Page 1 Form 941 for 2013 with all field designators shown. Top left box has all entity information including Employer Identification, Name, Trade Name, and complete address. Field Designator 01EIN, 01NC, 04ADD, 04CTY, 04ST and 04ZIPTop box on right has check boxes for the taxpayer to indicate which quarter of the year they are filling. Field Designator 01TXPPart 1, Line 1, How many employees did you have on a specific day of each quarter. No field designator for this line. Above this line in the right margin is the Field 01SIC if needed to be transcribed.Line 2, Compensation, tips and other compensation. Field Designator is 0202.Line 3, Income tax withheld from Compensation, tips and other compensation. Field Designator 02ITW.Line 4 Box to be checked if no Compensation are subject to social security or Medicare tax. Field Designator 0204.Line 5a, Taxable social security Compensation. Field Designator 02SSW.Line 5b, Taxable social security tips. Field Designator 02SST.Line 5c, Taxable Medicare Compensation and tips. Field Designator 02MED.Line 5d, Taxable Compensation and tips subject to additional Medicare tax withholding Field Designator 02XMTLine 5e, Total from lines 5a through 5d, column 2.Line 5f, Section 3121 (q) Notice and Demand- Tax due on unreported tips. Field Designator 02QTX.Line 6, Total taxes before adjustments. Field Designator 02BA.Line 7, Current quarter's adjustment for fractions of cents. Field Designator 02FC.Line 8, Current quarter's adjustment for sick pay. Field Designator 02SP.Line 9, Current quarter's adjustments for tips and group-term life insurance. Field Designator 02TG.Line 10, Total taxes after adjustments. Field Designator 02TT.Line 11, Total deposits including prior quarter overpayment. Field Designator 02DEP.Line 12a, COBRA premium assistance payments. Field Designator 02CPM.Line 12b, Number of individuals provided COBRA assistance. Field Designator 02CEM.Line 13, Total lines 11 and 12a. Field Designator 02STL.Line 14, Balance due. Field Designator 02B/R.Line 15, Overpayment of taxes. Field Designator 02B/R. Do you want it refunded? If yes Field Designator is 01ARNComputer Condition Codes are placed right beside statement telling them to complete both pages of Form 941. Field Designator is 01CCC and Action Codes are placed to the left of Field 01CCC.