Revenue 

Procedure 

2024-11

Reprinted from IR Bulletin 2024-13

Dated March 25, 2024

Publication 4436

General Rules and 

Specifications for Substitute 

Form 941, Schedule B (Form 

941), Schedule D (Form 941), 

Schedule R (Form 941), and 

Form 8974

IRS

Department of the Treasury

Internal Revenue Service

Publication 4436 (Rev. 03-2024)

Catalog Number 39499P

www.irs.gov
NOTE. This revenue procedure will be reproduced as the next revision of IRS 

Publication 4436, General Rules and Specifications for Substitute Form 941, 

Schedule B (Form 941), Schedule D (Form 941), Schedule R (Form 941), and Form 

8974.

Rev. Proc. 2024-11

TABLE OF CONTENTS

Part 1 – 

Section 1.1 – Purpose ............................................. 1

Section 1.2 – What’s New .......................................... 3

Section 1.3 – Reminders ........................................... 3

Section 1.4 – General Requirements for Reproducing IRS Official Form 941, 

Schedule B, Schedule D, Schedule R, and Form 8974 ............... 3

Section 1.5 – Reproducing Form 941, Schedule B, Schedule D, Schedule R, and 

Form 8974 for Software-Generated Paper Forms .................. 5

Section 1.6 – Specific Instructions for Schedule D .......................... 7

Section 1.7 – Specific Instructions for Schedule R ........................... 7

Section 1.8 – Specific Instructions for Form 8974 ........................... 8

Section 1.9 – Office of Management and Budget (OMB) Requirements for 

Substitute Forms ....................................... 8

Section 1.10 – Order Forms and Instructions .............................. 9

Section 1.11 – Effect on Other Documents ................................ 9

Section 1.12 – Helpful Information .................................... 9

Section 1.13 – Exhibits ........................................... 11
Part 1

Section 1.1 – Purpose

.01 The purpose of Revenue Procedure 2024-11, 2024-13 I.R.B. 721, available 

at IRS.gov/irb/2024-13_IRB#REV-PROC-2024-11, is to provide general rules 

and specifications from the IRS for paper and computer-generated substitutes 

for Form 941, Employer's QUARTERLY Federal Tax Return; Schedule B (Form 

941), Report of Tax Liability for Semiweekly Schedule Depositors (referred to 

in this revenue procedure as “Schedule B”); Schedule D (Form 941), Report of 

Discrepancies Caused by Acquisitions, Statutory Mergers, or Consolidations 

(referred to in this revenue procedure as “Schedule D”); Schedule R (Form 941), 

Allocation Schedule for Aggregate Form 941 Filers (referred to in this revenue 

procedure as “Schedule R”); and Form 8974, Qualified Small Business Payroll 

Tax Credit for Increasing Research Activities.

Caution. Before creating a substitute Form 941, see Pub. 1167, General Rules 

and Specifications for Substitute Forms and Schedules, for additional rules and 

specifications for payment vouchers (Vouchers), printing in margins (Marginal 

Printing), and additional instructions (Additional Instructions for All Forms).

Note. Substitute Spanish-language forms (for example, Form 941 (sp) and 

Schedule B (Form 941) (sp)) should also generally conform to the specifications 

outlined in this revenue procedure. However, some of the measurements 

provided in the exhibits, later, may need to be adjusted for substitute 

Spanish-language forms.

.02 This revenue procedure provides information for substitute Form 941, 

Schedule B, Schedule D, Schedule R, and Form 8974. If you need more 

in-depth information on who must complete these forms and how to complete 

them, see the Instructions for Form 941, the Instructions for Schedule B, the 

Instructions for Schedule D, the Instructions for Schedule R, the Instructions for 

Form 8974, and Pub. 15, Employer's Tax Guide, or go to IRS.gov.

Note. Failure to produce acceptable substitutes of the forms and schedules listed 

in this revenue procedure may result in delays in processing. This may result in 

penalties.

.03 Forms that completely follow the guidelines in this revenue procedure and 

are exact replicas of the official IRS forms do not need to be submitted to the 

IRS for specific approval. Substitute forms and schedules need to be scanned 

using IRS scanning equipment.

If you are uncertain of any specification and want clarification, do the following.

1. Submit a letter citing the specification.

2. State your understanding of the specification.

3. Enclose an example (if appropriate) of how the form would appear if 

produced using your understanding.

1
4. Be sure to include your name, complete address, phone number, and, if 

applicable, your email address with your correspondence. Send your request 

to SCRIPS@IRS.gov or SubstituteForms@IRS.gov, or use the following 

address.

Internal Revenue Service

Attn: Substitute Forms Program

SE:W:CAR:MP:P:TP:TP

ATSC

4800 Buford Highway, Mail Stop 061-N

Chamblee, GA 30341

Note. Allow at least 30 days for the IRS to respond.

.04 However, software developers and form producers should send a blank copy 

of their substitute Form 941, Schedule B, and Schedule R in Portable Document 

Format (PDF) to SCRIPS@IRS.gov. The purpose is not specifically for approval 

but to assist the IRS in preparing to scan these forms. Submitters will only 

receive comments if a significant problem is discovered through this process. 

Submitters are not expected to delay marketing their forms in order to receive 

feedback. Submitters must not include any “live” taxpayer data on any substitute 

form submitted for review.

.05 Form 941, Schedule B, Schedule R, and Form 8974 have a six-digit form ID 

code in the upper right-hand corner. The first two digits of the form ID code 

represent whether the form is an official paper form or a substitute 6x10 grid. 

The third and fourth digits of the form ID code are a unique identifier that is 

subject to change each quarter when changes are made to a page of the form. 

The fifth and six digits of the form ID code generally represent the year in 

which the IRS made major formatting changes to the layout of a page of the 

form. The following six-digit form ID codes, some of which have been updated 

for the first quarter of 2024, are currently used on Form 941, Schedule B, 

Schedule R, and Form 8974.

• Official paper forms: 950124 (Form 941, page 1); 950224 (Form 941, 

page 2); 960311 (Schedule B); 950424 (Schedule R, page 1); 950524 

(Schedule R, page 2); and 951823 (Form 8974).

• Substitute 6x10 grids: 970124 (Form 941, page 1); 970224 (Form 

941, page 2); 970311 (Schedule B); 970424 (Schedule R, page 1); 

970524 (Schedule R, page 2); and 971823 (Form 8974).

You must always use the form ID code provided on the current form for the 

applicable quarter for which you are creating a substitute form, even if this 

revenue procedure is not superseded to reflect a change to a form ID code.

.06 This revenue procedure will be updated only if there are major formatting 

changes to the layout of the forms (that is, changes to the measurements 

provided in the exhibits at the end of this revenue procedure) or there are other 

changes that impact the processing of substitute forms. This revenue procedure 

won’t be updated solely because a line is changed to “Reserved for future use” 

or solely because a form ID code changes without major formatting changes.

2
Section 1.2 – What’s New

.01 Form 941 was revised to delete all lines related to 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. Additionally, all lines that were previously 

“Reserved for future use” have been deleted. Form 941 is now a two-page form 

instead of a three-page form.

.02 The Privacy Act and Paperwork Reduction Act Notice was removed from 

Form 941. The Privacy Act and Paperwork Reduction Act Notice is now in the 

Instructions for Form 941.

.03 Forms 941-SS and 941-PR were discontinued after 2023. Employers in the 

U.S. territories will file Form 941, or if they prefer their form in Spanish, they 

can file new Form 941 (sp).

Section 1.3 – Reminders

.01 Draft forms. Draft forms can be found at IRS.gov/DraftForms.

Section 1.4 – General Requirements for Reproducing IRS Official Form 941, 

Schedule B, Schedule D, Schedule R, and Form 8974

.01 Submit substitute Form 941, Schedule B, Schedule D, Schedule R, and Form 

8974 to the IRS for specifications review. Substitute Form 941, Schedule B, 

Schedule D, Schedule R, and Form 8974 that completely conform to the 

specifications contained in this revenue procedure do not require prior approval 

from the IRS, but should be submitted to SCRIPS@IRS.gov to ensure that they 

conform to IRS format and scanning specifications.

.02 Print the form on standard 8.5-inch wide by 11-inch paper.

.03 Use white paper that meets generally accepted weight, color, and quality 

standards (minimum 20 lb. white bond paper).

Note. Reclaimed fiber in any percentage is permitted provided that the 

requirements of this standard are met.

.04 The IRS prefers printing Form 941 on both sides of a single sheet of paper, 

but it is acceptable to print on one side of each of two separate sheets of paper.

.05 Make the substitute paper form as identical to the official form as possible.

.06 Print the substitute form using nonreflective black (not blue or 

other-colored) ink. Printing in an ink color other than black may reduce 

3
readability in the scanning process. This may result in figures being too faint to 

be recognizable.

.07 Use typefaces that are substantially identical in size and shape to the official 

form and use rules and shading (if used) that are substantially identical to those 

on the official form. Use font size as large as possible within the fields.

.08 In the same location as shown on the official IRS forms, print the six-digit 

form ID code (if one exists on the official form) on each form using 

nonreflective black, carbon-based, 12-point font. The use of non-OCR-A font 

may reduce readability for scanning. Use the official form to develop your 

substitute form.

Note. Maintain as much white space as possible around the form ID code. Do 

not allow character strings to print adjacent to the code.

The following six-digit form ID codes are used on Form 941, Schedule B, 

Schedule R, and Form 8974 for the first quarter of 2024. Print “950124” on 

Form 941, page 1; “950224” on Form 941, page 2; “960311” on Schedule B; 

“950424” on Schedule R, page 1; “950524” on Schedule R, page 2; and 

“951823” on Form 8974. You must always use the form ID code provided on 

the current form for the applicable quarter for which you are creating a 

substitute form, even if this revenue procedure is not superseded to reflect a 

change to a form ID code. See Section 1.5 for information on form ID codes for 

software-generated forms.

.09 Print the OMB number in the same location as on the official form. Be sure 

to include the OMB number on Form 941, Schedule B, Schedule D, Schedule R, 

and Form 8974.

.10 Print all entry boxes and checkboxes exactly as shown (location and size) 

on the official forms.

Note. Instead of a four-sided checkbox for the entry, just the bottom line of the 

box can be used as long as the location and size remain the same.

.11 Print “For Privacy Act and Paperwork Reduction Act Notice, see separate 

instructions.” at the bottom of page 1 of Form 941.

.12 Print “For Paperwork Reduction Act Notice, see separate instructions.” at 

the bottom of Schedule B and Schedule D.

.13 Print “For Paperwork Reduction Act Notice, see the separate instructions.” 

at the bottom of Schedule R.

.14 Print “For Paperwork Reduction Act Notice, see the separate instructions.” 

at the bottom of Form 8974.

.15 Do not print the form catalog number (“Cat. No.”) at the bottom of the 

forms or instructions. Instead, print your IRS-issued three-letter substitute form 

source code in place of the catalog number on the left at the bottom of page 1 of 

Form 941, Schedule B, Schedule D, Schedule R, and Form 8974.

Note. You can obtain a three-letter substitute form source code by requesting it 

by email at SubstituteForms@IRS.gov. Enter "Substitute Forms" on the subject 

line.

4
.16 Do not print the Government Publishing Office (GPO) symbol at the bottom 

of the forms or instructions.

Section 1.5 – Reproducing Form 941, Schedule B, Schedule D, Schedule R, and 

Form 8974 for Software-Generated Paper Forms

.01 You may use the PDF files to develop the layout for your forms. Draft forms 

found at IRS.gov/DraftForms can be used to develop interim formats until the 

forms are finalized. When forms become finalized, they are posted and can be 

found at IRS.gov/Forms. You may use 6x10 grid formats to develop software 

versions of Form 941, Schedule B, Schedule D, Schedule R, and Form 8974. 

Please follow the specifications exactly to develop the fields.

.02 If you are developing software using the 6x10 grid, the following six-digit 

form ID codes are used on Form 941, Schedule B, Schedule R, and Form 8974 

for the first quarter of 2024.

• “970124” for Form 941, page 1; “970224” for Form 941, page 2; 

“970311” for Schedule B; “970424” for Schedule R, page 1; “970524” 

for Schedule R, page 2; and “971823” for Form 8974.

You must always use the form ID code provided on the current form, 

with the first two digits changed to “97” when using a 6x10 grid, for the 

applicable quarter for which you are creating a substitute form, even if this 

revenue procedure is not superseded to reflect a change to a form ID code.

Note. Maintain as much white space as possible around the form ID code. 

Do not allow character strings to print adjacent to the code.

• Place all 6x10 grid boxes and entry spaces in the same field locations 

as indicated on the official forms.

• Use single lines for “Employer Identification Number (EIN)” and other 

entry areas in the entity section of Form 941, pages 1 and 2; 

Schedule B; Schedule R, pages 1 and 2; and Form 8974.

• Reverse type is not needed as shown on the official form.

• Do not pre-print decimal points in the data boxes. However, where the 

amounts are required, the amounts should be printed with decimal 

points and place holders for cents.

• Delete the pre-printed formatting in any “date” boxes.

• Use a single box for “Personal Identification Number (PIN)” on Form 

941.

• You may delete all shading when using the 6x10 grid format.

.03 If producing both the form and the data or the form only, print your 

three-letter source code at the bottom of Form 941, page 1; Schedule B; 

Schedule D; Schedule R, page 1; or Form 8974. See Section 1.4.15.

.04 If producing only the data on the form, print your four-digit software 

industry vendor code on Form 941. The four-digit vendor code preceded by four 

zeros and a slash (0000/9876) must be pre-printed. If you have a valid vendor 

5
code issued to you through the National Association of Computerized Tax 

Processors (NACTP), you should use that code. If you do not have a valid 

vendor code, contact the NACTP via email at president@nactp.org for 

information on these codes.

.05 Print “For Privacy Act and Paperwork Reduction Act Notice, see separate 

instructions.” at the bottom of Form 941, page 1.

.06 Print “For Paperwork Reduction Act Notice, see separate instructions.” at 

the bottom of Schedule B and Schedule D.

.07 Print “For Paperwork Reduction Act Notice, see the separate instructions.” 

at the bottom of Schedule R, page 1.

.08 Print “For Paperwork Reduction Act Notice, see the separate instructions.” 

at the bottom of Form 8974.

.09 Be sure to print the OMB number in the same location as on the official 

forms on substitute Form 941, Schedule B, Schedule D, Schedule R, and Form 

8974.

.10 Do not print the form catalog number (“Cat. No.”) at the bottom of the 

forms or instructions.

.11 Do not print the Government Publishing Office (GPO) symbol at the bottom 

of the forms or instructions.

.12 To ensure accurate scanning and processing, enter data on Form 941, 

Schedule B, Schedule D, Schedule R, and Form 8974 as follows.

• Display/print the name and EIN on all pages and attachments in the 

proper associated fields.

• Use 12-point (minimum 10-point) Courier font (where possible).

• Omit dollar signs. Commas are optional.

• Except for Form 941, lines 1, 2, and 12, leave blank any data field with 

a value of zero. However, employers in American Samoa, Guam, the 

Commonwealth of the Northern Mariana Islands, the U.S. Virgin 

Islands, and Puerto Rico may leave line 2 blank, unless they have 

employees who are subject to U.S. income tax withholding.

• Enter negative amounts with a minus sign. For example, report 

“-10.59” instead of “(10.59).”

Note. The IRS prefers that you use a minus sign for negative amounts 

instead of parentheses or some other means. However, if your software 

only allows for parentheses in reporting negative amounts, you may use 

them.

6
Section 1.6 – Specific Instructions for Schedule D

.01 To properly file and to reduce delays and contact from the IRS, Schedule D 

must be produced as close as possible to the official form.

.02 Use Schedule D to explain why you have certain discrepancies. See the 

Instructions for Schedule D for more information. In many cases, the 

information on Schedule D helps the IRS resolve discrepancies without 

contacting you.

.03 If a substitute Schedule D is not submitted in similar format to the official 

IRS schedule, the substitutes may be returned, you may be contacted by the IRS, 

delays in processing may occur, and you may be subject to penalties.

Section 1.7 – Specific Instructions for Schedule R

.01 To properly file and to reduce delays and contact from the IRS, Schedule R 

and Continuation Sheets for Schedule R must be produced as close as possible 

to the official form.

Note. Do not present the information in spreadsheet or similar format. We may 

not be able to properly process nonconforming documents with an excessive 

number of entries. Complete as many Continuation Sheets for Schedule R 

(Schedule R, page 2) as necessary. If Continuation Sheets are not used or they 

vary in form from the official form, processing may be delayed and you may be 

subject to penalties.

.02 Use Schedule R to allocate the aggregate information reported on Form 941 

to each client. If you have more than 5 clients, complete as many Continuation 

Sheets for Schedule R as necessary. Attach Schedule R, including any 

Continuation Sheets, to your aggregate Form 941 and file it with your return. 

Enter your business information carefully.

Make sure all information exactly matches the information shown on the 

aggregate Form 941. Compare the total of each column on Schedule R, line 9 

(including your information on line 8), to the amounts reported on the aggregate 

Form 941. For each column total of Schedule R, the relevant line from Form 

941 is noted in the column heading. The March 2024 revision of Schedule R 

now has some columns that are used only when Schedule R is attached to Form 

941-X. If the totals on Schedule R, line 9, do not match the totals on Form 941, 

there is an error that must be corrected before submitting Form 941 and 

Schedule R.

.03 Do:

• Develop and submit only conforming Schedules R;

• Follow the format and fields exactly as on the official Schedule R, even 

if this revenue procedure is not superseded to reflect a change in a 

column heading on Schedule R; and

7
• Maintain the same number of entry lines on the substitute Schedule R 

as on the official form.

.04 Do not:

• Add or delete entry lines;

• Submit spreadsheets, database printouts, or similar formatted 

documents instead of using the Schedule R format to report data; and

• Reduce or expand font size to add or delete extra data or lines.

.05 If substitute Schedules R and Continuation Sheets for Schedule R are not 

submitted in similar format to the official schedule, the substitutes may be 

returned, you may be contacted by the IRS, delays in processing may occur, and 

you may be subject to penalties.

Section 1.8 – Specific Instructions for Form 8974

.01 To properly file and to reduce delays and contact from the IRS, Form 8974 

must be produced as close as possible to the official form.

.02 Use Form 8974 only if you are claiming the qualified small business payroll 

tax credit for increasing research activities.

.03 If a substitute Form 8974 is not submitted in similar format to the official 

IRS form, the substitutes may be returned, you may be contacted by the IRS, 

delays in processing may occur, and you may be subject to penalties.

Section 1.9 – Office of Management and Budget (OMB) Requirements for 

Substitute Forms

.01 The Paperwork Reduction Act (the Act) of 1995 (P.L. 104-13) requires the 

following.

• OMB approves all IRS tax forms that are subject to the Act.

• Each IRS form contains the OMB approval number, if assigned. The 

official OMB numbers may be found on the official IRS-printed forms.

• Each IRS form (or its instructions) states:

1. Why the IRS needs the information,

2. How it will be used, and

3. Whether or not the information is required to be furnished to the 

IRS.

.02 This information must be provided to any users of official or substitute IRS 

forms or instructions.

8
.03 The OMB requirements for substitute IRS forms are the following.

• Any substitute form or substitute statement to a recipient must show the 

OMB number as it appears on the official form.

• For Form 941, Schedule B, Schedule D, Schedule R, and Form 8974, 

the OMB number (1545-0029) must appear exactly as shown on the 

official form.

• For Form 941, Schedule B, Schedule D, Schedule R, and Form 8974, 

the OMB number must use one of the following formats.

1. OMB No. 1545-0029 (preferred).

2. OMB # 1545-0029 (acceptable).

.04 If no instructions are provided to users of your forms, you must furnish to 

them the exact text of the Privacy Act and Paperwork Reduction Act Notice.

Section 1.10 – Order Forms and Instructions

.01 You can order forms and instructions at IRS.gov/OrderForms.

Section 1.11 – Effect on Other Documents

.01 Revenue Procedure 2023-13, 2023-13 I.R.B. 581, dated March 27, 2023, is 

superseded.

Section 1.12 – Helpful Information

.01 Please follow the specifications and guidelines to produce substitute Form 

941, Schedule B, Schedule D, Schedule R, and Form 8974.

.02 These forms are subject to review and possible changes, as required. 

Therefore, employers are cautioned against overstocking supplies of privately 

printed substitutes.

.03 Here is a review of references that were listed throughout this document.

• Form 941, Employer’s QUARTERLY Federal Tax Return.

• Schedule B (Form 941), Report of Tax Liability for Semiweekly 

Schedule Depositors (referred to in this revenue procedure as 

“Schedule B”).

9
• Schedule D (Form 941), Report of Discrepancies Caused by 

Acquisitions, Statutory Mergers, or Consolidations (referred to in this 

revenue procedure as “Schedule D”).

• Schedule R (Form 941), Allocation Schedule for Aggregate Form 941 

Filers (referred to in this revenue procedure as “Schedule R”).

• Form 8974, Qualified Small Business Payroll Tax Credit for Increasing 

Research Activities.

• Instructions for Form 941.

• Instructions for Schedule B (Form 941).

• Instructions for Schedule D (Form 941).

• Instructions for Schedule R (Form 941).

• Instructions for Form 8974.

• Pub. 15, Employer’s Tax Guide.

• SCRIPS@IRS.gov for submissions.

• SubstituteForms@IRS.gov for questions.

• For questions:

Internal Revenue Service

Attn: Substitute Forms Program

SE:W:CAR:MP:P:TP:TP

ATSC

4800 Buford Highway, Mail Stop 061-N

Chamblee, GA 30341

• IRS.gov/DraftForms for draft forms.

• IRS.gov/Forms for final forms.

10
Section 1.13 – Exhibits

Exhibit A Form 941 Page 1

Form 941 for 2024:

(Rev. March 2024)

Employer’s QUARTERLY Federal Tax Return

Department of the Treasury — Internal Revenue Service

950124

OMB No. 1545-0029

Employer identification number (EIN) —

Name (not your trade name)

Trade name (if any)

Address

Number Street Suite or room number

City State ZIP code

Foreign country name Foreign province/county Foreign postal code

Report for this Quarter of 2024 

(Check one.)

1: January, February, March

2: April, May, June

3: July, August, September

4: October, November, December

Go to www.irs.gov/Form941 for 

instructions and the latest information.

Read the separate instructions before you complete Form 941. Type or print within the boxes.

Part 1: Answer these questions for this quarter. Employers in American Samoa, Guam, the Commonwealth of the Northern 

Mariana Islands, the U.S. Virgin Islands, and Puerto Rico can skip lines 2 and 3, unless you have employees who are 

subject to U.S. income tax withholding.

1 Number of employees who received wages, tips, or other compensation for the pay period 

including: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 1

2 Wages, tips, and other compensation . . . . . . . . . . . . . . . . . 2 .

3 Federal income tax withheld from wages, tips, and other compensation . . . . . . 3 .

4 If no wages, tips, and other compensation are subject to social security or Medicare tax Check here and go to line 6.

Column 1 Column 2

5a Taxable social security wages . . . × 0.124 = .

5b Taxable social security tips . . . . × 0.124 = .

5c Taxable Medicare wages & tips. . . × 0.029 = .

5d Taxable wages & tips subject to 

Additional Medicare Tax withholding . × 0.009 = .

5e Total social security and Medicare taxes. Add Column 2 from lines 5a, 5b, 5c, and 5d . . . . 5e .

5f Section 3121(q) Notice and Demand—Tax due on unreported tips (see instructions) . . 5f .

6 Total taxes before adjustments. Add lines 3, 5e, and 5f . . . . . . . . . . . . 6 .

7 Current quarter’s adjustment for fractions of cents . . . . . . . . . . . . . 7 .

8 Current quarter’s adjustment for sick pay . . . . . . . . . . . . . . . . 8 .

9 Current quarter’s adjustments for tips and group-term life insurance . . . . . . . 9 .

10 Total taxes after adjustments. Combine lines 6 through 9 . . . . . . . . . . . 10 .

11 Qualified small business payroll tax credit for increasing research activities. Attach Form 8974 11

12 Total taxes after adjustments and nonrefundable credits. Subtract line 11 from line 10 . . 12 .

13 Total deposits for this quarter, including overpayment applied from a prior quarter and 

overpayments applied from Form 941-X, 941-X (PR), or 944-X filed in the current quarter 13 .

14 Balance due. If line 12 is more than line 13, enter the difference and see instructions . . . 14 .

.

15 Overpayment. If line 13 is more than line 12, enter the difference . Check one: Apply to next return. Send a refund.

You MUST complete both pages of Form 941 and SIGN it.

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 17001Z Form 941 (Rev. 3-2024)

.50 in

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2.50 in

1.29 in

7.83 in

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11
Exhibit B Form 941 Page 2

.66 in

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1.90 in .50 in

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1.10 in

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950224

Name (not your trade name) Employer identification number (EIN)

–

Part 2: Tell us about your deposit schedule and tax liability for this quarter.

If you’re unsure about whether you’re a monthly schedule depositor or a semiweekly schedule depositor, see section 11 of Pub. 15.

16 Check one: Line 12 on this return is less than $2,500 or line 12 on the return for the prior quarter was less than $2,500, 

and you didn’t incur a $100,000 next-day deposit obligation during the current quarter. If line 12 for the prior 

quarter was less than $2,500 but line 12 on this return is $100,000 or more, you must provide a record of your 

federal tax liability. If you’re a monthly schedule depositor, complete the deposit schedule below; if you’re a 

semiweekly schedule depositor, attach Schedule B (Form 941). Go to Part 3.

You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total 

liability for the quarter, then go to Part 3.

Tax liability: Month 1 .

Month 2 .

Month 3 .

Total liability for quarter . Total must equal line 12.

You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B (Form 941), 

Report of Tax Liability for Semiweekly Schedule Depositors, and attach it to Form 941. Go to Part 3.

Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank.

17 If your business has closed or you stopped paying wages . . . . . . . . . . . ... . Check here and

enter the nal date you paid wages / / ; also attach a statement to your return. See instructions.

18 If you’re a seasonal employer and you don’t have to file a return for every quarter of the year . . . Check here.

Part 4: May we speak with your third-party designee?

Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions

for details.

Yes. Designee’s name and phone number

Select a 5-digit personal identication number (PIN) to use when talking to the IRS.

No.

Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN it.

Under penalties of perjury, I declare that I have examined this return, 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.

Sign your 

name here

Date / /

Print your 

name here

Print your 

title here

Best daytime phone

Paid Preparer Use Only Check if you’re self-employed . . .

Preparer’s name PTIN

Preparer’s signature Date / /

Firm’s name (or yours 

if self-employed) EIN

Address Phone

City State ZIP code

Page 2 Form 941 (Rev. 3-2024)

12
Exhibit C Form 941-V

.50 in

6.50 in

4.80 in

5.20 in 1.10 in

.60 in 1.80 in .50 in

1.22 in

1.30 in

2.17 in

1.50 in

Form 941-V, 

Payment Voucher

Detach Here and Mail With Your Payment and Form 941.

Form 941-V

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

Don’t staple this voucher or your payment to Form 941.

OMB No. 1545-0029

2024 1 Enter your employer identication 

number (EIN).

–

2

Enter the amount of your payment.

Make your check or money order payable to “United States Treasury.”

Dollars Cents

3 Tax Period

1st 

Quarter

2nd 

Quarter

3rd 

Quarter

4th 

Quarter

4 Enter your business name (individual name if sole proprietor).

Enter your address.

Enter your city, state, and ZIP code; or your city, foreign country name, foreign province/county, and foreign postal code.

13
Schedule B (Form 941):

(Rev. March 2024)

Report of Tax Liability for Semiweekly Schedule Depositors

Department of the Treasury — Internal Revenue Service

960311

OMB No. 1545-0029

Employer identification number 

(EIN) —

Name (not your trade name)

Calendar year (Also check quarter)

Report for this Quarter... 

(Check one.)

1: January, February, March

2: April, May, June

3: July, August, September

4: October, November, December

Use this schedule to show your TAX LIABILITY for the quarter; don’t use it to show your deposits. When you file this schedule with Form 941, 

don’t change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this schedule and attach it to Form 941 

if you’re a semiweekly schedule depositor or became one because your accumulated tax liability on any day was $100,000 or more. Write 

your daily tax liability on the numbered space that corresponds to the date wages were paid. See Section 11 in Pub. 15 for details.

Month 1

1 .

2 .

3 .

4 .

5 .

6 .

7 .

8 .

9 .

10 .

11 .

12 .

13 .

14 .

15 .

16 .

17 .

18 .

19 .

20 .

21 .

22 .

23 .

24 .

25 .

26 .

27 .

28 .

29 .

30 .

31 .

Tax liability for Month 1

.

Month 2

1 .

2 .

3 .

4 .

5 .

6 .

7 .

8 .

9 .

10 .

11 .

12 .

13 .

14 .

15 .

16 .

17 .

18 .

19 .

20 .

21 .

22 .

23 .

24 .

25 .

26 .

27 .

28 .

29 .

30 .

31 .

Tax liability for Month 2

.

Month 3

1 .

2 .

3 .

4 .

5 .

6 .

7 .

8 .

9 .

10 .

11 .

12 .

13 .

14 .

15 .

16 .

17 .

18 .

19 .

20 .

21 .

22 .

23 .

24 .

25 .

26 .

27 .

28 .

29 .

30 .

31 .

Tax liability for Month 3

.

Fill in your total liability for the quarter (Month 1 + Month 2 + Month 3). 

Total must equal line 12 on Form 941. 

Total liability for the quarter

. For Paperwork Reduction Act Notice, 

see separate instructions.

www.irs.gov/Form941 Cat. No. 11967Q Schedule B (Form 941) (Rev. 3-2024)

Exhibit D Schedule B (Form 941)

1.00 in

3.50 in

2.20 in

1.20 in

6.30 in

.50 in

3.27 in

3.50 in

1.80 in

1.33 in

1.57 in

1.58 in

1.41 in

.20 in

.50 in

.50 in

1.20 in

2.50 in

.60 in

.55 in

.20 in

14
Exhibit E Form 941 Schedule D Page 1

Schedule D (Form 941):

Report of Discrepancies Caused by Acquisitions, Statutory Mergers, or Consolidations

(Rev. June 2011) Department of the Treasury—Internal Revenue Service

OMB No. 1545-0029

Employer Identification Number (EIN) —

Name (not your trade name)

Trade name (if any)

Address

Number Street Suite or room number

City State ZIP code

Phone number

Tax Year of Discrepancies (Fill in)

Format: YYYY

Type of Submission (Check one)

Original

Corrected

About this schedule

Each year the Internal Revenue Service (IRS) and the Social Security Administration (SSA) compare the totals on your Forms 941, 

Employer’s QUARTERLY Federal Tax Return, with the totals on Forms W-2, Wage and Tax Statement, to verify that:

• The wages you reported on Forms 941 match those you reported on Forms W-2 (Copy A) so that your 

employees’ social security earnings records are complete for benet purposes; and

• You have paid the appropriate taxes.

Generally, the totals on your Forms W-2 (Copy A) should equal the totals you reported on Forms 941. Use this schedule if discrepancies 

exist between the totals you reported on those forms ONLY as a result of an acquisition, statutory merger, or consolidation. In many cases, 

the information on this schedule should help the IRS resolve discrepancies without contacting you. If you are an eligible employer 

who elects to use the alternate procedure set forth in Rev. Proc. 2004-53, explained in the instructions, you should le this schedule.

Read the separate instructions before you fill out this schedule.

Part 1: Answer these background questions.

1. Are you filing this schedule —

After a statutory merger or consolidation? (See Rev. Rul. 62-60, 1962-1 C.B. 186 and Rev. Proc. 2004-53, 2004-2 C.B. 320.)

You are either: An acquired corporation or

A surviving corporation. OR

After an acquisition and you are using the alternate procedure under Rev. Proc. 2004-53, 2004-2 C.B. 320?

You are either: A predecessor or

A successor.

2. The effective date of the statutory merger/consolidation or acquisition is .........................

MM / DD / YYYY

3. The OTHER PARTY in this transaction is . . .

Other party’s EIN —

Other party’s name

Trade name (if any)

Address

Number Street Suite or room number

City State ZIP code

Phone number Next ■▶

For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 38791Y Schedule D (Form 941) (Rev. 6-2011)

.50 in

2.85 in .75 in

.50 in

4.20 in

3.70 in

3.40 in

2.60 in

2.29 in

.50 in .90 in 2.20 in

1.08 in

.50 in

4.91 in

2.30 in

6.00 in

1.70 in

15
Exhibit F Form 941 Schedule D Page 2

Your EIN —

Name (not your trade name)

Other party’s EIN —

Tax Year of Discrepancies (Fill in)

Format: YYYY

Part 2: Tell us about the discrepancies with your returns.

Column A

Amount you reported to IRS 

for the tax year

Totals from Forms 941 as corrected 

by any Forms 941-X

–

Column B

Amount you reported to SSA 

for the tax year

Totals from Forms W-2 (Copy A) as 

corrected by any Forms W-2c (Copy A)

=

Column C

The difference

4. Social security wages – =

5. Medicare wages and tips – =

6. Social security tips – =

7. Federal income tax 

withheld – =

8. Advance earned income credit 

(EIC) payments (for tax years 

ending before January 1, 2011)

– =

If you are ling for one transaction only, STOP here. If you are ling for more than one transaction, go to Part 3.

Part 3: Fill this part out ONLY if you are filing more than one Schedule D (Form 941) for any calendar year.

9. File one Schedule D (Form 941) for each separate transaction. This is schedule of . (Example: This is schedule 1 of 3.)

Column A

Amount you reported to IRS 

for the tax year for the 

employees affected by the 

transaction reported on this 

Schedule D (Form 941)

Totals from Forms 941 as corrected 

by any Forms 941-X

–

Column B

Amount you reported to SSA 

for the tax year for the 

employees affected by the 

transaction reported on this 

Schedule D (Form 941)

Totals from Forms W-2 (Copy A) as 

corrected by any Forms W-2c (Copy A)

=

Column C

The difference

10. Social security wages – =

11. Medicare wages and tips – =

12. Social security tips – =

13. Federal income tax 

withheld – =

14. Advance earned income credit 

(EIC) payments (for tax years 

ending before January 1, 2011)

– =

Page 2 Schedule D (Form 941) (Rev. 6-2011)

.50 in

2.86 in .50 in

3.60 in

1.51 in

7.09 in

5.80 in

.80 in

2.20 in

1.80 in

.20 in

.50 in

.70 in

16
Schedule R (Form 941): Allocation Schedule for Aggregate Form 941 Filers

9200- 5451. o N B MO eci vr eS euneveRl anr et nI —yr usaer T eht f ot ne mtr ape D ) 4202 hcr a M. veR(

950424 Employer identification number (EIN)

—

Name as shown on Form 941

Type of filer (check one): Section 3504 Agent CPEO Other Third Party

Report for calendar year:

Check the quarter (same as Form 941):

1: January, February, March

2: April, May, June3: July, August, September

4: October, November, December

This Schedule R is attached to:

Form 941Form 941-X 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 (e) Form 941, line 3 (f) Form 941-X, lines 9 

and 10, column 1, total

(g) Form 941, lines 5a 

and 5b, column 2, total 

(h) Form 941, line 5c, 

column 2

(i) Form 941, line 5e

1 . . . . . .

2 . . . . . .

3 . . . . . .

4 . . . . . .

5 . . . . . .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 (k) Form 941, line 11 (l) Form 941-X, lines 17 

and 25, column 1, total

(m) Reserved for 

future use

(n) Form 941-X, lines 18b 

and 26b, column 1, total

(o) Form 941-X, lines 18c 

and 26c, column 1, total

(p) Form 941-X, line 18d, 

column 1

(q) Form 941, line 12

1 . . . . . . .

2 . . . . . . .

3 . . . . . . .

4 . . . . . . .

5 . . . . . . .

6 . . . . . . .

7 . . . . . . .

8 . . . . . . .

9 . . . . . . .

(r) Form 941, line 13 (s) Reserved for 

future use

(t) Reserved for 

future use

(u) Form 941-X, lines 28 

and 29, column 1, total

(v) Reserved for 

future use

(w) Form 941-X, lines 35 

and 37, column 1, total

(x) Form 941-X, lines 36 

and 39, column 1, total

(y) Form 941-X, lines 38 

and 40, column 1, total

1 . . . . . . .

2 . . . . . . .

3 . . . . . . .

4 . . . . . . .

5 . . . . . . .

6 . . . . . . .7 . . . . . . .8 . . . . . . .

9 . . . . . . .

For Paperwork Reduction Act Notice, see the separate instructions. www.irs.gov/Form941 Cat. No. 49301K Schedule R (Form 941) (Rev. 3-2024)

.80 in

Exhibit G Must Be in Landscape Form 941 Schedule R Page 1 2.10 in .50 in 5.70 in 3.25 in 3.90 in .50 in

1.66 in

.50 in

1.40 in

1.16 in

.16 in

.90 in

1.00 in

.33 in

1.24in

1.10 in

.70 in

.50 in

.40 in

.90 in .40 in

1.50 in

.80 in

.91 in

1.20 in

1.40 in

.80 in .40 in

.40 in

1.20 in

17
Exhibit H Must Be in Landscape Form 941 Schedule R Page 2 .50 in Page of Continuation Sheet for Schedule R (Form 941) (Rev. March 2024)

950524 Employer identification number (EIN)

—

Name as shown on Form 941

Type of filer (check one): Section 3504 Agent CPEO Other Third Party

Report for calendar year:

Check the quarter (same as Form 941):

1: January, February, March

2: April, May, June3: July, August, September

4: October, November, December

This Schedule R is attached to:

Form 941Form 941-X

(a) Client’s EIN (b) Type of wages 

(CPEO only)

(c) Form 941, line 1 (d) Form 941, line 2 (e) Form 941, line 3 (f) Form 941-X, lines 9 

and 10, column 1, total

(g) Form 941, lines 5a 

and 5b, column 2, total

(h) Form 941, line 5c, 

column 2

(i) Form 941, line 5e

1 . . . . . .

2 . . . . . .

3 . . . . . .

4 . . . . . .5 . . . . . .

6 . . . . . .

7 . . . . . .8 . . . . . .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 (k) Form 941, line 11 (l) Form 941-X, lines 17 

and 25, column 1, total

(m) Reserved for 

future use

(n) Form 941-X, lines 18b 

and 26b, column 1, total

(o) Form 941-X, lines 18c 

and 26c, column 1, total

(p) Form 941-X, line 18d, 

column 1

(q) Form 941, line 12

1 . . . . . . .2 . . . . . . .3 . . . . . . .4 . . . . . . .

5 . . . . . . .

6 . . . . . . .

7 . . . . . . .

8 . . . . . . .

9 . . . . . . .

(r) Form 941, line 13 (s) Reserved for 

future use

(t) Reserved for 

future use

(u) Form 941-X, lines 28 

and 29, column 1, total

(v) Reserved for 

future use

(w) Form 941-X, lines 35 

and 37, column 1, total

(x) Form 941-X, lines 36 

and 39, column 1, total

(y) Form 941-X, lines 38 

and 40, column 1, total

1 . . . . . . .

2 . . . . . . .

3 . . . . . . .

4 . . . . . . .

5 . . . . . . .6 . . . . . . .7 . . . . . . .8 . . . . . . .

9 . . . . . . .

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

18
Exhibit I Form 8974

3.60 in

3.27 in

.50 in

.50 in 1.50 in

.90 in

1.20 in

1.80 in

6.10 in

2.10 in

.70 in 1.20 in .80 in 1.10 in

.30 in

1.10 in

3.70 in

.42 in

1.83 in

2.42 in

7.25 in

.18 in

.83 in

.92 in

.25 in

.21 in

1.42 in

.17 in

1.10 in

.50 in

5.70 in

.39 in

1.28 in

5.00 in

.20 in

1.25in .20 in

1.25 in

2.66 in 2.83 in

2.85 in

.04 in

Form 8974:

(Rev. December 2023)

Qualified Small Business Payroll Tax Credit for Increasing Research Activities

Department of the Treasury — Internal Revenue Service OMB No. 1545-0029

951823

Employer identification 

number (EIN) —

Name 

(not your trade name)

The credit from Part 2, line 12 or, if applicable, 

line 17, will be reported on (check only one box): Form 941 (all 941 series)

Form 943 (all 943 series)

Form 944 (all 944 series)

Calendar year You must select a quarter if you le Form 941.

Report for this quarter...

Check only one box.

1: January, February, March

2: April, May, June

3: July, August, September

4: October, November, December

Part 1: Tell us about your income tax return.

(a) 

Ending date of 

income tax period

(b) 

Income 

tax return 

led that 

included 

Form 6765

(c) 

Date income tax 

return was led

(d) 

EIN used on 

Form 6765

(e) 

Amount from 

Form 6765, line 44 

or, if applicable, 

the amount that was 

allocated to your EIN 

(f) 

Amount of credit 

from column (e) 

taken on a 

previous period(s) 

(g) 

Remaining credit 

(subtract column (f) 

from column (e)) 

1 / / / / . . .

2 / / / / . . .

3 / / / / . . .

4 / / / / . . .

5 / / / / . . .

6 Add lines 1(g) through 5(g) and enter the total here . . . . . . . . . . . . . . . . . . . Part 2: Determine the credit that you can use this period.

7 Enter the amount from Part 1, line 6(g) . . . . . . . . . . . . . . . . 7 . 8 Enter the amount from Form 941, line 5a, column 2; 

Form 943, line 3; or Form 944, line 4a, column 2 . . 8 .

9 Enter the amount from Form 941, line 5b, column 2; or 

Form 944, line 4b, column 2 . . . . . . . . . 9 .

10 Add lines 8 and 9 . . . . . . . . . . . . 10 .

11 Multiply line 10 by 50% (0.50). Check this box if you’re a third-party payer of sick pay or

check this box if you received a Section 3121(q) Notice and Demand. See the instructions

before completing line 11 . . . . . . . . . . . . . . . . . . . . . . 11 . 12 Credit against the employer share of social security tax. Enter the smaller of line 7 or 

11, but not more than $250,000. See the instructions before entering an amount if you le

Form 943 or Form 944. If you entered the amount from line 7, stop here and also enter this

amount on Form 941, line 11a; Form 943, line 12a; or Form 944, line 8a . . . . . . 12 .

13 Subtract line 12 from line 7 . . . . . . . . . 13 . 14 Enter the amount from Form 941, line 5c, column 2; 

Form 943, line 5; or Form 944, line 4c, column 2 . . 14 .

15 Multiply line 14 by 50% (0.50). If you’re a third-party payer 

of sick pay or you received a Section 3121(q) Notice and

Demand, see the instructions before completing line 15 15 .

16 Credit against the employer share of Medicare tax. Enter the smaller of line 13 or 15 . 16 .

17 Total credit. Add lines 12 and 16. Also, enter this amount on Form 941, line 11a; Form 943, 

line 12a; or Form 944, line 8a . . . . . . . . . . . . . . . . . . . . . 17 . For Paperwork Reduction Act Notice, see the separate instructions. www.irs.gov/Form8974 Cat. No. 37797C Form 8974 (Rev. 12-2023)

19