:

/
/
(MM / DD / YYYY)

Foreign postal code

Read the separate instructions before completing this form. Use this form to correct errors you made on Form 943, Employer’s Annual Federal
Tax Return for Agricultural Employees. Use a separate Form 943-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 943 unless you’re reclassifying workers; see the instructions for line 40.

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 25, if less than zero, may only be applied as
a credit to your Form 943 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 25. 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 943-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 they haven’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 they haven’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 they haven’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 they haven’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 they haven’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/Form943X

Cat. No. 20332F

Form 943-X (Rev. 2-2024)

Name (not your trade name)

Correcting Calendar Year (YYYY)

Employer identification number (EIN)

–

Part 3: Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank.
Column 1
Total corrected amount —
(for ALL employees)

Column 2

Column 3

Column 4

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

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

Tax correction

=

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
6.

Wages subject to social
security tax (Form 943, line 2)

.

—

=

.

× 0.124* =

.

.

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

7.

Qualified sick leave wages*
(Form 943, line 2a)

.

—

=

.

× 0.062 =

.

.

* Use line 7 only for qualified sick leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

8.

Qualified family leave wages*
(Form 943, line 2b)

.

—

=

.

× 0.062 =

.

.

* Use line 8 only for qualified family leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

9.

Wages subject to Medicare
tax (Form 943, line 4)

.

—

=

.

× 0.029* =

.

.

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

10.

Wages subject to Additional
Medicare Tax withholding
(Form 943, line 6)

.

—

=

.

× 0.009* =

.

.

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

11.

Federal income tax withheld
(Form 943, line 8)

.

—

.

=

.

Copy Column
3 here

.

12.

Tax adjustments (Form 943,
line 10)

.

—

.

=

.

See
instructions

.

13.

Qualified small business
payroll tax credit for
increasing research activities
(Form 943, line 12a; you must
attach Form 8974)

.

—

.

=

.

See
instructions

.

14.

Nonrefundable portion of
credit for qualified sick and
family leave wages for leave
taken before April 1, 2021
(Form 943, line 12b)

.

—

.

=

.

See
instructions

.

15a.

Nonrefundable portion of
employee retention credit*
(Form 943, line 12c)

.

—

.

=

.

See
instructions

.

* Line 15a can only be used if correcting a 2020 or 2021 Form 943.

15b.

Nonrefundable portion of
credit for qualified sick and
family leave wages for leave
taken after March 31, 2021,
and before October 1, 2021
(Form 943, line 12d)

15c.

Nonrefundable portion of
COBRA premium assistance
credit (Form 943, line 12e)

15d.

Number of individuals
provided COBRA premium
assistance (Form 943, line 12f)

16.

Special addition to wages for
federal income tax

.

—

.

17.

Special addition to wages for
social security taxes

.

—

18.

Special addition to wages for
Medicare taxes

.

19.

Special addition to wages for
Additional Medicare Tax

.

20.

Subtotal. Combine the amounts on lines 6 through 19 of Column 4 .

Page 2

.

—

.

=

.

See
instructions

.

.

—

.

=

.

See
instructions

.

=

.

See
instructions

.

.

=

.

See
instructions

.

—

.

=

.

See
instructions

.

—

.

=

.

See
instructions

.

=

—

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

.

Form 943-X (Rev. 2-2024)

Name (not your trade name)

Employer identification number (EIN)

Correcting Calendar Year (YYYY)

–

Part 3: Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank. (continued)
Column 1
Total corrected amount —
(for ALL employees)

Column 2

Column 3

Column 4

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

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

Tax correction

=

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
21.

22.

Deferred amount of the
employer share of social
security tax* (Form 943, line 14b)
Deferred amount of the
employee share of social
security tax* (Form 943, line 14c)

23.

Refundable portion of credit
for qualified sick and family
leave wages for leave taken
before April 1, 2021 (Form 943,
line 14d)

24a.

Refundable portion of
employee retention credit*
(Form 943, line 14e)

.

—

.

=

.

See
instructions

.

.

=

.

See
instructions

.

* Line 21 can only be used if correcting a 2020 Form 943.

.

—

* Line 22 can only be used if correcting a 2020 Form 943.

.

—

.

=

.

See
instructions

.

.

—

.

=

.

See
instructions

.

* Line 24a can only be used if correcting a 2020 or 2021 Form 943.

24b.

Refundable portion of credit
for qualified sick and family
leave wages for leave taken
after March 31, 2021, and
before October 1, 2021 (Form
943, line 14f)

24c.

Refundable portion of COBRA
premium assistance credit
(Form 943, line 14g)

25.

Total. Combine the amounts on lines 20 through 24c of Column 4 . . . . . . . . . . . . . . . .
If line 25 is less than zero:
• If you checked line 1, this is the amount you want applied as a credit to your Form 943 for the tax period in which
you’re filing this form.

.

—

.

=

.

See
instructions

.

.

—

.

=

.

See
instructions

.

.

• If you checked line 2, this is the amount you want refunded or abated.

If line 25 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.

26.

Qualified health plan
expenses allocable to
qualified sick leave wages for
leave taken before April 1,
2021 (Form 943, line 18)

27.

Qualified health plan
expenses allocable to
qualified family leave wages
for leave taken before April 1,
2021 (Form 943, line 19)

28.

Qualified wages for the
employee retention credit*
(Form 943, line 20)

29.

30.

Page 3

Qualified health plan
expenses for the employee
retention credit* (Form 943,
line 21)
Credit from Form 5884-C, line
11, for the year* (Form 943,
line 22)

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

=

.

=

.

* Line 28 can only be used if correcting a 2020 or 2021 Form 943.

.

—

.

* Line 29 can only be used if correcting a 2020 or 2021 Form 943.

.

—

.

* Line 30 can only be used if correcting a 2020 Form 943.

Form 943-X (Rev. 2-2024)

Name (not your trade name)

Employer identification number (EIN)

Correcting Calendar Year (YYYY)

–

Part 3: 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)

Column 3

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

=

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

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
Caution: Lines 31–38 don’t apply to years beginning before January 1, 2021.

31.

Qualified sick leave wages for
leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 22)

32.

Qualified health plan
expenses allocable to
qualified sick leave wages for
leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 23)

33.

Amounts under certain
collectively bargained
agreements allocable to
qualified sick leave wages for
leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 24)

34.

Qualified family leave wages
for leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 25)

35.

Qualified health plan
expenses allocable to
qualified family leave wages
for leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 26)

36.

Amounts under certain
collectively bargained
agreements allocable to
qualified family leave wages
for leave taken after March 31,
2021, and before October 1,
2021 (Form 943, line 27)

37.

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 943, lines 12c and 14e
(or, if corrected, Form 943-X,
lines 15a and 24a), for the
third quarter of 2021* (Form
943, line 28)

38.

Page 4

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 943, lines 12c and 14e
(or, if corrected, Form 943-X,
lines 15a and 24a), for the
fourth quarter of 2021* (Form
943, line 29)

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

.

—

.

=

.

.

=

.

* Line 37 can only be used if correcting a 2021 Form 943.

.

—

* Line 38 can only be used if correcting a 2021 Form 943.

Form 943-X (Rev. 2-2024)

Name (not your trade name)

Correcting Calendar Year (YYYY)

Employer identification number (EIN)

–

Part 4: Explain your corrections for the calendar year you’re correcting.
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 41.

39.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
40.

Check here if any corrections involve reclassified workers. Explain on line 41.

41.

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

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 943 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
/

/

Paid Preparer Use Only

Best daytime phone
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 943-X (Rev. 2-2024)

Form 943-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.

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 25 by the time you file Form 943-X.

Overreported
tax amounts
ONLY

The process you
use depends on
when you file
Form 943-X.

TREASURY/IRS
AND OMB USE
ONLY DRAFT
December 14, 2023
DO NOT FILE
If you’re filing Form 943-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 943 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 25 credited to your Form
943 for the period in which you file Form 943-X.
Check the box on line 1.
OR
Choose the claim process if you want the
amount shown on line 25 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 943-X.

If you’re filing Form 943-X
WITHIN 90 days of the expiration
of the period of limitations on
credit or refund for Form 943...

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

If you’re filing Form 943-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 943 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 943.
• File one Form 943-X, and
• Check the box on line 1 and follow the
instructions on line 25.
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
943-X to correct the underreported tax amounts.
Check the box on line 1. Pay the amount you
owe from line 25 by the time you file Form 943-X.
2. For the claim process, file a second Form
943-X to correct the overreported tax amounts.
Check the box on line 2.
If you’re filing Form 943-X
WITHIN 90 days of the expiration
of the period of limitations on
credit or refund for Form 943...

You must use both the adjustment process
and the claim process.
File two separate forms.
1. For the adjustment process, file one Form
943-X to correct the underreported tax amounts.
Check the box on line 1. Pay the amount you
owe from line 25 by the time you file Form 943-X.
2. For the claim process, file a second Form
943-X to correct the overreported tax amounts.
Check the box on line 2.

Page 6

Form 943-X (Rev. 2-2024)