941-X - Adjusted Employer’s QUARTERLY Federal Tax Return or Claim for Refund
Form 941-X is an IRS form used by employers to correct errors on previously filed Form 941, the Employer's Quarterly Federal Tax Return. This form allows employers to make necessary adjustments or changes to the information reported on the original Form 941.
To use the Upload PDF endpoint for this document, you must use a_941_x in the form_type parameter.
Field descriptions
The following fields are available on this form type:
| JSON Attribute | Data Type | Description |
|---|---|---|
a_941_x-General:employerIdentificationNumber | EIN | Employer Identification Number |
a_941_x-General:name(NotYourTradeName) | Text | Name (Not Your Trade Name) |
a_941_x-General:tradeName(IfAny) | Text | Trade Name (If Any) |
a_941_x-General:address:numberAndStreet | Text | Address |
a_941_x-General:address:suiteOrRoomNumber | Text | Address |
a_941_x-General:address:city | Text | Address |
a_941_x-General:address:state | State | Address |
a_941_x-General:address:zipCode | ZIP Code | Address |
a_941_x-General:address:foreignCountryName | Text | Address |
a_941_x-General:address:foreignProvince/County | Text | Address |
a_941_x-General:address:foreignPostalCode | Text | Address |
a_941_x-General:returnYou'ReCorrecting:941 | CHECKED, NOT CHECKED | Return You're Correcting |
a_941_x-General:returnYou'ReCorrecting:941-ss | CHECKED, NOT CHECKED | Return You're Correcting |
a_941_x-General:checkTheOneQuarterYou'ReCorrecting | 1 - JANUARY FEBRUARY MARCH, 2 - APRIL MAY JUNE, 3 - JULY AUGUST SEPTEMBER, 4 - OCTOBER NOVEMBER DECEMBER | Check The One Quarter You're Correcting |
a_941_x-General:enterTheCalendarYearOfTheQuarterYou'ReCorrecting | Integer | Enter The Calendar Year Of The Quarter You're Correcting |
a_941_x-Part1-SelectOnlyOneProcess:selectOnlyOneProcess | 1 - ADJUSTED EMPLOYMENT TAX RETURN, 2 - CLAIM | Select Only One Process |
a_941_x-Part1-SelectOnlyOneProcess:enterTheDateYouDiscoveredErrors | Date | Enter The Date You Discovered Errors |
a_941_x-Part2-CompleteTheCertifications:line3-ICertifyThatI'VeFiledOrWillFileFormsW-2WageAndTaxStatement | CHECKED, NOT CHECKED | Line 3 - I Certify That I've Filed Or Will File Forms W-2 Wage And Tax Statement |
a_941_x-Part2-CompleteTheCertifications:line4-IfYouCheckedLine1BecauseYou'ReAdjustingOverreportedFederalIncomeTax:a-IRepaidOrReimbursedEachAffectedEmployeeForTheOvercollectedFederalIncomeTax | CHECKED, NOT CHECKED | Line 4 - If You Checked Line 1 Because You're Adjusting Overreported Federal Income Tax |
a_941_x-Part2-CompleteTheCertifications:line4-IfYouCheckedLine1BecauseYou'ReAdjustingOverreportedFederalIncomeTax:b-TheAdjustmentsOfSocialSecurityTaxAndMedicareTaxAreForTheEmployer'SShare | CHECKED, NOT CHECKED | Line 4 - If You Checked Line 1 Because You're Adjusting Overreported Federal Income Tax |
a_941_x-Part2-CompleteTheCertifications:line4-IfYouCheckedLine1BecauseYou'ReAdjustingOverreportedFederalIncomeTax:c-TheAdjustmentIsForFederalIncomeTaxSocialSecurityTaxMedicareTax | CHECKED, NOT CHECKED | Line 4 - If You Checked Line 1 Because You're Adjusting Overreported Federal Income Tax |
a_941_x-Part2-CompleteTheCertifications:line5-IfYouCheckedLine2BecauseYou'ReClaimingARefundOrAbatement:a-IRepaidOrReimbursedEachAffectedEmployeeForTheOvercollectedSocialSecurityTax | CHECKED, NOT CHECKED | Line 5 - If You Checked Line 2 Because You're Claiming A Refund Or Abatement |
a_941_x-Part2-CompleteTheCertifications:line5-IfYouCheckedLine2BecauseYou'ReClaimingARefundOrAbatement:b-IHaveAWrittenConsentFromEachAffectedEmployee | CHECKED, NOT CHECKED | Line 5 - If You Checked Line 2 Because You're Claiming A Refund Or Abatement |
a_941_x-Part2-CompleteTheCertifications:line5-IfYouCheckedLine2BecauseYou'ReClaimingARefundOrAbatement:c-TheClaimForSocialSecurityTaxAndMedicareTaxIsForTheEmployer'SShareOnly | CHECKED, NOT CHECKED | Line 5 - If You Checked Line 2 Because You're Claiming A Refund Or Abatement |
a_941_x-Part2-CompleteTheCertifications:line5-IfYouCheckedLine2BecauseYou'ReClaimingARefundOrAbatement:d-TheClaimIsForFederalIncomeTaxSocialSecurityTaxMedicareTax | CHECKED, NOT CHECKED | Line 5 - If You Checked Line 2 Because You're Claiming A Refund Or Abatement |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line6-WagesTipsAndOtherCompensation:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 6 - Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line6-WagesTipsAndOtherCompensation:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 6 - Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line6-WagesTipsAndOtherCompensation:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 6 - Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line7-FederalIncomeTaxWithheldFromWagesTipsAndOtherCompensation:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 7 - Federal Income Tax Withheld From Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line7-FederalIncomeTaxWithheldFromWagesTipsAndOtherCompensation:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 7 - Federal Income Tax Withheld From Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line7-FederalIncomeTaxWithheldFromWagesTipsAndOtherCompensation:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 7 - Federal Income Tax Withheld From Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line7-FederalIncomeTaxWithheldFromWagesTipsAndOtherCompensation:column4-TaxCorrection | Money | Line 7 - Federal Income Tax Withheld From Wages Tips And Other Compensation |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line8-TaxableSocialSecurityWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 8 - Taxable Social Security Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line8-TaxableSocialSecurityWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 8 - Taxable Social Security Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line8-TaxableSocialSecurityWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 8 - Taxable Social Security Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line8-TaxableSocialSecurityWages:column4-TaxCorrection | Money | Line 8 - Taxable Social Security Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line9-QualifiedSickLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 9 - Qualified Sick Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line9-QualifiedSickLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 9 - Qualified Sick Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line9-QualifiedSickLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 9 - Qualified Sick Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line9-QualifiedSickLeaveWages:column4-TaxCorrection | Money | Line 9 - Qualified Sick Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line10-QualifiedFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 10 - Qualified Family Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line10-QualifiedFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 10 - Qualified Family Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line10-QualifiedFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 10 - Qualified Family Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line10-QualifiedFamilyLeaveWages:column4-TaxCorrection | Money | Line 10 - Qualified Family Leave Wages |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line11-TaxableSocialSecurityTips:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 11 - Taxable Social Security Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line11-TaxableSocialSecurityTips:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 11 - Taxable Social Security Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line11-TaxableSocialSecurityTips:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 11 - Taxable Social Security Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line11-TaxableSocialSecurityTips:column4-TaxCorrection | Money | Line 11 - Taxable Social Security Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line12-TaxableMedicareWages&Tips:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 12 - Taxable Medicare Wages & Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line12-TaxableMedicareWages&Tips:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 12 - Taxable Medicare Wages & Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line12-TaxableMedicareWages&Tips:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 12 - Taxable Medicare Wages & Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line12-TaxableMedicareWages&Tips:column4-TaxCorrection | Money | Line 12 - Taxable Medicare Wages & Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line13-TaxableWages&TipsSubjectToAdditionalMedicareTaxWithholding:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 13 - Taxable Wages & Tips Subject To Additional Medicare Tax Withholding |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line13-TaxableWages&TipsSubjectToAdditionalMedicareTaxWithholding:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 13 - Taxable Wages & Tips Subject To Additional Medicare Tax Withholding |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line13-TaxableWages&TipsSubjectToAdditionalMedicareTaxWithholding:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 13 - Taxable Wages & Tips Subject To Additional Medicare Tax Withholding |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line13-TaxableWages&TipsSubjectToAdditionalMedicareTaxWithholding:column4-TaxCorrection | Money | Line 13 - Taxable Wages & Tips Subject To Additional Medicare Tax Withholding |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line14-Section3121(Q)NoticeAndDemand-TaxDueOnUnreportedTips:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 14 - Section 3121(Q) Notice And Demand - Tax Due On Unreported Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line14-Section3121(Q)NoticeAndDemand-TaxDueOnUnreportedTips:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 14 - Section 3121(Q) Notice And Demand - Tax Due On Unreported Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line14-Section3121(Q)NoticeAndDemand-TaxDueOnUnreportedTips:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 14 - Section 3121(Q) Notice And Demand - Tax Due On Unreported Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line14-Section3121(Q)NoticeAndDemand-TaxDueOnUnreportedTips:column4-TaxCorrection | Money | Line 14 - Section 3121(Q) Notice And Demand - Tax Due On Unreported Tips |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line15-TaxAdjustments:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 15 - Tax Adjustments |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line15-TaxAdjustments:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 15 - Tax Adjustments |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line15-TaxAdjustments:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 15 - Tax Adjustments |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line15-TaxAdjustments:column4-TaxCorrection | Money | Line 15 - Tax Adjustments |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line16-QualifiedSmallBusinessPayrollTaxCreditForIncreasingResearchActivities:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 16 - Qualified Small Business Payroll Tax Credit For Increasing Research Activities |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line16-QualifiedSmallBusinessPayrollTaxCreditForIncreasingResearchActivities:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 16 - Qualified Small Business Payroll Tax Credit For Increasing Research Activities |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line16-QualifiedSmallBusinessPayrollTaxCreditForIncreasingResearchActivities:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 16 - Qualified Small Business Payroll Tax Credit For Increasing Research Activities |
a_941_x-Part3-1-EnterTheCorrectionsForThisQuarter:line16-QualifiedSmallBusinessPayrollTaxCreditForIncreasingResearchActivities:column4-TaxCorrection | Money | Line 16 - Qualified Small Business Payroll Tax Credit For Increasing Research Activities |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line17-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 17 - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line17-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 17 - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line17-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 17 - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line17-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection | Money | Line 17 - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18A-NonrefundablePortionOfEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 18A - Nonrefundable Portion Of Employee Retention Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18A-NonrefundablePortionOfEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 18A - Nonrefundable Portion Of Employee Retention Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18A-NonrefundablePortionOfEmployeeRetentionCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 18A - Nonrefundable Portion Of Employee Retention Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18A-NonrefundablePortionOfEmployeeRetentionCredit:column4-TaxCorrection | Money | Line 18A - Nonrefundable Portion Of Employee Retention Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18B-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 18B - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18B-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 18B - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18B-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 18B - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18B-NonrefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection | Money | Line 18B - Nonrefundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18C-NonrefundablePortionOfCobraPremiumAssistanceCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 18C - Nonrefundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18C-NonrefundablePortionOfCobraPremiumAssistanceCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 18C - Nonrefundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18C-NonrefundablePortionOfCobraPremiumAssistanceCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 18C - Nonrefundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18C-NonrefundablePortionOfCobraPremiumAssistanceCredit:column4-TaxCorrection | Money | Line 18C - Nonrefundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18D-NumberOfIndividualsProvidedCobraPremiumAssistance:column1-TotalCorrectedAmount(ForAllEmployees) | Integer | Line 18D - Number Of Individuals Provided Cobra Premium Assistance |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18D-NumberOfIndividualsProvidedCobraPremiumAssistance:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Integer | Line 18D - Number Of Individuals Provided Cobra Premium Assistance |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line18D-NumberOfIndividualsProvidedCobraPremiumAssistance:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Integer | Line 18D - Number Of Individuals Provided Cobra Premium Assistance |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line19-SpecialAdditionToWagesForFederalIncomeTax:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 19 - Special Addition To Wages For Federal Income Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line19-SpecialAdditionToWagesForFederalIncomeTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 19 - Special Addition To Wages For Federal Income Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line19-SpecialAdditionToWagesForFederalIncomeTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 19 - Special Addition To Wages For Federal Income Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line19-SpecialAdditionToWagesForFederalIncomeTax:column4-TaxCorrection | Money | Line 19 - Special Addition To Wages For Federal Income Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line20-SpecialAdditionToWagesForSocialSecurityTaxes:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 20 - Special Addition To Wages For Social Security Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line20-SpecialAdditionToWagesForSocialSecurityTaxes:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 20 - Special Addition To Wages For Social Security Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line20-SpecialAdditionToWagesForSocialSecurityTaxes:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 20 - Special Addition To Wages For Social Security Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line20-SpecialAdditionToWagesForSocialSecurityTaxes:column4-TaxCorrection | Money | Line 20 - Special Addition To Wages For Social Security Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line21-SpecialAdditionToWagesForMedicareTaxes:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 21 - Special Addition To Wages For Medicare Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line21-SpecialAdditionToWagesForMedicareTaxes:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 21 - Special Addition To Wages For Medicare Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line21-SpecialAdditionToWagesForMedicareTaxes:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 21 - Special Addition To Wages For Medicare Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line21-SpecialAdditionToWagesForMedicareTaxes:column4-TaxCorrection | Money | Line 21 - Special Addition To Wages For Medicare Taxes |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 22 - Special Addition To Wages For Additional Medicare Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 22 - Special Addition To Wages For Additional Medicare Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 22 - Special Addition To Wages For Additional Medicare Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column4-TaxCorrection | Money | Line 22 - Special Addition To Wages For Additional Medicare Tax |
a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line23-CombineTheAmountsOnLines7Through22OfColumn4:column4-TaxCorrection | Money | Line 23 - Combine The Amounts On Lines 7 Through 22 Of Column 4 |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 24 - Deferred Amount Of Social Security Tax |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 24 - Deferred Amount Of Social Security Tax |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 24 - Deferred Amount Of Social Security Tax |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column4-TaxCorrection | Money | Line 24 - Deferred Amount Of Social Security Tax |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 25 - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 25 - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 25 - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection | Money | Line 25 - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 26A - Refundable Portion Of Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 26A - Refundable Portion Of Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 26A - Refundable Portion Of Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column4-TaxCorrection | Money | Line 26A - Refundable Portion Of Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 26B - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 26B - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 26B - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection | Money | Line 26B - Refundable Portion Of Credit For Qualified Sick And Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 26C - Refundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 26C - Refundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 26C - Refundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column4-TaxCorrection | Money | Line 26C - Refundable Portion Of Cobra Premium Assistance Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line27-TotalCombineTheAmountsOnLines23Through26COfColumn4:column4-TaxCorrection | Money | Line 27 - Total Combine The Amounts On Lines 23 Through 26C Of Column 4 |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line28-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 28 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line28-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 28 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line28-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 28 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line29-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 29 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line29-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 29 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line29-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 29 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line30-QualifiedWagesForTheEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 30 - Qualified Wages For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line30-QualifiedWagesForTheEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 30 - Qualified Wages For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line30-QualifiedWagesForTheEmployeeRetentionCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 30 - Qualified Wages For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31A-QualifiedHealthPlanExpensesForTheEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 31A - Qualified Health Plan Expenses For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31A-QualifiedHealthPlanExpensesForTheEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 31A - Qualified Health Plan Expenses For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31A-QualifiedHealthPlanExpensesForTheEmployeeRetentionCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 31A - Qualified Health Plan Expenses For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31B-CheckHereIfYou'ReEligibleForTheEmployeeRetentionCredit | CHECKED, NOT CHECKED | Line 31B - Check Here If You're Eligible For The Employee Retention Credit |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 32 - Credit From Form 5884-C Line 11 For This Quarter |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 32 - Credit From Form 5884-C Line 11 For This Quarter |
a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 32 - Credit From Form 5884-C Line 11 For This Quarter |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33A-QualifiedWagesPaidMarch13ThroughMarch312020ForTheEmployeeRetention:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 33A - Qualified Wages Paid March 13 Through March 31 2020 For The Employee Retention |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33A-QualifiedWagesPaidMarch13ThroughMarch312020ForTheEmployeeRetention:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 33A - Qualified Wages Paid March 13 Through March 31 2020 For The Employee Retention |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33A-QualifiedWagesPaidMarch13ThroughMarch312020ForTheEmployeeRetention:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 33A - Qualified Wages Paid March 13 Through March 31 2020 For The Employee Retention |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33B-DeferredAmountOfTheEmployeeShareOfSocialSecurityTax:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 33B - Deferred Amount Of The Employee Share Of Social Security Tax |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33B-DeferredAmountOfTheEmployeeShareOfSocialSecurityTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 33B - Deferred Amount Of The Employee Share Of Social Security Tax |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line33B-DeferredAmountOfTheEmployeeShareOfSocialSecurityTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 33B - Deferred Amount Of The Employee Share Of Social Security Tax |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line34-QualifiedHealthPlanExpensesAllocableToWagesReportedOnForm941Or941-Ss:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 34 - Qualified Health Plan Expenses Allocable To Wages Reported On Form 941 Or 941-SS |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line34-QualifiedHealthPlanExpensesAllocableToWagesReportedOnForm941Or941-Ss:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 34 - Qualified Health Plan Expenses Allocable To Wages Reported On Form 941 Or 941-SS |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line34-QualifiedHealthPlanExpensesAllocableToWagesReportedOnForm941Or941-Ss:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 34 - Qualified Health Plan Expenses Allocable To Wages Reported On Form 941 Or 941-SS |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line35-QualifiedSickLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 35 - Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line35-QualifiedSickLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 35 - Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line35-QualifiedSickLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 35 - Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line36-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 36 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line36-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 36 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line36-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 36 - Qualified Health Plan Expenses Allocable To Qualified Sick Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line37-AmountsUnderCertainCollectivelyBargainedAgreements:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 37 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line37-AmountsUnderCertainCollectivelyBargainedAgreements:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 37 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line37-AmountsUnderCertainCollectivelyBargainedAgreements:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 37 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line38-QualifiedFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 38 - Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line38-QualifiedFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 38 - Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line38-QualifiedFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 38 - Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line39-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 39 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line39-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 39 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line39-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 39 - Qualified Health Plan Expenses Allocable To Qualified Family Leave Wages |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line40-AmountsUnderCertainCollectivelyBargainedAgreements:column1-TotalCorrectedAmount(ForAllEmployees) | Money | Line 40 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line40-AmountsUnderCertainCollectivelyBargainedAgreements:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees) | Money | Line 40 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part3-4-EnterTheCorrectionsForThisQuarter:line40-AmountsUnderCertainCollectivelyBargainedAgreements:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.) | Money | Line 40 - Amounts Under Certain Collectively Bargained Agreements |
a_941_x-Part4-ExplainYourCorrectionsForThisQuarter:line41-CheckHereIfAnyCorrectionsYouEnteredOnALineIncludeBothAmounts | CHECKED, NOT CHECKED | Line 41 - Check Here If Any Corrections You Entered On A Line Include Both Amounts |
a_941_x-Part4-ExplainYourCorrectionsForThisQuarter:line42-CheckHereIfAnyCorrectionsInvolveReclassifiedWorkersExplainOnLine43 | CHECKED, NOT CHECKED | Line 42 - Check Here If Any Corrections Involve Reclassified Workers Explain On Line 43 |
a_941_x-Part4-ExplainYourCorrectionsForThisQuarter:line43-YouMustGiveUsADetailedExplanationOfHowYouDeterminedYourCorrections | Text | Line 43 - You Must Give Us A Detailed Explanation Of How You Determined Your Corrections |
a_941_x-Part5-SignHereYouMustCompleteAllFivePagesOfThisFormAndSignIt:signYourNameHere | SIGNED, NOT SIGNED | Sign Your Name Here |
a_941_x-Part5-SignHereYouMustCompleteAllFivePagesOfThisFormAndSignIt:date | Date | Date |
a_941_x-Part5-SignHereYouMustCompleteAllFivePagesOfThisFormAndSignIt:printYourNameHere | Text | Print Your Name Here |
a_941_x-Part5-SignHereYouMustCompleteAllFivePagesOfThisFormAndSignIt:printYourTitleHere | Text | Print Your Title Here |
a_941_x-Part5-SignHereYouMustCompleteAllFivePagesOfThisFormAndSignIt:bestDaytimePhone | Phone Number | Best Daytime Phone |
a_941_x-Part6-PaidPreparerUseOnly:checkIfYou'ReSelf-Employed | CHECKED, NOT CHECKED | Check If You're Self-Employed |
a_941_x-Part6-PaidPreparerUseOnly:preparer'sName | Text | Preparer's Name |
a_941_x-Part6-PaidPreparerUseOnly:ptin | Text | PTIN |
a_941_x-Part6-PaidPreparerUseOnly:preparer'sSignature | SIGNED, NOT SIGNED | Preparer's Signature |
a_941_x-Part6-PaidPreparerUseOnly:date | Date | Date |
a_941_x-Part6-PaidPreparerUseOnly:firm'sName(OrYoursIfSelf-Employed) | Text | Firm's Name (Or Yours If Self-Employed) |
a_941_x-Part6-PaidPreparerUseOnly:ein | EIN | EIN |
a_941_x-Part6-PaidPreparerUseOnly:phone | Phone Number | Phone |
a_941_x-Part6-PaidPreparerUseOnly:address:addressLine1 | Text | Address |
a_941_x-Part6-PaidPreparerUseOnly:address:addressLine2 | Text | Address |
a_941_x-Part6-PaidPreparerUseOnly:address:city | Text | Address |
a_941_x-Part6-PaidPreparerUseOnly:address:state | State | Address |
a_941_x-Part6-PaidPreparerUseOnly:address:zipCode | ZIP Code | Address |
Sample form
The below Ocrolus sample PDF (input) matches the below sample JSON result (output).
drive.google.comSample JSON result
{
"pk": 40915897,
"uuid": "c1b0cf80-5734-4d20-884c-40e636798326",
"name": "API documentations",
"created": "2023-10-25T17:58:37Z",
"created_ts": "2023-10-25T17:58:37Z",
"verified_pages_count": 35,
"book_status": "ACTIVE",
"id": 40915897,
"forms": [
{
"pk": 50724958,
"uuid": "20d256b1-e456-4782-8578-0718ccc33974",
"uploaded_doc_pk": 61716143,
"form_type": "A_941_X",
"raw_fields": {
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"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31B-CheckHereIfYou'ReEligibleForTheEmployeeRetentionCredit": {
"value": "NOT CHECKED",
"is_empty": false,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line23-CombineTheAmountsOnLines7Through22OfColumn4:column4-TaxCorrection": {
"value": "-8270.54",
"is_empty": false,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column4-TaxCorrection": {
"value": "-61575.71",
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"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column4-TaxCorrection": {
"value": "",
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"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column4-TaxCorrection": {
"value": "",
"is_empty": true,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line27-TotalCombineTheAmountsOnLines23Through26COfColumn4:column4-TaxCorrection": {
"value": "-69846.25",
"is_empty": false,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
"is_empty": true,
"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection": {
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"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column4-TaxCorrection": {
"value": "",
"is_empty": true,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
"is_empty": true,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "61575.71",
"is_empty": false,
"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line30-QualifiedWagesForTheEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees)": {
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"confidence": 1.0
},
"a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column1-TotalCorrectedAmount(ForAllEmployees)": {
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column1-TotalCorrectedAmount(ForAllEmployees)": {
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"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.)": {
"value": "",
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line31A-QualifiedHealthPlanExpensesForTheEmployeeRetentionCredit:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.)": {
"value": "",
"is_empty": true,
"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line24-DeferredAmountOfSocialSecurityTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees)": {
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line25-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
"is_empty": true,
"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.)": {
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"is_empty": false,
"alias_used": null,
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"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26B-RefundablePortionOfCreditForQualifiedSickAndFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
"is_empty": true,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line28-QualifiedHealthPlanExpensesAllocableToQualifiedSickLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees)": {
"value": "",
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},
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"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line29-QualifiedHealthPlanExpensesAllocableToQualifiedFamilyLeaveWages:column1-TotalCorrectedAmount(ForAllEmployees)": {
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"confidence": 1.0
},
"a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.)": {
"value": "",
"is_empty": true,
"alias_used": null,
"source_filename": "941_X.pdf",
"confidence": 1.0
},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26C-RefundablePortionOfCobraPremiumAssistanceCredit:column3-Difference(IfThisAmountIsANegativeNumberUseAMinusSign.)": {
"value": "",
"is_empty": true,
"alias_used": null,
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line32-CreditFromForm5884-CLine11ForThisQuarter:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees)": {
"value": "",
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line26A-RefundablePortionOfEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees)": {
"value": "0.00",
"is_empty": false,
"alias_used": null,
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},
"a_941_x-Part3-3-EnterTheCorrectionsForThisQuarter:line30-QualifiedWagesForTheEmployeeRetentionCredit:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees)": {
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},
"a_941_x-Part3-2-EnterTheCorrectionsForThisQuarter:line22-SpecialAdditionToWagesForAdditionalMedicareTax:column2-AmountOriginallyReportedOrAsPreviouslyCorrected(ForAllEmployees)": {
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Updated 5 months ago