Fillable Form 941 (Schedule D)

What is Schedule D (Form 941)?

Schedule D (Form 941), Report of Discrepancies Caused by Acquisitions, Statutory Mergers, or Consolidations, is an Internal Revenue Service (IRS) form used by employers to explain certain discrepancies between W-2 forms, Wage and Tax Statement, and 941 forms, Employer’s Quarterly Federal Tax Return, for the totals of social security wages, Medicare wages and tips, social security tips, federal income tax withheld, and advance earned income credit (EIC) payments (for tax years ending before January 1, 2011).

Each year the Internal Revenue Service (IRS) and the Social Security Administration (SSA) compare the totals on your 941 forms, Employer’s Quarterly Federal Tax Return, with the totals on your W-2 forms, Wage and Tax Statement (Copy A), to verify:

• The wages you reported on 941 forms match those you reported on W-2 forms (Copy A) so that your employees’ social security earnings records are complete for benefit purposes.
• The appropriate taxes you have paid.

Generally, the totals of all your W-2 forms, Wage and Tax Statement (Copy A) should equal the aggregate quarterly totals you reported on 941 forms, Employer’s Quarterly Federal Tax Return. Use Schedule D (Form 941) only if discrepancies exist between the totals you reported on those forms are a result of an acquisition, statutory merger, or consolidation.

How to fill out Schedule D (Form 941)?

Filling out Schedule D (Form 941) is quick and simple. You can download and print a PDF copy of Schedule D (Form 941) from the Internal Revenue Service (IRS) website that you can manually complete. But for your convenience, you can also fill out Schedule D (Form 941) electronically on PDFRun. By following the instructions below, you can accomplish the form in minutes.

Employer Identification Number (EIN)

Enter your employer identification number.

Be certain that the EIN on Schedule D (Form 941) exactly matches the EIN the Internal Revenue Service (IRS) assigned to your business.

Name

Enter your full name.

Trade Name

Enter your trade name, if any.

Address

Enter your residential number, street, and suite or room number. Enter your residential city. Select your residential state from the drop-down list. Enter your ZIP code.

Phone Number

Enter your phone number.

Tax Year of Discrepancies

Enter the tax year (not the quarter) in which the discrepancies occurred, following the format: YYYY.

Make sure you fill in the correct tax year so you can reconcile the information appropriately.

Type of Submission

Mark the appropriate box to show whether this form is the original Schedule D (Form 941) for a specific transaction or if it corrects a Schedule D (Form 941) you previously submitted. You may select:

• Original
• Corrected

Part 1

Line 1

Mark the appropriate box if you are filing this schedule after a statutory merger or consolidation, or an acquisition for which you are using the alternate procedure under Rev. Proc. 2004-53, 2004-2 C.B. 320. You may select:

• After a statutory merger or consolidation – If you checked this box, mark the box below if you are:
  • An acquired corporation
  • A surviving corporation
• After an acquisition and you are using the alternate procedure under Rev. Proc. 2004-53, 2004-2 C.B. 320 – If you checked this box, mark the box below if you are:
  • A predecessor
  • A successor

Line 2

Enter the effective date of the statutory merger or consolidation, or acquisition, following the format: MM/DD/YYYY.

Line 3

Enter the contact information of the other party in the transaction including the other party’s employee identification number (EIN), full name, trade name (if any), complete address, (number, street, suite or room number, city, state, and ZIP code), and phone number.

Your EIN

Enter your employee identification number.

Name

Enter your full name.

Other Party’s EIN

Enter the other party’s employee identification number.

Tax Year of Discrepancies

Enter the tax year (not the quarter) in which the discrepancies occurred, following the format: YYYY.

Part 2

Prepare the information about your social security wages, Medicare wages and tips, social security tips, federal income tax withheld, and advance earned income credit (EIC) payments for tax years ending before January 1, 2011.

When entering money amounts from your Forms 941, Employer’s Quarterly Federal Tax Return, and W-2, Wage and Tax Statement (Copy A), you may round to the nearest dollars. Do not show dollar signs but do use commas as appropriate. Show an amount (even if it is zero) for every column of a line.

Lines 4 – 8

In Column A, fill in the amount you reported to the Internal Revenue Service (IRS) for the tax year for each of the items. Add the totals from all Forms 941, Employer’s Quarterly Federal Tax Return, as corrected by any Forms 941-X, Adjusted Employer’s Quarterly Federal Income Tax or Claim for Refund, and enter the sum on the appropriate lines.

In Column B, fill in the amount you reported to the Social Security Administration (SSA) for each of the items. Add the totals from all Forms W-2, Wage and Tax Statement (Copy A), as corrected by any Forms W-2c, Corrected Wage and Tax Statement (Copy A), and enter the sum on the appropriate lines.

In Column C, calculate the differences between the entries in Columns A and B, and enter the result on the appropriate lines. Enter any negative result in parentheses, if possible.

Part 3

Complete this section only if you are filing for more than one transaction.

When more than one statutory merger, consolidation, or acquisition occurs during a calendar year, file a separate Schedule D (Form 941) for each transaction. Complete this section for each transaction.

Line 9

Enter the number of schedules you are filing for the year and identify which schedule this is. For example, if you had three different transactions in a calendar year and you are filing a Schedule D (Form 941) to describe the second transaction, enter “2” and “3” so the sentence reads: “This is schedule 2 of 3.”

Lines 10 – 14

For the purposes of Part 3, Columns A and B, the term “employees affected by the transaction reported on this Schedule D (Form 941)” means those employees who received wages that were reported on Forms 941, Employer’s Quarterly Federal Tax Return, filed by one employer but whose wages were reported on Form W-2, Wage and Tax Statement (Copy A), filed by another employer as a result of this particular transaction.

Report the totals for security wages, Medicare wages and tips, social security tips, federal income tax withheld, and advance earned income credit (EIC) payments for tax years ending before January 1, 2011.

In Column A, fill in the amount you reported to the Internal Revenue Service (IRS) for the tax year for employees affected by the transaction reported on this Schedule D (Form 941) for each of the items. Add the totals from all your Forms 941, Employer’s Quarterly Federal Tax Return, as corrected by any Forms 941-X, Adjusted Employer’s Quarterly Federal Income Tax or Claim for Refund, and enter the sum on the appropriate lines.

In Column B, fill in the amount you reported to the Social Security Administration (SSA) for the tax year for employees affected by the transaction reported on this Schedule D (Form 941) for each of the items. Add the totals from all Forms W-2, Wage and Tax Statement (Copy A), as corrected by any Forms W-2c, Corrected Wage and Tax Statement (Copy A), and enter the sum on the appropriate lines.

In Column C, calculate the differences between the entries in Columns A and B, and enter the result on the appropriate lines. Enter any negative result in parentheses, if possible.