Instructions For Schedule D (Form 941) : (Rev. June 2011)
Instructions For Schedule D (Form 941) : (Rev. June 2011)
Part 1: Answer these background Part 3: Fill this part out ONLY if you
questions are filing more than one Schedule D
1. Check the appropriate box to explain the type of (Form 941) for any calendar year
transaction for which you are submitting Schedule D If you are filing only one Schedule D (Form 941) for the
(Form 941). See Types of Mergers and Acquisitions on calendar year, leave this part blank.
page 1 for details.
When more than one statutory merger, consolidation,
File Schedule D (Form 941) after either: or acquisition occurs during a calendar year, file a
a. A statutory merger or consolidation (Check whether separate Schedule D (Form 941) for each transaction.
you are an acquired corporation or a surviving Complete Part 3 for each transaction. For instance, if you
corporation.), or have 11 different transactions in a calendar year, you
b. An acquisition for which you are using the alternate need to file 11 different Schedules D (Form 941). Part 2
procedure under Rev. Proc. 2004-53. (Check whether would be the same for each schedule. Part 3 would show
you are a predecessor or a successor.) one of the 11 transactions. For example, the amount
2. Fill in the effective date of the transaction in the entered in Part 2 on line 4 for Column C should equal the
box. Make sure you write the month, day, and year in this total of all 11 entries in Part 3 on line 10 for Column C.
format: MM/DD/YYYY. The year must be the same as the Line 9. Show the number of schedules you are filing for
calendar year you write in the box at the top of the the year and identify which schedule this is. For example,
schedule. if you had three different transactions in a calendar year
3. Fill in the contact information about the OTHER and you are filing a Schedule D (Form 941) to describe
PARTY in the transaction by including the other party’s the second transaction, fill in “2” and “3” so the sentence
EIN, name, trade name (doing business as or d/b/a), reads: “This is schedule 2 of 3. ”
complete address, and phone number. Verify the other Lines 10–14. For purposes of Part 3, Columns A and B,
party’s EIN to make sure it is correct. the term “employees affected by the transaction reported
on this Schedule D” means those employees who
Part 2: Tell us about the received wages that were reported on Forms 941 filed by
one employer but whose wages were reported on Form
discrepancies with your returns W-2 (Copy A) filed by another employer as a result of this
Lines 4–8. Gather your information about the social particular transaction. Report the totals for social security
security wages, Medicare wages and tips, social security wages, Medicare wages and tips, social security tips,
tips, federal income tax withheld, and advance earned federal income tax withheld, and advance earned income
income credit (EIC) payments (for tax years ending credit (EIC) payments (for tax years ending before
before January 1, 2011) you reported. When entering January 1, 2011).
money amounts from your Forms 941 and W-2 (Copy A) In Column A, fill in the amount you reported to the IRS
on lines 4–14, you may round to the nearest dollar. Do for the tax year for employees affected by the transaction
not show dollar signs but do use commas as appropriate. reported on this Schedule D (Form 941) for each of the
Show an amount (even if it is zero) for each column of a items. Add the totals from all your Forms 941, as
line. corrected by any Forms 941-X, and write your answers
In Column A, fill in the amount you reported to the IRS on the appropriate lines.
for the tax year for each of the items. Add the totals from In Column B, fill in the amount you reported to SSA for
all Forms 941, as corrected by any Forms 941-X, the tax year for employees affected by the transaction
Adjusted Employer’s QUARTERLY Federal Tax Return reported on this Schedule D (Form 941) for each of the
or Claim for Refund, and write your answers on the items. Add the totals from all Forms W-2 (Copy A), as
appropriate lines. corrected by any Forms W-2c (Copy A), and write your
In Column B, fill in the amount you reported to SSA for answers on the appropriate lines.
each of the items. Add the totals from all Forms W-2 Calculate the differences between the entries in the
(Copy A), as corrected by any Forms W-2c, Corrected columns:
Wage and Tax Statement (Copy A), and write your Column A
answers on the appropriate lines. – Column B
Calculate the differences between the entries in the Column C
columns:
Column A Enter any negative result in parentheses, if possible.
– Column B For example, if line 12, Column A is “-0-” and line 12,
Column C Column B is “6,000,” write “(6,000)” on line 12, Column
C.
Enter any negative result in parentheses, if possible. If no Forms W-2 (Copy A) were filed by you, write
For example, if line 6, Column A is “-0-” and line 6, ! “-0-” in Column B, “Amount you reported to SSA
Column B is “6,000,” write “(6,000)” on line 6, Column C. CAUTION
for the tax year.”
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Paperwork Reduction Act Notice. We ask for the circumstances. The estimated average time is:
information on Schedule D (Form 941) to carry out the Recordkeeping, 11 hr., 43 min.; Learning about the
Internal Revenue laws of the United States. You are law or the form, 18 min.; Preparing, copying,
required to give us the information. We need it to ensure assembling, and sending the form to the IRS, 30 min.
you are complying with these laws and to allow us to If you have comments concerning the accuracy of this
figure and collect the right amount of tax. time estimate or suggestions for making Schedule D
You are not required to provide the information (Form 941) simpler, we would be happy to hear from you.
requested on a form that is subject to the Paperwork You can email us at: [email protected]. Enter “Schedule
Reduction Act unless the form displays a valid OMB D (Form 941)” on the subject line. Or write to: Internal
control number. Books or records relating to a form or its Revenue Service, Tax Products Coordinating Committee,
instructions must be retained as long as their contents SE:W:CAR:MP:T:T:SP, 1111 Constitution Ave. NW,
may become material in the administration of any Internal IR-6526, Washington, DC 20224. Do not send Schedule
Revenue law. Generally, tax returns and return D (Form 941) to this address. Instead, see How Should
information are confidential, as required by section 6103. You File?, earlier.
The time needed to complete and file Schedule D
(Form 941) will vary depending on individual
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