Form 944-X:

(Rev. February 2015)

Adjusted Employer’s ANNUAL Federal Tax Return or Claim for Refund

Department of the Treasury — Internal Revenue Service OMB No. 1545-2007

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

Read the separate instructions before completing this form. Use this form to correct errors 

you made on Form 944 or Form 944-SS. Use a separate Form 944-X for each year that 

needs correction. Type or print within the boxes. You MUST complete all three pages. Do 

not attach this form to Form 944.

 Return You Are Correcting ...

Check the type of return you are 

correcting:

944

944-SS

Enter the calendar year you are 

correcting:

(YYYY)

Enter the date you discovered errors:

/ /

(MM / DD / YYYY)

Part 1: Select ONLY one process. See page 4 for additional guidance.

1. Adjusted employment tax return. Check this box if you underreported amounts. Also check this box if you overreported amounts and you 

would like to use the adjustment process to correct the errors. You must check this box if you are correcting both underreported and 

overreported amounts on this form. The amount shown on line 19, if less than zero, may only be applied as a credit to your Form 944, 

Form 941, or Form 941-SS for the tax period in which you are filing this form.

2. Claim. Check this box if you overreported amounts only and you would like to use the claim process to ask for a refund or abatement of the 

amount shown on line 19. Do not check this box if you are correcting ANY underreported amounts on this form.

Part 2: Complete the certifications.

3. I certify that I have filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement, as 

required.

Note. If you are correcting underreported amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you are correcting overreported 

amounts, for purposes of the certifications on lines 4 and 5, Medicare tax does not include Additional Medicare Tax. Form 944-X cannot be 

used to correct overreported amounts of Additional Medicare Tax unless the amounts were not withheld from employee wages.

4. If you checked line 1 because you are adjusting overreported amounts, check all that apply. You must check at least one box.

I certify that:

a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I have a

written statement from each affected employee stating that he or she has not claimed (or the claim was rejected) and will not claim a

refund or credit for the overcollection.

b. The adjustments of social security tax and Medicare tax are for the employer’s share only. I could not find the affected employees or 

each affected employee did not give me a written statement that he or she has not claimed (or the claim was rejected) and will not

claim a refund or credit for the overcollection.

c. The adjustment is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I did not withhold from 

employee wages.

5. If you checked line 2 because you are claiming a refund or abatement of overreported employment taxes, check all that apply.

You must check at least one box.

 I certify that:

a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I have a

written statement from each affected employee stating that he or she has not claimed (or the claim was rejected) and will not claim a

refund or credit for the overcollection.

b. I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social security tax

and Medicare tax overcollected in prior years. I also have a written statement from each affected employee stating that he or she 

has not claimed (or the claim was rejected) and will not claim a refund or credit for the overcollection.

c. The claim for social security tax and Medicare tax is for the employer’s share only. I could not find the affected employees; or each 

affected employee did not give me a written consent to file a claim for the employee’s share of social security tax and Medicare tax; 

or each affected employee did not give me a written statement that he or she has not claimed (or the claim was rejected) and will not 

claim a refund or credit for the overcollection.

d. The claim is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I did not withhold from 

employee wages.

Next ■▶

For Paperwork Reduction Act Notice, see the separate instructions. IRS.gov/form944x Cat. No. 20335M Form 944-X (Rev. 2-2015)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 3: Enter the corrections for the calendar year you are correcting. If any line does not apply, leave it blank.

Column 1

Total corrected 

amount (for ALL 

employees)

—

Column 2

Amount originally 

reported or as 

previously corrected 

(for ALL employees)

=

Column 3

Difference 

(If this amount is a 

negative number, 

use a minus sign.)

Column 4

Tax correction

6. Wages, tips and other 

compensation (Form 944, line 1) . — . = .

Use the amount in Column 1 

when you prepare your Forms 

W-2 or Forms W-2c.

7. Federal income tax withheld from 

wages, tips, and other 

compensation (Form 944, line 2) . — . = .

Copy 

Column 3 

here ▶ .

8. Taxable social security wages 

(Form 944 or Form 944-SS, line 

4a, Column 1)

. — . = . × .124* = .

*If you are correcting a 2011 or 2012 return, use .104. If you are correcting your employer share only, use .062. See instructions.

9. Taxable social security tips 

(Form 944 or Form 944-SS, line 

4b, Column 1) . — . = . × .124* = .

*If you are correcting a 2011 or 2012 return, use .104. If you are correcting your employer share only, use .062. See instructions.

10. Taxable Medicare wages & tips 

(Form 944 or Form 944-SS, line 

4c, Column 1)

. — . = . × .029* = .

*If you are correcting your employer share only, use .0145. See instructions.

11. Taxable wages & tips subject to 

Additional Medicare Tax withholding 

(Form 944 line 4d, only for years 

beginning after December 31, 2012)

. — . = . × .009* = .

*Certain wages & tips reported in Column 3 should not be multiplied by .009. See instructions.

12. Tax adjustments (Form 944 or 

Form 944-SS, line 6) . — . = .

Copy 

Column 3 

here ▶ .

13. Special addition to wages for 

federal income tax . — . = .

See 

instructions .

14. Special addition to wages for 

social security taxes . — . = .

See 

instructions .

15. Special addition to wages for 

Medicare taxes . — . = .

See 

instructions .

16. Special addition to wages for 

Additional Medicare Tax . — . = .

See 

instructions .

17. Subtotal. Combine the amounts on lines 7–16 of Column 4 . . . . . . . . . . . . . . . . . . .

18 a. COBRA premium assistance 

payments (see instructions) . — . = .

See 

instructions .

18 b. Number of individuals provided 

COBRA premium assistance 

(see instructions)

— =

19. Total. Combine the amounts on lines 17 and 18a of Column 4 . . . . . . . . . . . . . . . . . . .

If line 19 is less than zero:

• If you checked line 1, this is the amount you want applied as a credit to your Form 944 for the tax period in which you are filing this form 

(If you are currently filing a Form 941 or Form 941-SS, Employer’s QUARTERLY Federal Tax Return, see the instructions.)

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

If line 19 is more than zero, this is the amount you owe. Pay this amount by the time you file this return. For information on how to pay, 

see Amount you owe in the instructions.

Next ■▶

Page 2 Form 944-X (Rev. 2-2015)
 / /

 / /

Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 4: Explain your corrections for the calendar year you are correcting.

20. Check here if any corrections you entered on a line include both underreported and overreported amounts. 

Explain both your underreported and overreported amounts on line 22.

21. Check here if any corrections involve reclassified workers. Explain on line 22.

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

Part 5: Sign here. You must complete all three pages of this form and sign it.

Under penalties of perjury, I declare that I have filed an original Form 944 or Form 944-SS and that I have examined this adjusted return or claim 

and any schedules or statements that are attached, and to the best of my knowledge and belief, they are 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 are 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 3 Form 944-X (Rev. 2-2015)
Type of errors Form 944-X: Which process should you use?

you are 

correcting

Underreported 

amounts 

ONLY

Use the adjustment process to correct underreported amounts.

• Check the box on line 1.

• Pay the amount you owe from line 19 by the time you file Form 944-X.

Overreported 

amounts 

ONLY

The process you 

use depends on 

when you file 

Form 944-X.

If you are filing Form 944-X 

MORE THAN 90 days before the 

period of limitations on credit or 

refund for Form 944 or Form 

944-SS expires . . .

Choose either the adjustment process or the claim 

process to correct the overreported amounts.

Choose the adjustment process if you want the

amount shown on line 19 credited to your Form 944, 

941, or 941-SS, for the period in which you file Form 

944-X. Check the box on line 1.

OR

Choose the claim process if you want the amount

shown on line 19 refunded to you or abated. Check

the box on line 2.

If you are filing Form 944-X 

WITHIN 90 days of the expiration 

of the period of limitations on 

credit or refund for Form 944 or 

Form 944-SS . . .

You must use the claim process to correct the 

overreported amounts. Check the box on line 2.

BOTH 

underreported 

and 

overreported 

amounts 

The process you 

use depends on 

when you file 

Form 944-X.

If you are filing Form 944-X 

MORE THAN 90 days before the 

period of limitations on credit or 

refund for Form 944 or Form 

944-SS expires . . .

Choose either the adjustment process or both the 

adjustment process and the claim process when you 

correct both underreported and overreported amounts.

Choose the adjustment process if combining your

underreported amounts and overreported amounts

results in a balance due or creates a credit that you

want applied to Form 944, 941, or 941-SS.

• File one Form 944-X, and 

• Check the box on line 1 and follow the instructions 

on line 19.

OR

Choose both the adjustment process and the 

claim process if you want the overreported amount

refunded to you or abated.

File two separate forms. 

1. For the adjustment process, file one Form 944-X

to correct the underreported amounts. Check the

box on line 1. Pay the amount you owe from line 19

by the time you file Form 944-X. 

2. For the claim process, file a second Form 944-X 

to correct the overreported amounts. Check the 

box on line 2.

If you are filing Form 944-X 

WITHIN 90 days of the 

expiration of the period of 

limitations on credit or refund 

for Form 944 or Form 944-SS. . .

You must use both the adjustment process and 

the claim process.

File two separate forms. 

1. For the adjustment process, file one Form 944-X to 

correct the underreported amounts. Check the box 

on line 1. Pay the amount you owe from line 19 by 

the time you file Form 944-X. 

2. For the claim process, file a second Form 944-X to 

correct the overreported amounts. Check the box 

on line 2.

Page 4 Form 944-X (Rev. 2-2015)