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Get 941ame Form

Or the quarter .... $ . 2. Correct withholding for the quarter ................... $ . 3. Amount of adjustment (+ or -) (see instructions) ... $ . 4. Underpayment to be paid (line 3 amount is negative) . $ . 5. Withholding Account Number: Overpayment to be refunded (line 3 amount is positive)... $ . Name: Address City State ZIP Code If this form is received after the end of the calendar year to which it applies, check each box below that applies, include a detailed explanatio.

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