Form 944-X:
(Rev. February 2018)
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, Employer’s
ANNUAL Federal Tax Return. Use a separate Form 944-X for each year that needs correction. Type or print within the boxes. You
MUST complete all three pages. Don’t attach this form to Form 944 unless you’re reclassifying workers; see the instructions for
line 22.
Return You’re Correcting ...
Enter the calendar year of the return
you’re correcting:
(YYYY)
Enter the date you discovered errors:
/ /
(MM / DD / YYYY)
Select ONLY one process. See page 4 for additional guidance.Part 1:
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’re correcting both underreported and
overreported amounts on this form. The amount shown on line 20, 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’re 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 20. Don’t check this box if you’re correcting ANY underreported amounts on this form.
Complete the certifications.Part 2:
3. I certify that I’ve 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’re correcting underreported amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you’re correcting overreported
amounts, for purposes of the certifications on lines 4 and 5, Medicare tax doesn’t include Additional Medicare Tax. Form 944-X can’t be used
to correct overreported amounts of Additional Medicare Tax unless the amounts weren’t withheld from employee wages.
4. If you checked line 1 because you’re 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 hasn’t claimed (or the claim was rejected) and won’t 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 couldn’t find the affected employees or
each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t 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 didn’t withhold from
employee wages.
5. If you checked line 2 because you’re 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 hasn’t claimed (or the claim was rejected) and won’t 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
hasn’t claimed (or the claim was rejected) and won’t 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 couldn’t find the affected employees; or each
affected employee didn’t 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 didn’t give me a written statement that he or she hasn’t claimed (or the claim was rejected) and won’t
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 didn’t withhold from
employee wages.
Next
For Paperwork Reduction Act Notice, see the separate instructions.
www.irs.gov/Form944X Cat. No. 20335M
Form
944-X (Rev. 2-2018)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)
Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank.
Part 3:
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, line 4a, Column 1)
.
.
=
.
× 0.124*
=
.
*If you’re correcting your employer share only, use 0.062. See instructions.
9.
Taxable social security tips
(Form 944, line 4b, Column 1)
.
.
=
.
× 0.124*
=
.
*If you’re correcting your employer share only, use 0.062. See instructions.
10.
Taxable Medicare wages
&
tips
(Form 944, line 4c, Column 1)
.
.
=
.
× 0.029*
=
.
*If you’re correcting your employer share only, use 0.0145. See instructions.
11.
Taxable wages & tips subject to
Additional Medicare Tax withholding
(Form 944, line 4d)
.
.
=
.
× 0.009*
=
.
*Certain wages & tips reported in Column 3 shouldn’t be multiplied by 0.009. See instructions.
12.
Tax adjustments (Form 944,
line 6)
.
.
=
.
Copy
Column 3
here
.
13.
Qualified small business payroll
tax credit for increasing research
activities (Form 944, line 8; you
must attach Form 8974)
.
.
=
.
See
instructions
.
14. Special addition to wages for
federal income tax
.
.
=
.
See
instructions
.
15. Special addition to wages for
social security taxes
.
.
=
.
See
instructions
.
16. Special addition to wages for
Medicare taxes
.
.
=
.
See
instructions
.
17. Special addition to wages for
Additional Medicare Tax
.
.
=
.
See
instructions
.
18. Subtotal. Combine the amounts on lines 7–17 of Column 4 . . . . . . . . . . . . . . . . . .
.
19
a.
COBRA premium assistance
payments
(see instructions)
.
.
=
.
See
instructions
.
19
b.
Number of individuals provided
COBRA premium assistance
(see instructions)
=
20. Total. Combine the amounts on lines 18 and 19a of Column 4 . . . . . . . . . . . . . . . . . .
.
If line 20 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’re filing this form.
(If you’re 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 20 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. 2-2018)
/ /
/ /
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)
Explain your corrections for the calendar year you’re correcting.Part 4:
21.
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 23.
22. Check here if any corrections involve reclassified workers. Explain on line 23.
23. You must give us a detailed explanation of how you determined your corrections. See the instructions.
Sign here. You must complete all three pages of this form and sign it.Part 5:
Under penalties of perjury, I declare that I have filed an original Form 944 and that I have examined this adjusted return or claim, including
accompanying schedules or statements, and to the best of my knowledge and belief, it is 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’re 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. 2-2018)
click to sign
signature
click to edit
dd mmm yyyy
click to sign
signature
click to edit
dd mmm yyyy
Form 944-X: Which process should you use?
Type of errors
you’re
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 20 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’re filing Form 944-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 944 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 20 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 20 refunded to you or abated. Check
the box on line 2.
If you’re filing Form 944-X WITHIN
90 days of the expiration of the
period of limitations on credit or
refund for Form 944 . . .
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’re filing Form 944-X
MORE THAN 90 days before the
period of limitations on credit or
refund for Form 944 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 20.
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 20
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’re filing Form 944-X WITHIN
90 days of the
expiration of the period of
limitations on credit or refund
for Form 944. . .
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 20 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. 2-2018)