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Instructions for Form 943, Employer's Annual Federal Tax Return for Agricultural Employees (2021)

Summary

These 2021 Department of the Treasury Internal Revenue Service instructions cover Form 943, Employer's Annual Federal Tax Return for Agricultural Employees. The What's New section says the Medicare tax rate is 1.45% each for the employee and employer, unchanged from 2020, with no wage base limit for Medicare tax. It says the COVID-19 related credit for qualified sick and family leave wages has been extended and amended. It states that the FFCRA employer mandate expired on December 31, 2020, that the COVID-related Tax Relief Act of 2020 extends the periods for claiming credits for leave taken before April 1, 2021, and that the American Rescue Plan Act of 2021 adds new sections 3131, 3132, and 3133 to the Internal Revenue Code.

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Cite this document

“Instructions for Form 943, Employer's Annual Federal Tax Return for Agricultural Employees (2021).” Original at www.irs.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/internal-revenue-service-form-943-instructions-december-2021-revision-c42ed3287d/, SHA-256 4da08ba0a0c831619482449fa51e5fa0bd34277c1ded0adc020dd76654c9af4d.

Full text

2021                                                                                                        Department of the Treasury
                                                                                                            Internal Revenue Service

Instructions for Form 943
Employer's Annual Federal Tax Return for Agricultural Employees
Section references are to the Internal Revenue Code                             The Medicare tax rate is 1.45% (0.0145) each for the
unless otherwise noted.                                                       employee and employer, unchanged from 2020. There is
                                                                              no wage base limit for Medicare tax.
Contents                                                              Page
Future Developments . . . . . . . . . . . . . . . . . . . . . . . . 1         The COVID-19 related credit for qualified sick and
What's New . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1    family leave wages has been extended and amen-
Reminders . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4   ded. The Families First Coronavirus Response Act
                                                                              (FFCRA) was amended by legislation. The FFCRA
General Instructions . . . . . . . . . . . . . . . . . . . . . . . . . 7
                                                                              requirement that employers provide paid sick and family
    Purpose of Form 943 . . . . . . . . . . . . . . . . . . . . . 7           leave for reasons related to COVID-19 (the employer
    Who Must File Form 943? . . . . . . . . . . . . . . . . . . 8             mandate) expired on December 31, 2020; however, the
    When Must You File? . . . . . . . . . . . . . . . . . . . . . 8           COVID-related Tax Relief Act of 2020 extends the periods
    How Should You Complete Form 943? . . . . . . . . . 9                     for which employers providing leave that otherwise meets
    Where Should You File? . . . . . . . . . . . . . . . . . . . 9            the requirements of the FFCRA may continue to claim tax
                                                                              credits for qualified sick and family leave wages paid for
    Depositing Your Taxes . . . . . . . . . . . . . . . . . . . 10
                                                                              leave taken before April 1, 2021. The American Rescue
    What About Penalties and Interest? . . . . . . . . . . 11                 Plan Act of 2021 (the ARP) adds new sections 3131,
Specific Instructions . . . . . . . . . . . . . . . . . . . . . . . . 11      3132, and 3133 to the Internal Revenue Code to provide
Third-Party Designee . . . . . . . . . . . . . . . . . . . . . . . 24         credits for qualified sick and family leave wages similar to
Who Must Sign (Approved Roles) . . . . . . . . . . . . . . 24                 the credits that were previously enacted under the FFCRA
Paid Preparer Use Only . . . . . . . . . . . . . . . . . . . . . . 25         and amended and extended by the COVID-related Tax
How To Get Forms, Instructions, and Publications . . . 25                     Relief Act of 2020. The credits under sections 3131 and
                                                                              3132 are available for qualified leave wages paid for leave
Worksheet 1. Credit for Qualified Sick and Family                             taken after March 31, 2021, and before October 1, 2021.
    Leave Wages for Leave Taken Before April 1,                               Below are the major changes made under the ARP.
    2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
                                                                              • The ARP keeps the daily wage thresholds that
Worksheet 2. Employee Retention Credit for                                    previously existed. The aggregate cap on qualified sick
    Qualified Wages Paid After December 31,                                   leave wages remains at 80 hours (10 days), but the
    2020, and Before July 1, 2021 . . . . . . . . . . . . . . 27              limitation on the number of days resets with respect to
Worksheet 3. Credit for Qualified Sick and Family                             leave taken by employees beginning on April 1, 2021. The
    Leave Wages for Leave Taken After March 31,                               aggregate cap on qualified family leave wages increases
    2021, and Before October 1, 2021 . . . . . . . . . . . 28                 to $12,000 from the previous cap of $10,000, and the
Worksheet 4. Employee Retention Credit for                                    aggregate cap resets with respect to leave taken by
    Qualified Wages Paid After June 30, 2021, and                             employees beginning on April 1, 2021.
    before January 1, 2022 . . . . . . . . . . . . . . . . . . . 29           • The ARP also created a new category of leave under
Worksheet 5. COBRA Premium Assistance                                         the Emergency Paid Sick Leave Act (EPSLA) and the
    Credit . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30   Expanded Family and Medical Leave Act (Expanded
                                                                              FMLA) to include the time the employee is seeking or
Future Developments                                                           awaiting the results of a diagnostic test for, or a medical
For the latest information about developments related to                      diagnosis of, COVID-19 (and the employee has been
Form 943 and its instructions, such as legislation enacted                    exposed to COVID-19 or the employee's employer has
after they were published, go to IRS.gov/Form943.                             requested such test or diagnosis), or the employee is
                                                                              obtaining or accompanying an individual who is obtaining
What's New                                                                    immunizations related to COVID-19 or recovering from or
Social security and Medicare tax for 2021. The rate of                        caring for an individual recovering from an injury,
social security tax on taxable wages, including qualified                     disability, illness, or condition related to such
sick leave wages and qualified family leave wages for                         immunization. Additionally, employers may provide
leave taken after March 31, 2021, and before October 1,                       employees with paid family leave if the employee is
2021, is 6.2% (0.062) each for the employer and                               unable to work due to any of the conditions for which
employee or 12.4% (0.124) for both. Qualified sick leave                      eligible employers may provide paid sick leave under the
wages and qualified family leave wages for leave taken                        EPSLA.
before April 1, 2021, aren't subject to the employer share                    • The credits are still increased by the qualified health
of social security tax; therefore, the tax rate on these                      plan expenses allocable to the qualified sick and family
wages is 6.2% (0.062). The social security wage base                          leave wages, but the credits are now also increased,
limit is $142,800.                                                            subject to the qualified leave wage limitations, by certain
                                                                              amounts paid under collective bargaining agreements that

Dec 20, 2021                                                        Cat. No. 25976L
are properly allocable to the qualified leave wages. The              through which the credit may be claimed to qualified
collectively bargained contributions paid by an eligible              wages paid before July 1, 2021.
employer that are eligible for the credit are collectively                The ARP adds new section 3134 to the Internal
bargained defined benefit pension plan contributions and              Revenue Code to provide an employee retention credit
collectively bargained apprenticeship program                         similar to the credit that was previously enacted under the
contributions that are properly allocable to qualified leave          CARES Act and amended and extended by the Taxpayer
wages.                                                                Certainty and Disaster Tax Relief Act of 2020. Generally,
• Under section 3133, the credits are increased by the                the rules for the employee retention credit for qualified
amount of the employer share of social security tax and               wages paid before July 1, 2021, and qualified wages paid
Medicare tax on the qualified sick and family leave wages.            after June 30, 2021, are substantially similar. However,
• Governmental employers (except for the federal                      the Infrastructure Investment and Jobs Act (Infrastructure
government and its agencies and instrumentalities unless              Act) amends section 3134 of the Internal Revenue Code,
described in section 501(c)(1)) may now claim the credits.            as enacted under the ARP, to limit the availability of the
• Generally, the same wages can't be used as both                     employee retention credit in the fourth quarter of 2021 to
qualified sick leave wages and qualified family leave                 employers that are recovery startup businesses, as
wages. Additionally, you may not benefit from both the                defined in section 3134(c)(5). Thus, for wages paid after
credit for qualified sick and family leave wages and the              September 30, 2021, and before January 1, 2022, only
employee retention credit with respect to the same wages.             the wages paid by recovery startup businesses can be
The credit for qualified sick leave wages and qualified               qualified wages as described in these instructions. See
family leave wages doesn't apply to wages taken into                  Recovery startup business, later, for more information
account as payroll costs for a Small Business Interruption            about a recovery startup business.
Loan under the Paycheck Protection Program (PPP) that
                                                                          Qualified wages for the employee retention credit under
is forgiven or in connection with shuttered operator grants
                                                                      section 3134 don't include wages taken into account for
and restaurant revitalization grants.
                                                                      credits under sections 41, 45A, 45P, 45S, 51, 1396, 3131,
• The credit for qualified sick and family leave wages isn't          and 3132. Additionally, qualified wages for the employee
allowed if the employer provides the leave in a manner
                                                                      retention credit can't include amounts used as payroll
that discriminates in favor of highly compensated
                                                                      costs for a Small Business Interruption Loan under the
employees, full-time employees, or employees on the
                                                                      PPP that is forgiven or amounts used as payroll costs for
basis of employment tenure. See Highly compensated
                                                                      shuttered operator grants and restaurant revitalization
employee, later, for the definition.
                                                                      grants.
    How you report qualified sick and family leave wages
                                                                          For wages paid before July 1, 2021, the nonrefundable
and the credit for qualified sick and family leave wages
                                                                      portion of the employee retention credit is against the
has changed. Taxable qualified sick and family leave
                                                                      employer share of social security tax. However, for wages
wages for leave taken after March 31, 2021, and before
                                                                      paid after June 30, 2021, the nonrefundable portion of the
October 1, 2021, are included on line 2 and taxed at
                                                                      employee retention credit is against the employer share of
12.4% for social security tax purposes on line 3. However,
                                                                      Medicare tax. The nonrefundable portion of the credit is
if you're reporting any qualified sick and family leave
                                                                      still claimed on line 12c and, if applicable, the refundable
wages for leave taken before April 1, 2021, these wages
                                                                      portion of the credit is still claimed on line 14e. For more
are reported on lines 2a and 2b, respectively, and taxed at
                                                                      information, see the instructions for line 12c and line 14e,
6.2% for social security tax purposes on lines 3a and 3b.
                                                                      later. Use Worksheet 2 to figure the credit for wages paid
For leave taken before April 1, 2021, the credit for
                                                                      before July 1, 2021. Use Worksheet 4 to figure the credit
qualified sick and family leave wages is reported on
                                                                      for wages paid after June 30, 2021, and before January 1,
line 12b (nonrefundable portion) and, if applicable,
                                                                      2022.
line 14d (refundable portion). For leave taken after March
31, 2021, and before October 1, 2021, the credit for                      See Notice 2021-23, 2021-16 I.R.B. 1113, available at
qualified sick and family leave wages is reported on                  IRS.gov/irb/2021-16_IRB#NOT-2021-23, for guidance on
line 12d (nonrefundable portion) and, if applicable, line 14f         the employee retention credit provided under section
(refundable portion); and the nonrefundable portion of the            2301 of the CARES Act, as amended by section 207 of
credit is against the employer share of Medicare tax. For             the Taxpayer Certainty and Disaster Tax Relief Act of
more information, see the instructions for line 12b,                  2020, for qualified wages paid after December 31, 2020,
line 12d, line 14d, and line 14f, later.                              and before July 1, 2021. See Notice 2021-49, 2021-34
                                                                      I.R.B. 316, available at IRS.gov/irb/
    Use Worksheet 1 to figure the credit for leave taken
                                                                      2021-34_IRB#NOT-2021-49, for guidance on the
before April 1, 2021. Use Worksheet 3 to figure the credit
                                                                      employee retention credit provided under the ARP for
for leave taken after March 31, 2021, and before October
                                                                      wages paid after June 30, 2021, and before January 1,
1, 2021. For more information about the credit for qualified
                                                                      2022. Notice 2021-49 also discusses miscellaneous
sick and family leave wages, go to IRS.gov/PLC.
                                                                      issues that apply to all of 2021. See Notice 2021-65,
The COVID-19 related employee retention credit has                    2021-51 I.R.B. 880, available at IRS.gov/irb/
been extended and amended. The Coronavirus Aid,                       2021-51_IRB#NOT-2021-65 for modifications to Notice
Relief, and Economic Security (CARES) Act was                         2021-49 under the Infrastructure Act. For more
amended by legislation. The Taxpayer Certainty and                    information about the employee retention credit, go to
Disaster Tax Relief Act of 2020 modifies the calculation of           IRS.gov/ERC.
the employee retention credit and extends the date


                                                                -2-                              Instructions for Form 943 (2021)
New credit for COBRA premium assistance pay-                           a taxpayer in excess of the amount to which the taxpayer
ments. Section 9501 of the ARP provides for COBRA                      is entitled is an erroneous refund that the employer must
premium assistance in the form of a full reduction in the              repay, regardless of whether the refund or credit is
premium otherwise payable by certain individuals and                   advanced. Accordingly, if an employer requested and
their families who elect COBRA continuation coverage                   received an advance payment of the employee retention
due to a loss of coverage as the result of a reduction in              credit for the fourth calendar quarter of 2021, and the
hours or an involuntary termination of employment                      employer isn't a recovery startup business, the employer
(assistance eligible individuals). This COBRA premium                  isn't eligible for an employee retention credit and must
assistance is available for periods of coverage beginning              repay the amount of the advance. Employers who need to
on or after April 1, 2021, through periods of coverage                 repay excess advance payments of the employee
beginning on or before September 30, 2021. Some                        retention credit must do so by January 31, 2022, by
multiemployer plans and insurers don't normally file an                including the advance payment on their 2021 Form 943,
employment tax return but will need to file one if they want           Part 1, line 14i, and paying any balance due by January
to claim the COBRA premium assistance credit.                          31, 2022.
   Section 9501(b) of the ARP adds new section 6432 to                 Deferral of the employer share of social security tax
the Internal Revenue Code that allows a credit (COBRA                  expired. The CARES Act allowed employers to defer the
premium assistance credit) against the employer share of               deposit and payment of the employer share of social
Medicare tax in an amount equal to the premiums not paid               security tax. The deferred amount of the employer share
by assistance eligible individuals for COBRA continuation              of social security tax was only available for deposits due
coverage by reason of section 9501(a)(1) of the ARP. The               on or after March 27, 2020, and before January 1, 2021,
nonrefundable portion of the credit is reported on line 12e            as well as deposits and payments due after January 1,
and, if applicable, the refundable portion of the credit is            2021, that are required for wages paid on or after March
reported on line 14g. If you claim this credit, you must also          27, 2020, and before January 1, 2021. Therefore, the line
report the number of individuals provided COBRA                        previously used for the employer deferral has been
premium assistance on line 12f. Use Worksheet 5 to                     “Reserved for future use.” One-half of the employer share
figure the credit. For more information, see the                       of social security tax is due by December 31, 2021, and
instructions for line 12e, line 12f, and line 14g, later. For          the remainder is due by December 31, 2022. Because
more information on COBRA premium assistance                           both December 31, 2021, and December 31, 2022, are
payments and the credit, see Notice 2021-31, 2021-23                   nonbusiness days, payments made on the next business
I.R.B. 1173, available at IRS.gov/irb/                                 day will be considered timely. Any payments or deposits
2021-23_IRB#NOT-2021-31; and Notice 2021-46,                           you make before December 31, 2021, are first applied
2021-33 I.R.B. 305, available at IRS.gov/irb/                          against your payment due on December 31, 2021, and
2021-33_IRB#NOT-2021-46.                                               then applied against your payment due on December 31,
                                                                       2022. For more information about the deferral of
Advance payment of COVID-19 credits extended.
                                                                       employment tax deposits, go to IRS.gov/ETD. See Paying
Based on the extensions of the credit for qualified sick
                                                                       the deferred amount of the employer share of social
and family leave wages and the employee retention credit,
                                                                       security tax and How to pay the deferred amount of the
and the new credit for COBRA premium assistance
                                                                       employer and employee share of social security tax, later,
payments, discussed above, Form 7200, Advance
                                                                       for information about paying the deferred amount of the
Payment of Employer Credits Due to COVID-19, may be
                                                                       employer share of social security tax.
filed to request an advance payment. For more
information, including information on which employers are              Deferral of the employee share of social security tax
eligible to request an advance payment, the deadlines for              expired. The Presidential Memorandum on Deferring
requesting an advance, and the amount that can be                      Payroll Tax Obligations in Light of the Ongoing COVID-19
advanced, see the Instructions for Form 7200.                          Disaster, issued on August 8, 2020, directed the
    The Infrastructure Act amends section 3134 of the                  Secretary of the Treasury to defer the withholding,
Internal Revenue Code, as enacted under the ARP, to                    deposit, and payment of the employee share of social
limit the availability of the employee retention credit in the         security tax on wages paid during the period from
fourth quarter of 2021 to employers that are recovery                  September 1, 2020, through December 31, 2020. The
startup businesses, as defined in section 3134(c)(5). See              deferral of the withholding and payment of the employee
Recovery startup business, later, for more information                 share of social security tax was available for employees
about a recovery startup business. Some employers that                 whose social security wages paid for a biweekly pay
are no longer eligible to claim the employee retention                 period were less than $4,000, or the equivalent threshold
credit for the fourth quarter of 2021 may have already                 amount for other pay periods. The line previously used for
submitted Form 7200 to request an advance payment of                   the employee deferral has been “Reserved for future use.”
the employee retention credit for the fourth quarter of                The COVID-related Tax Relief Act of 2020 defers the due
2021. If the Form 7200 hasn't been processed, the IRS                  date for the withholding and payment of the employee
will use the employer's indication of whether it is a                  share of social security tax until the period beginning on
recovery startup business (Form 7200, Part 1, line H) as               January 1, 2021, and ending on December 31, 2021. For
part of the determination regarding whether the Form                   more information about the deferral of employee social
7200 claiming the employee retention credit in the fourth              security tax, see Notice 2020-65, 2020-38 I.R.B. 567,
quarter of 2021 should be accepted or rejected. A refund               available at IRS.gov/irb/2020-38_IRB#NOT-2020-65; and
or credit of any portion of the employee retention credit to           Notice 2021-11, 2021-06 I.R.B. 827, available at Notice


Instructions for Form 943 (2021)                                 -3-
2021-11. Also see Paying the deferred amount of the                   employee. The employer is liable to pay the deferred
employee share of social security tax and How to pay the              taxes to the IRS and must do so before January 1, 2022,
deferred amount of the employer and employee share of                 to avoid interest, penalties, and additions to tax on those
social security tax, later, for information about paying the          amounts. Because January 1, 2022, is a nonbusiness
deferred amount of the employee share of social security              day, payments made on January 3, 2022, will be
tax.                                                                  considered timely. Payment of the deferral isn't reported
New payroll tax credit for certain tax-exempt organi-                 on Form 943. For more information about the deferral of
zations affected by qualified disasters. Section 303(d)               the employee share of social security tax, see Notice
                                                                      2020-65, and Notice 2021-11.
of the Taxpayer Certainty and Disaster Tax Relief Act of
2020 allows for a new payroll tax credit for certain                  How to pay the deferred amount of the employer and
tax-exempt organizations affected by certain qualified                employee share of social security tax. You may pay
disasters not related to COVID-19. This new credit will be            the amount you owe electronically using the Electronic
claimed on new Form 5884-D (not on Form 943). Form                    Federal Tax Payment System (EFTPS), by credit or debit
5884-D is filed after the Form 943 for the year for which             card, or by a check or money order. The preferred method
the credit is being claimed has been filed. If you will claim         of payment is EFTPS. For more information, go to
this credit on Form 5884-D for 2021 and you're also                   EFTPS.gov, or call 800-555-4477 or 800-733-4829
claiming a credit for qualified sick and family leave wages           (TDD). To pay the deferred amount using EFTPS, select
for leave taken before April 1, 2021, and/or the employee             Form 943, calendar year 2020, and the option to pay the
retention credit for wages paid before July 1, 2021, you              deferred amount.
must include any credit that will be claimed on Form                     To pay by credit or debit card, go to IRS.gov/
5884-D on Worksheet 1 and/or Worksheet 2, respectively.               PayByCard. If you pay by check or money order, include a
For more information about this credit. go to IRS.gov/                2020 Form 943-V, Payment Voucher. The 2020 Form
Form5884D.                                                            943-V is on page 5 of Form 943 and is available at
Reminders                                                             IRS.gov/Form943 (select the link for “All Revisions for
                                                                      Form 943” under “Other Items You May Find Useful”).
Paying the deferred amount of the employer share of                   Make the check or money order payable to “United States
social security tax. One-half of the employer share of                Treasury.” Enter your EIN, “Form 943,” and “2020” on your
social security tax is due by December 31, 2021, and the              check or money order.
remainder is due by December 31, 2022. Because both                      Payments should be sent to:
December 31, 2021, and December 31, 2022, are
nonbusiness days, payments made on the next business                  Department of the Treasury           Department of the Treasury
day will be considered timely. Any payments or deposits               Internal Revenue Service      or     Internal Revenue Service
you make before December 31, 2021, are first applied                  Ogden, UT 84201-0030                 Kansas City, MO
against your payment due on December 31, 2021, and                                                         64999-0030
then applied against your payment due on December 31,
2022. For example, if your employer share of social
security tax for 2020 was $20,000 and you deposited                   Send your payment to the address above that is in the
$5,000 of the $20,000 during 2020 and you deferred                    same state as the address to which you would mail
$15,000 on Form 943, line 14b, then you must pay $5,000               returns filed without a payment, as shown under Where
by December 31, 2021, and $10,000 by December 31,                     Should You File, later. For more information about the
2022. However, if your employer share of social security              deferral of social security tax, go to IRS.gov/ETD and see
tax for 2020 was $20,000 and you deposited $15,000 of                 Notice 2020-65 and Notice 2021-11.
the $20,000 during 2020 and you deferred $5,000 on                    Qualified small business payroll tax credit for in-
Form 943, line 14b, then you don't need to pay any                    creasing research activities. For tax years beginning
deferred amount by December 31, 2021, because 50% of                  after 2015, a qualified small business may elect to claim
the amount that could have been deferred ($10,000) has                up to $250,000 of its credit for increasing research
already been paid and is first applied against your                   activities as a payroll tax credit against the employer
payment that would be due on December 31, 2021.                       share of social security tax. The payroll tax credit election
Accordingly, you must pay the $5,000 deferral by                      must be made on or before the due date of the originally
December 31, 2022. Payment of the deferral isn't reported             filed income tax return (including extensions). The portion
on Form 943. For additional information, go to IRS.gov/               of the credit used against the employer share of social
ETD.                                                                  security tax is allowed in the first calendar quarter
Paying the deferred amount of the employee share of                   beginning after the date that the qualified small business
social security tax. The due date for the withholding                 filed its income tax return. The first Form 943 that you
and payment of the employee share of social security tax              could claim this credit on is Form 943 filed for calendar
is postponed until the period beginning on January 1,                 year 2017. The election and determination of the credit
2021, and ending on December 31, 2021. The employer                   amount that will be used against the employer share of
must withhold and pay the total deferred employee share               social security tax are made on Form 6765, Credit for
of social security tax ratably from wages paid to the                 Increasing Research Activities. The amount from Form
employee between January 1, 2021, and December 31,                    6765, line 44, must then be reported on Form 8974,
2021. If necessary, the employer may make arrangements                Qualified Small Business Payroll Tax Credit for Increasing
to otherwise collect the total deferred taxes from the                Research Activities. Form 8974 is used to determine the

                                                                -4-                                Instructions for Form 943 (2021)
amount of the credit that can be used in the current year.           employees. For more information on the different types of
The amount from Form 8974, line 12, is reported on Form              third-party payer arrangements, see section 16 of Pub. 15.
943, line 12a. If you're claiming the research payroll tax
                                                                     COVID-19 employment tax credits when return filed
credit on your Form 943, you must attach Form 8974 to                by a third-party payer. If you're the common-law
Form 943. For more information about the payroll tax
                                                                     employer of the individuals that are paid qualified sick or
credit, see Notice 2017-23, 2017-16 I.R.B. 1100, available           family leave wages, paid wages qualifying for the
at IRS.gov/irb/2017-16_IRB#NOT-2017-23; and IRS.gov/                 employee retention credit, and/or provided COBRA
ResearchPayrollTC. Also see Adjusting tax liability for
                                                                     premium assistance, you're entitled to the credit for the
nonrefundable credits claimed on lines 12a, 12b, 12c,
                                                                     qualified sick and family leave wages, the employee
12d, and 12e, later.
                                                                     retention credit, and/or the COBRA premium assistance
Certification program for professional employer or-                  credit, regardless of whether you use a third-party payer
ganizations (PEOs). The Stephen Beck Jr., ABLE Act of                (such as a PEO, CPEO, or section 3504 agent) to report
2014 required the IRS to establish a voluntary certification         and pay your federal employment taxes. The third-party
program for PEOs. PEOs handle various payroll                        payer isn't entitled to the credits with respect to the wages
administration and tax reporting responsibilities for their          and taxes it remits on your behalf, or the COBRA premium
business clients and are typically paid a fee based on               assistance it remits on your behalf (regardless of whether
payroll costs. To become and remain certified under the              the third party is considered an "employer" for other
certification program, certified professional employer               purposes). With respect to the COBRA premium
organizations (CPEOs) must meet various requirements                 assistance credit, the preceding sentences assume the
described in sections 3511 and 7705 and related                      common-law employer is the person to whom premiums
published guidance. Certification as a CPEO may affect               are payable for purposes of the credit. If the insurer or
the employment tax liabilities of both the CPEO and its              multiemployer plan is the person to whom premiums are
customers. A CPEO is generally treated for employment                payable, the references to employer in this paragraph
tax purposes as the employer of any individual who                   should be read to refer to the insurer or multiemployer
performs services for a customer of the CPEO and is                  plan, as applicable.
covered by a contract described in section 7705(e)(2)                   Under an exception to the rule that only the
between the CPEO and the customer (CPEO contract),                   common-law employer is entitled to the COBRA premium
but only for wages and other compensation paid to the                assistance credit even if the common-law employer uses
individual by the CPEO. To become a CPEO, the                        a third-party payer, a third-party payer is entitled to the
organization must apply through the IRS Online                       credit if it is treated as the person to whom premiums are
Registration System. For more information or to apply to             payable. A third-party payer is treated as the person to
become a CPEO, go to IRS.gov/CPEO.                                   whom premiums are payable if it:
   CPEOs must generally file Form 943 and Schedule R                 • Maintains the group health plan;
(Form 943), Allocation Schedule for Aggregate Form 943               • Is considered the sponsor of the group health plan and
Filers, electronically. For more information about a                 is subject to the applicable Department of Labor (DOL)
CPEO's requirement to file electronically, see Rev. Proc.            COBRA guidance, including providing the COBRA
2017-14, 2017-3 I.R.B. 426, available at IRS.gov/irb/                election notices to qualified beneficiaries; and
2017-03_IRB#RP-2017-14.                                              • Would have received the COBRA premium payments
                                                                     directly from the assistance eligible individuals were it not
Outsourcing payroll duties. Generally, as an employer,
                                                                     for the COBRA premium assistance.
you’re responsible to ensure that tax returns are filed and
deposits and payments are made, even if you contract                    If a third-party payer satisfies the above conditions, the
with a third party to perform these acts. You remain                 third-party payer's clients aren't eligible for the COBRA
responsible if the third party fails to perform any required         premium assistance credit or an advance payment of the
action. Before you choose to outsource any of your payroll           COBRA premium assistance credit. Third-party payers
and related tax duties (that is, withholding, reporting, and         that are considered the person to whom premiums are
paying over social security, Medicare, FUTA, and income              payable may, in anticipation of receiving the COBRA
taxes) to a third-party payer, such as a payroll service             premium assistance credit, reduce the deposits of federal
provider or reporting agent, go to IRS.gov/                          employment taxes relating to their own employees (that is,
OutsourcingPayrollDuties for helpful information on this             those employees for whom they are filing as the
topic. If a CPEO pays wages and other compensation to                common-law employer, rather than as a third-party payer)
an individual performing services for you, and the services          on the day they become eligible for the credit. If the
are covered by a contract described in section 7705(e)(2)            anticipated credit exceeds the available reduction of these
between you and the CPEO (CPEO contract), then the                   deposits, the third-party payer may file Form 7200 to
CPEO is generally treated for employment tax purposes                request an advance after the payroll period in which the
as the employer, but only for wages and other                        third-party payer becomes entitled to the credit.
compensation paid to the individual by the CPEO.                     Aggregate Form 943 filers. Approved section 3504
However, with respect to certain employees covered by a              agents and CPEOs must complete and file Schedule R
CPEO contract, you may also be treated as an employer                (Form 943) when filing an aggregate Form 943. Aggregate
of the employees and, consequently, may also be liable               Forms 943 are filed by agents approved by the IRS under
for federal employment taxes imposed on wages and                    section 3504. To request approval to act as an agent for
other compensation paid by the CPEO to such                          an employer, the agent files Form 2678 with the IRS
                                                                     unless you're a state or local government agency acting

Instructions for Form 943 (2021)                               -5-
as an agent under the special procedures provided in                   Correcting a previously filed Form 943. If you
Rev. Proc. 2013-39, 2013-52 I.R.B. 830, available at                   discover an error on a previously filed Form 943, or if you
IRS.gov/irb/2013-52_IRB#RP-2013-39. Aggregate Forms                    otherwise need to amend a previously filed Form 943,
943 are also filed by CPEOs approved by the IRS under                  make the correction using Form 943-X. Form 943-X is
section 7705. To become a CPEO, the organization must                  filed separately from Form 943. For more information, see
apply through the IRS Online Registration System at                    the Instructions for Form 943-X, section 9 of Pub. 51, or
IRS.gov/CPEO. CPEOs file Form 8973, Certified                          go to IRS.gov/CorrectingEmploymentTaxes.
Professional Employer Organization/Customer Reporting
Agreement, to notify the IRS that they started or ended a              If you change your business name, business ad-
service contract with a customer. CPEOs must generally                 dress, or responsible party. Notify the IRS immediately
file Form 943 and Schedule R (Form 943) electronically.                if you change your business name, business address, or
For more information about a CPEO’s requirement to file                responsible party.
electronically, see Rev. Proc. 2017-14, 2017-3 I.R.B. 426,             • Write to the IRS office where you file your returns (using
available at IRS.gov/irb/2017-03_IRB#RP-2017-14.                       the Without a payment address under Where Should You
                                                                       File, later) to notify the IRS of any business name change.
    Other third-party payers that file aggregate Forms 943,
                                                                       See Pub. 1635 to see if you need to apply for a new
such as non-certified PEOs, must complete and file
                                                                       employer identification number (EIN).
Schedule R (Form 943) if they have clients that are
claiming the qualified small business payroll tax credit for
                                                                       • Complete and mail Form 8822-B to notify the IRS of a
                                                                       business address or responsible party change. Don't mail
increasing research activities, the credit for qualified sick
                                                                       Form 8822-B with your Form 943. For a definition of
and family leave wages, the employee retention credit,
                                                                       “responsible party,” see the Instructions for Form SS-4.
and/or the COBRA premium assistance credit.
                                                                       Federal tax deposits must be made by electronic
       If both an employer and a section 3504 authorized
                                                                       funds transfer (EFT). You must use EFT to make all
 TIP agent (or CPEO or other third-party payer) paid                   federal tax deposits. Generally, an EFT is made using
       wages to an employee during the year, both the                  EFTPS. If you don't want to use EFTPS, you can arrange
employer and the section 3504 authorized agent (or                     for your tax professional, financial institution, payroll
CPEO or other third-party payer, if applicable) should file            service, or other trusted third party to make electronic
Form 943 reporting the wages each entity paid to the                   deposits on your behalf. Also, you may arrange for your
employee during the year and issue Forms W-2 reporting                 financial institution to initiate a same-day wire payment on
the wages each entity paid to the employee during the
                                                                       your behalf. EFTPS is a free service provided by the
year.
                                                                       Department of the Treasury. Services provided by your
   If a third-party payer of sick pay is also paying qualified         tax professional, financial institution, payroll service, or
sick leave wages on behalf of an employer, the third party             other third party may have a fee.
would be making the payments as an agent of the                           For more information on making federal tax deposits,
employer. The employer is required to do the reporting                 see section 7 of Pub. 51. To get more information about
and payment of employment taxes with respect to the                    EFTPS or to enroll in EFTPS, go to EFTPS.gov, or call
qualified sick leave wages and claim the credit for the                800-555-4477 or 800-733-4829 (TDD). Additional
qualified sick leave wages, unless the employer has an                 information about EFTPS is also available in Pub. 966.
agency agreement with the third-party payer that requires
                                                                               For an EFTPS deposit to be on time, you must
the third-party payer to do the collecting, reporting, and/or
                                                                         !     submit the deposit by 8 p.m. Eastern time the day
paying or depositing employment taxes on the qualified                 CAUTION before the date the deposit is due.
sick leave wages. If the employer has an agency
agreement with the third-party payer, the third-party payer              Same-day wire payment option. If you fail to submit a
includes the qualified sick leave wages on the third party's           deposit transaction on EFTPS by 8 p.m. Eastern time the
aggregate Form 943, claims the sick leave credit on                    day before the date a deposit is due, you can still make
behalf of the employer on the aggregate Form 943, and                  your deposit on time by using the Federal Tax Collection
separately reports the credit allocable to the employers on            Service (FTCS) to make a same-day wire payment. To
Schedule R (Form 943). See section 6 of Pub. 15-A,                     use the same-day wire payment method, you will need to
Employer's Supplemental Tax Guide, for more information                make arrangements with your financial institution ahead of
about sick pay reporting.                                              time. Please check with your financial institution regarding
   If a third-party payer is considered the person to whom             availability, deadlines, and costs. Your financial institution
COBRA premiums are payable, as discussed earlier                       may charge you a fee for payments made this way. To
under COVID-19 employment tax credits when return filed                learn more about the information you will need to give
by a third-party payer, the third party must include the               your financial institution to make a same-day wire
applicable credit amount on Schedule R (Form 943),                     payment, go to IRS.gov/SameDayWire.
column n, line 8.                                                        Timeliness of federal tax deposits. If a deposit is
                                                                       required to be made on a day that isn't a business day, the
Work opportunity tax credit for qualified tax-exempt                   deposit is considered timely if it is made by the close of
organizations hiring qualified veterans. Qualified                     the next business day. A business day is any day other
tax-exempt organizations that hire eligible unemployed                 than a Saturday, Sunday, or legal holiday. The term “legal
veterans may be able to claim the work opportunity tax                 holiday” for deposit purposes includes only those legal
credit against their payroll tax liability using Form 5884-C.          holidays in the District of Columbia. Legal holidays in the
For more information, go to IRS.gov/WOTC.                              District of Columbia are provided in section 7 of Pub. 51.

                                                                 -6-                               Instructions for Form 943 (2021)
Electronic filing and payment. Businesses can enjoy                    that haven't elected to be taxed as corporations must
the benefits of filing tax returns and paying their federal            report and pay employment taxes on wages paid to their
taxes electronically. Whether you rely on a tax                        employees using the entities' own names and EINs. See
professional or handle your own taxes, the IRS offers you              Regulations sections 1.1361-4(a)(7) and 301.7701-2(c)(2)
convenient programs to make filing and paying easier.                  (iv).
Spend less time worrying about taxes and more time                     Where can you get telephone help? For answers to
running your business. Use e-file and EFTPS to your                    your questions about completing Form 943 or tax deposit
benefit.                                                               rules, you can call the IRS at 800-829-4933 or
• For e-file, go to IRS.gov/EmploymentEfile for additional             800-829-4059 (TDD/TTY for persons who are deaf, hard
information. A fee may be charged to file electronically.              of hearing, or have a speech disability), Monday–Friday
• For EFTPS, go to EFTPS.gov or call EFTPS Customer                    from 7:00 a.m. to 7:00 p.m. local time (Alaska and Hawaii
Service at 800-555-4477 or 800-733-4829 (TDD) for                      follow Pacific time).
additional information.
• For electronic filing of Forms W-2, Wage and Tax                     Photographs of Missing Children The IRS is a proud
Statement, go to SSA.gov/employer. You may be required                 partner with the National Center for Missing & Exploited
to file Forms W-2 electronically. For details, see the                 Children® (NCMEC). Photographs of missing children
General Instructions for Forms W-2 and W-3.                            selected by the Center may appear in instructions on
                                                                       pages that would otherwise be blank. You can help bring
         If you're filing your tax return or paying your               these children home by looking at the photographs and
  !      federal taxes electronically, a valid EIN is required         calling 1-800-THE-LOST (1-800-843-5678) if you
 CAUTION at the time the return is filed or the payment is
                                                                       recognize a child.
made. If a valid EIN isn't provided, the return or payment
won't be processed. This may result in penalties. See
How Should You Complete Form 943, later, for more                      General Instructions
information about applying for an EIN.
                                                                       Purpose of Form 943
         Always be sure the EIN on the form you file                   These instructions give you some background information
 TIP exactly matches the EIN the IRS assigned to your                  about Form 943. They tell you who must file Form 943,
         business. Don't use your SSN or ITIN on forms                 how to complete it line by line, and when and where to file
that ask for an EIN. If you used an EIN (including a prior             it.
owner's EIN) on Form 943 that is different from the EIN
reported on Form W-3, see Box h—Other EIN used this                       If you want more in-depth information about payroll tax
year in the General Instructions for Forms W-2 and W-3.                topics relating to Form 943, see Pub. 51 or go to IRS.gov/
Filing a Form 943 with an incorrect EIN or using another               EmploymentTaxes. For tax information relevant to
business's EIN may result in penalties and delays in                   agricultural employers, go to IRS.gov/
processing your return.                                                AgricultureTaxCenter.
  Electronic funds withdrawal (EFW). If you file Form                     Federal law requires you, as an employer, to withhold
943 electronically, you can e-file and use EFW to pay the              certain taxes from your employees' pay. Each time you
balance due in a single step using tax preparation                     pay wages, you must withhold—or take out of your
software or through a tax professional. However, don't use             employees' pay—certain amounts for federal income tax,
EFW to make federal tax deposits. For more information                 social security tax, and Medicare tax. You must also
on paying your taxes using EFW, go to IRS.gov/EFW.                     withhold Additional Medicare Tax from wages you pay to
                                                                       an employee in excess of $200,000 in a calendar year.
Credit or debit card payments. You can pay the                         Under the withholding system, taxes withheld from your
balance due shown on Form 943 by credit or debit card.                 employees are credited to your employees in payment of
Your payment will be processed by a payment processor                  their tax liabilities.
who will charge a processing fee. Don't use a credit or
                                                                          Federal law also requires you to pay any liability for the
debit card to make federal tax deposits. For more
                                                                       employer share of social security tax and Medicare tax.
information on paying your taxes with a credit or debit
                                                                       This share of social security tax and Medicare tax isn't
card, go to IRS.gov/PayByCard.
                                                                       withheld from employees.
Online payment agreement. You may be eligible to                          If you have household employees working in your
apply for an installment agreement online if you can't pay             private home on your farm operated for a profit, they aren't
the full amount of tax you owe when you file your return.              considered to be farm employees. To report social
For more information, see What if you can't pay in full,               security tax, Medicare tax, Additional Medicare Tax, and
later.                                                                 federal income tax withholding on the wages of household
Paid preparers. If you use a paid preparer to complete                 employees, you may either:
Form 943, the paid preparer must complete and sign the
paid preparer's section of the form.                                   • File Schedule H (Form 1040) with your Form 1040 or
                                                                       1040-SR, or
Disregarded entities and qualified subchapter S sub-
sidiaries (QSubs). Eligible single-owner disregarded                   • Include the wages with your farm employees' wages on
                                                                       Form 943.
entities and QSubs are treated as separate entities for
employment tax purposes. Eligible single-member entities                  If you paid wages to other nonfarm workers, don't
                                                                       report these on Form 943. Taxes on wages paid to

Instructions for Form 943 (2021)                                 -7-
nonfarm workers are reported on Form 941 or 941-SS,                          File Form 943 only once for each calendar year. If you
Employer's QUARTERLY Federal Tax Return, or Form                         filed Form 943 electronically, don't file a paper Form 943.
944, Employer's ANNUAL Federal Tax Return. See Pub.                      For more information about filing Form 943 electronically,
926 for more information about household employees.                      see Electronic filing and payment, earlier.
Who Must File Form 943?                                                     If we receive Form 943 after the due date, we will treat
                                                                         Form 943 as filed on time if the envelope containing Form
File Form 943 if you paid wages to one or more                           943 is properly addressed, contains sufficient postage,
farmworkers and the wages were subject to federal                        and is postmarked by the U.S. Postal Service on or before
income tax withholding or social security and Medicare                   the due date, or sent by an IRS-designated private
taxes under the tests discussed next. For more                           delivery service (PDS) on or before the due date. If you
information on farmworkers and wages, see Pub. 51.                       don't follow these guidelines, we will generally consider
                                                                         Form 943 filed when it is actually received. For more
   After you file your first Form 943, you must file a return
                                                                         information about PDSs, see Where Should You File,
for each year, even if you have no taxes to report, until
                                                                         later.
you file a final return. You’re encouraged to file Form 943
electronically. Go to IRS.gov/EmploymentEfile for more                   Forms W-2 and W-3
information on electronic filing.
                                                                         By January 31, 2022, give Form W-2 to each employee
The $150 Test or the $2,500 Test                                         who was working for you at the end of 2021. If an
                                                                         employee stops working for you before the end of the
All cash wages that you pay to farmworkers are subject to
                                                                         year, give him or her Form W-2 any time after employment
federal income tax withholding and social security and
                                                                         ends but no later than January 31, 2022. If the employee
Medicare taxes for any calendar year for which you meet
                                                                         asks you for Form W-2, give him or her the completed
either of the tests listed next.
                                                                         form within 30 days of the request or the last wage
                                                                         payment, whichever is later.
• You pay an employee cash wages of $150 or more in a
year for farmwork (count all wages paid on a time,                          File Copy A of all Forms W-2 with Form W-3,
piecework, or other basis). The $150 test applies                        Transmittal of Wage and Tax Statements, with the Social
separately to each farmworker that you employ. If you                    Security Administration (SSA) by January 31, 2022. For
employ a family of workers, each member is treated                       electronic filing of Forms W-2, go to SSA.gov/employer.
separately. Don't count wages paid by other employers.                   You may be required to file Forms W-2 electronically. For
• The total (cash and noncash) wages that you pay to all                 details, see the General Instructions for Forms W-2 and
farmworkers is $2,500 or more.                                           W-3.
   If the $2,500-or-more test for the group isn't met, the               Compensation paid to H-2A visa holders. Report
$150-or-more test for an individual still applies. Similarly, if         compensation of $600 or more paid to foreign agricultural
the $150-or-more test is not met for any individual, the                 workers who entered the country on H-2A visas in box 1 of
$2,500-or-more test for the group still applies.                         Form W-2. Compensation paid to H-2A workers for
  Exceptions. Special rules apply to certain                             agricultural labor performed in connection with H-2A visas
hand-harvest laborers who receive less than $150 in                      isn't subject to social security and Medicare taxes and
annual cash wages. For more information, see section 4                   therefore shouldn't be reported as wages subject to social
of Pub. 51.                                                              security tax (lines 2, 2a, and 2b), Medicare tax (line 4), or
                                                                         Additional Medicare Tax withholding (line 6) on Form 943,
Final Return                                                             and shouldn't be reported as social security wages (box 3)
If you stop paying wages during the year and don't expect                or Medicare wages (box 5) on Form W-2.
to pay wages again, file a final return for 2021. Be sure to                An employer isn't required to withhold federal income
mark the box above line 1 on the form indicating that you                tax from compensation paid to an H-2A worker for
don't have to file returns in the future. If you later restart           agricultural labor performed in connection with this visa
paying wages, then resume filing Form 943.                               unless the worker asks for withholding and the employer
                                                                         agrees. In this case, the worker must give the employer a
   Attach a statement to your final return showing the                   completed Form W-4. Federal income tax withheld is
name of the person keeping the payroll records and the                   reported on Form 943, line 8, and in box 2 of Form W-2.
address where these records will be kept. If the business                These reporting rules apply when the H-2A worker
has been sold or transferred to another person, the                      provides his or her taxpayer identification number (TIN) to
statement should include the name and address of such                    the employer. For the rules relating to backup withholding
person and the date on which the sale or transfer took                   and reporting when the H-2A worker doesn't provide a
place. If no sale or transfer occurred, or you don't know                TIN, see the Instructions for Forms 1099-MISC and
the name of the person to whom the business was sold or                  1099-NEC and the Instructions for Form 945. For more
transferred, that fact should be included in the statement.              information on foreign agricultural workers on H-2A visas,
When Must You File?                                                      go to IRS.gov/H2A.

For 2021, file Form 943 by January 31, 2022. However, if                 Forms 1099-MISC and 1099-NEC
you made deposits on time in full payment of the taxes                   Both paper and electronically filed Forms 1099-MISC,
due for the year, you may file the return by February 10,                Miscellaneous Information, and 1099-NEC, Nonemployee
2022.                                                                    Compensation, must be filed with the IRS by January 31,

                                                                   -8-                              Instructions for Form 943 (2021)
2022. Form 1099-MISC is used to report rents paid in your                         and cents to the right of it. Don’t round entries to whole
farming business, and Form 1099-NEC is generally used                             dollars. Always show an amount for cents, even if it is
to report payments to an individual who isn't your                                zero.
employee. Payments made to corporations for medical                               • Enter negative amounts using a minus sign (if possible).
and health care payments, including payments made to                              Otherwise, use parentheses.
veterinarians, must generally be reported on Form                                 • Staple multiple sheets in the upper left corner when
1099-MISC. Compensation of $600 or more paid in a                                 filing.
calendar year to an H-2A visa agricultural worker who                             Complete all 3 pages. You must complete all three
didn't give you a valid TIN is also reported on Form                              pages of Form 943 and sign on page 3. Failure to do so
1099-MISC; you must withhold federal income tax from                              may delay processing of your return.
these payments under the backup withholding rules. For
more information about filing Forms 1099-MISC and                                 Reconciliation of Form 943 to Forms W-2 and
1099-NEC, see the Instructions for Forms 1099-MISC and                            W-3
1099-NEC.
                                                                                  Certain amounts reported on Form 943 for 2021 should
How Should You Complete Form 943?                                                 agree with the Form W-2 totals reported on the 2021 Form
                                                                                  W-3. The amounts from Form 943 that should agree with
Enter your EIN, name, and address in the spaces                                   the related boxes on Form W-3 are: federal income tax
provided. Don't use your social security number (SSN) or                          withheld (line 8 and box 2), social security wages (lines 2,
individual taxpayer identification number (ITIN). Generally,                      2a, and 2b, and box 3), and Medicare wages (line 4 and
enter the business (legal) name you used when you                                 box 5). If the amounts don't agree, you may be contacted
applied for your EIN. For example, if you're a sole                               by the IRS or the SSA. For more information, see section
proprietor, enter “Barbara Smith” on the “Name” line and                          11 of Pub. 51. Keep all records that show why the totals
“Barbara's Farm” on the “Trade name” line. Leave the                              don't match.
“Trade name” line blank if it is the same as your “Name.”
   If you use a tax preparer to fill out Form 943, make sure                      Where Should You File?
the preparer shows your business name exactly as it                               You’re encouraged to file Form 943 electronically. Go to
appeared when you applied for your EIN.                                           IRS.gov/EmploymentEfile for more information on
   If you don't have an EIN, you may apply for one online                         electronic filing. If you file a paper return, where you file
by visiting IRS.gov/EIN. You may also apply for an EIN by                         depends on whether you include a payment with Form
faxing or mailing Form SS-4 to the IRS. If the principal                          943. Mail your return to the address listed for your location
business was created or organized outside of the United                           in the table that follows.
States or U.S. territories, you may also apply for an EIN by
calling 267-941-1099 (toll call). If you have applied for an                          PDSs can't deliver to P.O. boxes. You must use the
EIN but don't have your EIN by the time a return is due, file                     U.S. Postal Service to mail an item to a P.O. box address.
a paper return and write "Applied For" and the date you                           Go to IRS.gov/PDS for the current list of PDSs. For the
applied in the space shown for the number.                                        IRS mailing address to use if you’re using a PDS, go to
                                                                                  IRS.gov/PDSstreetAddresses. Select the mailing address
Completing Form 943                                                               listed on the webpage that is in the same state as the
Make entries on Form 943 as follows to enable accurate                            address to which you would mail returns filed without a
processing.                                                                       payment, as shown next.
• Don't enter dollar signs and decimal points. Commas
are optional. Enter dollars to the left of the preprinted line

Mailing Addresses for Form 943

 If you’re in . . .                                                          Without a payment . . .           With a payment . . .

 Connecticut, Delaware, District of Columbia, Georgia, Illinois, Indiana,    Department of the Treasury        Internal Revenue Service
 Kentucky, Maine, Maryland, Massachusetts, Michigan, New Hampshire,          Internal Revenue Service          P.O. Box 806533
 New Jersey, New York, North Carolina, Ohio, Pennsylvania, Rhode             Kansas City, MO 64999-0008        Cincinnati, OH 45280-6533
 Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia,
 Wisconsin

 Alabama, Alaska, Arizona, Arkansas, California, Colorado, Florida,          Department of the Treasury        Internal Revenue Service
 Hawaii, Idaho, Iowa, Kansas, Louisiana, Minnesota, Mississippi,             Internal Revenue Service          P.O. Box 932200
 Missouri, Montana, Nebraska, Nevada, New Mexico, North Dakota,              Ogden, UT 84201-0008              Louisville, KY 40293-2200
 Oklahoma, Oregon, South Dakota, Texas, Utah, Washington, Wyoming

 No legal residence or principal place of business in any state              Internal Revenue Service          Internal Revenue Service
                                                                             P.O. Box 409101                   P.O. Box 932200
                                                                             Ogden, UT 84409                   Louisville, KY 40293-2200




Instructions for Form 943 (2021)                                            -9-
 Special filing address for exempt organizations; federal, state, and      Department of the Treasury    Internal Revenue Service
 local governmental entities; and Indian tribal governmental entities,     Internal Revenue Service      P.O. Box 932200
 regardless of location                                                    Ogden, UT 84201-0008          Louisville, KY 40293-2200

         Your filing address may have changed from that                     credits. For more information, including an example, see
   !     used to file your employment tax return in prior                   frequently asked question 17 at IRS.gov/ETD.
 CAUTION years. Don't send Form 943 or any payments to
                                                                            Reducing your deposits for COVID-19 credits.
the SSA.                                                                    Employers eligible to claim the credit for qualified sick and
                                                                            family leave wages, the employee retention credit, and/or
Depositing Your Taxes                                                       the COBRA premium assistance credit can reduce their
         You must deposit all depository taxes                              deposits by the amount of their anticipated credits. You
         electronically by EFT. For more information, see                   may reduce your deposits of federal employment taxes in
   !
 CAUTION Federal tax deposits must be made by electronic
                                                                            anticipation of the COBRA premium assistance credit with
funds transfer (EFT) under Reminders, earlier.                              regard to a period of coverage as of the date you are
                                                                            entitled to the credit. Employers won’t be subject to an
                                                                            FTD penalty for reducing their deposits if certain
Must You Deposit Your Taxes?                                                conditions are met. See the instructions for line 12b,
You may have to deposit the federal income taxes you                        line 12c, line 12d, and line 12e, later, for more information
withheld and both the employer and employee social                          on these credits. For more information on reducing
security taxes and Medicare taxes.                                          deposits, see Notice 2020-22, 2020-17 I.R.B. 664,
                                                                            available at IRS.gov/irb/2020-17_IRB#NOT-2020-22; and
• If your total taxes after adjustments and                                 Notice 2021-24, 2021-18 I.R.B. 1122, available at
nonrefundable credits (line 13) are less than $2,500                        IRS.gov/irb/2021-18_IRB#NOT-2021-24. See the
for the year, you can pay the tax due with your return                      instructions for line 17, later, for information on adjusting
if you file on time. You don't have to make a deposit. To                   tax liabilities reported on line 17 or Form 943-A for
avoid a penalty, you must pay any amount due in full with                   nonrefundable credits.
a timely filed return or you must deposit any amount you
owe by the due date of the return. For more information on                     Due to the termination of the employee retention credit
paying with a timely filed return, see the instructions for                 for the fourth quarter of 2021 for employers that aren't
line 15, later.                                                             recovery startup businesses, the IRS will no longer waive
• If your total taxes after adjustments and                                 FTD penalties for employers that reduce deposits in
nonrefundable credits (line 13) are $2,500 or more                          anticipation of the employee retention credit after
for the year. You must make deposits by EFT throughout                      December 20, 2021, unless the employer is a recovery
the year in accordance with your deposit schedule. There                    startup business. Some employers that are no longer
are two deposit schedules—monthly or semiweekly—for                         eligible to claim the employee retention credit for the
determining when you must deposit. Before the beginning                     fourth quarter of 2021 may have already reduced their
of each calendar year, you must determine which of the                      employment tax deposits in anticipation of claiming the
two deposit schedules you must use. See section 7 of                        employee retention credit for the fourth quarter of 2021.
Pub. 51 for information and rules concerning federal tax                    For deposits due on or before December 20, 2021, with
deposits and to determine your status as a monthly or                       respect to wages paid on or after October 1, 2021, an
semiweekly schedule depositor.                                              employer that isn't a recovery startup business won't be
                                                                            subject to an FTD penalty for the fourth quarter of 2021 if
Note. If you're a monthly schedule depositor and                            the employer:
accumulate a $100,000 tax liability on any day during the                   • Reduced its deposits in anticipation of the employee
deposit period, you become a semiweekly schedule                            retention credit, consistent with the rules provided by
depositor on the next day and remain so for at least the                    section 3.b. of Notice 2021-24;
rest of the calendar year and for the following calendar                    • Deposits the amounts initially retained in anticipation of
year. If you become a semiweekly schedule depositor                         the employee retention credit on or before the due date of
under this rule solely as a result of the relief provided in                the deposit for wages paid on December 31, 2021
Notice 2021-65 regarding the early termination of the                       (regardless of whether wages are actually paid on that
employee retention credit for the fourth quarter of 2021,                   date); and
you may be converted back to a monthly schedule                             • Reports the tax liability associated with the termination
depositor by contacting the IRS. You may continue to                        of the employer's employee retention credit on their 2021
deposit in accordance with your status as a monthly                         Form 943, line 17, or, if a semiweekly schedule depositor,
schedule depositor, but you may receive a                                   on Form 943-A for the applicable day or days in
system-generated failure-to-deposit (FTD) penalty notice                    December.
after you file your Form 943 for 2022. Contact the IRS at                      Example. Reducing deposits for COBRA premium
the toll-free number on your FTD penalty notice to request                  assistance. Maple Co. has a semimonthly payroll period.
abatement of the FTD penalty and to be converted back to                    Sophie Rose elected COBRA premium assistance on
a monthly schedule depositor. Aside from this exception,                    May 17, 2021. Maple Co. became entitled to a COBRA
ordinary rules for determining deposit frequency will                       premium assistance credit as of May 17, 2021, for the
continue to apply. The $100,000 tax liability threshold                     premiums not paid by Sophie (an assistance eligible
requiring a next-day deposit is determined before you                       individual) for the periods of coverage of April 1, 2021,
consider any reduction of your liability for nonrefundable

                                                                         -10-                           Instructions for Form 943 (2021)
through April 30, 2021, and May 1, 2021, through May 31,                     For purposes of these instructions, all references
2021. Maple Co. could reduce its federal employment tax                TIP to “sick pay” mean ordinary sick pay, not “qualified
deposits as of May 17, 2021, in anticipation of the credit to              sick leave wages” that are reported on line 2a for
which Maple Co. has become entitled.                               leave taken before April 1, 2021, or reported on line 2 for
                                                                   leave taken after March 31, 2021, and before October 1,
What About Penalties and Interest?                                 2021.
Avoiding Penalties and Interest                                    Line 2. Wages Subject to Social
You can avoid paying penalties and interest if you do all of
the following.                                                     Security Tax
• Deposit or pay your taxes when they are due, unless              Enter the total cash wages, including qualified sick leave
you meet the requirements discussed in Notice 2020-22              wages and qualified family leave wages for leave taken
and Notice 2021-24. See Notice 2021-65 for modifications           after March 31, 2021, and before October 1, 2021;
to Notice 2021-24 under the Infrastructure Act.                    qualified wages (other than qualified health plan
• File your fully completed Form 943 on time.                      expenses) for the employee retention credit; sick pay; and
• Report your tax liability accurately.                            taxable fringe benefits subject to social security tax that
• Submit valid checks for tax payments.                            you paid to your employees for farmwork during the
• Furnish accurate Forms W-2 to employees.                         calendar year. Don’t include the qualified sick leave
• File Form W-3 and Copy A of Forms W-2 with the SSA               wages reported on line 2a or the qualified family leave
on time and accurately. Go to SSA.gov/employer for                 wages reported on line 2b for leave taken before April 1,
information on how to file Forms W-2 electronically.               2021. For this purpose, sick pay includes payments made
                                                                   by an insurance company to your employees for which
  Penalties and interest are charged on taxes paid late
                                                                   you received timely notice from the insurance company.
and returns filed late at a rate set by law. See sections 7
and 8 of Pub. 51 for details.                                         Enter the amount before payroll deductions. Cash
                                                                   wages include checks, money orders, etc. Don't include
  Use Form 843 to request abatement of assessed                    the value of noncash items, such as food or lodging, or
penalties or interest. Don't request abatement of                  pay for services other than farmwork. See section 3 of
assessed penalties or interest on Form 943 or Form                 Pub. 51 for information on cash and noncash wages. See
943-X.                                                             Purpose of Form 943, earlier, for household employee
   If you receive a notice about a penalty after you file          information.
your return, reply to the notice with an explanation and we           For 2021, the rate of social security tax on taxable
will determine if you meet reasonable-cause criteria. Don't        wages, except for qualified sick leave wages and qualified
attach an explanation when you file your return.                   family leave wages for leave taken before April 1, 2021, is
          If federal income, social security, and Medicare         6.2% (0.062) each for the employer and employee or
  !       taxes that must be withheld (that is, trust fund         12.4% (0.124) for both. Stop paying social security tax on
 CAUTION taxes) aren't withheld or aren't deposited or paid        and entering an employee's wages on line 2 when the
to the United States Treasury, the trust fund recovery             employee's taxable wages, including qualified sick leave
penalty may apply. The penalty is 100% of the unpaid               wages reported on line 2a and qualified family leave
trust fund tax. If these unpaid taxes can't be immediately         wages reported on line 2b, reach $142,800 for the year.
collected from the employer or business, the trust fund            However, continue to withhold income and Medicare
recovery penalty may be imposed on all persons who are             taxes for the whole year on all wages, including qualified
determined by the IRS to be responsible for collecting,            sick leave wages and qualified family leave wages, even
accounting for, or paying over these taxes, and who acted          when the social security wage base of $142,800 has been
willfully in not doing so. For more information, see section       reached. If you, as a qualifying employer, receive an
7 of Pub. 51. The trust fund recovery penalty won't apply          approved Form 4029, Application for Exemption From
to any amount of trust fund taxes an employer holds back           Social Security and Medicare Taxes and Waiver of
in anticipation of any credits they are entitled to. It also       Benefits, from one or more of your employees, enter
won't apply to applicable taxes deferred under section             “Form 4029” on the dotted line next to the entry space.
2302 of the CARES Act or applicable taxes deferred                    For purposes of the credit for qualified sick and family
under Notice 2020-65 and Notice 2021-11 if paid by the             leave wages, qualified sick leave and family leave wages
due date.                                                          are wages for social security and Medicare tax purposes,
                                                                   determined without regard to the exclusions from the
                                                                   definition of employment under sections 3121(b)(1)–(22),
Specific Instructions                                              that an employer pays that otherwise meet the
                                                                   requirements of the EPSLA or the Expanded FMLA, as
Line 1. Number of Agricultural                                     enacted under the FFCRA and amended for purposes of
Employees                                                          the ARP. However, don't include any wages otherwise
                                                                   excluded under section 3121(b) when reporting qualified
Enter the number of agricultural employees on your                 sick and family leave wages on lines 2, 2a, 2b, 4, and, if
payroll during the pay period that included March 12,              applicable, 6. See the instructions for line 12d for
2021. Don't include household employees, persons who               information about the credit for qualified sick and family
received no pay during the pay period, pensioners, or              leave wages for leave taken after March 31, 2021, and
members of the Armed Forces.                                       before October 1, 2021.

Instructions for Form 943 (2021)                                -11-
EPSLA. Employers with fewer than 500 employees and,                 maximum of up to 80 hours of paid sick leave in total for
for leave taken after March 31, 2021, and before October            leave taken after March 31, 2020, and before April 1,
1, 2021, certain governmental employers without regard              2021. The ARP resets this limit at 80 hours of paid sick
to number of employees (except for the federal                      leave for leave taken after March 31, 2021, and before
government and its agencies and instrumentalities unless            October 1, 2021. Therefore, for leave taken after March
described in section 501(c)(1)) are entitled to a credit if         31, 2020, and before April 1, 2021, the maximum amount
they provide paid sick leave to employees that otherwise            of paid sick leave wages can’t exceed $5,110 for an
meets the requirements of the EPSLA. Under the EPSLA,               employee for leave under (1), (2), or (3), and it can’t
as amended for purposes of the ARP, wages are qualified             exceed $2,000 for an employee for leave under (4), (5), or
sick leave wages if paid to employees that are unable to            (6). These maximum amounts also reset and apply to
work before October 1, 2021, because the employee:                  leave taken after March 31, 2021, and before October 1,
                                                                    2021.
   1. Is subject to a federal, state, or local quarantine or
isolation order related to COVID-19;                                   For more information about qualified sick and family
                                                                    leave wages, go to IRS.gov/PLC.
   2. Has been advised by a health care provider to
self-quarantine due to concerns related to COVID-19;                Expanded FMLA. Employers with fewer than 500
   3. Is experiencing symptoms of COVID-19 and                      employees and, for leave taken after March 31, 2021, and
seeking a medical diagnosis; or, for leave taken after              before October 1, 2021, certain governmental employers
March 31, 2021, and before October 1, 2021, is seeking              without regard to number of employees (except for the
or awaiting the results of a diagnostic test for, or a medical      federal government and its agencies and instrumentalities
diagnosis of, COVID-19 (and the employee has been                   unless described in section 501(c)(1)) are entitled to a
exposed to COVID-19 or the employee's employer has                  credit under the FFCRA, as amended for purposes of the
requested such test or diagnosis), or the employee is               ARP, if they provide paid family leave to employees that
obtaining immunizations related to COVID-19 or                      otherwise meets the requirements of the Expanded
recovering from an injury, disability, illness, or condition        FMLA. For leave taken before April 1, 2021, wages are
related to such immunization;                                       qualified family leave wages if paid to an employee who
                                                                    has been employed for at least 30 calendar days when an
   4. Is caring for an individual subject to an order               employee is unable to work due to the need to care for a
described in (1) or who has been advised as described in            son or daughter under 18 years of age or incapable of
(2);                                                                self-care because of a mental or physical disability
   5. Is caring for a son or daughter because the school            because the school or place of care for that child has
or place of care for that child has been closed, or the             been closed, or the childcare provider for that child is
childcare provider for that child is unavailable, due to            unavailable, due to a public health emergency. See Son
COVID-19 precautions; or                                            or daughter, earlier, for more information. For leave taken
   6. Is experiencing any other substantially similar               after March 31, 2021, and before October 1, 2021, the
condition specified by the U.S. Department of Health and            leave can be granted for any other reason provided by the
Human Services, which for leave taken after March 31,               EPSLA, as amended for purposes of the ARP.
2021, and before October 1, 2021, includes to                          For leave taken before April 1, 2021, the first 10 days
accompany an individual to obtain immunization related to           for which an employee takes leave may be unpaid. During
COVID-19, or to care for an individual who is recovering            this period, employees may use other forms of paid leave,
from any injury, disability, illness, or condition related to       such as qualified sick leave, accrued sick leave, annual
the immunization.                                                   leave, or other paid time off. After an employee takes
   Son or daughter. A son or daughter must generally                leave for 10 days, the employer must provide the
have been under 18 years of age or incapable of self-care           employee paid leave (that is, qualified family leave wages)
because of a mental or physical disability. A son or                for up to 10 weeks. For leave taken after March 31, 2021,
daughter includes a biological child, adopted child,                and before October 1, 2021, the 10-day rule discussed
stepchild, foster child, legal ward, or child for whom the          above doesn't apply and the paid leave can be provided
employee assumes parental status and carries out the                for up to 12 weeks.
obligations of a parent.                                               Rate of pay and limit on wages. The rate of pay must
   Limits on qualified sick leave wages. The EPSLA,                 be at least two-thirds of the employee's regular rate of pay
as amended for purposes of the ARP, provides different              (as determined under the Fair Labor Standards Act of
limitations for different circumstances under which                 1938), multiplied by the number of hours the employee
qualified sick leave wages are paid. For paid sick leave            would have otherwise been scheduled to work. For leave
qualifying under (1), (2), or (3) earlier, the amount of            taken after March 31, 2020, and before April 1, 2021, the
qualified sick leave wages is determined at the                     qualified family leave wages can't exceed $200 per day or
employee's regular rate of pay, but the wages may not               $10,000 in the aggregate per employee. For leave taken
exceed $511 for any day (or portion of a day) for which the         after March 31, 2021, and before October 1, 2021, the
individual is paid sick leave. For paid sick leave qualifying       limit resets and the total qualified leave wages can't
under (4), (5), or (6) earlier, the amount of qualified sick        exceed $200 per day or $12,000 in the aggregate per
leave wages is determined at two-thirds the employee's              employee.
regular rate of pay, but the wages may not exceed $200                 For more information about qualified sick and family
for any day (or portion of a day) for which the individual is       leave wages, go to IRS.gov/PLC.
paid sick leave. The EPSLA also limits each individual to a

                                                                 -12-                          Instructions for Form 943 (2021)
Line 2a. Qualified Sick Leave Wages                                 Line 3. Social Security Tax
Enter the qualified taxable (subject to social security tax)        Multiply line 2 by 12.4% (0.124) and enter the result on
sick leave wages you paid to your employees during the              line 3.
year for leave taken before April 1, 2021. Qualified sick
leave wages for leave taken before April 1, 2021, aren't            Line 3a. Social Security Tax on
subject to the employer share of social security tax;               Qualified Sick Leave Wages
therefore, the tax rate on these wages is 6.2% (0.062).
                                                                    Multiply line 2a by 6.2% (0.062) and enter the result on
Stop paying social security tax on and entering an
                                                                    line 3a.
employee's wages on line 2a when the employee's
taxable wages, including wages reported on line 2,                  Line 3b. Social Security Tax on
qualified sick leave wages reported on line 2a, and
qualified family leave wages reported on line 2b, reach             Qualified Family Leave Wages
$142,800 for the year. See the instructions for line 4 and          Multiply line 2b by 6.2% (0.062) and enter the result on
line 5 for reporting Medicare tax on qualified sick leave           line 3b.
wages, including the portion above the social security
wage base.                                                          Line 4. Wages Subject to Medicare
   For purposes of the credit for qualified sick and family         Tax
leave wages, qualified sick leave wages are wages for               Enter the total cash wages, including qualified sick leave
social security and Medicare tax purposes, determined               wages, qualified family leave wages, and qualified wages
without regard to the exclusions from the definition of             (excluding qualified health plan expenses) for the
employment under sections 3121(b)(1)–(22), that an                  employee retention credit; sick pay; and taxable fringe
employer pays that otherwise meet the requirements of               benefits that are subject to Medicare tax that you paid to
the EPSLA, as enacted under the FFCRA and amended                   your employees for farmwork during the calendar year.
by the COVID-related Tax Relief Act of 2020. However,               Enter the amount before deductions. Don't include the
don't include any wages otherwise excluded under                    value of noncash items, such as food or lodging, or pay
section 3121(b) when reporting qualified sick leave wages           for services other than farmwork. Unlike social security
on lines 2a, 4, and, if applicable, 6. See the instructions for     wages, there is no limit on the amount of wages subject to
line 12b for information about the credit for qualified sick        Medicare tax. If you, as a qualifying employer, receive an
and family leave wages for leave taken before April 1,              approved Form 4029 from one or more of your
2021.                                                               employees, enter “Form 4029” on the dotted line next to
                                                                    the entry space.
Line 2b. Qualified Family Leave
Wages                                                               Line 5. Medicare Tax
                                                                    Multiply line 4 by 2.9% (0.029) and enter the result on
Enter the qualified taxable (subject to social security tax)
                                                                    line 5.
family leave wages you paid to your employees during the
year for leave taken before April 1, 2021. Qualified family         Line 6. Wages Subject to Additional
leave wages for leave taken before April 1, 2021, aren't
subject to the employer share of social security tax;               Medicare Tax Withholding
therefore, the tax rate on these wages is 6.2% (0.062).             Enter all wages, including qualified sick leave wages,
Stop paying social security tax on and entering an                  qualified family leave wages, and qualified wages
employee's wages on line 2b when the employee's                     (excluding qualified health plan expenses) for the
taxable wages, including wages reported on line 2,                  employee retention credit; sick pay; and taxable fringe
qualified sick leave wages reported on line 2a, and                 benefits that are subject to Additional Medicare Tax
qualified family leave wages reported on line 2b, reach             withholding. You're required to begin withholding
$142,800 for the year. See the instructions for line 4 and          Additional Medicare Tax in the pay period in which you
line 5 for reporting Medicare tax on qualified family leave         pay wages in excess of $200,000 to an employee and
wages, including the portion above the social security              continue to withhold it each pay period until the end of the
wage base.                                                          calendar year. Additional Medicare Tax is only imposed
   For purposes of the credit for qualified sick and family         on the employee. There is no employer share of
leave wages, qualified family leave wages are wages for             Additional Medicare Tax. All wages that are subject to
social security and Medicare tax purposes, determined               Medicare tax are subject to Additional Medicare Tax
without regard to the exclusions from the definition of             withholding if paid in excess of the $200,000 withholding
employment under sections 3121(b)(1)–(22), that an                  threshold.
employer pays that otherwise meet the requirements of                 For more information on what wages are subject to
the Expanded FMLA, as enacted under the FFCRA and                   Medicare tax, see the chart, Special Rules for Various
amended by the COVID-related Tax Relief Act of 2020.                Types of Services and Payments, in section 15 of Pub. 15.
However, don't include any wages otherwise excluded                 For more information on Additional Medicare Tax, go to
under section 3121(b) when reporting qualified family               IRS.gov/ADMT.
leave wages on lines 2b, 4, and, if applicable, 6. See the
instructions for line 12b for information about the credit for
qualified sick and family leave wages for leave taken
before April 1, 2021.

Instructions for Form 943 (2021)                                 -13-
Line 7. Additional Medicare Tax                                     reimbursed on a cost-plus-fee basis for payment of sick
                                                                    pay and similar amounts. If an employer uses an agent to
Withholding                                                         pay sick pay, the employer reports the wages on line 2,
Multiply line 6 by 0.9% (0.009) and enter the result on             line 4, and, if the withholding threshold is met, line 6,
line 7.                                                             unless the employer has an agency agreement with the
                                                                    third-party payer that requires the third-party payer to do
Line 8. Federal Income Tax Withheld                                 the collecting, reporting, and/or paying or depositing
Enter the federal income tax that you withheld from your            employment taxes on the sick pay. See section 6 of Pub.
employees on this year's wages, including qualified sick            15-A for more information about sick pay reporting.
leave wages, qualified family leave wages, and qualified
wages (excluding qualified health plan expenses) for the            Line 11. Total Taxes After
employee retention credit. Generally, you must withhold             Adjustments
federal income tax from employees from whom you                     Combine lines 9 and 10; enter the result on line 11.
withhold social security and Medicare taxes. See section
5 of Pub. 51 for more information on withholding rules.             Line 12a. Qualified Small Business
Line 9. Total Taxes Before                                          Payroll Tax Credit for Increasing
Adjustments                                                         Research Activities
Add the total social security tax (lines 3, 3a, and 3b),            Enter the amount of the credit from Form 8974, line 12.
Medicare tax (line 5), Additional Medicare Tax withholding                   If you enter an amount on line 12a, you must
(line 7), and federal income tax withheld (line 8). Enter the                attach Form 8974. The December 2017 revision
result on line 9.                                                        !
                                                                     CAUTION of Form 8974 instructs you to enter the amount


Line 10. Current Year's Adjustments                                 from Form 8974, line 12, on Form 943, line 12. For 2021,
                                                                    the amount from Form 8974, line 12, should be entered on
Use line 10 to:                                                     Form 943, line 12a.
• Adjust for rounding of fractions of cents, or
• Adjust for the uncollected employee share of social                         Form 943 and these instructions use the terms
security and Medicare taxes on third-party sick pay or                  TIP “nonrefundable” and “refundable” when
group-term life insurance premiums paid for former                           discussing credits. The term “nonrefundable”
employees. See section 9 of Pub. 51.                                means the portion of the credit which is limited by law to
   Use a minus sign (if possible) to show an adjustment             the amount of certain taxes. The term “refundable” means
that decreases the total taxes shown on line 9. Otherwise,          the portion of the credit which is in excess of those taxes.
use parentheses.
Adjustment for fractions of cents. If there is a small
                                                                    Line 12b. Nonrefundable Portion of
difference between total taxes after adjustments and                Credit for Qualified Sick and Family
nonrefundable credits (line 13) and total deposits
(line 14a), it may be caused by rounding to the nearest
                                                                    Leave Wages for Leave Taken Before
cent each time you figured payroll. This rounding occurs            April 1, 2021
when you figure the amount of social security and                   Certain private employers with fewer than 500 employees
Medicare taxes to be withheld from each employee's                  that provide paid sick leave under the EPSLA and/or
wages. If the fractions of cents adjustment is the only             provide paid family leave under the Expanded FMLA are
entry on line 10, enter “Fractions Only” on the dotted line         eligible to claim the credit for qualified sick and family
to the left of the entry space for line 10. This adjustment         leave wages for leave taken before April 1, 2021. For
may be a positive or a negative adjustment.                         purposes of this credit, qualified sick leave wages and
Adjustment for sick pay. If your third-party payer of sick          qualified family leave wages are wages for social security
pay that isn't your agent (for example, an insurance                and Medicare tax purposes, determined without regard to
company) transfers the liability for the employer share of          the exclusions from the definition of employment under
the social security and Medicare taxes to you, enter a              section 3121(b)(1)–(22), that an employer pays that
negative adjustment on line 10 for the employee share of            otherwise meet the requirements of the EPSLA or
social security and Medicare taxes that were withheld and           Expanded FMLA. Enter the nonrefundable portion of the
deposited by your third-party sick pay payer on the sick            credit for qualified sick and family leave wages from
pay. If you’re the third-party sick pay payer and you               Worksheet 1, Step 2, line 2j. The credit for qualified sick
transferred the liability for the employer share of the social      and family leave wages consists of the qualified sick leave
security and Medicare taxes to the employer, enter a                wages, the qualified family leave wages, the qualified
negative adjustment on line 10 for any employer share of            health plan expenses allocable to those wages, and the
these taxes required to be paid by the employer. The sick           employer share of Medicare tax allocable to those wages.
pay should be included on line 2, line 4, and, if the               The nonrefundable portion of the credit is limited to the
withholding threshold is met, line 6.                               employer share of social security tax reported on Form
                                                                    943, line 3, after that share is first reduced by any credit
   No adjustment is reported on line 10 for sick pay that is
                                                                    claimed on Form 8974 for the qualified small business
paid through a third party as an employer’s agent. An
                                                                    payroll tax credit for increasing research activities, any
employer’s agent bears no insurance risk and is
                                                                    credit to be claimed on Form 5884-C for the work

                                                                 -14-                          Instructions for Form 943 (2021)
opportunity credit for qualified tax-exempt organizations          5884-D for the disaster credit for qualified tax-exempt
hiring qualified veterans, and/or any credit to be claimed         organizations, and/or any credit claimed for the
on Form 5884-D for the disaster credit for qualified               nonrefundable portion of the credit for qualified sick and
tax-exempt organizations.                                          family leave wages for leave taken before April 1, 2021.

   Any credit in excess of the remaining amount of the                Any credit in excess of the remaining amount of the
employer share of social security tax is refundable and            employer share of social security tax is refundable and
reported on Form 943, line 14d. For more information on            reported on Form 943, line 14e. For more information on
the credit for qualified sick and family leave wages, go to        the employee retention credit for qualified wages paid
IRS.gov/PLC.                                                       after December 31, 2020, and before July 1, 2021, see
                                                                   Notice 2021-23.
Qualified health plan expenses allocable to qualified
sick and family leave wages. The credit for qualified              Qualified wages for the employee retention credit
sick leave wages and qualified family leave wages is               paid after December 31, 2020, and before July 1,
increased to cover the qualified health plan expenses that         2021. The tax credit is equal to 70% of qualified wages
are properly allocable to the qualified leave wages for            paid to employees after December 31, 2020, and before
which the credit is allowed. These qualified health plan           July 1, 2021. Qualified wages, including qualified health
expenses are amounts paid or incurred by the employer              plan expenses, are limited to a maximum of $10,000 for
to provide and maintain a group health plan but only to the        each employee in each of the first quarter and the second
extent such amounts are excluded from the employees’               quarter of 2021 ($20,000 in total). Qualified wages are
income as coverage under an accident or health plan. The           wages for social security and Medicare tax purposes (for
amount of qualified health plan expenses generally                 government entities, determined without regard to section
includes both the portion of the cost paid by the employer         3121(b)(5), (6), (7), (10), or (13), except for services
and the portion of the cost paid by the employee with              performed by an inmate at a penal institution) paid to
pre-tax salary reduction contributions. However, qualified         certain employees during any period in a quarter in which
health plan expenses don’t include amounts that the                your operations are fully or partially suspended due to a
employee paid for with after-tax contributions. For more           governmental order or during a quarter in which your
information, go to IRS.gov/PLC.                                    gross receipts (within the meaning of section 448(c) or, if
                                                                   you're a tax-exempt organization, section 6033) are less
        You must include the full amount (both the
                                                                   than 80% of the gross receipts for the same calendar
 TIP nonrefundable and refundable portions) of the                 quarter in calendar year 2019.
        credit for qualified sick and family leave wages in
your gross income for the tax year that includes the last             The wages and qualified health plan expenses
day of any calendar quarter in which a credit is allowed.          considered in calculating your credit depend on the size of
You can't use the same wages for the employee retention            your workforce. Eligible employers that had an average
credit and the credits for paid sick and family leave.             number of 500 or fewer full-time employees during 2019
                                                                   count wages paid to all their employees and the qualified
Line 12c. Nonrefundable Portion of                                 health plan expenses paid or incurred for all employees
                                                                   during any period in the first and second quarters of 2021,
Employee Retention Credit                                          in which business operations are fully or partially
                                                                   suspended due to a governmental order or during a
        Certain government entities are entitled to the
                                                                   quarter in which gross receipts are less than 80% of the
 TIP credit for 2021, including (1) federal                        gross receipts for the same calendar quarter in calendar
         instrumentalities described in section 501(c)(1)
                                                                   year 2019. Eligible employers that had an average
and exempt from tax under section 501(a); and (2) any
                                                                   number of more than 500 full-time employees in 2019 may
government, agency, or instrumentality that is a college or
                                                                   count only wages paid to employees for time that the
university or the principal purpose or function of the entity
                                                                   employees weren't providing services, and qualified
is providing medical or hospital care.
                                                                   health plan expenses paid or incurred by the employer
                                                                   allocable to the time those employees weren't providing
Instructions for Qualified Wages Paid After                        services, due to the suspension or decline in gross
December 31, 2020, and Before July 1, 2021                         receipts.
Enter the nonrefundable portion of the employee retention             Qualified wages don't include wages for which the
credit from Worksheet 2, Step 2, line 2h. The employee             employer receives a credit for qualified sick and family
retention credit is 70% of the qualified wages you paid to         leave wages and any wages taken into account in
your employees after December 31, 2020, and before July            determining the employee retention credit can't be taken
1, 2021. Qualified wages include qualified health plan             into account as wages for purposes of the credits under
expenses for the employee retention credit. The                    sections 41, 45A, 45P, 45S, 51, and 1396. Employers can
nonrefundable portion of the credit is limited to the              receive both a Small Business Interruption Loan under the
employer share of social security tax reported on Form             PPP and the employee retention credit; however,
943, line 3, after that share is first reduced by any credit       employers can't receive both loan forgiveness and a credit
claimed on Form 8974 for the qualified small business              for the same wages.
payroll tax credit for increasing research activities, any            Qualified health plan expenses for the employee
credit to be claimed on Form 5884-C for the work                   retention credit. Qualified wages for the employee
opportunity credit for qualified tax-exempt organizations          retention credit include qualified health plan expenses.
hiring qualified veterans, any credit to be claimed on Form        Qualified health plan expenses are amounts paid or

Instructions for Form 943 (2021)                                -15-
incurred by the employer to provide and maintain a group         2022. Qualified wages, including qualified health plan
health plan but only to the extent such amounts are              expenses, are limited to a maximum of $10,000 for each
excluded from the employees' income as coverage under            employee in each of the third quarter and the fourth
an accident or health plan. The amount of qualified health       quarter of 2021 ($20,000 in total). Qualified wages are
plan expenses taken into account in determining the              wages for social security and Medicare tax purposes (for
amount of qualified wages generally includes both the            government entities, determined without regard to section
portion of the cost paid by the employer and the portion of      3121(b)(5), (6), (7), (10), or (13), except for services
the cost paid by the employee with pre-tax salary                performed by an inmate at a penal institution) paid to
reduction contributions. However, the qualified health plan      certain employees during any period in the third and fourth
expenses shouldn't include amounts that the employee             quarters of 2021 in which your business operations are
paid for with after-tax contributions. Generally, qualified      fully or partially suspended due to a governmental order or
health plan expenses are those which are allocable to an         during a quarter in which your gross receipts (within the
employee (and to a period) in which your business                meaning of section 448(c) or, if you're a tax-exempt
operations are fully or partially suspended due to a             organization, section 6033) are less than 80% of the gross
governmental order or experience a decline in gross              receipts for the same calendar quarter in calendar year
receipts. The allocation will be treated as proper if made       2019; or wages paid by a recovery startup business. See
on the basis of being pro rata among periods of coverage.        Recovery startup business, later, for more information
                                                                 about a recovery startup business. A recovery startup
        If you complete Worksheet 2 because you paid
                                                                 business must enter the total of any amounts included in
 TIP qualified wages for the employee retention credit
                                                                 lines 12c and 14e on lines 28 and 29, as applicable, for
         after December 31, 2020, and before July 1,
                                                                 wages paid after June 30, 2021, and before January 1,
2021, and you also complete Worksheet 4 because you
                                                                 2022. The recovery startup business is limited to a
paid qualified wages for the employee retention credit
                                                                 $50,000 employee retention credit in each of the third
after June 30, 2021, and before January 1, 2022, you
                                                                 quarter and the fourth quarter of 2021 ($100,000 in total
must add the amounts from Worksheet 2, Step 2, line 2h,
                                                                 for the year). For more information, see the instructions for
and Worksheet 4, Step 2, line 2h, together and report the
total on Form 943, line 12c.                                     line 28 and line 29, later.
                                                                     Unless you're a severely financially distressed
Instructions for Qualified Wages Paid After June                 employer, the wages and qualified health plan expenses
                                                                 considered in calculating your credit depend on the size of
30, 2021, and Before January 1, 2022                             your workforce. Eligible employers that had an average
         The Infrastructure Act amends section 3134 of the       number of 500 or fewer full-time employees during 2019
  !      Internal Revenue Code, as enacted under the             count wages paid to all their employees and the qualified
 CAUTION ARP, to limit the availability of the employee          health plan expenses paid or incurred for all employees
retention credit in the fourth quarter of 2021 to employers      during any period in the third and fourth quarters of 2021
that are recovery startup businesses, as defined in section      in which business operations are fully or partially
3134(c)(5). Thus, for wages paid after September 30,             suspended due to a governmental order or during a
2021, and before January 1, 2022, only the wages paid by         quarter in which gross receipts are less than 80% of the
recovery startup businesses can be qualified wages as            gross receipts for the same calendar quarter in calendar
described in these instructions. See Recovery startup            year 2019. Eligible employers that had an average
business, later, for more information about a recovery           number of more than 500 full-time employees in 2019 may
startup business.                                                count only wages paid to employees for time that the
                                                                 employees weren't providing services, and qualified
Enter the nonrefundable portion of the employee retention
                                                                 health plan expenses paid or incurred by the employer
credit from Worksheet 4, Step 2, line 2h. The employee
                                                                 allocable to the time those employees weren't providing
retention credit is 70% of the qualified wages you paid to
                                                                 services, due to the suspension or decline in gross
your employees after June 30, 2021, and before January
                                                                 receipts.
1, 2022. Qualified wages include qualified health plan
expenses for the employee retention credit. The                      Qualified wages under section 3134 for the employee
nonrefundable portion of the credit is limited to the            retention credit don't include wages taken into account for
employer share of Medicare tax reported on Form 943,             credits under sections 41, 45A, 45P, 45S, 51, 1396, 3131
line 5, after that share is first reduced by any credit          (qualified sick leave wages for leave taken after March 31,
claimed for the nonrefundable portion of the credit for          2021, and before October 1, 2021), and 3132 (qualified
qualified sick and family leave wages for leave taken after      family leave wages for leave taken after March 31, 2021,
March 31, 2021. Any credit in excess of the remaining            and before October 1, 2021). Qualified wages also don't
amount of the employer share of Medicare tax is                  include wages that were used as payroll costs in
refundable and reported on Form 943, line 14f. For more          connection with a Shuttered Venue Operator Grant under
information about the employee retention credit for              section 324 of the Economic Aid to Hard-Hit Small
qualified wages paid after June 30, 2021, and before             Businesses, Nonprofits, and Venues Act; or a restaurant
January 1, 2022, see Notice 2021-49.                             revitalization grant under section 5003 of the ARP.
                                                                 Employers can receive both a Small Business Interruption
Qualified wages for the employee retention credit                Loan under the PPP and the employee retention credit;
paid after June 30, 2021, and before January 1, 2022.            however, employers can't receive both loan forgiveness
The tax credit is equal to 70% of qualified wages paid to        and a credit for the same wages.
employees after June 30, 2021, and before January 1,

                                                              -16-                          Instructions for Form 943 (2021)
   Severely financially distressed employer. Severely              limitations, allocable to the qualified sick and family leave
financially distressed employers are eligible employers            wages; and
during the third quarter of 2021 whose gross receipts are          • Employer share of social security and Medicare tax
less than 10% of the gross receipts for the same calendar          allocable to the qualified sick and family leave wages.
quarter in calendar year 2019.
                                                                      The nonrefundable portion of the credit is limited to the
   Recovery startup business. A recovery startup                   employer share of Medicare tax reported on Form 943,
business is an employer that:                                      line 5. You can't claim the credit if you provide the leave in
• Began carrying on a trade or business after February             a manner that discriminates in favor of highly
15, 2020;                                                          compensated employees, full-time employees, or
• Had average annual gross receipts of $1 million or less          employees on the basis of employment tenure when
for the 3 tax years ending with the tax year before the            making qualified sick and/or family leave available to
calendar quarter in which the employee retention credit is         employees. See Highly compensated employee, later, for
claimed; and                                                       the definition.
• Only for credit claimed in the third quarter of 2021, isn't
otherwise eligible for the employee retention credit                  For qualified sick and family leave wages paid before
because business operations weren’t fully or partially             July 1, 2021, for leave taken after March 31, 2021, and
suspended due to a governmental order or because gross             before July 1, 2021, the credit for qualified sick and family
receipts (within the meaning of section 448(c) or, if you're       leave wages is reduced by the amount of the credit
a tax-exempt organization, section 6033) weren’t less              allowed under section 2301 of the CARES Act (for the
than 80% of the gross receipts for the same calendar               employee retention credit) or under section 41 (for the
quarter in calendar year 2019.                                     credit for increasing research activities) with respect to
                                                                   wages taken into account for determining both the credit
Line 12d. Nonrefundable Portion of                                 under section 2301 of the CARES Act or section 41 and
Credit for Qualified Sick and Family                               the credit for qualified sick and family leave wages; and
                                                                   any wages taken into account in determining the credit for
Leave Wages for Leave Taken After                                  qualified sick and family leave wages can't be taken into
March 31, 2021, and Before October                                 account as wages for purposes of the credits under
                                                                   sections 45A, 45P, 45S, and 51. For leave taken after
1, 2021                                                            June 30, 2021, the credit for qualified sick and family
Employers with fewer than 500 employees and certain                leave wages is reduced by the amount of the credit
governmental employers without regard to number of                 allowed under section 41 (for the credit for increasing
employees (except for the federal government and its               research activities) with respect to wages taken into
agencies and instrumentalities unless described in                 account for determining the credit for qualified sick and
section 501(c)(1)) are entitled to a credit if they provide        family leave wages; and any wages taken into account in
paid sick leave to employees that otherwise meets the              determining the credit for qualified sick and family leave
requirements of the EPSLA, as amended for purposes of              wages can't be taken into account as wages for purposes
the ARP, and/or provide paid family leave to employees             of the credits under sections 45A, 45P, 45S, 51, and
that otherwise meets the requirements under the                    3134. For leave taken after March 31, 2021, and before
Expanded FMLA, as amended for purposes of the ARP,                 October 1, 2021, qualified wages also don't include
for qualified sick and family leave wages for leave taken          wages that were used as payroll costs in connection with
after March 31, 2021, and before October 1, 2021. For              a Shuttered Venue Operator Grant under section 324 of
purposes of this credit, qualified sick leave wages and            the Economic Aid to Hard-Hit Small Businesses,
qualified family leave wages are wages for social security         Nonprofits, and Venues Act; or a restaurant revitalization
and Medicare tax purposes, determined without regard to            grant under section 5003 of the ARP. Employers can
the exclusions from the definition of employment under             receive both a Small Business Interruption Loan under the
sections 3121(b)(1)–(22), that an employer pays that               PPP and the credit for qualified sick and family leave
otherwise meet the requirements of the EPSLA or                    wages; however, employers can't receive both loan
Expanded FMLA, as enacted under the FFCRA and                      forgiveness and a credit for the same wages. The same
amended for purposes of the ARP. Enter the                         wages can't be treated as both qualified sick leave wages
nonrefundable portion of the credit for qualified sick and         and qualified family leave wages.
family leave wages from Worksheet 3, Step 2, line 2r.                 Any credit in excess of the remaining amount of the
                                                                   employer share of Medicare tax is refundable and
   The credit for qualified sick and family leave wages
                                                                   reported on Form 943, line 14f. For more information on
consists of the:
                                                                   the credit for qualified sick and family leave wages, go to
• Qualified sick leave wages and/or qualified family leave         IRS.gov/PLC.
wages;
• Qualified health plan expenses allocable to qualified            Qualified health plan expenses allocable to qualified
sick leave and family leave wages;                                 sick leave and family leave wages. The credit for
• Collectively bargained defined benefit pension plan              qualified sick leave wages and qualified family leave
contributions, subject to the qualified leave wage                 wages is increased to cover the qualified health plan
limitations, allocable to the qualified sick and family leave      expenses that are properly allocable to the qualified leave
wages;                                                             wages for which the credit is allowed. These qualified
• Collectively bargained apprenticeship program                    health plan expenses are amounts paid or incurred by the
contributions, subject to the qualified leave wage                 employer to provide and maintain a group health plan but

Instructions for Form 943 (2021)                                -17-
only to the extent such amounts are excluded from the                Allocation rules. The amount of collectively bargained
employees' income as coverage under an accident or                 apprenticeship program contributions allocated to
health plan. The amount of qualified health plan expenses          qualified sick leave wages and/or qualified family leave
generally includes both the portion of the cost paid by the        wages during the quarter for which you're claiming the
employer and the portion of the cost paid by the employee          credit is the apprenticeship program contribution rate
with pre-tax salary reduction contributions. However,              (expressed as an hourly rate) multiplied by the number of
qualified health plan expenses don't include amounts that          hours qualified sick leave wages and/or qualified family
the employee paid for with after-tax contributions. For            leave wages were provided to employees covered under
more information, go to IRS.gov/PLC.                               the collective bargaining agreement during the quarter for
Collectively bargained defined benefit pension plan                which you're claiming the credit.
contributions. For purposes of qualified sick and family           Highly compensated employee. A highly compensated
leave wages, collectively bargained defined benefit                employee is an employee who meets either of the
pension plan contributions are contributions during the            following tests.
quarter for which you're claiming the credit that are:                 1. The employee was a 5% owner at any time during
• Paid or incurred by an employer on behalf of its                 the year or the preceding year.
employees to a defined benefit plan, as defined in section
                                                                       2. The employee received more than $130,000 in pay
414(j), which meets the requirements of section 401(a);
                                                                   for the preceding year.
• Made based on a pension contribution rate; and
• Required to be made under the terms of a collective                You can choose to ignore test (2) if the employee
bargaining agreement in effect during the period for which         wasn't also in the top 20% of employees when ranked by
you're claiming the credit.                                        pay for the preceding year.
  Pension contribution rate. The pension contribution
rate is the contribution rate that the employer is obligated       Line 12e. Nonrefundable Portion of
to pay under the terms of a collective bargaining                  COBRA Premium Assistance Credit
agreement to a defined benefit plan, as the rate is applied
                                                                   Enter the COBRA premium assistance that you provided
to contribution base units, as defined by section 4001(a)
                                                                   for periods of coverage beginning on or after April 1, 2021,
(11) of the Employee Retirement Income Security Act of
                                                                   through periods of coverage beginning on or before
1974 (ERISA).
                                                                   September 30, 2021. You can claim the credit for a period
  Allocation rules. The amount of collectively bargained           of coverage once the individual elects COBRA
defined benefit pension plan contributions allocated to            continuation coverage, and for any period of coverage
qualified sick leave wages and/or qualified family leave           beginning after the election, as of the beginning of such
wages during the quarter for which you're claiming the             period of coverage for which the individual doesn't pay the
credit is the pension contribution rate (expressed as an           premiums for the coverage. Don't include any amount that
hourly rate) multiplied by the number of hours qualified           was included as qualified wages for the employee
sick leave wages and/or qualified family leave wages               retention credit or included as qualified health plan
were provided to employees covered under the collective            expenses allocable to qualified sick leave and family leave
bargaining agreement during the quarter for which you're           wages. Enter the nonrefundable portion of the COBRA
claiming the credit.                                               premium assistance credit from Worksheet 5, Step 2,
Collectively bargained apprenticeship program con-                 line 2g. See COBRA background next for more
tributions. For purposes of qualified sick and family              information about COBRA.
leave wages, collectively bargained apprenticeship                 COBRA background. The Consolidated Omnibus
program contributions are contributions during the quarter         Budget Reconciliation Act of 1985 (COBRA) provides
for which you're claiming the credit that are:                     certain former employees, retirees, spouses, former
• Paid or incurred by an employer on behalf of its                 spouses, and dependent children the right to temporary
employees to a registered apprenticeship program, which            continuation of health coverage at group rates. COBRA
is an apprenticeship registered under the National                 generally covers multiemployer health plans and health
Apprenticeship Act of August 16, 1937, and meets the               plans maintained by private-sector employers (other than
standards of Federal Regulations under subpart A of Part           churches) with 20 or more full- and part-time employees.
29 and Part 30 of title 29;                                        Parallel requirements apply to these plans under ERISA.
• Made based on an apprenticeship program contribution             Under the Public Health Service Act, COBRA
rate; and                                                          requirements also apply to health plans covering state or
• Required to be made under the terms of a collective              local government employees. Similar requirements apply
bargaining agreement in effect during the quarter for              under some state laws.
which you're claiming the credit.
   Apprenticeship program contribution rate. The                   Line 12f. Number of Individuals
apprenticeship program contribution rate is the
contribution rate that the employer is obligated to pay
                                                                   Provided COBRA Premium
under the terms of a collective bargaining agreement for           Assistance
benefits under a registered apprenticeship program, as             Enter the number of individuals provided COBRA
the rate is applied to contribution base units, as defined by      premium assistance for periods of coverage beginning on
section 4001(a)(11) of ERISA.                                      or after April 1, 2021, through periods of coverage
                                                                   beginning on or before September 30, 2021. Count each

                                                                -18-                          Instructions for Form 943 (2021)
assistance eligible individual that received assistance as        after June 30, 2021, and before January 1, 2022, you
one individual, whether or not the COBRA coverage was             must add the amounts from Worksheet 2, Step 2, line 2i,
for insurance that covered more than one assistance               and Worksheet 4, Step 2, line 2i, together and report the
eligible individual. For example, if the coverage was for a       total on Form 943, line 14e.
former employee, spouse, and two children, you would
include one individual on line 12f. Further, each individual      Credit for qualified wages paid after December 31,
is reported only once per year. For example, an                   2020, and before July 1, 2021. Enter the refundable
assistance eligible individual that received assistance           portion of the employee retention credit from Worksheet 2,
monthly is only reported as one individual.                       Step 2, line 2i. The employee retention credit is 70% of the
                                                                  Qualified wages for the employee retention credit paid
Line 12g. Total Nonrefundable Credits                             after December 31, 2020, and before July 1, 2021. The
Add lines 12a, 12b, 12c, 12d, and 12e. Enter the total on         refundable portion of the credit is allowed after the
line 12g.                                                         employer share of social security tax is reduced to zero by
                                                                  nonrefundable credits that are applied against the
Line 13. Total Taxes After                                        employer share of social security tax.
Adjustments and Nonrefundable                                              The Infrastructure Act amends section 3134 of the
Credits                                                               !    Internal Revenue Code, as enacted under the
                                                                   CAUTION ARP, to limit the availability of the employee
Subtract line 12g from line 11 and enter the result on            retention credit in the fourth quarter of 2021 to employers
line 13. The amount entered on line 13 can't be less than         that are recovery startup businesses, as defined in section
zero.                                                             3134(c)(5). Thus, for wages paid after September 30,
Line 14a. Total Deposits                                          2021, and before January 1, 2022, only the wages paid by
                                                                  recovery startup businesses can be qualified wages as
Enter your deposits for this year, including any                  described in these instructions. See Recovery startup
overpayment that you applied from filing Form 943-X, in           business, earlier, for more information about a recovery
the current year. Also include in the amount shown any            startup business.
overpayment from a previous period that you applied to
this return. Don’t include any amount you didn’t deposit          Credit for qualified wages paid after June 30, 2021,
because you reduced your deposits in anticipation of the          and before January 1, 2022. Enter the refundable
credit for qualified sick and family leave wages, the             portion of the employee retention credit from Worksheet 4,
employee retention credit, and/or the COBRA premium               Step 2, line 2i. The employee retention credit is 70% of the
assistance credit, as discussed in Notice 2020-22 and             qualified wages for the employee retention credit paid
Notice 2021-24.                                                   after June 30, 2021, and before January 1, 2022. The
Line 14d. Refundable Portion of                                   refundable portion of the credit is allowed after the
                                                                  employer share of Medicare tax is reduced to zero by
Credit for Qualified Sick and Family                              nonrefundable credits that are applied against the
Leave Wages for Leave Taken Before                                employer share of Medicare tax.

April 1, 2021                                                     Line 14f. Refundable Portion of Credit
Certain private employers with fewer than 500 employees           for Qualified Sick and Family Leave
that provide paid sick leave under the EPSLA and/or
provide paid family leave under the Expanded FMLA are
                                                                  Wages for Leave Taken After March
eligible to claim the credit for qualified sick and family        31, 2021, and Before October 1, 2021
leave wages. Enter the refundable portion of the credit for       Employers with fewer than 500 employees and certain
qualified sick and family leave wages from Worksheet 1,           governmental employers without regard to number of
Step 2, line 2k. The credit for qualified sick and family         employees (except for the federal government and its
leave wages consists of the qualified sick leave wages,           agencies and instrumentalities unless described in
the qualified family leave wages, the qualified health plan       section 501(c)(1)) are entitled to a credit if they provide
expenses allocable to those wages, and the employer               paid sick leave to employees that otherwise meets the
share of Medicare tax allocable to those wages. The               requirements of the EPSLA, as amended for purposes of
refundable portion of the credit is allowed after the             the ARP, and/or provide paid family leave to employees
employer share of social security tax is reduced to zero by       that otherwise meets the requirements under the
nonrefundable credits that are applied against the                Expanded FMLA, as amended for purposes of the ARP,
employer share of social security tax.                            for leave taken after March 31, 2021, and before October
Line 14e. Refundable Portion of                                   1, 2021. Enter the refundable portion of the credit for
                                                                  qualified sick and family leave wages from Worksheet 3,
Employee Retention Credit                                         Step 2, line 2s. The refundable portion of the credit is
                                                                  allowed after the employer share of Medicare tax is
        If you complete Worksheet 2 because you paid
                                                                  reduced to zero by nonrefundable credits that are applied
 TIP qualified wages for the employee retention credit            against the employer share of Medicare tax.
       after December 31, 2020, and before July 1,
2021, and you also complete Worksheet 4 because you
paid qualified wages for the employee retention credit

Instructions for Form 943 (2021)                               -19-
Line 14g. Refundable Portion of                                     required to make federal tax deposits or you're a monthly
                                                                    schedule depositor making a payment under the accuracy
COBRA Premium Assistance Credit                                     of deposits rule (see section 7 of Pub. 51), you may pay
Enter the refundable portion of the COBRA premium                   the amount shown on line 15 by EFT, credit card, debit
assistance credit from Worksheet 5, Step 2, line 2h. The            card, check, money order, or EFW. For more information
refundable portion of the credit is allowed after the               on electronic payment options, go to IRS.gov/Payments.
employer share of Medicare tax is reduced to zero by
nonrefundable credits that are applied against the                     If you pay by EFT, credit card, or debit card, file your
employer share of Medicare tax.                                     return using the Without a payment address under Where
                                                                    Should You File, earlier. Don't file Form 943-V, Payment
Line 14h. Total Deposits and                                        Voucher.
Refundable Credits                                                     If you pay by check or money order, make it payable to
Add lines 14a, 14d, 14e, 14f, and 14g. Enter the total on           “United States Treasury.” Enter your EIN, “Form 943,” and
line 14h.                                                           the tax period on your check or money order. Complete
                                                                    Form 943-V and enclose it with Form 943.
Line 14i. Total Advances Received
                                                                                If you're required to make deposits and instead
From Filing Form(s) 7200 for the Year                                     !     pay the taxes with Form 943, you may be subject
                                                                        CAUTION to a penalty.
Enter the total advances received from filing Form(s) 7200
for the year. If you filed a Form 7200 but you haven’t
received the advance before filing Form 943, don’t include          What if you can't pay in full? If you can't pay the full
that amount. Employers were eligible to file Form 7200 if           amount of tax you owe, you can apply for an installment
they paid qualified sick leave wages, qualified family leave        agreement online. You can apply for an installment
wages, or qualified wages for the employee retention                agreement online if:
credit, and/or provided COBRA premium assistance and                • You can't pay the full amount shown on line 15,
the amount of employment tax deposits they retained                 • The total amount you owe is $25,000 or less, and
wasn’t sufficient to cover their anticipated credits. Include       • You can pay the liability in full in 24 months.
on line 14i any advance payment of the employee                        To apply using the Online Payment Agreement
retention credit that you received for the fourth quarter of        Application, go to IRS.gov/OPA.
2021 even if you're no longer eligible for the employee
                                                                       Under an installment agreement, you can pay what you
retention credit because you're not a recovery startup
                                                                    owe in monthly installments. There are certain conditions
business. See Advance payment of COVID-19 credits
                                                                    you must meet to enter into and maintain an installment
extended, earlier, for more information.
                                                                    agreement, such as paying the liability within 24 months,
        Form 7200 may be filed up to the earlier of                 and making all required deposits and timely filing tax
 TIP January 31, 2022, or the filing of Form 943 for the            returns during the length of the agreement.
         year. However, if you file Form 7200 after the end            If your installment agreement is accepted, you will be
of the year, it's possible that it may not be processed prior       charged a fee and you will be subject to penalties and
to the processing of the filed Form 943. Advance payment            interest on the amount of tax not paid by the due date of
requests on Form 7200 won't be paid after your Form 943             the return.
is processed. When the IRS processes Form 943, we will
correct the amount reported on line 14i to match the                Line 16. Overpayment
amount of advance payments issued or contact you to                 If line 14j is more than line 13, enter the difference on
reconcile the difference before we finish processing Form           line 16. Never make an entry on both lines 15 and 16.
943.
                                                                      If you deposited more than the correct amount for the
Line 14j. Total Deposits and                                        year, you can choose to have the IRS either refund the
                                                                    overpayment or apply it to your next return. Check only
Refundable Credits Less Advances                                    one box on line 16. If you don't check either box or if you
Subtract line 14i from line 14h. Enter the result on line 14j.      check both boxes, we will generally apply the
                                                                    overpayment to your next return. Regardless of any box
Line 15. Balance Due                                                you check or don't check on line 16, we may apply your
If line 13 is more than line 14j, enter the difference on           overpayment to any past due tax account that is shown in
line 15. Otherwise, see Line 16. Overpayment, later.                our records under your EIN.
Never make an entry on both lines 15 and 16.
                                                                      If line 16 is less than $1, we will send you a refund or
   You don't have to pay if line 15 is under $1. Generally,         apply it to your next return only if you ask us in writing to
you should have a balance due only if your total taxes              do so.
after adjustments and nonrefundable credits (line 13) are
less than $2,500. However, see section 7 of Pub. 51                 Line 17. Monthly Summary of Federal
regarding payments made under the accuracy of deposits              Tax Liability
rule.
                                                                    This is a summary of your monthly tax liability, not a
   If you were required to make federal tax deposits, pay           summary of deposits made. If line 13 is less than $2,500,
the amount shown on line 15 by EFT. If you weren't                  don't complete line 17 or Form 943-A.

                                                                 -20-                            Instructions for Form 943 (2021)
   Complete line 17 only if you were a monthly schedule                social security tax for the quarter, the excess credit may
depositor for the entire year and line 13 is $2,500 or                 be carried forward to the succeeding quarter and allowed
more. The amount entered on line 17M must equal the                    as a payroll tax credit for the succeeding quarter. The
amount reported on line 13. If it doesn't, your tax deposits           payroll tax credit may not be taken as a credit against
and payments may not be counted as timely. Don't reduce                income tax withholding, Medicare tax, or the employee
your total liability reported on line 17 by the refundable             share of social security tax.
portion of the credit for qualified sick and family leave                  Also, the remaining payroll tax credit may not be
wages, the refundable portion of the employee retention                carried back and taken as a credit against wages paid
credit, or the refundable portion of the COBRA premium                 from preceding quarters that are reported on the same
assistance credit. Don't change your current year tax                  Form 943 or on Forms 943 for preceding years. If an
liability reported on line 13 by adjustments reported on               amount of payroll tax credit is unused at the end of the
any Forms 943-X. See section 7 of Pub. 51 for details on               calendar year because it is in excess of the employer
the deposit rules. You're a monthly schedule depositor for             share of social security tax on wages paid during the
the calendar year if the amount of your “Total taxes after             applicable quarters in the calendar year, the remaining
adjustments and credits” reported for the lookback period              payroll tax credit may be carried forward to the first
isn't more than $50,000. The lookback period is the                    quarter of the succeeding calendar year as a payroll tax
second calendar year preceding the current calendar                    credit against the employer share of social security tax on
year. For example, the lookback period for 2022 is 2020.               wages paid in that quarter.
        If you were a semiweekly schedule depositor                       Example. Rose Co. is an employer with a calendar tax
   !    during any part of the year, don't complete line 17.           year that filed its timely income tax return on April 15,
CAUTION Instead, complete Form 943-A.                                  2021. Rose Co. elected to take the qualified small
                                                                       business payroll tax credit for increasing research
Reporting adjustments from line 10 on line 17. If your                 activities on Form 6765. The third quarter of 2021 is the
net adjustment during a month is negative and it exceeds               first quarter that begins after Rose Co. filed the income tax
your total liability for the month, don't enter a negative             return making the payroll tax credit election. Therefore,
amount for the month. Instead, enter “-0-” for the month               the payroll tax credit applies against Rose Co.’s share of
and carry over the unused portion of the adjustment to the             social security tax on wages paid to employees in the third
next month.                                                            quarter of 2021. Rose Co. is a semiweekly schedule
Adjusting tax liability for nonrefundable credits                      depositor. Rose Co. completes Form 943-A by reducing
claimed on lines 12a, 12b, 12c, 12d, and 12e. Monthly                  the amount of liability entered for the first payroll payment
schedule depositors and semiweekly schedule depositors                 in the third quarter of 2021 that includes wages subject to
must account for nonrefundable credits claimed on lines                social security tax by the lesser of (1) its share of social
12a, 12b, 12c, 12d, and 12e when reporting their tax                   security tax on the wages, or (2) the available payroll tax
liabilities on line 17 or Form 943-A. The total tax liability for      credit. If the payroll tax credit elected is more than Rose
the year must equal the amount reported on line 13.                    Co.’s share of social security tax on the first payroll
Failure to account for nonrefundable credits on line 17 or             payment of the quarter, the excess payroll tax credit
Form 943-A may cause line 17 or Form 943-A to report                   would be carried forward to succeeding payroll payments
more than the total tax liability reported on line 13. Don't           in the third quarter until it is used. If the amount of the
reduce your monthly tax liability reported on lines 17a                payroll tax credit exceeds Rose Co.’s share of social
through 17l or your daily tax liability reported on Form               security tax on wages paid to its employees in the third
943-A below zero.                                                      quarter, the excess credit would be treated as a payroll
                                                                       tax credit against its share of social security tax on wages
   Qualified small business payroll tax credit for
                                                                       paid in the fourth quarter. If the amount of the payroll tax
increasing research activities (line 12a). The qualified
                                                                       credit remaining exceeded Rose Co.’s share of social
small business payroll tax credit for increasing research
                                                                       security tax on wages paid in the fourth quarter, it could be
activities is limited to the employer share of social security
                                                                       carried forward and treated as a payroll tax credit for the
tax on wages paid during the quarter that begins after the
                                                                       first quarter of 2022.
income tax return electing the credit has been filed. In
completing line 17 or Form 943-A, you take into account                   Nonrefundable portion of credit for qualified sick
the payroll tax credit against your liability for the employer         and family leave wages for leave taken before April
share of social security tax starting with the first payroll           1, 2021 (line 12b). The nonrefundable portion of the
payment of the quarter that includes payments of wages                 credit for qualified sick and family leave wages for leave
to your employees subject to social security tax. The                  taken before April 1, 2021, is limited to the employer share
credit may be taken to the extent of the employer share of             of social security tax on wages paid during the year that is
social security tax on wages associated with the first                 remaining after that share is first reduced by any credit
payroll payment, and then to the extent of the employer                claimed on Form 943, line 12a, for the qualified small
share of social security tax associated with succeeding                business payroll tax credit for increasing research
payroll payments in the quarter until the credit is used.              activities; any credit to be claimed on Form 5884-C,
Consistent with the entries on line 17 or Form 943-A, the              line 11, for the work opportunity credit for qualified
payroll tax credit should be taken into account in making              tax-exempt organizations hiring qualified veterans; and/or
deposits of employment tax. If any payroll tax credit is               any credit to be claimed on Form 5884-D for the disaster
remaining at the end of the quarter that hasn’t been used              credit for qualified tax-exempt organizations. In
completely because it exceeds the employer share of                    completing line 17 or Form 943-A, you take into account
                                                                       the nonrefundable portion of the credit for qualified sick

Instructions for Form 943 (2021)                                    -21-
and family leave wages against the liability for the first                     The Infrastructure Act amends section 3134 of the
payroll payment of the year, but not below zero. Then                     !    Internal Revenue Code, as enacted under the
reduce the liability for each successive payroll payment of            CAUTION ARP, to limit the availability of the employee

the year until the nonrefundable portion of the credit is             retention credit in the fourth quarter of 2021 to employers
used. Any credit for qualified sick and family leave wages            that are recovery startup businesses, as defined in section
for leave taken before April 1, 2021, that is remaining at            3134(c)(5). Thus, for wages paid after September 30,
the end of the year because it exceeds the employer                   2021, and before January 1, 2022, only the wages paid by
share of social security tax is claimed on line 14d as a              recovery startup businesses can be qualified wages as
refundable credit. The refundable portion of the credit               described in these instructions. See Recovery startup
doesn’t reduce the liability reported on line 17 or Form              business, earlier, for more information about a recovery
943-A.                                                                startup business.
  Example. Maple Co. is a monthly schedule depositor
that pays employees every Friday. In 2021, Maple Co.                  If you're no longer eligible to claim the employee retention
had pay dates every Friday of 2021 starting January 1,                credit for the fourth quarter of 2021, but you already
2021. Maple Co. paid qualified sick and family leave                  reduced your employment tax deposits in anticipation of
wages on March 12 and March 19. The nonrefundable                     claiming the employee retention credit for the fourth
portion of the credit for qualified sick and family leave             quarter of 2021, you must deposit the amounts initially
wages for the year is $1,000. On line 17, Maple Co. will              retained in anticipation of the employee retention credit on
use the $1,000 to reduce the liability for the January 1 pay          or before the due date of the deposit for wages paid on
date, but not below zero. If any nonrefundable portion of             December 31, 2021 (regardless of whether wages are
the credit remains, Maple Co. applies it to the liability for         actually paid on that date), based on how you choose to
the January 8 pay date, then the January 15 pay date, and             report the tax liability resulting from the termination of the
so forth until the entire $1,000 is used.                             employee retention credit on Form 943-A or, if a monthly
  Nonrefundable portion of employee retention                         depositor, of Form 943, line 17. In order to obtain the relief
credit for wages paid after December 31, 2020, and                    under Notice 2021-65 and avoid an FTD penalty,
before July 1, 2021 (line 12c). The nonrefundable                     employers must deposit the amounts in accordance with
portion of the employee retention credit is limited to the            the due date or dates of the applicable day or days the tax
employer share of social security tax on wages paid                   liabilities resulting from the termination of the employee
during the year that is remaining after that share is first           retention credit are reported on Form 943-A or Form 943,
reduced by any credit claimed on Form 943, line 12a, for              line 17, as applicable. However, this relief doesn't apply to
the qualified small business payroll tax credit for                   deposit payments that were untimely due to any
increasing research activities; any credit to be claimed on           circumstance other than the change in eligibility for the
Form 5884-C, line 11, for the work opportunity credit for             employee retention credit or to employers who reduced
qualified tax-exempt organizations hiring qualified                   deposits after December 20, 2021. See Notice 2021-65
veterans; any credit to be claimed on Form 5884-D for the             for more information.
disaster credit for qualified tax-exempt organizations;                  Nonrefundable portion of employee retention
and/or any credit claimed on Form 943, line 12b, for the              credit for wages paid after June 30, 2021, and before
nonrefundable portion of the credit for qualified sick and            January 1, 2022 (line 12c). The nonrefundable portion
family leave wages for leave taken before April 1, 2021. In           of the employee retention credit is limited to the employer
completing line 17 or Form 943-A, you take into account               share of Medicare tax on wages paid during the year that
the nonrefundable portion of the employee retention credit            is remaining after that share is first reduced by any credit
against the liability for the first payroll payment of the year,      claimed on Form 943, line 12d, for the nonrefundable
but not below zero. Then reduce the liability for each                portion of the credit for qualified sick and family leave
successive payroll payment in the year until the                      wages for leave taken after March 31, 2021. In completing
nonrefundable portion of the credit is used. Any employee             line 17 or Form 943-A, you take into account the
retention credit that is remaining at the end of the year             nonrefundable portion of the employee retention credit
because it exceeds the employer share of social security              against the liability for the first payroll payment of the year,
tax is claimed on Form 943, line 14e, as a refundable                 but not below zero. Then reduce the liability for each
credit. The refundable portion of the credit doesn’t reduce           successive payroll payment of the year until the
the liability reported on line 17 or Form 943-A.                      nonrefundable portion of the credit is used. Any employee
  Example. Maple Co. is a monthly schedule depositor                  retention credit that is remaining at the end of the year
that pays employees every Friday. In 2021, Maple Co.                  because it exceeds the employer share of Medicare tax is
had pay dates every Friday of 2021 starting January 1,                claimed on line 14e as a refundable credit. The refundable
2021. Maple Co. paid qualified wages for the employee                 portion of the credit doesn't reduce the liability reported on
retention credit on May 7 and May 14. The nonrefundable               line 17 or Form 943-A.
portion of the employee retention credit for the year is                 Nonrefundable portion of credit for qualified sick
$1,000. On line 17, Maple Co. will use the $1,000 to                  and family leave wages for leave taken after March
reduce the liability for the January 1 pay date, but not              31, 2021, and before October 1, 2021 (line 12d). The
below zero. If any nonrefundable portion of the credit                nonrefundable portion of the credit for qualified sick and
remains, Maple Co. applies it to the liability for the                family leave wages for leave taken after March 31, 2021,
January 8 pay date, then the January 15 pay date, and so              and before October 1, 2021, is limited to the employer
forth until the entire $1,000 is used.                                share of Medicare tax on wages paid during the year. In
                                                                      completing line 17 or Form 943-A, you take into account

                                                                   -22-                            Instructions for Form 943 (2021)
the nonrefundable portion of the credit for qualified sick         Line 19. Qualified Health Plan Expenses
and family leave wages against the liability for the first         Allocable to Qualified Family Leave Wages for
payroll payment of the year, but not below zero. Then              Leave Taken Before April 1, 2021
reduce the liability for each successive payroll payment of
the year until the nonrefundable portion of the credit is          Enter the qualified health plan expenses allocable to
used. Any credit for qualified sick and family leave wages         qualified family leave wages for leave taken before April 1,
for leave taken after March 31, 2021, and before October           2021. This amount is also entered on Worksheet 1, Step
1, 2021, that is remaining at the end of the year because it       2, line 2f.
exceeds the employer share of Medicare tax is claimed on                       The total amount reported on lines 20 and 21,
line 14f as a refundable credit. The refundable portion of               !     discussed next, can't exceed $10,000 per
the credit doesn't reduce the liability reported on line 17 or         CAUTION employee, each quarter.

Form 943-A.
   Nonrefundable portion of COBRA premium                          Line 20. Qualified Wages for the Employee
assistance credit (line 12e). The nonrefundable portion            Retention Credit
of the COBRA premium assistance credit is limited to the
employer share of Medicare tax on wages paid during the            Enter the qualified wages for the employee retention
year that is remaining after that share is first reduced by        credit (excluding the amount of any qualified health plan
any credit claimed on Form 943, line 12d, for the                  expenses). For qualified wages paid after December 31,
nonrefundable portion of the credit for qualified sick and         2020, and before July 1, 2021, the applicable qualified
family leave wages for leave taken after March 31, 2021;           wages from the total entered on line 20 are entered on
and/or any credit claimed on Form 943, line 12c, for the           Worksheet 2, Step 2, line 2a. For qualified wages paid
nonrefundable portion of the employee retention credit for         after June 30, 2021, and before January 1, 2022, the
wages paid after June 30, 2021, and before January 1,              applicable qualified wages from the total on line 20 are
2022. In completing line 17 or Form 943-A, you take into           entered on Worksheet 4, Step 2, line 2a.
account the nonrefundable portion of the COBRA
                                                                   Line 21. Qualified Health Plan Expenses for the
premium assistance credit against the liability for the first
payroll payment but not below zero. Then reduce the                Employee Retention Credit
liability for each successive payroll payment of the year          Enter the qualified health plan expenses for the employee
until the nonrefundable portion of the credit is used. Any         retention credit. These expenses are generally those
COBRA premium assistance credit that is remaining at the           which are allocable to an employee (and to a period) in
end of the year because it exceeds the employer share of           which your business operations are fully or partially
Medicare tax is claimed on line 14g as a refundable credit.        suspended due to a governmental order or experience a
The refundable portion of the credit doesn't reduce the            decline in gross receipts. The allocation will be treated as
liability reported on line 17 or Form 943-A.                       proper if made on the basis of being pro rata among
                                                                   periods of coverage. For more information, go to IRS.gov/
        You may reduce your deposits by the amount of              ERC. For qualified health plan expenses allocable to
 TIP the nonrefundable and refundable portions of the              qualified wages paid after December 31, 2020, and before
         credit for qualified sick and family leave wages,         July 1, 2021, the applicable qualified expenses from the
the nonrefundable and refundable portions of the                   total entered on line 21 are entered on Worksheet 2, Step
employee retention credit, and the nonrefundable and               2, line 2b. For qualified health plan expenses allocable to
refundable portions of the COBRA premium assistance                qualified wages paid after June 30, 2021, and before
credit, as discussed earlier under Reducing your deposit           January 1, 2022, the applicable qualified expenses from
for COVID-19 credits.                                              the total entered on line 21 are entered on Worksheet 4,
                                                                   Step 2, line 2b.
Lines 18 Through 29
                                                                   Line 22. Qualified Sick Leave Wages for Leave
         The amounts entered on lines 18 through 27 are
  TIP amounts that you use on the worksheets at the                Taken After March 31, 2021, and Before October
         end of these instructions to figure certain credits.      1, 2021
If you're claiming these credits, you must enter the               Enter the qualified sick leave wages you paid to your
applicable amounts. Lines 28 and 29 apply only if you're           employees for leave taken after March 31, 2021, and
eligible for the employee retention credit in the third or         before October 1, 2021, including any qualified sick leave
fourth quarter of 2021 solely because your business is a           wages that were above the social security wage base and
recovery startup business.                                         any qualified sick leave wages excluded from the
                                                                   definition of employment under sections 3121(b)(1)–(22).
Line 18. Qualified Health Plan Expenses                            See the instructions for line 12d, earlier, for more
Allocable to Qualified Sick Leave Wages for                        information about qualified sick leave wages for leave
                                                                   taken after March 31, 2021, and before October 1, 2021.
Leave Taken Before April 1, 2021                                   This amount is also entered on Worksheet 3, Step 2,
Enter the qualified health plan expenses allocable to              line 2a.
qualified sick leave wages for leave taken before April 1,
2021. This amount is also entered on Worksheet 1, Step
2, line 2b.


Instructions for Form 943 (2021)                                -23-
Line 23. Qualified Health Plan Expenses                           payer filing an aggregate Form 943 with an attached
Allocable to Qualified Sick Leave Wages                           Schedule R (Form 943).
Reported on Line 22                                               Line 29. If You're Eligible for the Employee
Enter the qualified health plan expenses allocable to             Retention Credit in the Fourth Quarter Solely
qualified sick leave wages for leave taken after March 31,
                                                                  Because Your Business Is a Recovery Startup
2021, and before October 1, 2021. This amount is also
entered on Worksheet 3, Step 2, line 2b.                          Business . . .
                                                                  Under the Infrastructure Act, you must be a recovery
Line 24. Amounts Under Certain Collectively                       startup business to claim the employee retention credit for
Bargained Agreements Allocable to Qualified                       qualified wages paid after September 30, 2021, and
Sick Leave Wages Reported on Line 22                              before January 1, 2022 (fourth quarter 2021). If you're
                                                                  eligible for the employee retention credit in the fourth
Enter the collectively bargained defined benefit pension
                                                                  quarter of 2021 solely because your business is a
plan contributions and collectively bargained
                                                                  recovery startup business, enter the total of any amounts
apprenticeship program contributions allocable to
                                                                  included on lines 12c and 14e that are attributable to
qualified sick leave wages for leave taken after March 31,
                                                                  qualified wages paid after September 30, 2021, and
2021, and before October 1, 2021. This amount is also
                                                                  before January 1, 2022. Leave line 29 blank if you're a
entered on Worksheet 3, Step 2, line 2c.
                                                                  third-party payer filing an aggregate Form 943 with an
Line 25. Qualified Family Leave Wages for                         attached Schedule R (Form 943).
Leave Taken After March 31, 2021, and Before                      Third-Party Designee
October 1, 2021                                                   If you want to allow an employee, a paid tax preparer, or
Enter the qualified family leave wages you paid to your           another person to discuss your Form 943 with the IRS,
employees for leave taken after March 31, 2021, and               check the “Yes” box in the Third-Party Designee section.
before October 1, 2021, including any qualified family            Enter the name, phone number, and five-digit personal
leave wages that were above the social security wage              identification number (PIN) of the specific person to speak
base and any qualified family leave wages excluded from           with—not the name of the firm who prepared your tax
the definition of employment under sections 3121(b)(1)–           return. The designee may choose any five numbers as his
(22). See the instructions for line 12d, earlier, for more        or her PIN.
information about qualified family leave wages for leave
taken after March 31, 2021, and before October 1, 2021.              By checking “Yes,” you authorize the IRS to talk to the
This amount is also entered on Worksheet 3, Step 2,               person you named (your designee) about any questions
line 2g.                                                          we may have while we process your return. You also
                                                                  authorize your designee to do all of the following.
Line 26. Qualified Health Plan Expenses                           • Give us any information that is missing from your return.
Allocable to Qualified Family Leave Wages                         • Call us for information about processing your return.
Reported on Line 25                                               • Respond to certain IRS notices that you have shared
                                                                  with your designee about math errors and return
Enter the qualified health plan expenses allocable to
                                                                  preparation. The IRS won't send notices to your designee.
qualified family leave wages for leave taken after March
31, 2021, and before October 1, 2021. This amount is also            You’re not authorizing your designee to bind you to
entered on Worksheet 3, Step 2, line 2h.                          anything (including additional tax liability) or to otherwise
                                                                  represent you before the IRS. If you want to expand your
Line 27. Amounts Under Certain Collectively                       designee’s authorization, see Pub. 947.
Bargained Agreements Allocable to Qualified
Family Leave Wages Reported on Line 25                               The authorization will automatically expire 1 year from
Enter the collectively bargained defined benefit pension          the due date (without regard to extensions) for filing your
plan contributions and collectively bargained                     Form 943. If you or your designee wants to terminate the
apprenticeship program contributions allocable to                 authorization, write to the IRS office for your location using
qualified family leave wages for leave taken after March          the Without a payment address under Where Should You
31, 2021, and before October 1, 2021. This amount is also         File, earlier.
entered on Worksheet 3, Step 2, line 2i.                          Who Must Sign (Approved Roles)
Line 28. If You're Eligible for the Employee                      The following persons are authorized to sign the return for
Retention Credit in the Third Quarter Solely                      each type of business entity.
Because Your Business Is a Recovery Startup                       • Sole proprietorship—The individual who owns the
                                                                  business.
Business . . .                                                    • Corporation (including a limited liability company
If you're eligible for the employee retention credit in the       (LLC) treated as a corporation)—The president, vice
third quarter of 2021 solely because your business is a           president, or other principal officer duly authorized to sign.
recovery startup business, enter the total of any amounts         • Partnership (including an LLC treated as a
included on lines 12c and 14e that are attributable to            partnership) or unincorporated organization—A
qualified wages paid after June 30, 2021, and before              responsible and duly authorized partner, member, or
October 1, 2021. Leave line 28 blank if you're a third-party      officer having knowledge of its affairs.

                                                               -24-                           Instructions for Form 943 (2021)
• Single-member LLC treated as a disregarded entity                  Privacy Act and Paperwork Reduction Act Notice.
for federal income tax purposes—The owner of the
                                                                     We ask for the information on Forms 943, 943-A, and
LLC or a principal officer duly authorized to sign.
                                                                     943-V to carry out the Internal Revenue laws of the United
• Trust or estate—The fiduciary.                                     States. We need it to figure and collect the right amount of
    Form 943 may also be signed by a duly authorized                 tax. Subtitle C, Employment Taxes, of the Internal
agent of the taxpayer if a valid power of attorney has been          Revenue Code imposes employment taxes on wages and
filed.                                                               provides for income tax withholding. These forms are
                                                                     used to report the amount of taxes that you owe. Section
Alternative signature method. Corporate officers or                  6011 requires you to provide the requested information if
duly authorized agents may sign Form 943 by rubber                   the tax applies to you. Section 6109 requires you to
stamp, mechanical device, or computer software                       provide your identification number. If you fail to provide
program. For details and required documentation, see                 this information in a timely manner, or provide false or
Rev. Proc. 2005-39, 2005-28 I.R.B. 82, available at                  fraudulent information, you may be subject to penalties.
IRS.gov/irb/2005-28_IRB#RP-2005-39.
                                                                        You’re not required to provide the information
Paid Preparer Use Only                                               requested on a form that is subject to the Paperwork
A paid preparer must sign Form 943 and provide the                   Reduction Act unless the form displays a valid OMB
information in the Paid Preparer Use Only section if the             control number. Books or records relating to a form or its
preparer was paid to prepare Form 943 and isn't an                   instructions must be retained as long as their contents
employee of the filing entity. Paid preparers must sign              may become material in the administration of any Internal
paper returns with a manual signature. The preparer must             Revenue law.
give you a copy of the return in addition to the copy to be             Generally, tax returns and return information are
filed with the IRS.                                                  confidential, as required by section 6103. However,
   If you're a paid preparer, enter your Preparer Tax                section 6103 allows or requires us to disclose this
Identification Number (PTIN) in the space provided.                  information to others as described in the Code. We may
Include your complete address. If you work for a firm,               disclose your tax information to the Department of Justice
enter the firm's name and the EIN of the firm. You can               for civil and criminal litigation, and to cities, states, the
apply for a PTIN online or by filing Form W-12. For more             District of Columbia, and U.S. commonwealths and
information about applying for a PTIN online, go to                  possessions to administer their tax laws. We may also
IRS.gov/PTIN. You can't use your PTIN in place of the EIN            disclose this information to other countries under a tax
of the tax preparation firm.                                         treaty, to federal and state agencies to enforce federal
                                                                     nontax criminal laws, or to federal law enforcement and
    Generally, don't complete this section if you're filing the      intelligence agencies to combat terrorism.
return as a reporting agent and have a valid Form 8655 on               The time needed to complete and file these forms will
file with the IRS. However, a reporting agent must                   vary depending on individual circumstances. The
complete this section if the reporting agent offered legal           estimated average time for Form 943 is: Recordkeeping,
advice, for example, advising the client on determining              14 hr., 49 min.; Learning about the law or the form, 40
whether its workers are employees or independent                     min.; Preparing and sending the form to the IRS, 2 hr., 7
contractors for federal tax purposes.                                min. The estimated average time for Form 943-V is 14
How To Get Forms, Instructions, and                                  min. If you have comments concerning the accuracy of
                                                                     these time estimates or suggestions for making this form
Publications                                                         simpler, we would be happy to hear from you. You can
                                                                     send us comments from IRS.gov/FormComments. Or you
        You can view, download, or print most of the
                                                                     can write to the Internal Revenue Service, Tax Forms and
        forms, instructions, and publications you may
                                                                     Publications Division, 1111 Constitution Ave. NW,
        need at IRS.gov/Forms. Otherwise, you can go to
                                                                     IR-6526, Washington, DC 20224. Don't send Form 943 to
IRS.gov/OrderForms to place an order and have forms
                                                                     this address. Instead, see Where Should You File, earlier.
mailed to you.




Instructions for Form 943 (2021)                                  -25-
Worksheet 1. Credit for Qualified Sick and Family Leave Wages for
Leave Taken Before April 1, 2021                                                                                                                         Keep for Your Records
Determine how you will complete this worksheet. (If you’re a third-party payer, you must complete this worksheet for each client for
which it is applicable, on a client-by-client basis.)
If you paid qualified sick leave wages and/or qualified family leave wages for leave taken before April 1, 2021, complete Step 1 and Step 2. Caution:
Use Worksheet 3 to figure the credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before October 1, 2021.

Step 1.             Determine the employer share of social security tax after it is reduced by any credit claimed on Form 8974 and any credit
                    to be claimed on Form 5884-C and/or Form 5884-D
          1a        Enter the amount of social security tax from Form 943, line 3 . . . . . . . . . . . . . . . . . . . . 1a
          1b        Employer share of social security tax. Mulitply line 1a by 50% (0.50) . . . . . . . . . . .                                1b
          1c        Enter the amount from Form 943, line 12a (credit from Form 8974) . . . . . . . . . . . . . . . 1c
          1d        Enter the amount to be claimed on Form 5884-C, line 11, for this year . . . . . . . . . . . . . 1d
          1e        Enter the amount to be claimed on Form 5884-D, line 12, for this year . . . . . . . . . . . . . 1e
          1f        Total nonrefundable credits already used against the employer share of social
                    security tax. Add lines 1c, 1d, and 1e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             1f
          1g        Employer share of social security tax remaining. Subtract line 1f
                    from line 1b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1g

Step 2.             Figure the sick and family leave credit
          2a        Qualified sick leave wages reported on Form 943, line 2a . . . . . . . . . . . . . . . . . . . . . .                           2a
          2a(i)     Qualified sick leave wages included on Form 943, line 4, but not included on Form 943,
                    line 2a, because the wages reported on that line were limited by the social security wage
                    base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2a(i)
          2a(ii)    Total qualified sick leave wages. Add lines 2a and 2a(i) . . . . . . . . . . . . . . . . . . . . . . .                         2a(ii)
          2a(iii)   Qualified sick leave wages excluded from the definition of employment under sections
                    3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2a(iii)
          2b        Qualified health plan expenses allocable to qualified sick leave wages (Form 943,
                    line 18) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2b
          2c        Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by
                    1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2c
          2d        Credit for qualified sick leave wages. Add lines 2a(ii), 2a(iii), 2b, and 2c . . . . . . . . .                                                    2d
          2e        Qualified family leave wages reported on Form 943, line 2b . . . . . . . . . . . . . . . . . . . .                             2e
          2e(i)     Qualified family leave wages included on Form 943, line 4, but not included on Form 943,
                    line 2b, because the wages reported on that line were limited by the social security wage
                    base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2e(i)
          2e(ii)    Total qualified family leave wages. Add lines 2e and 2e(i) . . . . . . . . . . . . . . . . . . . . . .                         2e(ii)
          2e(iii)   Qualified family leave wages excluded from the definition of employment under sections
                    3121(b)(1)–(22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        2e(iii)
          2f        Qualified health plan expenses allocable to qualified family leave wages (Form 943,
                    line 19) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2f
          2g        Employer share of Medicare tax on qualified family leave wages. Multiply line 2e(ii) by
                    1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2g
          2h        Credit for qualified family leave wages. Add lines 2e(ii), 2e(iii), 2f, and 2g . . . . . . . .                                                    2h
          2i        Credit for qualified sick and family leave wages. Add lines 2d and 2h . . . . . . . . . .                                                         2i
          2j        Nonrefundable portion of credit for qualified sick and family leave wages for
                    leave taken before April 1, 2021. Enter the smaller of line 1g or line 2i. Enter this
                    amount on Form 943, line 12b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                  2j
          2k        Refundable portion of credit for qualified sick and family leave wages for leave
                    taken before April 1, 2021. Subtract line 2j from line 2i and enter this amount on Form
                    943, line 14d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         2k




                                                                                                -26-                                                    Instructions for Form 943 (2021)
Worksheet 2. Employee Retention Credit for Qualified Wages Paid
After December 31, 2020, and Before July 1, 2021                                                                   Keep for Your Records
Determine how you will complete this worksheet. (If you’re a third-party payer, you must complete this worksheet for each client for which
it is applicable, on a client-by-client basis.)
If you paid qualified wages after December 31, 2020, and before July 1, 2021, for purposes of the employee retention credit, complete Step 1 and Step
2. If you’re claiming a credit for qualified sick and family leave wages for leave taken before April 1, 2021, complete Worksheet 1 before starting this
worksheet. Caution: Use Worksheet 4 to figure the employee retention credit for qualified wages paid after June 30, 2021, and before January 1, 2022.

Step 1.          Determine the employer share of social security tax after it is reduced by any credit claimed on Form 8974 and any credit
                 to be claimed on Form 5884-C and/or Form 5884-D
          1a     If you completed Worksheet 1 to claim a credit for qualified sick and family leave wages for
                 leave taken before April 1, 2021, enter the amount from Worksheet 1, Step 1, line 1g, and
                 go to Step 2. If you’re not claiming a credit for qualified sick and family leave wages for
                 leave taken before April 1, 2021, continue by completing lines 1b–1h below and then go to
                 Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1a
          1b     Enter the amount of social security tax from Form 943, line 3 . . . . . . . . . . . . . . . . . . . . . 1b
          1c     Employer share of social security tax. Multiply line 1b by 50% (0.50) . . . . . . . . . . . . .                                1c
          1d     Enter the amount from Form 943, line 12a (credit from Form 8974) . . . . . . . . . . . . . . . . . 1d
          1e     Enter the amount to be claimed on Form 5884-C, line 11, for this year . . . . . . . . . . . . . . . 1e
          1f     Enter the amount to be claimed on Form 5884-D, line 12, for this year . . . . . . . . . . . . . . . 1f
          1g     Total nonrefundable credits already used against the employer share of social
                 security tax. Add lines 1d, 1e, and 1f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               1g
          1h     Employer share of social security tax remaining. Subtract line 1g from line 1c . . . . . .                                     1h

Step 2.          Figure the employee retention credit for qualified wages paid after December 31, 2020, and before July 1, 2021
                 Caution: The total amount included on lines 2a and 2b is limited to a maximum of $10,000 per employee in each of the first quarter
                 and the second quarter of 2021 ($20,000 in total for purposes of this worksheet).
          2a     Qualified wages (excluding qualified health plan expenses) for the employee retention
                 credit for qualified wages paid after December 31, 2020, and before July 1, 2021 (these
                 qualified wages are included in the total reported on Form 943, line 20) . . . . . . . . . . . . . 2a
          2b     Qualified health plan expenses allocable to qualified wages for the employee retention
                 credit for qualified wages paid after December 31, 2020, and before July 1, 2021 (these
                 qualified wages are included in the total reported on Form 943, line 21) . . . . . . . . . . . . . 2b
          2c     Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
          2d     Retention credit. Multiply line 2c by 70% (0.70) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               2d
          2e     Enter the amount of the employer share of social security tax from Step 1, line 1a, or, if
                 applicable, Step 1, line 1h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e
          2f     Enter the nonrefundable portion of the credit for qualified sick and family leave wages for
                 leave taken before April 1, 2021, from Worksheet 1, Step 2, line 2j . . . . . . . . . . . . . . . . . 2f
          2g     Subtract line 2f from line 2e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g
          2h     Nonrefundable portion of employee retention credit. Enter the smaller of line 2d or
                 line 2g. Enter this amount on Form 943, line 12c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               2h
          2i     Refundable portion of employee retention credit. Subtract line 2h from line 2d and
                 enter this amount on Form 943, line 14e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            2i




Instructions for Form 943 (2021)                                         -27-
Worksheet 3. Credit for Qualified Sick and Family Leave Wages for
Leave Taken After March 31, 2021, and Before October 1, 2021                                                                                               Keep for Your Records
Determine how you will complete this worksheet. (If you’re a third-party payer, you must complete this worksheet for each client for which
it is applicable, on a client-by-client basis.)
If you paid qualified sick leave wages and/or qualified family leave wages for leave taken after March 31, 2021, and before October 1, 2021, complete
Step 1 and Step 2. Caution: Use Worksheet 1 to figure the credit for qualified sick and family leave wages for leave taken before April 1, 2021.

Step 1.             Determine the employer share of Medicare tax
          1a        Enter the amount of Medicare tax from Form 943, line 5 . . . . . . . . . . . . . . . . . . . . . . . . .                         1a
          1b        Employer share of Medicare tax. Multiply line 1a by 50% (0.50) . . . . . . . . . . . . . . . . .                                                    1b

Step 2.             Figure the sick and family leave credit
          2a        Qualified sick leave wages for leave taken after March 31, 2021, and before October 1,
                    2021 (Form 943, line 22) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2a
          2a(i)     Qualified sick leave wages included on Form 943, line 22, that were not included as wages
                    reported on Form 943, lines 2 and 4, because the qualified sick leave wages were
                    excluded from the definition of employment under sections 3121(b)(1)–(22) . . . . . . . . . .                                    2a(i)
          2a(ii)    Subtract line 2a(i) from line 2a . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2a(ii)
          2a(iii)   Qualified sick leave wages included on Form 943, line 22, that were not included as wages
                    reported on Form 943, line 2, because the qualified sick leave wages were limited by the
                    social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .            2a(iii)
          2a(iv)    Subtract line 2a(iii) from line 2a(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2a(iv)
          2b        Qualified health plan expenses allocable to qualified sick leave wages for leave taken after
                    March 31, 2021, and before October 1, 2021 (Form 943, line 23) . . . . . . . . . . . . . . . . . .                               2b
          2c        Amounts under certain collectively bargained agreements allocable to qualified sick leave
                    wages for leave taken after March 31, 2021, and before October 1, 2021 (Form 943,
                    line 24) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2c
          2d        Employer share of social security tax on qualified sick leave wages. Multiply line 2a(iv) by
                    6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       2d
          2e        Employer share of Medicare tax on qualified sick leave wages. Multiply line 2a(ii) by 1.45%
                    (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .     2e
          2f        Credit for qualified sick leave wages. Add lines 2a, 2b, 2c, 2d, and 2e . . . . . . . . . . . .                                                     2f
          2g        Qualified family leave wages for leave taken after March 31, 2021, and before October 1,
                    2021 (Form 943, line 25) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2g
          2g(i)     Qualified family leave wages included on Form 943, line 25, that were not included as
                    wages reported on Form 943, lines 2 and 4, because the qualified family leave wages were
                    excluded from the definition of employment under sections 3121(b)(1)–(22) . . . . . . . . . .                                    2g(i)
          2g(ii)    Subtract line 2g(i) from line 2g . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2g(ii)
          2g(iii)   Qualified family leave wages included on Form 943, line 25, that were not included as
                    wages reported on Form 943, line 2, because the qualified family leave wages were limited
                    by the social security wage base . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .               2g(iii)
          2g(iv)    Subtract line 2g(iii) from line 2g(ii) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2g(iv)
          2h        Qualified health plan expenses allocable to qualified family leave wages for leave taken
                    after March 31, 2021, and before October 1, 2021 (Form 943, line 26) . . . . . . . . . . . . . .                                 2h
          2i        Amounts under certain collectively bargained agreements allocable to qualified family
                    leave wages for leave taken after March 31, 2021, and before October 1, 2021 (Form 943,
                    line 27) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2i
          2j        Employer share of social security tax on qualified family leave wages. Multiply line 2g(iv) by
                    6.2% (0.062) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       2j
          2k        Employer share of Medicare tax on qualified family leave wages. Multiply line 2g(ii) by
                    1.45% (0.0145) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2k
          2l        Credit for qualified family leave wages. Add lines 2g, 2h, 2i, 2j, and 2k . . . . . . . . . . . .                                                   2l
          2m        Credit for qualified sick and family leave wages. Add lines 2f and 2l . . . . . . . . . . . . .                                                     2m
          2n        Enter any employee retention credit claimed under section 2301 of the CARES Act (from
                    Worksheet 2, line 2d) with respect to qualified wages paid after March 31, 2021, and
                    before July 1, 2021, that were also taken into account for the credit for qualified sick and
                    family leave wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         2n
          2o        Enter any credit claimed under section 41 for increasing research activities with respect to
                    any wages taken into account for the credit for qualified sick and family leave
                    wages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .    2o
          2p        Add lines 2n and 2o . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .          2p
          2q        Credit for qualified sick and family leave wages after adjusting for other credits.
                    Subtract line 2p from line 2m . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                               2q
          2r        Nonrefundable portion of credit for qualified sick and family leave wages for leave
                    taken after March 31, 2021, and before October 1, 2021. Enter the smaller of line 1b or
                    line 2q. Enter this amount on Form 943, line 12d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                        2r
          2s        Refundable portion of credit for qualified sick and family leave wages for leave
                    taken after March 31, 2021, and before October 1, 2021. Subtract line 2r from line 2q
                    and enter this amount on Form 943, line 14f . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                                       2s




                                                                                                 -28-                                                     Instructions for Form 943 (2021)
Worksheet 4. Employee Retention Credit for Qualified Wages Paid
After June 30, 2021, and before January 1, 2022                                                                                                 Keep for Your Records
Determine how you will complete this worksheet. (If you’re a third-party payer, you must complete this worksheet for each client for which
it is applicable, on a client-by-client basis.)
If you paid qualified wages after June 30, 2021, and before January 1, 2022, for purposes of the employee retention credit, complete Step 1 and Step 2.
If you’re claiming a credit for qualified sick and family leave wages for leave taken after March 31, 2021, complete Worksheet 3 before starting this
worksheet. Caution: Use Worksheet 2 to figure the employee retention credit for qualified wages paid after December 31, 2020, and before July 1,
2021.

Step 1.          Determine the employer share of Medicare tax
          1a     If you completed Worksheet 3 to claim a credit for qualified sick and family leave wages for
                 leave taken after March 31, 2021, enter the amount from Worksheet 3, Step 1, line 1b, and
                 go to Step 2. If you’re not claiming a credit for qualified sick and family leave wages for
                 leave taken after March 31, 2021, continue by completing lines 1b and 1c below and then
                 go to Step 2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              1a
          1b     Enter the amount of Medicare tax from Form 943, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . 1b
          1c     Employer share of Medicare tax. Multiply line 1b by 50% (0.50). . . . . . . . . . . . . . . . . .                                         1c

Step 2.          Figure the employee retention credit for qualified wages paid after June 30, 2021, and before January 1, 2022
                 Caution: Under the Infrastructure Act, you must be a recovery startup business to claim the employee retention credit for qualified
                 wages paid after September 30, 2021, and before January 1, 2022 (fourth quarter 2021). The total amount included on lines 2a and
                 2b is limited to a maximum of $10,000 per employee in each of the third quarter and the fourth quarter of 2021 ($20,000 in total for
                 purposes of this worksheet).
          2a     Qualified wages (excluding qualified health plan expenses) for the employee retention
                 credit for qualified wages paid after June 30, 2021, and before January 1, 2022 (these
                 qualified wages are included in the total reported on Form 943, line 20) . . . . . . . . . . . . . 2a
          2b     Qualified health plan expenses allocable to qualified wages for the employee retention
                 credit for qualified wages paid after June 30, 2021, and before January 1, 2022 (these
                 qualified health plan expenses are included in the total reported on Form 943,
                 line 21) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2b
          2c     Add lines 2a and 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2c
          2d     Retention credit. Multiply line 2c by 70% (0.70). If you qualify for the employee retention
                 credit solely because your business is a recovery startup business, don't enter more than
                 $50,000 for each of the third quarter and the fourth quarter of 2021 ($100,000 in total for
                 the year) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      2d
          2e     Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if
                 applicable, Step 1, line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2e
          2f     Enter any amount of the nonrefundable portion of the credit for qualified sick and family
                 leave wages for leave taken after March 31, 2021, from Worksheet 3, Step 2,
                 line 2r . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2f
          2g     Subtract line 2f from line 2e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2g
          2h     Nonrefundable portion of employee retention credit. Enter the smaller of line 2d or
                 line 2g. Enter this amount on Form 943, line 12c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                       2h
          2i     Refundable portion of employee retention credit. Subtract line 2h from line 2d and
                 enter this amount on Form 943, line 14e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                    2i




Instructions for Form 943 (2021)                                                         -29-
Worksheet 5. COBRA Premium Assistance Credit                                                                                                             Keep for Your Records
Determine how you will complete this worksheet. (If you’re a third-party payer, you must complete this worksheet for each client for which
it is applicable, on a client-by-client basis. If you're a third-party payer that is treated as the person to whom premiums are payable, you
must complete this worksheet for yourself as well.)
If you provided COBRA premium assistance, complete Step 1 and Step 2. If you’re claiming the credit for qualified sick and family leave wages for leave
taken after March 31, 2021, complete Worksheet 3 before starting this worksheet. If you’re also claiming an employee retention credit for qualified
wages paid after June 30, 2021, and before January 1, 2022, complete Worksheet 4 before starting this worksheet.

Step 1.          Determine the employer share of Medicare tax
          1a     If you completed Worksheet 3 or Worksheet 4, enter the amount listed on Worksheet 3,
                 line 1b, or Worksheet 4, line 1a or 1c (as applicable). If you’re not claiming either of these
                 credits this year, continue by completing lines 1b and 1c below and then go to Step
                 2 ................................................................                                                                                   1a
          1b     Enter the amount of Medicare tax from Form 943, line 5 . . . . . . . . . . . . . . . . . . . . . . . . . 1b
          1c     Employer share of Medicare tax. Multiply line 1b by 50% (0.50) . . . . . . . . . . . . . . . . .                                                     1c

Step 2.          Figure the COBRA premium assistance credit
          2a     Enter the COBRA premium assistance that you provided for periods of coverage beginning
                 on or after April 1, 2021, through periods of coverage beginning on or before September
                 30, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      2a
          2b     Enter the amount of the employer share of Medicare tax from Step 1, line 1a, or, if
                 applicable, Step 1, line 1c . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           2b
          2c     Enter any amount of the nonrefundable portion of the credit for qualified sick and family
                 leave wages for leave taken after March 31, 2021, from Worksheet 3, Step 2,
                 line 2r . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   2c
          2d     Enter any amount of the nonrefundable portion of the employee retention credit from
                 Worksheet 4, Step 2, line 2h . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .              2d
          2e     Other nonrefundable credits used against the employer share of Medicare tax. Add
                 lines 2c and 2d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .       2e
          2f     Subtract line 2e from line 2b . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             2f
          2g     Nonrefundable portion of the COBRA premium assistance credit. Enter the smaller
                 of line 2a or line 2f. Enter this amount on Form 943, line 12e . . . . . . . . . . . . . . . . . . . . .                                             2g
          2h     Refundable portion of the COBRA premium assistance credit. Subtract line 2g from
                 line 2a and enter this amount on Form 943, line 14g . . . . . . . . . . . . . . . . . . . . . . . . . . .                                            2h




                                                                                              -30-                                                      Instructions for Form 943 (2021)


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