Form 941 for 2023:
(Rev. March 2023)
Employer’s QUARTERLY Federal Tax Return
Department of the Treasury — Internal Revenue Service
950122
OMB No. 1545-0029
Employer identification number (EIN)
—
Name (not your trade name)
Trade name (if any)
Address
Number Street Suite or room number
City State ZIP code
Foreign country name Foreign province/county Foreign postal code
Report for this Quarter of 2023
(Check one.)
1: January, February, March
2: April, May, June
3: July, August, September
4: October, November, December
Go to www.irs.gov/Form941 for
instructions and the latest information.
Read the separate instructions before you complete Form 941. Type or print within the boxes.
Part 1:
Answer these questions for this quarter.
1 Number of employees who received wages, tips, or other compensation for the pay period
including: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 1
2 Wages, tips, and other compensation . . . . . . . . . . . . . . . . . 2 .
3 Federal income tax withheld from wages, tips, and other compensation . . . . . . 3 .
4 If no wages, tips, and other compensation are subject to social security or Medicare tax Check and go to line 6.
Column 1 Column 2
5a Taxable social security wages* . . . × 0.124 = .
5a (i) Qualified sick leave wages* . . × 0.062 = .
5a (ii) Qualified family leave wages* . . × 0.062 = .
* Include taxable qualified sick and
family leave wages paid in this
quarter of 2023 for leave taken
after March 31, 2021, and before
October 1, 2021, on line 5a. Use
lines 5a(i) and 5a(ii) only for taxable
qualified sick and family leave
wages paid in this quarter of 2023
for leave taken after March 31,
2020, and before April 1, 2021.
5b Taxable social security tips . . . . × 0.124 = .
5c Taxable Medicare wages & tips . . . × 0.029 = .
5d Taxable wages & tips subject to
Additional Medicare Tax withholding
. × 0.009 = .
5e Total social security and Medicare taxes. Add Column 2 from lines 5a, 5a(i), 5a(ii), 5b, 5c, and 5d 5e .
5f Section 3121(q) Notice and Demand—Tax due on unreported tips (see instructions) . . 5f .
6 Total taxes before adjustments. Add lines 3, 5e, and 5f . . . . . . . . . . . . 6 .
7 Current quarter’s adjustment for fractions of cents . . . . . . . . . . . . . 7 .
8 Current quarter’s adjustment for sick pay . . . . . . . . . . . . . . . . 8 .
9 Current quarter’s adjustments for tips and group-term life insurance . . . . . . . 9 .
10 Total taxes after adjustments. Combine lines 6 through 9 . . . . . . . . . . . 10 .
11a Qualified small business payroll tax credit for increasing research activities. Attach Form 8974 11a .
11b Nonrefundable portion of credit for qualified sick and family leave wages for leave taken
before April 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . 11b
.
11c Reserved for future use . . . . . . . . . . . . . . . . . . . . . . 11c .
You MUST complete all three pages of Form 941 and SIGN it.
For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Cat. No. 17001Z Form 941 (Rev. 3-2023)