Fillable Form 941-SS (2021)

What is Form 941-SS?

Form 941-SS, Employer’s Quarterly Federal Tax Return, is an Internal Revenue Service (IRS) form used by employers to report income taxes, social security tax, or Medicare tax withheld from employees' paychecks.

Federal law requires employers to withhold certain taxes from their employee’s pay. Each time they pay an employee’s wages, they must withhold (or in other words take out of their employee’s pay) certain amounts of what is known as federal income tax, social security tax, and Medicare tax. Additional Medicare tax must also be withheld from wages paid to an employee in excess of $200,000 in a calendar year. Under the withholding system, taxes withheld from employees are credited to them in payment of their tax liabilities.

Federal law also requires employers to pay any liability for the employer's share of social security and medicare taxes. This share of social security and Medicare taxes isn't withheld from employees.

The 941-SS form is used to report these taxes for a particular quarter of the year for workers in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands. While most employers must file the IRS 941-SS form on a quarterly basis, there are certain special rules that employers will need to follow if they meet certain conditions. These rules are as follows:

• If you received a notification to file Form 944, you must file Form 944 annually; don't file Form 941-SS quarterly.
• Seasonal employers don't have to file a Form 941-SS for quarters in which they have no tax liability because they have paid no wages. To tell the IRS that you won't file a return for one or more quarters during the year, check the box on line 18a every quarter you file Form 941-SS. See section 12 of Pub. 15 for more information.
• Employers of household employees don't usually file Form 941-SS. See Pub. 926 and Schedule H (Form 1040) for more information.
• Employers of farm employees don't file Form 941-SS for wages paid for agricultural labor. See Form 943 and Pub. 51 for more information.

Who needs to use Form 941-SS?

If you pay wages to workers in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, and the U.S. Virgin Islands that are subject to federal income tax withholding or social security and medicare taxes, you must file Form 941-SS IRS quarterly to report the following amounts:

• Wages you’ve paid.
• Tips your employees reported to you.
• Federal income tax you withheld.
• Both the employer’s and the employee’s share of social security and Medicare taxes.
• Additional Medicare Tax withheld from employees.
• Current quarter's adjustments to social security and Medicare taxes for fractions of cents, sick pay, tips, and group-term life insurance.
• Qualified small business payroll tax credit for increasing research activities.
• Credit for qualified sick and family leave wages.
• Employee retention credit.
• Credit for COBRA premium assistance payments.
• Total advances received from filing Form(s) 7200 for the quarter.

How to fill out Form 941-SS?

Form 941-SS is a long, but ultimately very simple form to fill out. Make sure to have the relevant documents prepared in order to ensure that you are entering the correct information in the correct areas. You may also download a PDF copy of the instructions for Form 941-SS from the IRS website.

Employer Information

Employer Identification Number

Enter your Employer Identification Number (EIN).

Name

Enter your full legal name - not your trade name.

Trade Name

If you have a trade name, enter it here.

Address

Enter the following information for your address;

• Number
• Street
• Suite or Room Number
• City
• State
• ZIP Code
• Foreign Country Name (If applicable)
• Foreign Province/County (If applicable)
• Foreign Postal Code (If applicable)

Reporting For Quarter of 2021

Check the appropriate box that indicates which quarter of 2021 you are filing IRS Form 941-SS for. You may choose one of the following:

• April, May, June
• July, August, September
• October, November, December

Part 1 - Questions for the Quarter

Line 1

Enter the number of employees who received wages, tips, or any other compensation for the pay period, including the following dates depending on the quarter:

• March 12 (Quarter 1)
• June 12 (Quarter 2)
• September 12 (Quarter 3)
• December 12 (Quarter 4)

Lines 2 and 3

These Lines are reserved for future use.

Line 4

If no wages, tips, and compensation are subject to social security or medicare tax, check the box provided and skip to Line 6.

Line 5a

Enter the total amount of taxable social security wages in Column 1. Then multiply it by 0.124 and enter the product in Column 2.

Line 5a (i)

Enter the total amount of qualified sick leave wages in Column 1. Then multiply it by 0.062 and enter the product in Column 2.

Line 5a (ii)

Enter the total amount of qualified family leave wages in Column 1. Then multiply it by 0.062 and enter the product in Column 2.

Line 5b

Enter the total amount of taxable social security tips in Column 1. Then multiply it by 0.124 and enter the product in Column 2.

Line 5c

Enter the total amount of taxable Medicare wages and tips in Column 1. Then multiply it by 0.029 and enter the product in Column 2.

Line 5d

Enter the total amount of taxable wages and tips subject to additional medicare tax withholding in Column 1. Then multiply it by 0.009 and enter the product in Column 2.

Line 5e

Add Column 2 from Lines 5a, 5a(i), 5a(ii), 5b, 5c, and 5d and enter the sum.

Line 5f

Enter the tax due on unreported tips are outlined in Section 3121(q), Notice and Demand,

Line 6

Add Lines 5e and 5f.

Line 7

Enter the adjustment for the current quarter for fractions of cents.

Line 8

Enter the current quarter’s adjustment for sick pay.

Line 9

Enter the current quarter’s adjustments for tips and group-term life insurance.

Line 10

Add Lines 6 through 9.

Line 11a

Enter the qualified small business payroll tax credit for increasing research activities. Attach Form 8974 to this form.

Line 11b

Enter the nonrefundable portion of the credit for qualified sick and family leave taken before April 1, 2021.

Line 11c

Enter the nonrefundable portion of employee retention credit.

Line 11d

Enter the nonrefundable portion of the credit for qualified sick and family leave taken after March 31, 2021.

Line 11e

Enter the nonrefundable portion of COBRA premium assistance credit.

Line 11f

Enter the number of individuals provided with COBRA premium assistance.

Line 11g

Add Lines 11a, 11b, 11c, 11d, and 11e and enter the sum.

Line 12

Subtract Line 11g from Line 10 and enter the difference.

Line 13a

Enter the total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form 941-SS-X, 941-SS-X (PR), 944-X, or 944-X (SP) filed in the current quarter.

Line 13b

This line is reserved for future use.

Line 13c

Enter the refundable portion of the credit for qualified sick and family leave taken before April 1, 2021.

Line 13d

Enter the refundable portion of employee retention credit.

Line 13e

Enter the refundable portion of credit for qualified sick and family leave taken after March 31, 2021.

Line 13f

Enter the refundable portion of COBRA premium assistance credit.

Line 13g

Add Lines 13a, 13c, 13d, 13e, and 13f and enter the sum.

Line 13h

Enter the total advances received from filing Form 7200 for this quarter.

Line 13i

Subtract Line 13h from Line 13g and enter the difference.

Line 14

If Line 12 is greater than Line 13i, enter the difference and consult the instructions for Form 941-SS on the IRS website. Do not fill out Line 15 if you fill out this Line.

Line 15

If Line 13i is greater than Line 12, enter the difference and check one of either:

• Apply to next return
• Send a refund

Part 2 - Deposit Schedule and Tax Liability For the Quarter

Line 16

Check only one of the following boxes as best applies to your deposit schedule and tax liability for the quarter. Read each option on the form carefully, and follow the instructions written on the option of your choice:

• Line 12 on this return is less than $2500, or Line 12 on the return for the prior quarter was less than $2500, and no $100,000 next-day deposit obligation was incurred during the current quarter. You may need to provide a record of your federal tax liability, complete a deposit schedule, or attach Schedule B (Form 941-SS), Report of Tax Liability for Semiweekly Schedule Depositors, to this form. Proceed to Part 3.
• You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liability for the quarter, then proceed to Part 3.
• You were a semiweekly depositor for any part of this quarter. Complete Schedule B (Form 941-SS) and attach it to this form. Proceed to Part 3.

Part 3 - Business Information

If a question in this section does not apply to your business, leave it blank.

Line 17

If your business has closed or you have stopped paying wages, check the box provided and enter the final date that you paid wages in the space provided.

Line 18a

If you are a seasonal employer and therefore do not have to file a return for every quarter of the year, check the box provided.

Line 18b

If you are eligible for the employee retention credit solely because your business is a recovery startup business, check the box provided.

Line 19

Enter the total of all qualified health plan expenses allocable to qualified sick leave wages for leave taken before April 1, 2021.

Line 20

Enter the total of all qualified health plan expenses allocable to qualified family leave wages for leave taken before April 1, 2021.

Line 21

Enter the total qualified wages for employee retention credit.

Line 22

Enter the total qualified health plan expenses allocable to the wages reported on Line 21.

Line 23

Enter the total of all qualified sick leave wages for leave taken after March 31, 2021.

Line 24

Enter the total qualified health plan expenses allocable to the wages reported on Line 23.

Line 25

Enter the total amount under certain collectively bargained agreements allocable to qualified sick leave wages reported on Line 23.

Line 26

Enter the total qualified family leave wages for leave taken after March 31, 2021.

Line 27

Enter the total qualified health plan expenses allocable to the wages reported on Line 26.

Line 28

Enter the total amount under certain collectively bargained agreements allocable to qualified family leave wages reported on Line 26.

Part 4 - Contact with Third Party Designee

If you wish to allow an employee, paid tax preparer, or another person to discuss this return with the IRS, check “Yes” and provide the following details:

• Designee’s Name and Phone Number
• A 5 digit Personal Identification Number (PIN) for the designee to use when talking to the IRS.

Otherwise, check “No”.

Part 5 - Signature

Enter your signature in the space provided.

Name and Title

Enter your full name and any titles associated in the spaces provided.

Date

Enter the date the form was signed.

Best Daytime Phone

Enter the daytime phone number you use most often.

Paid Preparer Use Only

This section should only be filled out by the person paid to prepare this tax form on behalf of the filer.

Self-employed

Check the box if the preparer is self-employed.

Preparer’s Name

Enter the preparer’s full name.

Preparer Tax Identification Number

Enter the preparer’s Preparer Tax Identification Number (PTIN).

Preparer’s Signature

Have the preparer sign in the space provided.

Date

Enter the date that the preparer signed this form.

Firm’s Name

Enter the name of the firm that the preparer works for. If the preparer is self-employed, enter their name instead.

Employer Identification Number

Enter the preparer’s EIN.

Address

Enter the preparer’s street address and room or suite number (if applicable).

Phone Number

Enter the preparer’s primary phone number.

City

Enter the city of the preparer.

State

Enter the State that the preparer resides or operates in.

ZIP Code

Enter the preparer’s ZIP Code.

Payment Voucher

Do not staple this voucher or the payment to Form 941-SS.

Box 1 - EIN

Enter your EIN.

Box 2 - Amount of Payment

Enter the amount you are paying (through check or money order made payable to the United States Treasury) in dollars and cents.

Box 3 - Tax Period

Mark the appropriate circle to indicate which quarter of the tax period you are paying for.

Box 4 - Business/Individual Details

Enter the following information in the space provided:

• Business Name (If the business is a sole proprietorship, enter your individual name instead).
• Address
• City, State, and ZIP Code OR city, foreign country name, foreign province or country, and foreign postal code.

Tips when filling out Form 941-SS

Considering the length of Form 941-SS, it is very important to make sure that one is putting the correct and necessary information in each part to avoid any legal issues.

Double-check the information entered. Make sure that you have entered the correct information in the appropriate fields. It may be beneficial to consult the instructions of Form 941-SS on the IRS website if you require more details on what must be entered in the form.

Practice Good Contract Management. Keep a copy of this form (filled out) in a safe place. This is to make sure that you have a copy of it ready when necessary, whether for legal purposes or simply to serve as a record or backup.