Table of Contents
- Part 1:Answer These Questions for This Year
- 1. Wages, Tips, and Other Compensation
- 2. Federal Income Tax Withheld From Wages, Tips, and Other Compensation
- 3. If No Wages, Tips, and Other Compensation are Subject to Social Security or Medicare Tax
- 4. Taxable Social Security and Medicare Wages and Tips
- 5. Total Taxes Before Adjustments
- 6.Current Year's Adjustments
- 7. Total Taxes After Adjustments
- 8. Total Deposits for This Year
- 9a. COBRA Premium Assistance Payments
- 9b. Number of Individuals Provided COBRA Premium Assistance on Line 9a
- 10. Total Deposits and Credits
- 11. Balance Due
- 12.Overpayment
- Complete both pages.
- Part 2:Tell Us About Your Deposit Schedule and Tax Liability for This Year
- Part 3:Tell Us About Your Business
- Part 4:May We Speak With Your Third-party Designee?
- Part 5:Sign Here
- How to Order Forms, Instructions, and Publications From the IRS

Enter amounts on line 1 that would also be included in box 1 of your employees' Forms W-2. See the General Instructions for Forms W-2 and W-3 for details.
Enter the federal income tax that you withheld (or were required to withhold) from your employees on this year's wages, tips, taxable fringe benefits, and supplemental unemployment compensation benefits.

If no wages, tips, and other compensation are subject to social security or Medicare taxes, check the box on line 3 and go to line 5. If this question does not apply to you, leave the box blank. For more information about exempt wages, see section 15 of Pub. 15 (Circular E), section 12 of Pub. 80 (Circular SS), or section 15 of Pub. 179 (Circular PR). For religious exemptions, see section 4 of Pub. 15-A, Employer's Supplemental Tax Guide.
Report the total wages, sick pay, and fringe benefits subject to social security taxes that you paid to your employees during the year.
Enter the amount before deductions. Do not include tips on this line. For information on types of wages subject to social security taxes, see section 5 of Pub. 15 (Circular E), section 4 of Pub. 80 (Circular SS), or section 5 of Pub. 179 (Circular PR).
For 2012, the rate of social security tax on taxable wages is 6.2% (.062) for the employer and 4.2% (.042) for the employee, or 10.4% (.104) for both. Stop paying social security tax on and reporting an employee's wages on line 4a when the employee's taxable wages (including tips) reach $110,100 for the year. However, continue to withhold income and Medicare taxes for the whole year on wages and tips even when the social security wage base of $110,100 has been reached.
| line 4a | (column 1) | ||
| x.104 | |||
| line 4a | (column 2) |
Enter all tips your employees reported to you during the year until the total of the tips and wages for an employee reach $110,100 for the year. Include all tips your employees reported to you even if you were unable to withhold the 4.2% employee's share of social security tax.
Your employee must report cash tips to you by the 10th day of the month after the month the tips are received. The report should include charged tips you paid over to the employee for charge customers, tips the employee received directly from customers, and tips received from other employees under any tip-sharing arrangement. Both directly and indirectly tipped employees must report tips to you. No report is required for months when tips are less than $20. Employees may use Form 4070, Employee's Report of Tips to Employer (available only in Pub. 1244, Employee's Daily Record of Tips and Report of Tips to Employer), or Form 4070-PR, Informe al Patrono de Propinas Recibidas por el(la) Empleado(a) (available only in Pub. 1244-PR, Registro Diario de Propinas Recibidas por el(la) Empleado(a) e Informe al Patrono), or submit a written statement or electronic tip record.
| line 4b | (column 1) | ||
| x .104 | |||
| line 4b | (column 2) |
Report all wages, tips, sick pay, and taxable fringe benefits that are subject to Medicare tax. Unlike social security wages, there is no limit on the amount of wages subject to Medicare tax.
The rate of Medicare tax is 1.45% (.0145) each for the employer and employee, or 2.9% (.029) for both. Include all tips your employees reported during the year, even if you were unable to withhold the employee tax of 1.45%.
| line 4c | (column 1) | ||
| x .029 | |||
| line 4c | (column 2) |
For more information on tips, see section 6 of Pub. 15 (Circular E), section 5 of Pub. 80 (Circular SS), or section 6 of Pub. 179 (Circular PR).
Add the income tax withheld from wages, tips, and other compensation from line 2 and the total social security and Medicare taxes before adjustments from line 4d. Enter the result on line 5.
Enter tax amounts that result from current period adjustments. Use a minus sign (if possible) to show an adjustment that decreases the total taxes shown on line 5. Otherwise, use parentheses.
In certain cases, you must adjust the amounts you reported as social security and Medicare taxes in column 2 of lines 4a, 4b, and 4c to figure your correct tax liability for this year's Form 944. See section 13 of Pub. 15 (Circular E), section 9 of Pub. 80 (Circular SS), or section 12 of Pub. 179 (Circular PR).
If you need to adjust any amount reported on line 6 or 6a from a previously filed Form 944 or 944-SS, complete and file Form 944-X. Form 944-X is an adjusted returns and is filed separately from Form 944. See section 13 of Pub. 15 (Circular E) or section 9 of Pub. 80 (Circular SS).
If you need to adjust any amount reported on line 6 or 6a from a previously filed Form 944-PR, complete and file Form 944-X (PR). Form 944-X (PR) is an adjusted return and is filed separately from Form 944. See section 12 of Pub. 179 (Circular PR).
Enter adjustments for fractions of cents (due to rounding) relating to the employee share of social security and Medicare taxes withheld. The employee share of amounts shown in column 2 of lines 4a, 4b, and 4c may differ slightly from amounts actually withheld from employees' paychecks due to rounding social security and Medicare taxes based on statutory rates.
Enter the adjustment for the employee share of social security and Medicare taxes that were withheld and deposited by your third-party sick pay payer with regard to sick pay paid by the third party. These wages should be included on lines 4a and 4c. If you are the third-party sick pay payer, enter the adjustment for any employer share of these taxes required to be paid by the employer.
Enter adjustments for both of the following items.
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Any uncollected employee share of social security and Medicare taxes on tips.
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The uncollected employee share of social security and Medicare taxes on group-term life insurance premiums paid for former employees.
Combine the amounts shown on lines 5 and 6 and enter the result on line 7.
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If line 7 is less than $2,500, you may pay the amount with Form 944 or you may deposit the amount. See section 11 of Pub. 15 (Circular E), section 8 of Pub. 80 (Circular SS), or section 11 of Pub. 179 (Circular PR) for information about federal tax deposits.
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If line 7 is $2,500 or more, you generally must deposit your tax liabilities by electronic funds transfer. However, if you deposited all taxes accumulated in the first three quarters of the year and your fourth quarter liability is less than $2,500, you may pay taxes accumulated during the fourth quarter with Form 944. The amount shown on line 7 must equal the amount shown on line 13m.
Enter your deposits for this year, including any overpayment that you applied from filing Form 944-X, 944-X (PR), 944-X (SP), 941-X, or 941-X (PR) in the current year. Also include in the amount shown any overpayment from a previous period that you applied to this return.
Report 65% of the COBRA premiums for assistance eligible individuals. Take the COBRA premium assistance credit on this line only after the assistance eligible individual's 35% share of the premium has been paid. For COBRA coverage provided under a self-insured plan, COBRA premium assistance is treated as having been made for each assistance eligible individual who pays 35% of the COBRA premium. Do not include the assistance eligible individual's 35% of the premium in the amount entered on this line. For more information on the COBRA premium assistance credit, visit IRS.gov and enter the keyword COBRA.

Form 945-A.
Enter the total number of assistance eligible individuals provided COBRA premium assistance reported on line 9a. Count each assistance eligible individual who paid a reduced COBRA premium in the year as one individual, whether or not the reduced premium was for insurance that covered more than one assistance eligible individual. For example, if the reduced COBRA premium was for coverage for a former employee, spouse, and two children, you would include one individual in the number entered on line 9b for the premium assistance. Further, each individual is reported only once per year. For example, an assistance eligible individual who made monthly premium payments during the year would only be reported as one individual.
If line 7 is more than line 10, enter the difference on line 11. Otherwise, see Overpayment, later.
You do not have to pay if line 11 is less than $1. Generally, you should have a balance due only if your total taxes after adjustments (line 7) are less than $2,500. See If line 7 is $2,500 or more, earlier, for an exception.
If line 11 is:
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Less than $1, you do not have to pay it.
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$1 or more, but less than $2,500, you can pay the amount owed with your return. Make your check or money order payable to the “United States Treasury” and write your EIN, “Form 944,” and “2012” on the check or money order. Complete Form 944-V, Payment Voucher, and enclose it with your return.
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$2,500 or more, you must deposit your tax. See Must You Deposit Your Taxes, earlier.
You may pay the amount shown on line 11 using EFTPS, a credit or debit card, or electronic funds withdrawal (EFW). Do not use a credit or debit card or EFW to pay taxes that were required to be deposited. For more information on electronic payment
options, visit the IRS website at
www.irs.gov/e-pay.
If you pay by EFTPS or credit or debit card, file your return using the Without a payment address under Where Should You File, earlier. Do not file Form 944-V.

If line 10 is more than line 7, enter the amount on line 12. Never make an entry on both lines 11 and 12.
If you deposited more than the correct amount for the year, you can choose to have the IRS either refund the overpayment or apply it to your next return. Check only one box on line 12. If you do not check either box or if you check both boxes, generally we will apply the overpayment to your account. We may apply your overpayment to any past due tax account that is shown in our records under your EIN.
If line 12 is less than $1, we will send a refund or apply it to your next return only if you ask us in writing to do so.
If line 7 is less than $2,500, check the first box on line 13 and go to line 14.
If line 7 is $2,500 or more, check the second box on line 13. If you are a monthly schedule depositor, enter your tax liability for each month and figure the total liability for the year. If you do not enter your tax liability for each month, the IRS will not know when you should have made deposits and may assess an “averaged” failure-to-deposit penalty. See section 11 of Pub. 15 (Circular E), section 8 of Pub. 80 (Circular SS), or section 11 of Pub. 179 (Circular PR). If your tax liability for any month is negative (for example, if you are adjusting an overreported liability in a prior month), do not enter a negative amount for the month. Instead, enter zero for the month and subtract that negative amount from your tax liability for the next month.
If you are a semiweekly schedule depositor or if you accumulate $100,000 or more in tax liability on any day in a deposit period, you must complete Form 945-A and file it with Form 944. See the $100,000 Next Day Deposit Rule in section 11 of Pub. 15 (Circular E), section 8 of Pub. 80 (Circular SS), or section 11 of Pub. 179 (Circular PR). Do not complete lines 13a–13m if you file Form 945-A.
In Part 3, answer question 14 only if it applies to your business. If it does not apply, leave it blank and go to Part 4.
If you want to allow an employee, a paid tax preparer, or another person to discuss your Form 944 with the IRS, check the “Yes” box in Part 4. Enter the name, phone number, and the 5-digit personal identification number (PIN) of the specific person to contact—not the name of the firm that prepared your tax return. The designee may choose any numbers as his or her PIN.
By checking “Yes,” you authorize the IRS to talk to the person you named (your designee) about any questions we may have while we process your return. You also authorize your designee to do all of the following.
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Give us any information that is missing from your return.
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Call us for information about processing your return.
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Respond to certain IRS notices that you have shared with your designee about math errors and return preparation. The IRS will not send notices to your designee.
You are not authorizing your designee to bind you to anything (including additional tax liability) or to otherwise represent you before the IRS. If you want to expand your designee's authorization, see Pub. 947, Practice Before the IRS and Power of Attorney.
The authorization will automatically expire 1 year after the due date (without regard to extensions) for filing Form 944. If you or your designee want to terminate the authorization, write to the IRS office for your locality using the Without a payment address under Where Should You File, earlier.
Complete all information in Part 5 and sign Form 944 as follows.
If you have filed a valid power of attorney, your duly authorized agent may also sign Form 944.
www.irs.gov/irb/2005-28_IRB/ar16.html.
A paid preparer must sign Form 944 and provide the information in the Paid Preparer Use Only section of Part 5 if the preparer was paid to prepare Form 944 and is not an employee of the filing entity. Paid preparers must sign paper returns with a manual signature. The preparer must give you a copy of the return in addition to the copy to be filed with the IRS.
If you are a paid preparer, enter your Preparer Tax Identification Number (PTIN) in the space provided. Include your complete address. If you work for a firm, enter the firm's name and the EIN of the firm. You can apply for a PTIN online or by filing Form W-12, IRS Paid Preparer Tax Identification Number (PTIN) Application and Renewal. For more information about applying for a PTIN online, visit the IRS website at www.irs.gov/ptin. You cannot use your PTIN in place of the EIN of the tax preparation firm.
Generally, do not complete this section if you are filing the return as a reporting agent and have a valid Form 8655, Reporting Agent Authorization, on file with the IRS. However, a reporting agent must complete this section if the reporting agent offered legal advice, for example, advising the client on determining whether its workers are employees or independent contractors for federal tax purposes.


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