Instructions for Form 943-X

(Rev. February 2015)

Adjusted Employer's Annual Federal Tax Return for Agricultural Employees or 

Claim for Refund

Department of the Treasury

Internal Revenue Service

Section references are to the Internal Revenue Code unless 

otherwise noted.

Future Developments

For the latest information about developments related to 

Form 943-X and its instructions, such as legislation enacted 

after they were published, go to www.irs.gov/form943x.

What's New

Employee consents to support a claim for refund. 

Notice 2015-15 provides guidance to employers on the 

requirements for employee consents used by an employer to 

support a claim for refund of overcollected social security tax 

and Medicare tax. The notice and proposed revenue 

procedure clarifies the basic requirements for a request for a 

consent and for the employee consent itself, and permits a 

consent to be requested, furnished, and retained in an 

electronic format as an alternative to a paper format. The 

notice also requests comments and contains guidance 

concerning what constitutes “reasonable efforts” if a consent 

is not secured to permit the employer to claim a refund of the 

employer share of overcollected social security tax and 

Medicare tax. For more information, see Notice 2015-15, 

2015-9 I.R.B. 687, available at www.irs.gov/irb/2015–9_IRB/

ar07.html.

Claiming the COBRA premium assistance credit. The 

COBRA premium assistance credit was available to an 

employer for premiums paid on behalf of employees who 

were involuntarily terminated from employment between 

September 1, 2008, and May 31, 2010. The COBRA 

premium assistance credit is not available for individuals who 

were involuntarily terminated after May 31, 2010. Therefore, 

only in rare circumstances, such as instances where COBRA 

eligibility was delayed as a result of employer provided health 

insurance coverage following termination, will the credit be 

available. If you are eligible to claim the credit, use Form 

943-X, lines 16a and 16b. Form 943-X should be filed after 

filing your Form 943. Filing a Form 943-X before filing a Form 

943 may result in errors or delays in processing your Form 

943-X. For more information, visit IRS.gov and enter 

"COBRA" in the search box.

If you are entitled to claim the COBRA premium 

assistance credit, but are not otherwise required to 

file Form 943, file a Form 943 with -0- entered on 

line 15 before filing a Form 943-X to claim the credit.

Period of limitations to make certain corrections expired. Generally, you may correct overreported taxes on a 

previously filed Form 943 if you file Form 943-X within 3 

years of the date Form 943 was filed or 2 years from the date 

you paid the tax reported on Form 943, whichever is later. 

For purposes of the period of limitations, Form 943 is 

considered filed on April 15 of the succeeding year if filed 

before that date.

The period of limitations to correct the qualified employer's 

tax exemption on wages paid to qualified employees; the 

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qualified employer's tax credit on wages paid to qualified 

employees March 19–31, 2010; and advance earned income 

credit (EIC) payments expired on April 15, 2014, for most 

employers. The lines formerly used for these corrections 

were removed from Form 943-X. If the period of limitations 

for any of these corrections is still open, you will need to file 

the February 2014 revision of Form 943-X. The February 

2014 revision of Form 943-X is available on IRS.gov.

Retroactive increase in excludible transit benefits. The 

Tax Increase Prevention Act of 2014 increased the monthly 

transit benefit exclusion from $130 per participating 

employee to $250 per participating employee for the period 

of January 1, 2014, through December 31, 2014. Employers 

were provided instructions on how to correct the social 

security and Medicare taxes on the excess transit benefits in 

Notice 2015-2, 2015-4 I.R.B. 334, available at www.irs.gov/

irb/2015-4_IRB/ar06.html.

Reminders

Correcting Additional Medicare Tax withholding. 

Beginning in 2013, wages subject to Additional Medicare Tax 

withholding are reported on Form 943, line 6, and the 

withholding is reported on line 7. Any errors discovered on a 

previously filed Form 943 are corrected on Form 943-X, 

line 8. For more information about Additional Medicare Tax 

withholding, see the Instructions for Form 943 and go to 

IRS.gov and enter "Additional Medicare Tax" in the search 

box. See the instructions for line 8, later, for more information 

on the types of errors that can be corrected and how the 

correction is reported on Form 943-X.

Social security tax rate for 2011 and 2012. In 2011 and 

2012, the employee social security tax rate was 4.2% and the 

employer social security tax rate was 6.2% (10.4% total). Be 

sure to use the correct rate when reporting corrections on 

line 6.

Correcting the COBRA premium assistance credit. For 

tax periods ending before January 1, 2014, employers who 

made COBRA premium assistance payments for assistance 

eligible individuals were allowed a credit on their Form 943. 

Any errors discovered on a previously filed Form 943 for this 

credit are corrected on Form 943-X, lines 16a and 16b. 

Effective for tax periods beginning after December 31, 2013, 

Form 943-X is used to both report the total COBRA premium 

assistance credit an employer is entitled to claim and correct 

any previously reported credit. For more information, see the 

instructions for lines 16a and 16b, later.

Mar 02, 2015 Cat. No. 20333Q
General Instructions:

Understanding Form 943-X

What Is the Purpose of Form 943-X?

For tax periods beginning after December 31, 2013, 

Form 943 will no longer be used to claim the credit 

for COBRA premium assistance payments. Instead 

use Form 943-X. For more information, see the instructions 

for lines 16a and 16b, later.

Use Form 943-X to correct errors on a previously filed 

Form 943. Use Form 943-X to correct:

Income tax withheld from wages,

Taxable social security wages,

Taxable Medicare wages,

Total wages subject to Additional Medicare Tax 

withholding, and

Credits for COBRA premium assistance payments.

Use Form 843, Claim for Refund and Request for 

Abatement, to request a refund or abatement of assessed 

interest or penalties. Do not request a refund or abatement 

of assessed interest or penalties on Form 943 or Form 

943-X.

We use the terms “correct” and “corrections” on 

Form 943-X and in these instructions to include 

interest-free adjustments under sections 6205 and 

6413 and claims for refund and abatement under sections 

6402, 6414, and 6404. See Rev. Rul. 2009-39 for examples 

of how the interest-free adjustment and claim for refund rules 

apply in 10 different situations. You can find Rev. Rul. 

2009-39, 2009-52 I.R.B. 951, at www.irs.gov/irb/

2009-52_IRB/ar14.html.

When you discover an error on a previously filed Form 

943, you must:

Correct that error using Form 943-X,

File a separate Form 943-X for each Form 943 that you are 

correcting, and

File Form 943-X separately. Do not file Form 943-X with 

Form 943.

If you did not file a Form 943 for one or more years, do 

not use Form 943-X. Instead, file Form 943 for each of those 

years. See also When Should You File Form 943-X, later. 

However, if you did not file Forms 943 because you 

improperly treated workers as independent contractors or 

nonemployees and are now reclassifying them as 

employees, see the instructions for line 19, later.

Report the correction of underreported and overreported 

amounts for the same year on a single Form 943-X, unless 

you are requesting a refund or abatement. If you are 

requesting a refund or abatement and you are correcting 

both underreported and overrreported amounts, file one 

Form 943-X correcting the underreported amounts only and 

a second Form 943-X correcting the overreported amounts.

You will use the adjustment process if you underreported 

employment taxes and are making a payment, or if you 

overreported employment taxes and will be applying the 

credit to Form 943 for the period during which you file Form 

943-X. However, see the Caution under Is There a Deadline 

for Filing Form 943-X, later, if you are correcting overreported 

amounts during the last 90 days of a period of limitations. 

You will use the claim process if you overreported 

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employment taxes and are requesting a refund or abatement 

of the overreported amount. Follow the chart on the back of 

Form 943-X for help in choosing whether to use the 

adjustment process or the claim process. Be sure to give us 

a detailed explanation on line 20 for each correction that you 

show on Form 943-X.

Continue to report current year adjustments for fractions of 

cents, third-party sick pay, and group-term life insurance on 

Form 943, line 10.

You have additional requirements to complete when filing 

Form 943-X, such as certifying that you filed (or will file) all 

applicable Forms W-2, Wage and Tax Statement, and Forms 

W-2c, Corrected Wage and Tax Statement. For corrections 

of overreported federal income tax, social security tax, or 

Medicare tax, you must make any certifications that apply to 

your situation.

Do not use Form 943-X to correct Form CT-1, 941, 

941-SS, 944, or 945. Instead, use the “X” form that 

corresponds to those forms (Form CT-1 X, 941-X, 

944-X, or 945-X).

Where Can You Get Help?

For help filing Form 943-X or for questions about federal 

employment taxes and tax corrections, you can:

Visit the IRS website at www.irs.gov/businesses and click 

on the Employment Taxes link under Businesses Topics,

See Pub. 51 (Circular A), Agricultural Employer's Tax 

Guide, or

Call the IRS Business and Specialty Tax Line toll free at 

1-800-829-4933 or 1-800-829-4059 (TDD/TTY for persons 

who are deaf, hard of hearing, or have a speech disability) 

Monday–Friday from 7:00 a.m.– 7:00 p.m. local time (Alaska 

and Hawaii follow Pacific time).

See also How Can You Order Forms, Instructions, and 

Publications from the IRS, later.

When Should You File Form 943-X?

File Form 943-X when you discover an error on a previously 

filed Form 943.

However, if your only errors on Form 943 relate to the 

number of employees (Form 943, line 1) or to federal tax 

liabilities reported on your Monthly Summary of Federal Tax 

Liability on Form 943 or on Form 943-A, Agricultural 

Employer's Record of Federal Tax Liability, do not file Form 

943-X. For more information about correcting federal tax 

liabilities reported on your Monthly Summary of Federal Tax 

Liability on Form 943 or on Form 943-A, see the Form 943-A 

instructions.

Due dates. The due date for filing Form 943-X depends on 

when you discover an error and if you underreported or 

overreported tax. If you underreported tax, see 

Underreported tax, later. For overreported amounts, you may 

choose to either make an interest-free adjustment or file a 

claim for refund or abatement. If you are correcting 

overreported amounts, see Overreported tax—adjustment 

process and Overreported tax—claim process, later.

If any due date falls on a Saturday, Sunday, or legal 

holiday, you may file Form 943-X on the next business day. If 

we receive Form 943-X after the due date, we will treat Form 

943-X as filed on time if the envelope containing Form 943-X 

is properly addressed, contains sufficient postage, and is 

postmarked by the U.S. Postal Service on or before the due 

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-2- Instructions for Form 943-X (Rev. 2-2015)
date, or sent by an IRS-designated private delivery service 

on or before the due date. If you do not follow these 

guidelines, we will consider Form 943-X filed when it is 

actually received. See Pub. 51 (Circular A) for more 

information on legal holidays and IRS-designated private 

delivery services.

Underreported tax. If you are correcting underreported tax, 

you must file Form 943-X by the due date of the return for the 

return period in which you discovered the error (January 31 

of the following year) and pay the amount you owe by the 

time you file. Doing so will generally ensure that your 

correction is interest free and not subject to failure-to-pay or 

failure-to-deposit (FTD) penalties. See What About Penalties 

and Interest, later. For details on how to make a payment, 

see the instructions for line 17, later.

If Form 943-X is filed late (after the due date of the return 

for the return period in which you discovered the error), you 

must attach an amended Form 943-A to Form 943-X. 

Otherwise, the IRS may assess an “averaged” FTD penalty. 

The total tax reported on Form 943-A, line M, must match the 

corrected tax (Form 943, line 11 (line 9 for calendar years 

2011 and 2012), combined with any correction reported on 

Form 943-X, line 15) for the year, less any previous 

abatements and interest-free tax assessments.

Example—You owe tax. On February 11, 2014, you 

discovered that you underreported $1,000 of social security 

and Medicare wages on your 2013 Form 943. File Form 

943-X and pay the amount you owe by February 2, 2015, 

because you discovered the error in 2014 and February 2, 

2015, is the due date for that year. If you file Form 943-X 

before February 2, 2015, pay the amount you owe when you 

file.

Form 943-X cannot be used to correct 

underreported amounts of Additional Medicare Tax 

unless the amounts were withheld from employee 

wages.

Overreported tax—adjustment process. If you 

overreported tax and choose to apply the credit to Form 943, 

file an adjusted return on Form 943-X soon after you discover 

the error but more than 90 days before the period of 

limitations on the credit or refund for Form 943 expires. See 

Is There a Deadline for Filing Form 943-X, later.

Form 943-X cannot be used to correct overreported 

amounts of Additional Medicare Tax unless the 

amounts were not withheld from employee wages.

Example—You want your credit applied to Form 943. 

You filed your 2014 Form 943 on February 2, 2015, and 

payments were timely made. On May 1, 2015, you discover 

that you overreported tax on your 2014 Form 943. You file 

Form 943-X on June 2, 2015. The IRS treats your credit as a 

tax deposit made on January 1, 2015. When you file your 

2015 Form 943, include the amount from Form 943-X, 

line 17, on the “Total deposits” line of your 2015 Form 943.

If you reduced your deposits by the amount of the 

COBRA premium assistance credit that will be 

reflected on your Form 943-X, do not use the 

adjustment process to claim the COBRA premium assistance 

credit. Use the claim process. See the instructions for lines 

16a and 16b, later.

Overreported tax—claim process. If you overreported tax 

on Form 943, you may choose to file a claim for refund or 

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abatement on Form 943-X any time before the period of 

limitations on the credit or refund expires. If you also need to 

correct any underreported amounts, you must file another 

Form 943-X reporting only corrections to the underreported 

amounts. See Is There a Deadline for Filing Form 943-X, 

later.

You may not file a refund claim to correct federal 

income tax or Additional Medicare Tax actually 

withheld from employees.

Is There a Deadline for Filing Form 

943-X?

Generally, you may correct overreported taxes on a 

previously filed Form 943 if you file Form 943-X within 3 

years of the date Form 943 was filed or 2 years from the date 

you paid the tax reported on Form 943, whichever is later. 

You may correct underreported taxes on a previously filed 

Form 943 if you file Form 943-X within 3 years of the date the 

Form 943 was filed. We call each of these time frames a 

“period of limitations.” For purposes of the period of 

limitations, Form 943 is considered filed on April 15 of the 

succeeding calendar year if filed before that date.

Example. You filed your 2012 Form 943 on January 25, 

2013, and payments were timely made. The IRS treats the 

return as if it were filed on April 15, 2013. On January 22, 

2016, you discovered that you overreported social security 

and Medicare wages on that form by $10,000. To correct the 

error, you must file Form 943-X by April 18, 2016, which is 

the end of the period of limitations, and use the claim 

process.

If you file Form 943-X to correct overreported 

amounts in the last 90 days of a period of limitations, 

you must use the claim process. You cannot use the 

adjustment process. If you are also correcting underreported 

amounts, you must file another Form 943-X to correct the 

underreported amounts using the adjustment process and 

pay any tax due.

Where Should You File Form 943-X?

Send your completed Form 943-X to the address shown 

below.

IF you are in . . . THEN use this address . . .

Connecticut, Delaware, District of 

Columbia, Florida, Georgia, Illinois, 

Indiana, Kentucky, Maine, 

Maryland, Massachusetts, 

Michigan, New Hampshire, New 

Jersey, New York, North Carolina, 

Ohio, Pennsylvania, Rhode Island, 

South Carolina, Tennessee, 

Vermont, Virginia, West Virginia, 

Wisconsin

Department of the Treasury

Internal Revenue Service 

Cincinnati, OH 45999-0008

Alabama, Alaska, Arizona, 

Arkansas, California, Colorado, 

Hawaii, Idaho, Iowa, Kansas, 

Louisiana, Minnesota, Mississippi, 

Missouri, Montana, Nebraska, 

Nevada, New Mexico, North 

Dakota, Oklahoma, Oregon, South 

Dakota, Texas, Utah, Washington, 

Wyoming

Department of the Treasury

Internal Revenue Service 

Ogden, UT 84201-0008

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Instructions for Form 943-X (Rev. 2-2015) -3-
IF you are in . . . THEN use this address . . .

No legal residence or principal place 

of business in any state

Internal Revenue Service 

P.O. Box 409101 

Ogden, UT 84409

Special filing addresses for 

exempt organizations; federal, state, 

and local governmental entities; and 

Indian tribal governmental entities; 

regardless of location

Department of the Treasury 

Internal Revenue Service 

Ogden, UT 84201-0008

How Should You Complete Form 

943-X?

Use a Separate Form 943-X for Each Year You 

Are Correcting

Use a separate Form 943-X for each Form 943 that you are 

correcting. For example, if you found errors on your Forms 

943 for 2013 and 2014, file one Form 943-X to correct the 

2013 Form 943. File a second Form 943-X to correct the 

2014 Form 943.

EIN, Name, and Address

Enter your EIN, name, and address in the spaces provided. 

Also enter your name and EIN on the top of pages 2 and 3, 

and on any attachments. If your address has changed since 

you filed your Form 943, enter the corrected information and 

the IRS will update your address of record. Be sure to write 

your name, EIN, “Form 943-X,” and the calendar year you are 

correcting on the top of any attachments.

Return You Are Correcting

Enter the calendar year of the Form 943 you are correcting in 

the box at the top of page 1. Enter the calendar year on 

pages 2 and 3, and on any attachments. Be sure to write your 

name, EIN, “Form 943-X,” and the calendar year you are 

correcting on the top of any attachments.

Enter the Date You Discovered Errors

You must enter the date you discovered errors. You discover 

an error when you have enough information to be able to 

correct it. If you are reporting several errors that you 

discovered at different times, enter the earliest date you 

discovered them here. Report any subsequent dates and 

related errors on line 20.

Must You Make an Entry on Each Line?

You must provide all of the information requested at the top 

of page 1 of Form 943-X. You must check one box (but not 

both) in Part 1. In Part 2, you must check the box on line 3 

and any applicable boxes on lines 4 and 5. In Part 3, if any 

line does not apply, leave it blank. Complete Parts 4 and 5 as 

instructed.

How Should You Report Negative Amounts?

Form 943-X uses negative numbers to show reductions in tax 

(credits) and positive numbers to show additional tax 

(amounts you owe).

When reporting a negative amount in columns 3 and 4, 

use a minus sign instead of parentheses. For example, enter 

“–10.59” instead of “(10.59).” However, if you are completing 

the return on your computer and your software only allows 

you to use parentheses to report negative amounts, you may 

use them.

How Should You Make Entries on Form 943-X?

You can help the IRS process Form 943-X timely and 

accurately if you follow these guidelines.

Type or print your entries.

Use Courier font (if possible) for all typed or 

computer-generated entries.

Omit dollar signs. You may use commas and decimal 

points, if desired. Enter dollar amounts to the left of any 

preprinted decimal point and cents to the right of it.

Always show an amount for cents. Do not round entries to 

whole dollars.

Complete all three pages and sign Form 943-X on page 3.

Staple multiple sheets in the upper-left corner.

What About Penalties and Interest?

Generally, your correction of an underreported amount will 

not be subject to a failure-to-pay penalty, FTD penalty, or 

interest if you:

File on time (by the due date of Form 943 for the year in 

which you discover the error),

Pay the amount shown on line 17 by the time you file 

Form 943-X,

Enter the date you discovered the error, and

Explain in detail the grounds and facts relied on to support 

the correction.

No correction will be eligible for interest-free treatment if 

any of the following apply.

The amounts underreported relate to an issue that was 

raised in an examination of a prior period.

You knowingly underreported your employment tax 

liability.

You received a notice and demand for payment.

You received a Notice of Determination of Worker 

Classification.

If you receive a notice about a penalty after you file this 

return, reply to the notice with an explanation and we will 

determine if you meet reasonable-cause criteria. Do not 

attach an explanation when you file your return.

Overview of the Process

The process to correct a previously filed Form 943 or to file a 

claim is outlined below.

If you underreported the tax. If you underreported the 

tax on a previously filed Form 943, check the box on line 1 

and pay any additional amount you owe by the time you file 

Form 943-X. For details on how to make a payment, see the 

instructions for line 17, later.

Example—You underreported employment taxes. On 

June 20, 2014, you discovered an error that results in 

additional tax on your 2013 Form 943. File Form 943-X by 

February 2, 2015, and pay the amount you owe by the time 

you file. See When Should You File Form 943-X, earlier. Do 

not attach Form 943-X to your 2014 Form 943.

If you overreported the tax. If you overreported the tax 

on a previously filed Form 943, you may choose one of the 

following options.

Use the adjustment process. Check the box on line 1 to 

apply any credit (negative amount) from line 17 to Form 943 

for the year during which you file Form 943-X.

-4- Instructions for Form 943-X (Rev. 2-2015)
Use the claim process. Check the box on line 2 to file a 

claim on Form 943-X requesting a refund or abatement of the 

amount shown on line 17.

To ensure that the IRS has enough time to process a 

credit for an overreporting adjustment in the year 

during which you file Form 943-X, you are 

encouraged to file Form 943-X correcting the overreported 

amount in the first 11 months of a year. For example, if you 

discover an overreported amount in December, you may 

want to file Form 943-X during the first 11 months of the next 

year. This should ensure that the IRS will have enough time 

to process Form 943-X so the credit will be posted before 

you file Form 943, thus avoiding an erroneous balance due 

notice from the IRS. See the example below.

Example—You want your overreported tax applied as 

a credit to Form 943. On December 18, 2015, you discover 

you overreported your tax on your 2014 Form 943 and want 

to make a correction using the adjustment process. To allow 

the IRS enough time to process the credit, you file Form 

943-X on January 4, 2016, and take the credit on your 2016 

Form 943.

Specific Instructions:

Part 1: Select ONLY One Process

Because Form 943-X may be used to file either an adjusted 

employment tax return or a claim for refund or abatement, 

you must check one box on either line 1 or line 2. Do not 

check both boxes.

1. Adjusted Employment Tax Return

Check the box on line 1 if you are correcting underreported 

amounts or overreported amounts and you would like to use 

the adjustment process to correct the errors.

If you are correcting both underreported amounts and 

overreported amounts on this form, you must check this box. 

If you check this box, any negative amount shown on line 17 

will be applied as a credit (tax deposit) to your Form 943 for 

the year in which you are filing this form. See Example—You 

want your overreported tax applied as a credit to Form 943, 

earlier.

If you owe tax. Pay the amount shown on line 17 by the 

time you file Form 943-X. Generally, you will not be charged 

interest if you file on time, pay on time, enter the date you 

discovered the error, and explain the correction on line 20.

If you have a credit. You overreported employment taxes 

(you have a negative amount on line 17) and want the IRS to 

apply the credit to Form 943 for the period during which you 

filed Form 943-X. The IRS will apply your credit on the first 

day of the Form 943 year during which you filed Form 943-X. 

However, the credit you show on Form 943-X, line 17, may 

not be fully available on your Form 943 if the IRS corrects it 

during processing or you owe other taxes, penalties, or 

interest. The IRS will notify you if your claimed credit changes 

or if the amount available as a credit on Form 943 was 

reduced because of unpaid taxes, penalties, or interest.

Do not check the box on line 1 if you are either: (a) 

correcting overreported amounts and the period of 

limitations on credit or refund for Form 943 will 

expire within 90 days of the date you file Form 943-X, or (b) 

claiming a credit for COBRA premium assistance payments 

and you reduced your deposits in anticipation of the credit. 

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Instead, in either case, check the box on line 2 to file a Form 

943-X under the claim process. See Is There a Deadline for 

Filing Form 943-X, earlier. See the instructions for lines 16a 

and 16b, later.

2. Claim

Check the box on line 2 to use the claim process if you are 

correcting overreported amounts only and you are 

claiming a refund or abatement for the negative amount 

(credit) shown on line 17. Do not check this box if you are 

correcting any underreported amounts on this form.

You must check the box on line 2 if you have a credit and 

the period of limitations on credit or refund for Form 943 will 

expire within 90 days of the date you file Form 943-X. See Is 

There a Deadline for Filing Form 943-X, earlier.

The IRS usually processes claims shortly after they are 

filed. The IRS will notify you if your claim is denied, accepted 

as filed, or selected to be examined. See Pub. 556, 

Examination of Returns, Appeal Rights, and Claims for 

Refund, for more information.

Unless the IRS corrects Form 943-X during processing or 

you owe other taxes, penalties, or interest, the IRS will refund 

the amount shown on line 17, plus any interest that applies.

You may not file a refund claim to correct federal 

income tax or Additional Medicare Tax actually 

withheld from employees.

Part 2: Complete the Certifications

You must complete all certifications that apply by checking 

the appropriate boxes. If all of your corrections relate to 

underreported amounts, complete line 3 only; skip lines 4 

and 5 and go to Part 3.

If your corrections relate to overreported amounts, you 

have a duty to ensure that your employees' rights to recover 

overpaid employee social security and Medicare taxes that 

you withheld are protected. The certifications on lines 4 and 5 

address the requirement to:

Repay or reimburse your employees for the overcollection 

of employee social security and Medicare taxes, or

Obtain consents from your employees to file a claim on 

their behalf. See Notice 2015–15 for guidance on consents.

3. Filing Forms W-2 or Forms W-2c

Check the box on line 3 to certify that you filed or will file 

Forms W-2 or Forms W-2c, as required, showing your 

employees' correct wage and tax amounts. See the General 

Instructions for Forms W-2 and W-3 for detailed information 

about filing requirements. References to Form W-2 on Form 

943-X and in these instructions also apply to Forms W-2AS, 

W-2CM, W-2GU, and W-2VI unless otherwise noted.

You must check the box on line 3 to certify that you filed 

Forms W-2 or Forms W-2c even if your corrections on Form 

943-X do not change amounts shown on those forms. For 

example, if your only correction to Form 943 involves 

misstated tax adjustments (see the instructions for line 10), 

check the box on line 3 to certify that you already filed all 

required Forms W-2 and W-2c with the Social Security 

Administration (SSA).

4. Certifying Overreporting Adjustments

If you overreported federal income tax, social security tax, 

Medicare tax, or Additional Medicare Tax and checked the 

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Instructions for Form 943-X (Rev. 2-2015) -5-
box on line 1, check the appropriate box on line 4. You may 

need to check more than one box. If you obtained written 

statements from some employees but you could not locate 

employees or secure the statements of the remaining 

employees, check all applicable boxes. Provide a summary 

on line 20 of the amount of the corrections for the employees 

who provided written statements and for those who did not.

You may not use Form 943-X to correct 

overreported amounts of Additional Medicare Tax 

unless the amounts were not withheld from 

employee wages.

4a. Check the box on line 4a if your overreported amount 

includes each affected employee share of overcollected 

taxes. You are certifying that you repaid or reimbursed the 

employee share of prior year taxes and you received written 

statements from the employees stating that they did not and 

will not receive a refund or credit for the prior year taxes. Do 

not send these statements to the IRS. Keep them for your 

records. Generally, all employment tax records must be kept 

for at least 4 years.

4b. Check the box on line 4b to certify that your overreported 

amount is only for the employer share of taxes on those 

employees who you were unable to find or those who did not 

give you a statement described on line 4a.

4c. Check the box on line 4c to certify that your overreported 

amount is only for federal income tax, social security tax, 

Medicare tax, or Additional Medicare Tax that you did not 

withhold from your employees.

5. Certifying Claims

If you are filing a claim for refund or abatement of 

overreported federal income tax, social security tax, 

Medicare tax, or Additional Medicare Tax and checked the 

box on line 2, check the appropriate box on line 5. You may 

need to check more than one box. If you obtained written 

statements or consents from some employees but you could 

not locate employees or secure the statements of the 

remaining employees, check all applicable boxes. Provide a 

summary on line 20 of the amount of the corrections for the 

employees who provided statements or consents and for 

those who did not.

You may not file a refund claim to correct federal 

income tax or Additional Medicare Tax actually 

withheld from employees.

5a. Check the box on line 5a if your overreported tax 

includes each affected employee share of prior year social 

security and Medicare tax. You are certifying that you repaid 

or reimbursed to the employees their share of prior year 

social security and Medicare tax and you received written 

statements from those employees stating that they did not 

and will not receive a refund or credit for the prior year taxes.

5b. Check the box on line 5b if your overreported tax 

includes each affected employee share of prior year social 

security and Medicare tax and you have not yet repaid or 

reimbursed the employee share of taxes. You are certifying 

that you received consent from each affected employee to 

file a claim on the employee share of those taxes and you 

received written statements from those employees stating 

that they did not and will not receive a refund or credit for the 

prior year taxes. Do not send these statements and 

consents to the IRS. Keep them for your records. Generally, 

all employment tax records must be kept for at least 4 years.

CAUTION

!

CAUTION

!

In certain situations, you may not have repaid or 

reimbursed your employees or obtained their consents prior 

to filing a claim, such as in cases where the period of 

limitations on credit or refund is about to expire. In those 

situations, file Form 943-X, but do not check a box on line 5. 

Tell us on line 20 that you have not repaid or reimbursed 

employees or obtained consents at the time you file the 

claim. However, you must repay or reimburse your 

employees and certify that you have done so before the IRS 

can allow the claim.

5c. Check the box on line 5c to certify that your overreported 

tax is only for the employer share of social security and 

Medicare tax. This applies when affected employees did not 

give you consent to file a claim for refund for the employee 

share of social security and Medicare tax, they could not be 

found, or they did not give you a statement described on 

line 5b.

5d. Check the box on line 5d to certify that your overreported 

amount is only for federal income tax, social security tax, 

Medicare tax, or Additional Medicare Tax that you did not 

withhold from your employees.

Part 3: Enter the Corrections for the 

Calendar Year You Are Correcting

What Amounts Should You Report in Part 3?

On lines 6–9, columns 1 and 2, show amounts for all of your 

employees, not just for those employees whose amounts you 

are correcting.

If a correction that you report in column 4 includes both 

underreported and overreported amounts (see the 

instructions for line 18), give us details for each error on 

line 20.

Because special circumstances apply for lines 10–14, 

16a, and 16b, read the instructions for each line carefully 

before entering amounts in the columns.

If you previously adjusted or amended Form 943 

using Form 943-X or because of an IRS examination 

change, show amounts in column 2 that include 

those previously reported corrections.

6. Total Wages Subject to Social Security Tax

The 2011 and 2012 employee tax rate for social 

security was 4.2%.

If you are correcting the taxable social security wages you 

reported on Form 943, line 2, enter the total corrected 

amount in column 1. In column 2, enter the amount you 

originally reported or as previously corrected. In column 3, 

enter the difference between columns 1 and 2.

 line 6 (column 1)

- line 6 (column 2)

 line 6 (column 3) If the amount in column 2 is larger than the 

amount in column 1, use a minus sign in 

column 3.

Multiply the amount in column 3 by .124 (.104 for 

corrections to a 2011 or 2012 return) and enter that result in 

column 4.

CAUTION

!

CAUTION

!

-6- Instructions for Form 943-X (Rev. 2-2015)
line 6 (column 3)

 x .124 (Use .104 for corrections to a 2011 or 

2012 return.)

line 6 (column 4) If the amount in column 3 used a minus sign, 

also use a minus sign in column 4.

Note. If you are correcting only the employer share of tax on 

a decrease to social security wages, use .062 (6.2%) when 

multiplying the amount shown in column 3. If you are 

correcting both shares of tax for some employees and only 

the employer share for other employees, enter the properly 

calculated amount in column 4. Be sure to show your 

calculations on line 20.

Example—Social security wages decreased. You 

reported $9,000 as social security wages on your 2014 Form 

943, line 2. In December of 2015, you discover that you 

included $2,000 in social security wages for one of your 

employees twice. To correct the error, figure the difference 

on Form 943-X as shown.

Column 1 (corrected amount) 7,000.00

Column 2 (Form 943, line 2) - 9,000.00

Column 3 (difference) - 2,000.00

Use the difference in column 3 to determine your tax 

correction.

Column 3 (difference) -2,000.00

Tax rate (12.4%) x .124 

Column 4 (tax correction) -248.00

Be sure to explain the reasons for this correction on 

line 20.

Note. If the example above was for a correction to a 2011 or 

2012 return, the amount in column 3 would be multiplied 

by .104.

7. Total Wages Subject to Medicare Tax

If you are correcting the taxable Medicare wages you 

reported on Form 943, line 4, enter the total corrected 

amount in column 1. In column 2, enter the amount you 

originally reported or as previously corrected. In column 3, 

enter the difference between columns 1 and 2.

 line 7 (column 1)

- line 7 (column 2)

 line 7 (column 3) If the amount in column 2 is larger than the 

amount in column 1, also use a minus sign in 

column 3.

Multiply the amount in column 3 by .029 (2.9% tax rate) 

and enter that result in column 4.

line 7 (column 3)

 x .029 

line 7 (column 4) If the amount in column 3 used a minus sign, 

also use a minus sign in column 4.

Note. If you are correcting only the employer share of tax on 

a decrease to Medicare wages, use .0145 (1.45%) when 

multiplying the amount in column 3. If you are correcting both 

shares of tax for some employees and only the employer 

share for other employees, enter the properly calculated 

amount in column 4. Be sure to explain your calculations on 

line 20.

Example—Medicare wages decreased. Following 

Example—Social security wages decreased in the 

instructions for line 6, the wages that you counted twice were 

also taxable Medicare wages. To correct the error, figure the 

difference on Form 943-X as shown.

Column 1 (corrected amount) 7,000.00

Column 2 (Form 943, line 4) - 9,000.00

Column 3 (difference) - 2,000.00

Use the difference in column 3 to determine your tax 

correction.

Column 3 (difference) -2,000.00

Tax rate (2.9%) x .029 

Column 4 (tax correction) -58.00

Be sure to explain the reasons for this correction on 

line 20.

8. Total Wages Subject to Additional Medicare 

Tax Withholding

Generally, you may correct errors to Additional Medicare Tax 

withholding only if you discovered the errors in the same 

calendar year the wages were paid to employees. However, 

you may correct errors to Additional Medicare Tax 

withholding for prior years if the amount reported on Form 

943, line 7, does not agree with the amount you actually 

withheld. This type of error is an administrative error. You 

may also correct errors to Additional Medicare Tax 

withholding for prior years if section 3509 rates apply. If 

section 3509 rates apply, see the instructions for line 14, 

later.

If a prior year error was a nonadminstrative error, you may 

correct only the wages subject to Additional Medicare Tax 

withholding that were originally reported on Form 943, line 6, 

or previously corrected on Form 943-X. You cannot correct 

the tax reported on Form 943, line 7.

Prior year administrative errors. If you are correcting the 

wages subject to Additional Medicare Tax withholding that 

you reported on Form 943, line 6, enter the total corrected 

amount in column 1. In column 2, enter the amount you 

originally reported or as previously corrected. In column 3, 

enter the difference between columns 1 and 2.

 line 8 (column 1)

- line 8 (column 2)

 line 8 (column 3) If the amount in column 2 is larger than the 

amount in column 1, also use a minus sign in 

column 3.

Multiply the amount in column 3 by .009 (0.9% tax rate) 

and enter that result in column 4.

Instructions for Form 943-X (Rev. 2-2015) -7-
line 8 (column 3)

 x .009 

line 8 (column 4) If the amount in column 3 used a minus sign, 

also use a minus sign in column 4.

Example—Prior year administrative error (incorrectly 

reported amount of Additional Medicare Tax actually 

withheld). Employee A's wages exceeded the $200,000 

withholding threshold for Additional Medicare Tax in 

November 2014. The total wages paid to Employee A for 

2014 were $230,000. You withheld $270 ($30,000 x .009) 

from the employee's wages. However, on your 2014 Form 

943 you mistakenly reported $3,000 on line 6, and Additional 

Medicare Tax withheld of $27 on line 7. You discover the 

error on March 16, 2015. This is an example of an 

administrative error that may be corrected in a later calendar 

year because the amount actually withheld differs from the 

amount reported on your 2014 Form 943. Use Form 943-X, 

line 8, to correct the error as shown below.

Column 1 (corrected amount) 30,000.00

Column 2 (Form 943, line 6) - 3,000.00

Column 3 (difference) 27,000.00

Use the difference in column 3 to determine your tax 

correction.

Column 3 (difference) 27,000.00

Tax rate (0.9%) x .009 

Column 4 (tax correction) 243.00

Be sure to explain the reasons for this correction on 

line 20.

Prior year nonadministrative errors. You may correct 

only the taxable wages subject to Additional Medicare Tax 

withholding that you reported on Form 943, line 6. Enter the 

total corrected amount in column 1. In column 2, enter the 

amount you originally reported or as previously corrected. In 

column 3, enter the difference between columns 1 and 2.

 line 8 (column 1)

- line 8 (column 2)

 line 8 (column 3) If the amount in column 2 is larger than the 

amount in column 1, use a minus sign in 

column 3.

Do not multiply the amount in column 3 by .009 (0.9% tax 

rate). Leave column 4 blank and explain the reasons for this 

correction on line 20.

Example—Prior year nonadministrative error (failure 

to withhold Additional Medicare Tax when required). 

Employee B's wages exceeded the $200,000 withholding 

threshold for Additional Medicare Tax in December 2014. 

The total wages paid to Employee B for 2014 were $220,000. 

You were required to withhold $180 ($20,000 x .009) but you 

withheld nothing and did not report an amount on line 6 or 

line 7 of your 2014 Form 943. You discover the error on 

March 16, 2015. File Form 943-X to correct the wages 

subject to Additional Medicare Tax withholding for your 2014 

Form 943, but you may not correct the Additional Medicare 

Tax withheld (column 4) because the error involves a 

previous year and the amount previously reported for the 

employee represents the actual amount withheld from the 

employee during 2014.

Combination of prior year administrative and nonadministrative errors. If you are reporting both administrative 

errors and nonadministrative errors for the same prior year, 

enter the total corrected amount in column 1. In column 2, 

enter the amount you originally reported or as previously 

corrected. In column 3, enter the difference between columns 

1 and 2. However, multiply only the amount of wages 

reported in column 3 that are related to administrative errors 

by .009 (0.9% tax rate). Do not multiply any wages reported 

in column 3 that are related to nonadministrative errors 

by .009 (0.9% tax rate). Use line 20 to explain in detail your 

corrections. The explanation must include the reasons for the 

corrections and a breakdown of the amount reported in 

column 3 into the amounts related to administrative errors 

and nonadministrative errors.

Example—Combination of prior year administrative 

and nonadministrative errors. Employee A's wages 

exceeded the $200,000 withholding threshold for Additional 

Medicare Tax in November 2014. The total wages paid to 

Employee A for 2014 were $230,000. You withheld $270 

($30,000 x .009) from the employee's wages. However, on 

your 2014 Form 943 you mistakenly reported $3,000 on 

line 6, and Additional Medicare Tax withheld of $27 on line 7. 

The difference in wages subject to Additional Medicare Tax 

related to this administrative error is $27,000 ($30,000 – 

$3,000).

Employee B's wages exceeded the $200,000 withholding 

threshold for Additional Medicare Tax in December 2014. 

The total wages paid to Employee B for 2014 were $220,000. 

You were required to withhold $180 ($20,000 x .009) but you 

withheld nothing and did not report Employee B’s $20,000 in 

wages subject to Additional Medicare Tax withholding on 

line 6 of your 2014 Form 943.

You discover both errors on March 16, 2015. Use Form 

943-X, line 8, to correct the errors as shown below.

Column 1 (corrected amount) 50,000.00

Column 2 (Form 943, line 6) - 3,000.00

Column 3 (difference) 47,000.00

Determine the portion of wages reported in column 3 that 

is related to the administrative error ($47,000 - $20,000 

(nonadministrative error) = $27,000 (administrative error)). 

Multiply this portion of column 3 by .009 (0.9% tax rate) to 

determine your tax correction.

Difference related to administrative error 27,000.00

Tax rate (0.9%) x .009 

Column 4 (tax correction) 243.00

Be sure to explain the reasons for these corrections on 

line 20. You must also report that $20,000 of the amount 

shown in column 3 was related to the correction of a prior 

year nonadministrative error and $27,000 of the amount 

shown in column 3 was related to the correction of an 

administrative error.

-8- Instructions for Form 943-X (Rev. 2-2015)
9. Federal Income Tax Withheld

If you are correcting the federal income tax withheld from 

wages that you reported on Form 943, line 8 (line 6 for years 

ending before January 1, 2013), enter the total corrected 

amount in column 1. In column 2, enter the amount you 

originally reported or as previously corrected. In column 3, 

enter the difference between columns 1 and 2.

 line 9 (column 1)

- line 9 (column 2)

 line 9 (column 3) If the amount in column 2 is larger than the 

amount in column 1, use a minus sign in 

column 3.

Copy the amount in column 3 to column 4. Include any 

minus sign shown in column 3.

Generally, you may correct federal income tax 

withholding errors only if you discovered the errors 

in the same calendar year you paid the wages. 

However, you may correct errors to federal income tax 

withholding for prior years if the amount reported on Form 

943 does not agree with the amount you actually withheld. 

This type of error is an administrative error. You may also 

correct errors to federal income tax withholding for prior 

years if section 3509 rates apply. See section 9 of Pub. 51 

(Circular A) for more information about corrections during the 

calendar year and about administrative errors. If section 3509 

rates apply, see the instructions for line 11, later.

Example—Failure to withhold income tax when 

required. You were required to withhold $400 of federal 

income tax from an employee bonus that was paid in 

December of 2014 but you withheld nothing. You discovered 

the error on March 17, 2015. You cannot file Form 943-X to 

correct your 2014 Form 943 because the error involves a 

previous year and the amount previously reported for the 

employee represents the actual amount withheld from the 

employee during 2014.

Example—Administrative error reporting income tax. 

You had three employees. In 2014, you withheld $1,000 of 

federal income tax from Employee A, $2,000 from Employee 

B, and $6,000 from employee C. The total amount of federal 

income tax you withheld was $9,000. You mistakenly 

reported $6,000 on your 2014 Form 943, line 8. You 

discovered the error on March 17, 2015. This is an example 

of an administrative error that may be corrected in a later 

calendar year because the amount actually withheld from 

employees' wages differs from the amount reported on Form 

943. Use Form 943-X to correct the error. Enter $9,000 in 

column 1 and $6,000 in column 2. Subtract the amount in 

column 2 from the amount in column 1.

Column 1 (corrected amount) 9,000.00

Column 2 (Form 943, line 8) - 6,000.00

Column 3 (difference) 3,000.00

Report the 3,000.00 as a tax correction in column 4.

Be sure to explain the reasons for this correction on 

line 20.

CAUTION

!

10. Tax Adjustments

Do not enter an amount on line 10 unless you need to 

correct any adjustments reported on Form 943, line 10 

(line 8 for years ending before January 1, 2013). Amounts 

reported on line 10 reflect corrections of amounts misstated 

on Form 943, line 10 (line 8 for years ending before January 

1, 2013). See Example—Adjustment for third-party sick pay 

underreported below.

Enter the corrected amount for tax adjustments in column 

1. Enter the originally reported or previously corrected 

amount from Form 943, line 10 (line 8 for years ending before 

January 1, 2013), in column 2. In column 3, enter the 

difference between columns 1 and 2.

 line 10 (column 1)

- line 10 (column 2)

line 10 (column 3) 

You may need to report negative numbers in any 

column. Make sure that the difference you enter in 

column 3 accurately represents the change to 

adjustments originally reported or previously corrected on 

Form 943, line 10 (line 8 for years ending before January 1, 

2013).

Copy the amount in column 3 to column 4. Include any 

minus sign shown in column 3.

On line 20, describe what you misreported on Form 943. 

Tell us if your adjustment is for fractions of cents, third-party 

sick pay, or group-term life insurance.

Example—Adjustment for third-party sick pay 

underreported. You reported $6,900 (shown as

“–6,900.00”) as a third-party sick pay adjustment (reduction 

to tax) on your 2014 Form 943, line 10. Your third-party sick 

pay adjustment should have been $9,600 (shown as “–

9,600.00”) because your third-party sick pay payer withheld 

that amount of social security and Medicare taxes from your 

employees. You discovered the error in April of 2015. To 

correct the error, figure the difference on Form 943-X as 

shown.

Column 1 (corrected amount) -9,600.00

Column 2 (Form 943, line 10) - (6,900.00)

Column 3 (difference) -2,700.00

Here is how you would enter the numbers on Form 943-X.

Column 1 Column 2 Column 3

(corrected amount) (Form 943, line 10) (difference)

 -9,600.00 -6,900.00 -2,700.00

Report “–2,700.00” as your correction in column 4.

In this example, you are claiming a credit for $2,700 in 

overreported tax for your 2014 Form 943. Always enter the 

same amount in column 4 (including any minus sign) that you 

enter in column 3.

Be sure to explain the reasons for this correction on 

line 20.

TIP

Instructions for Form 943-X (Rev. 2-2015) -9-
Note. If the example above was for a correction to a year 

ending before January 1, 2013, the references to line 10 

change to line 8.

Only use line 10 to correct adjustments for fractions 

of cents, third-party sick pay, or group-term life 

insurance previously reported. File a separate Form 

943-X for each year being corrected.

11–14. Special Additions to Wages for Federal 

Income Tax, Social Security Tax, Medicare Tax, 

and Additional Medicare Tax

Section 3509 provides special rates for the employee share 

of social security tax, Medicare tax, Additional Medicare Tax, 

and income tax withholding when workers are reclassified as 

employees in certain circumstances. The applicable rate 

depends on whether you filed required information returns. 

An employer cannot recover any tax paid under this provision 

from the employees. The full employer share of social 

security and Medicare tax is due for all reclassifications.

Note. Section 3509 rates are not available if you 

intentionally disregarded the requirements to withhold taxes 

from the employee, or if you withheld income tax but did not 

withhold social security and Medicare tax. Section 3509 rates 

are also not available for certain statutory employees.

On lines 11–14, enter only corrections to wages resulting 

from reclassifying certain workers as employees when 

section 3509 rates are used to calculate the taxes.

If the employer issued the required information returns, 

use the section 3509 rates as follows.

For social security taxes, use the employer rate of 6.2% 

plus 20% of the employee rate of 6.2% (4.2% for 2011 and 

2012), for a total rate of 7.44% (7.04% for 2011 and 2012) of 

wages.

For Medicare taxes, use the employer rate of 1.45% plus 

20% of the employee rate of 1.45%, for a total rate of 1.74% 

of wages.

For Additional Medicare Tax, 0.18% (20% of the employee 

rate of 0.9%) of wages subject to Additional Medicare Tax.

For income tax withholding, the rate is 1.5% of wages.

If the employer did not issue the required information 

returns, use the section 3509 rates as follows.

For social security taxes, use the employer rate of 6.2% 

plus 40% of the employee rate of 6.2% (4.2% for 2011 and 

2012), for a total rate of 8.68% (7.88% for 2011 and 2012) of 

wages.

For Medicare taxes, use the employer rate of 1.45% plus 

40% of the employee rate of 1.45%, for a total rate of 2.03% 

of wages.

For Additional Medicare Tax, 0.36% (40% of the employee 

rate of 0.9%) of wages subject to Additional Medicare Tax.

For income tax withholding, the rate is 3.0% of wages.

Unlike other lines on Form 943-X, enter in column 1 only 

the corrected wages for workers being reclassified, not the 

amount paid to ALL employees. Enter in column 2 previously 

reported wages (if any) to reclassified employees. To get the 

amount for column 4, use the applicable section 3509 rates. 

If you filed the required information returns for some 

employees but did not file them for other employees, be sure 

to use the applicable rates for each employee when 

calculating the amounts in column 4 and show your 

calculations on line 20. The tax correction in column 4 will be 

a positive number if you increased the amount of wages you 

CAUTION

!

previously reported. See the instructions for line 19 for more 

information.

15. Subtotal

Combine the amounts from column 4 on lines 6–14 and enter 

the result on line 15.

Example. You entered “-500.00” in column 4 of line 6, 

“-100.00” in column 4 of line 7, and “1,400.00” in column 4 of 

line 10. Combine these amounts and enter “800.00” in 

column 4 of line 15.

Line 6 -500.00

Line 7 -100.00

Line 10 +1,400.00

Line 15 800.00

16a. Claiming or Correcting the COBRA 

Premium Assistance Credit

The COBRA premium assistance credit was 

available to an employer for premiums paid on 

behalf of employees who were involuntarily 

terminated from employment between September 1, 2008, 

and May 31, 2010. The COBRA premium assistance credit is 

not available for individuals who were involuntarily terminated 

after May 31, 2010. Therefore, only in rare circumstances, 

such as instances where COBRA eligibility was delayed as a 

result of employer provided health insurance coverage 

following termination, will the credit be available.

Enter 65% of the total COBRA premium assistance 

payments for all assistance eligible individuals in column 1. 

Report the premium assistance payments on this line only 

after the assistance eligible individual's 35% share of the 

premium has been paid. For COBRA coverage provided 

under a self-insured plan, COBRA premium assistance is 

treated as having been made for each assistance eligible 

individual who paid 35% of the COBRA premium. Do not 

include the assistance eligible individual's 35% of the 

premium in the amount entered on this line.

For tax periods ending before January 1, 2014, enter any 

COBRA premium assistance payments previously claimed 

on Form 943, line 13a (line 11a for calendar years 2011 and 

2012), in column 2. For tax periods beginning after 

December 31, 2013, enter -0- in column 2, unless you are 

correcting a COBRA premium assistance payment 

previously reported on a Form 943-X. If you or the IRS 

previously corrected the amount reported, the amount 

entered in column 2 should take into account all previous 

corrections.

Enter the difference between column 1 and 2 in column 3. 

Copy the amount in column 3 to column 4. However, to 

properly show the amount as a credit or balance due item, 

enter a positive number in column 3 as a negative number in 

column 4 or a negative number in column 3 as a positive 

number in column 4.

The COBRA premium assistance credit is treated as 

a credit on the first day of the return period (that is, 

January 1). However, because the credit is now 

claimed on Form 943-X filed AFTER submission of the Form 

943, an employer that reduces its required deposits in 

anticipation of the credit will receive a system-generated 

notice reflecting a balance due and associated penalties and 

CAUTION

!

CAUTION

!

-10- Instructions for Form 943-X (Rev. 2-2015)
interest, if applicable. The balance due, including any related 

penalties and interest, resulting from the reduction in 

deposits in anticipation of the credit will be abated when the 

credit is applied. Such abatement will generally occur without 

any further action from the employer. Alternatively, to prevent 

triggering a system-generated balance due notice, the 

employer can make its deposits without a reduction in 

anticipation of the COBRA premium assistance credit and 

follow these instructions for claiming the COBRA premium 

assistance credit.

For more information on the COBRA premium subsidy, 

visit IRS.gov and enter “COBRA” in the search box.

16b. Number of Individuals Provided COBRA 

Premium Assistance on Line 16a

Enter the total number of assistance eligible individuals 

provided COBRA premium assistance in column 1. Count 

each assistance eligible individual who paid a reduced 

COBRA premium as one individual, whether or not the 

reduced premium was for insurance that covered more than 

one assistance eligible individual. For example, if the 

reduced COBRA premium was for coverage for a former 

employee, spouse, and two children, you would include one 

individual in the number entered on line 16b for the premium 

assistance entered on line 16a. Further, each individual is 

reported only once. For example, an assistance eligible 

individual who made monthly premium payments would only 

be reported as one individual on line 16b.

For tax periods ending before January 1, 2014, enter the 

number of assistance eligible individuals provided COBRA 

premium assistance previously reported on Form 943, line 

13b (line 11b for calendar years 2011 and 2012), in column 

2. For tax periods beginning after December 31, 2013, 

enter -0- in column 2, unless you are correcting a previously 

filed Form 943-X. If you or the IRS previously corrected the 

number of individuals reported, the number entered in 

column 2 should take into account all previous corrections.

17. Total

Combine lines 15 and 16a of column 4, and enter the result 

on line 17.

Your credit. If the amount entered on line 17 is less than 

zero, for example, “-115.00,” you have a credit because you 

overreported your federal employment taxes.

If you checked the box on line 1, include this amount on 

the "Total Deposits" line of Form 943 for the year during 

which you filed Form 943-X. Do not make any changes to 

your Monthly Summary of Federal Tax Liability on Form 943 

or on Form 943-A. The amounts reported in your Monthly 

Summary of Federal Tax Liability or on Form 943-A should 

reflect your actual tax liability for the period.

If you checked the box on line 2, you are filing a claim for 

refund or abatement of the amount shown.

If your credit is less than $1, we will send a refund or apply 

it only if you ask us in writing to do so.

Amount you owe. If the amount on line 17 is a positive 

number, you must pay the amount you owe by the time you 

file Form 943-X. You may not use any credit that you show on 

another Form 943-X to pay the amount you owe, even if you 

filed for the amount you owe and the credit at the same time.

If you owe tax and are filing a timely Form 943-X, do not 

file an amended Form 943-A unless you were assessed an 

FTD penalty caused by an incorrect, incomplete, or missing 

Form 943-A. Do not include the tax increase reported on 

Form 943-X on any amended Form 943-A you file.

If you owe tax and are filing a late Form 943-X, that is, 

after the due date for the return period in which you 

discovered the error, you must file an amended Form 943-A 

with the Form 943-X. Otherwise, the IRS may assess an 

“averaged” FTD penalty. The total tax reported on Form 

943-A, line M, must match the corrected tax (Form 943, 

line 11 (line 9 for calendar years 2011 and 2012), combined 

with any correction reported on Form 943-X, line 15) for the 

year, less any previous abatements and interest-free tax 

assessments.

Payment methods. You may pay the amount you owe on 

line 17 electronically using the Electronic Federal Tax 

Payment System (EFTPS), by credit card or debit card, or by 

a check or money order.

The preferred method of payment is EFTPS. For more 

information, visit www.eftps.gov, call EFTPS Customer 

Service at 1-800-555-4477 or 1-800-733-4829 (TDD) toll 

free, or see Pub. 966, Electronic Federal Tax Payment 

System: A Guide To Getting Started.

To pay by credit or debit card, visit the IRS website

www.irs.gov/e-pay.

If you pay by check or money order, make it payable to 

“United States Treasury.” On your check or money order, be 

sure to write your EIN, “Form 943-X,” and the year corrected.

You do not have to pay if the amount you owe is less than 

$1.

Previously assessed FTD penalty. If line 17 reflects 

overreported tax and the IRS previously assessed a FTD 

penalty, you may be able to reduce the penalty. For more 

information, see the Form 943-A instructions.

Part 4: Explain Your Corrections for 

the Calendar Year You Are Correcting

18. Correction of Both Underreported and 

Overreported Amounts

Check the box on line 18 if any corrections you entered on 

lines 6–14 and 16a and 16b in column 3 reflect both 

underreported and overreported amounts.

Example. If you had an increase to social security wages 

of $15,000 for Employee A and a decrease to social security 

wages of $5,000 for Employee B, you would enter $10,000 

on line 6, column 3. That $10,000 represents the net change 

from corrections.

On line 20, you must explain the reason for both the 

$15,000 increase and the $5,000 decrease.

19. Did You Reclassify Any Workers

Check the box on line 19 if you reclassified any workers to be 

independent contractors or nonemployees. Also check this 

box if the IRS (or you) determined that workers you treated 

as independent contractors or nonemployees should be 

classified as employees. On line 20, give us a detailed 

reason why any worker was reclassified and, if you used 

section 3509 rates on lines 11–14 for any worker reclassified 

as an employee, explain why section 3509 rates apply and 

what rates you used.

Return not filed because you did not treat any workers 

as employees. If you did not previously file Form 943 

because you mistakenly treated all workers as independent 

Instructions for Form 943-X (Rev. 2-2015) -11-
contractors or as nonemployees, file a Form 943 for each 

delinquent year.

On each Form 943 for which you are entitled to use 

section 3509 rates, complete the following steps.

Write “Misclassified Employees” in bold letters across 

the top margin of page 1.

Enter a zero on the line for “Total taxes after adjustments.”

Complete the signature area.

Attach a completed Form 943-X (see instructions below).

On each attached Form 943-X, complete the following 

steps.

Complete the top of Form 943-X, including the date you 

discovered the error.

Enter the wage amounts on lines 11–14, column 1.

Enter zeros on lines 11–14, column 2.

Complete columns 3 and 4 as instructed in Part 3.

Provide a detailed statement on line 20.

Complete the signature area.

If you cannot use section 3509 rates (for example, 

because the workers you treated as nonemployees 

were certain statutory employees), file a Form 943 

for each delinquent year. Write “Misclassified Employees” 

in bold letters across the top margin of page 1 of each Form 

943. Complete Form 943 using the Instructions for Form 943. 

Attach a Form 943-X to each Form 943. Complete the top of 

Form 943-X, including the date you discovered the error, and 

provide a detailed explanation on line 20.

20. Explain Your Corrections

Treasury regulations require you to explain in detail the 

grounds and facts relied upon to support each correction. On 

line 20, describe in detail each correction you entered in 

column 4 on lines 6–14 and 16a. Also explain any correction 

made on line 16b. If you need more space, attach additional 

sheets, but be sure to write your name, EIN, “Form 943-X,” 

and the calendar year you are correcting.

You must describe the events that caused the 

underreported or overreported amounts. Explanations such 

as “social security and Medicare wages were overstated” or 

“administrative/payroll errors were discovered” are 

insufficient and may delay processing your Form 943-X 

because the IRS may need to ask for a more complete 

explanation.

Provide the following information in your explanation for 

each correction.

Form 943-X line number(s) affected.

Date you discovered the error.

Difference (amount of the error).

Cause of the error.

You may report the information in paragraph form. The 

following paragraph is an example.

“The $1,000 difference shown in column 3 of lines 6 and 7 

was discovered on May 15, 2014, during an internal audit. 

We discovered that we included $1,000 of wages for one of 

the employees twice. This correction removes the reported 

wages that were never paid.”

For corrections shown on lines 11–14, explain why the 

correction was necessary and attach any notice you received 

from the IRS.

CAUTION

!

Part 5. Sign Here

You must complete all three pages of Form 943-X and sign it. 

If you do not sign it on page 3, processing of Form 943-X will 

be delayed.

Who must sign the Form 943-X? The following persons 

are authorized to sign the return for each type of business 

entity.

Sole proprietorship—The individual who owns the 

business.

Corporation (including limited liability company 

(LLC) treated as a corporation)—The president, vice 

president, or other principal officer duly authorized to sign.

Partnership (including LLC treated as a partnership) 

or unincorporated organization—A responsible and duly 

authorized partner, member, or officer having knowledge of 

its affairs.

Single member LLC treated as a disregarded entity 

for federal income tax purposes—The owner of the LLC 

or a principal officer duly authorized to sign.

Trust or estate—The fiduciary.

Form 943-X may also be signed by a duly authorized 

agent of the taxpayer if a valid power of attorney has been 

filed.

Alternative signature method. Corporate officers or duly 

authorized agents may sign Form 943-X by rubber stamp, 

mechanical device, or computer software program. For 

details and required documentation, see Rev. Proc. 2005-39. 

You can find Rev. Proc. 2005-39 on page 82 of Internal 

Revenue Bulletin 2005-28 at www.irs.gov/irb/2005-28_IRB/

ar16.html.

Paid Preparer Use Only

A paid preparer must sign Form 943-X and provide the 

information in the Paid Preparer Use Only section of Part 5 if 

the preparer was paid to prepare Form 943-X and is not an 

employee of the filing entity. Paid preparers must sign paper 

returns with a manual signature. The preparer must give you 

a copy of the return in addition to the copy to be filed with the 

IRS.

If you are a paid preparer, enter your Preparer Tax 

Identification Number (PTIN) in the space provided. Include 

your complete address. If you work for a firm, enter the firm's 

name and the EIN of the firm. You can apply for a PTIN 

online or by filing Form W-12, IRS Paid Preparer Tax 

Identification Number (PTIN) Application and Renewal. For 

more information about applying for a PTIN online, visit the 

IRS website at www.irs.gov/ptin. You cannot use your PTIN 

in place of the EIN of the tax preparation firm.

Generally, you are not required to complete this section if 

you are filing the return as a reporting agent and have a valid 

Form 8655, Reporting Agent Authorization, on file with the 

IRS. However, a reporting agent must complete this section if 

the reporting agent offered legal advice, for example, 

advising the client on determining whether its workers are 

employees or independent contractors for federal tax 

purposes.

-12- Instructions for Form 943-X (Rev. 2-2015)
How Can You Order Forms, 

Instructions, and Publications from 

the IRS?

Visit the IRS website at www.irs.gov/formspubs.

Call the IRS at 1-800-TAX-FORM (1-800-829-3676).

Additional Information

You may find the following forms, instructions, and 

publications helpful when using Form 943-X.

Form W-2, Wage and Tax Statement

Form W-3, Transmittal of Wage and Tax Statements

General Instructions for Forms W-2 and W-3

Form W-2AS, American Samoa Wage and Tax Statement

Form W-2CM, Wage and Tax Statement (Northern 

Mariana Islands)

Form W-2GU, Guam Wage and Tax Statement

Form W-2VI, U.S. Virgin Islands Wage and Tax Statement

Form W-3SS, Transmittal of Wage and Tax Statements

Form W-2c, Corrected Wage and Tax Statement

Form W-3c, Transmittal of Corrected Wage and Tax 

Statements

Form 943-A, Agricultural Employer's Record of Federal 

Tax Liability

Instructions for Form 843

Instructions for Form 943

Pub. 15 (Circular E), Employer's Tax Guide

Pub. 51 (Circular A), Agricultural Employer's Tax Guide

Pub. 80 (Circular SS), Federal Tax Guide for Employers in 

the U.S. Virgin Islands, Guam, American Samoa, and the 

Commonwealth of the Northern Mariana Islands

Pub. 966, Electronic Federal Tax Payment System: A 

Guide To Getting Started

Paperwork Reduction Act Notice. We ask for the 

information on Form 943-X to carry out the Internal Revenue 

laws of the United States. We need it to figure and collect the 

right amount of tax. Subtitle C, Employment Taxes, of the 

Internal Revenue Code imposes employment taxes, 

including federal income tax withholding, on wages. This 

form is used to determine the amount of taxes you owe. 

Section 6011 requires you to provide the requested 

information if the tax applies to you.

You are not required to provide the information requested 

on a form that is subject to the Paperwork Reduction Act 

unless the form displays a valid OMB control number. Books 

and records relating to a form or its instructions must be 

retained as long as their contents may become material in 

the administration of any Internal Revenue law.

The time needed to complete and file Form 943-X will vary 

depending on individual circumstances. The estimated 

average time is:

Recordkeeping ....................... 14 hr., 6 min.

Learning about the law or the form........... 52 min.

Preparing and sending the form to the IRS...... 2 hr., 20 min.

If you have comments concerning the accuracy of these 

time estimates or suggestions for making this form simpler, 

we would be happy to hear from you. You can send us 

comments from www.irs.gov/formspubs. Click on More 

Information and then click on Give us feedback. Or you can 

write to the Internal Revenue Service, Tax Forms and 

Publications Division, 1111 Constitution Ave. NW, IR-6526, 

Washington, DC 20224. Do not send Form 943-X to this 

address. Instead, see Where Should You File Form 943-X, 

earlier.

Instructions for Form 943-X (Rev. 2-2015) -13-