Form 943-X: Adjusted Employer’s Annual Federal Tax Return for Agricultural Employees or Claim for Refund

Summary

Form 943-X (Rev. February 2022), the Internal Revenue Service form titled Adjusted Employer’s Annual Federal Tax Return for Agricultural Employees or Claim for Refund, OMB No. 1545-0035. The form states that it is used to correct errors made on Form 943 and that a separate Form 943-X must be used for each year that needs correction. It states that all five pages must be completed and asks for the calendar year of the return being corrected and the date errors were discovered. Part 1 directs the filer to select only one process, the adjusted employment tax return or the claim.

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“Form 943-X: Adjusted Employer’s Annual Federal Tax Return for Agricultural Employees or Claim for Refund.” Original at www.irs.gov. Archived at Pandemic Darlings, https://pandemicdarlings.com/source-documents/internal-revenue-service-form-943-x-pdf-www-irs-gov-b97de89d6a-6eec956310/, SHA-256 2152e02ef858320f430c112cc1c78746bed4a1793a21a9048a40baaf3fae680e.

Full text

Form 943-X: Adjusted Employer’s Annual Federal Tax Return for Agricultural
Employees or Claim for Refund
(Rev. February 2022) Department of the Treasury — Internal Revenue Service OMB No. 1545-0035

Employer identification number
— Return You’re Correcting...
(EIN)
Enter the calendar year of the return
you’re correcting:
Name (not your trade name)
(YYYY)
Trade name (if any)

Address
Number Street Suite or room number Enter the date you discovered errors:

/ /
City State ZIP code (MM / DD / YYYY)

Foreign country name Foreign province/county Foreign postal code

Read the separate instructions before completing this form. Use this form to correct errors you made on Form 943, Employer’s Annual Federal
Tax Return for Agricultural Employees. Use a separate Form 943-X for each year that needs correction. Type or print within the boxes. You
MUST complete all five pages. Don’t attach this form to Form 943 unless you’re reclassifying workers; see the instructions for line 40.
Part 1: Select ONLY one process. See page 6 for additional guidance, including information on how to treat
employment tax credits and social security tax deferrals.
1. Adjusted employment tax return. Check this box if you underreported tax amounts. Also check this box if you overreported tax
amounts and you would like to use the adjustment process to correct the errors. You must check this box if you’re correcting both
underreported and overreported tax amounts on this form. The amount shown on line 25, if less than zero, may only be applied as
a credit to your Form 943 for the tax period in which you’re filing this form.

2. Claim. Check this box if you overreported tax amounts only and you would like to use the claim process to ask for a refund or
abatement of the amount shown on line 25. Don’t check this box if you’re correcting ANY underreported tax amounts on this form.

Part 2: Complete the certifications.
3. I certify that I’ve filed or will file Forms W-2, Wage and Tax Statement, or Forms W-2c, Corrected Wage and Tax Statement,
as required.
Note: If you’re correcting underreported tax amounts only, go to Part 3 on page 2 and skip lines 4 and 5. If you’re correcting overreported
tax amounts, for purposes of the certifications on lines 4 and 5, Medicare tax doesn’t include Additional Medicare Tax. Form 943-X can’t
be used to correct overreported amounts of Additional Medicare Tax unless the amounts weren’t withheld from employee wages.
4. If you checked line 1 because you’re adjusting overreported federal income tax, social security tax, Medicare tax, or
Additional Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I
have a written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and
won’t claim a refund or credit for the overcollection.
b. The adjustments of social security tax and Medicare tax are for the employer’s share only. I couldn’t find the affected
employees or each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was
rejected) and won’t claim a refund or credit for the overcollection.
c. The adjustment is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold
from employee wages.

5. If you checked line 2 because you’re claiming a refund or abatement of overreported federal income tax, social security
tax, Medicare tax, or Additional Medicare Tax, check all that apply. You must check at least one box.
I certify that:
a. I repaid or reimbursed each affected employee for the overcollected social security tax and Medicare tax for prior years. I
have a written statement from each affected employee stating that he or she hasn’t claimed (or the claim was rejected) and
won’t claim a refund or credit for the overcollection.
b. I have a written consent from each affected employee stating that I may file this claim for the employee’s share of social
security tax and Medicare tax overcollected in prior years. I also have a written statement from each affected employee
stating that he or she hasn’t claimed (or the claim was rejected) and won’t claim a refund or credit for the overcollection.
c. The claim for social security tax and Medicare tax is for the employer’s share only. I couldn’t find the affected employees; or
each affected employee didn’t give me a written consent to file a claim for the employee’s share of social security tax and
Medicare tax; or each affected employee didn’t give me a written statement that he or she hasn’t claimed (or the claim was
rejected) and won’t claim a refund or credit for the overcollection.
d. The claim is for federal income tax, social security tax, Medicare tax, or Additional Medicare Tax that I didn’t withhold from
employee wages.
Next ■▶
For Paperwork Reduction Act Notice, see the separate instructions. www.irs.gov/Form943X Cat. No. 20332F Form 943-X (Rev. 2-2022)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 3: Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank.
Column 1 Column 2 Column 3 Column 4
Amount originally Difference
Total corrected amount — reported or as = (If this amount is a Tax correction
(for ALL employees) previously corrected negative number,
(for ALL employees) use a minus sign.)

6. Wages subject to social
security tax (Form 943, line 2) .
—
. = . × 0.124* = .
* If you’re correcting your employer share only, use 0.062. See instructions.

7. Qualified sick leave wages*
(Form 943, line 2a) .
—
. = . × 0.062 = .
* Use line 7 only for qualified sick leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

8. Qualified family leave wages*
(Form 943, line 2b) .
—
. = . × 0.062 = .
* Use line 8 only for qualified family leave wages paid after March 31, 2020, for leave taken before April 1, 2021.

9. Wages subject to Medicare
tax (Form 943, line 4) .
—
. = . × 0.029* = .
* If you’re correcting your employer share only, use 0.0145. See instructions.

10. Wages subject to Additional
Medicare Tax withholding .
—
. = . × 0.009* = .
(Form 943, line 6) * Certain wages reported in Column 3 shouldn’t be multiplied by 0.009. See instructions.

11. Federal income tax withheld Copy Column
(Form 943, line 8) .
—
. = . 3 here ▶ .
12. Tax adjustments (Form 943, See
line 10) .
—
. = . instructions .
13. Qualified small business See
payroll tax credit for .
—
. = . instructions .
increasing research activities
(Form 943, line 12a; you must
attach Form 8974)

14. Nonrefundable portion of See
credit for qualified sick and .
—
. = . instructions .
family leave wages for leave
taken before April 1, 2021
(Form 943, line 12b)

15a. Nonrefundable portion of See
employee retention credit .
—
. = . instructions .
(Form 943, line 12c)
15b. Nonrefundable portion of See
credit for qualified sick and .
—
. = . instructions .
family leave wages for leave
taken after March 31, 2021
(Form 943, line 12d)

15c. Nonrefundable portion of See
COBRA premium assistance .
—
. = . instructions .
credit (Form 943, line 12e)
15d. Number of individuals
provided COBRA premium — =
assistance (Form 943, line 12f)

16. Special addition to wages for See
federal income tax .
—
. = . instructions .
17. Special addition to wages for See
social security taxes .
—
. = . instructions .
18. Special addition to wages for See
Medicare taxes .
—
. = . instructions .
19. Special addition to wages for See
Additional Medicare Tax .
—
. = . instructions .

20. Subtotal. Combine the amounts on lines 6 through 19 of Column 4 . . . . . . . . . . . . . . . . .

Next ■▶
Page 2 Form 943-X (Rev. 2-2022)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 3: Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank. (continued)
Column 1 Column 2 Column 3 Column 4
Amount originally Difference
Total corrected amount — reported or as = (If this amount is a Tax correction
(for ALL employees) previously corrected negative number,
(for ALL employees) use a minus sign.)

21. Deferred amount of the See
employer share of social .
—
. = . instructions .
security tax* (Form 943, line 14b) * Line 21 can only be used if correcting a 2020 Form 943.

22. Deferred amount of the See
employee share of social .
—
. = . instructions .
security tax* (Form 943, line 14c) * Line 22 can only be used if correcting a 2020 Form 943.

23. Refundable portion of credit See
for qualified sick and family .
—
. = . instructions .
leave wages for leave taken
before April 1, 2021 (Form 943,
line 14d)

24a. Refundable portion of See
employee retention credit .
—
. = . instructions .
(Form 943, line 14e)
24b. Refundable portion of credit See
for qualified sick and family .
—
. = . instructions .
leave wages for leave taken
after March 31, 2021 (Form
943, line 14f)

24c. Refundable portion of COBRA See
premium assistance credit .
—
. = . instructions .
(Form 943, line 14g)

25. Total. Combine the amounts on lines 20 through 24c of Column 4 . . . . . . . . . . . . . . . . .
If line 25 is less than zero:
• If you checked line 1, this is the amount you want applied as a credit to your Form 943 for the tax period in which
you’re filing this form.
• If you checked line 2, this is the amount you want refunded or abated.
If line 25 is more than zero, this is the amount you owe. Pay this amount by the time you file this return. For
information on how to pay, see Amount you owe in the instructions.

26. Qualified health plan
expenses allocable to .
—
. = .
qualified sick leave wages for
leave take before April 1, 2021
(Form 943, line 18)

27. Qualified health plan
expenses allocable to .
—
. = .
qualified family leave wages
for leave taken before April 1,
2021 (Form 943, line 19)
28. Qualified wages for the
employee retention credit .
—
. = .
(Form 943, line 20)

29. Qualified health plan
expenses for the employee .
—
. = .
retention credit (Form 943,
line 21)
30. Credit from Form 5884-C, line
.
—
. = .
11, for the year* (Form 943,
line 22) * Line 30 can only be used if correcting a 2020 Form 943.

Next ■▶
Page 3 Form 943-X (Rev. 2-2022)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 3: Enter the corrections for the calendar year you’re correcting. If any line doesn’t apply, leave it blank. (continued)
Column 1 Column 2 Column 3
Amount originally Difference
Total corrected amount — reported or as = (If this amount is a
(for ALL employees) previously corrected negative number,
(for ALL employees) use a minus sign.)

Caution: Lines 31–38 don’t apply to years beginning before January 1, 2021.

31. Qualified sick leave wages for
leave taken after March 31, .
—
. = .
2021 (Form 943, line 22)

32. Qualified health plan
expenses allocable to .
—
. = .
qualified sick leave wages for
leave taken after March 31,
2021 (Form 943, line 23)

33. Amounts under certain
collectively bargained .
—
. = .
agreements allocable to
qualified sick leave wages for
leave taken after March 31,
2021 (Form 943, line 24)

34. Qualified family leave wages
for leave taken after March 31, .
—
. = .
2021 (Form 943, line 25)

35. Qualified health plan
expenses allocable to .
—
. = .
qualified family leave wages
for leave taken after March 31,
2021 (Form 943, line 26)

36. Amounts under certain
collectively bargained .
—
. = .
agreements allocable to
qualified family leave wages
for leave taken after March 31,
2021 (Form 943, line 27)

37. If you’re eligible for the
employee retention credit in .
—
. = .
the third quarter of 2021
solely because your business
is a recovery startup
business, enter the total of
any amounts included on
Form 943, lines 12c and 14e
(or, if corrected, Form 943-X,
lines 15a and 24a), for the
third quarter of 2021 (Form
943, line 28)

38. If you’re eligible for the
employee retention credit in .
—
. = .
the fourth quarter of 2021
solely because your business
is a recovery startup
business, enter the total of
any amounts included on
Form 943, lines 12c and 14e
(or, if corrected, Form 943-X,
lines 15a and 24a), for the
fourth quarter of 2021 (Form
943, line 29)

Next ■▶
Page 4 Form 943-X (Rev. 2-2022)
Name (not your trade name) Employer identification number (EIN) Correcting Calendar Year (YYYY)

Part 4: Explain your corrections for the calendar year you’re correcting.

39. Check here if any corrections you entered on a line include both underreported and overreported amounts.
Explain both your underreported and overreported amounts on line 41.

40. Check here if any corrections involve reclassified workers. Explain on line 41.

41. You must give us a detailed explanation of how you determined your corrections. See the instructions.

Part 5: Sign here. You must complete all five pages of this form and sign it.
Under penalties of perjury, I declare that I have filed an original Form 943 and that I have examined this adjusted return or claim, including
accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer
(other than taxpayer) is based on all information of which preparer has any knowledge.

✗
Print your
name here
Sign your
name here Print your
title here

Date / / Best daytime phone

Paid Preparer Use Only Check if you’re self-employed . . . . . . . .

Preparer’s name PTIN

Preparer’s signature Date / /

Firm’s name (or yours
if self-employed) EIN

Address Phone

City State ZIP code

Page 5 Form 943-X (Rev. 2-2022)
Form 943-X: Which process should you use?
Unless otherwise specified in the separate instructions, an underreported employment tax credit or social
security tax deferral should be treated like an overreported tax amount. An overreported employment tax credit
or social security tax deferral should be treated like an underreported tax amount. For more information,
Type of errors including which process to select on lines 1 and 2, see Correcting an employment tax credit or social security
you’re correcting tax deferral in the separate instructions.

Underreported Use the adjustment process to correct underreported tax amounts.
tax amounts • Check the box on line 1.
ONLY • Pay the amount you owe from line 25 by the time you file Form 943-X.

Overreported The process you If you’re filing Form 943-X Choose either the adjustment process or the claim
tax amounts use depends on MORE THAN 90 days before the process to correct the overreported tax amounts.
ONLY when you file period of limitations on credit or
Form 943-X. refund for Form 943 expires... Choose the adjustment process if you want the
amount shown on line 25 credited to your Form
943 for the period in which you file Form 943-X.
Check the box on line 1.
OR
Choose the claim process if you want the
amount shown on line 25 refunded to you or
abated. Check the box on line 2.

If you’re filing Form 943-X You must use the claim process to correct the
WITHIN 90 days of the expiration overreported tax amounts. Check the box on
of the period of limitations on line 2.
credit or refund for Form 943...

BOTH The process you If you’re filing Form 943-X Choose either the adjustment process or both the
underreported use depends on MORE THAN 90 days before the adjustment process and the claim process when
and when you file period of limitations on credit or you correct both underreported and overreported
overreported Form 943-X. refund for Form 943 expires... tax amounts.
tax amounts
Choose the adjustment process if combining
your underreported tax amounts and overreported
tax amounts results in a balance due or creates a
credit that you want applied to Form 943.
• File one Form 943-X, and
• Check the box on line 1 and follow the
instructions on line 25.
OR
Choose both the adjustment process and the
claim process if you want the overreported tax
amount refunded to you or abated.
File two separate forms.
1. For the adjustment process, file one Form
943-X to correct the underreported tax amounts.
Check the box on line 1. Pay the amount you
owe from line 25 by the time you file Form 943-X.
2. For the claim process, file a second Form
943-X to correct the overreported tax amounts.
Check the box on line 2.

If you’re filing Form 943-X You must use both the adjustment process
WITHIN 90 days of the expiration and the claim process.
of the period of limitations on
credit or refund for Form 943... File two separate forms.
1. For the adjustment process, file one Form
943-X to correct the underreported tax amounts.
Check the box on line 1. Pay the amount you
owe from line 25 by the time you file Form 943-X.
2. For the claim process, file a second Form
943-X to correct the overreported tax amounts.
Check the box on line 2.

Page 6 Form 943-X (Rev. 2-2022)

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