Schedule R (Form 940): Allocation Schedule for Aggregate Form 940 Filers

(December 2011)

Department of the Treasury — Internal Revenue Service

860511

OMB No. 1545-0028

Employer identification number 

(EIN) —

Name as shown on

Form 940

Report for calendar year:

(Same as Form 940):

Read the separate instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate line 

for the allocated amounts of each of your clients.

 (a) 

Client Employer 

Identification Number 

(EIN) 

(b) 

State 

abbreviation 

from Form 

940, line 1a,

or Schedule 

A (Form 940)

(c) 

Total taxable FUTA 

wages allocated to

the listed client EIN

from Form 940, line 7a

(d) 

Total adjustments 

to FUTA tax 

allocated to the

listed client EIN from

Form 940, line 9 or 

line 10

(e) 

Credit reduction 

amount allocated

to the listed client

EIN from Form 940, 

line 11

(f) 

Total FUTA tax 

after adjustments 

allocated to the

listed client EIN from

Form 940, line 12

(g) 

Total FUTA tax 

deposits from 

Form 940, line 13, 

plus any payment 

made with the 

return allocated to

the listed client EIN

1 . . . . .

2 . . . . .

3 . . . . .

4 . . . . .

5 . . . . .

6 . . . . .

7 . . . . .

8 . . . . .

9 . . . . .

10 . . . . .

11 . . . . .

12 . . . . .

13 . . . . .

14 . . . . .

15 . . . . . 16 Subtotal for clients. 

Add all amounts on lines 1

through 15. . . . . . 17 Enter the combined 

subtotal from line 26 of 

all Continuation Sheets 

for Schedule R (Form 

940). . . . . . 18 Enter Form 940 amounts 

for employees of the 

agent. . . . . . 19 Totals. Add lines 16, 17,

and 18. The column totals

must match the related

lines on the aggregate

Form 940. . . . . . For Paperwork Reduction Act Notice, see the instructions. Cat. No. 53082A Schedule R (Form 940) (12-2011)
Page of 860611

Continuation Sheet for Schedule R (Form 940)

(December 2011)

Employer identification number 

(EIN) —

Name as shown on

Form 940

Report for calendar year:

(Same as Form 940):

Read the separate instructions before you complete Schedule R (Form 940). Type or print within the boxes. Complete a separate line 

for the allocated amounts of each of your clients.

(a) 

Client Employer 

Identification Number 

(EIN) 

(b) 

State 

abbreviation 

from Form 

940, line 1a,

or Schedule 

A (Form 940) 

(c) 

Total taxable FUTA 

wages allocated to

the listed client EIN

from Form 940, line 7a

(d) 

Total adjustments 

to FUTA tax 

allocated to the

listed client EIN from

Form 940, line 9 or

line 10

(e) 

Credit reduction 

amount allocated

to the listed client

EIN from Form 940, 

line 11

(f) 

Total FUTA tax 

after adjustments 

allocated to the

listed client EIN from

Form 940, line 12

(g) 

Total FUTA tax 

deposits from 

Form 940, line 13, 

plus any payment 

made with the 

return allocated to

the listed client EIN

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 Subtotals for clients. Add

lines 1 through 25. Include

the subtotals from line 26

on Schedule R (Form 940), 

line 17. . . . . . Schedule R (Form 940) (12-2011)
860711

Schedule R (Form 940) (12-2011)

General Instructions

Section references are to the Internal Revenue Code unless 

otherwise noted.

Purpose of Form 

Use Schedule R to allocate the aggregate information reported 

on Form 940 to each home care service recipient client. An 

aggregate Form 940 may only be filed by section 3504 Agents 

acting on behalf of home care service recipients. If you are an 

agent for home care service recipients and have more than 15 

clients, complete continuation sheets as necessary. Schedule R 

may be filed electronically or by paper submission. However, 

agents filing for 1,000 or more clients must file a paper return. 

Attach Schedule R, including any continuation sheets, to your 

aggregate Form 940 and file it with your Form 940.

Who Must File?

You must complete Schedule R each time you file 

an aggregate Form 940, Employer’s Annual Federal 

Unemployment (FUTA) Tax Return. Aggregate Forms 940 are 

filed by agents of home care service recipients approved by 

the IRS under section 3504. To request approval to act as an 

agent for an employer, you must file Form 2678, Employer/

Payer Appointment of Agent, with the IRS, unless you are a 

state or local government agency acting as agent under the 

special procedures provided in Notice 2003-70. On Schedule R, 

we call those employers your clients. 

When Must You File?

If you are an aggregate Form 940 filer, file Schedule R with your 

aggregate Form 940 every year when your Form 940 is due.

Specific Instructions

Enter Your Business Information

Carefully enter your employer identification number (EIN) and 

the name of your business at the top of the schedule. Make 

sure they exactly match the EIN and name shown on the 

attached Form 940.

Calendar Year

Enter the calendar year for which you are filing your Form 940. 

Make sure that the year entered on the top of Schedule R 

matches the year on the attached Form 940.

On Schedule R, including any continuation sheets, you must 

report the following for each client:

The employer identification number (EIN).

The state abbreviation of the listed client's location.

Total taxable FUTA wages (Form 940, line 7a) allocated to the 

listed client EIN.

Total adjustments to FUTA tax (Form 940, line 9 or line 10) 

allocated to the listed client EIN.

Credit reduction amount (Form 940, line 11) allocated to the 

listed client EIN.

Total FUTA tax after adjustments (Form 940, line 12) allocated 

to the listed client EIN.

Total FUTA tax deposits for the tax year plus any other 

payments (Form 940, line 13) allocated for the listed client 

EIN.

You must also report the same information for your 

employees on line 18 of Schedule R.

Compare the total of each column on line 19 (including your 

information on line 18) to the amounts reported on the 

aggregate Form 940. For each column total, the relevant line 

from Form 940 is noted in the column heading.

If the totals on line 19 of the Schedule R do not match the 

totals on Form 940, there is an error that must be corrected 

before submitting Form 940 and Schedule R.

Paperwork Reduction Act Notice. We ask for the

information on Schedule R to carry out the Internal Revenue 

laws of the United States. You are required to give us this 

information. We need it to ensure that you are complying with 

these laws and to allow us to figure and collect the right amount 

of tax.

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 

or 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. Generally, tax 

returns and return information are confidential, as required by 

section 6103.

The time needed to complete and file Schedule R will vary 

depending on individual circumstances. The estimated average 

time is:

Recordkeeping . . . . . . . . . . . 10 hrs., 45 min.

Learning about the law or the form . . . . 0 hrs., 12 min.

Preparing . . . . . . . . . . . . 0 hrs., 22 min.

Copying, assembling, and 

sending the form to the IRS . . . . . . 0 hrs., 00 min.

If you have comments concerning the accuracy of these 

time estimates or suggestions for making Schedule R simpler, 

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

taxforms@irs.gov. Enter “Schedule R (Form 940)” on the subject 

line. Or write to: Internal Revenue Service, Tax Products 

Coordinating Committee, SD:W:CAR:MP:T:M:S, 1111 

Constitution Ave., NW, IR-6526, Washington, DC 20224. Do not 

send Schedule R to this address. Instead, see Where Do You 

File? in the Instructions for Form 940.