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Form 941-X: Adjusted Employer's QUARTERLY …

form 941-X:(Rev. April 2017) Adjusted Employer's QUARTERLY Federal Tax Return or Claim for RefundDepartment of the Treasury internal revenue ServiceOMB No. 1545-0029 Employer identification number (EIN) Name (not your trade name)Trade name (if any)AddressNumber Street Suite or room numberCityStateZIP codeForeign country nameForeign province/countyForeign postal codeRead the separate instructions before completing this form . Use this form to correct errors you made on form 941 or 941-SS. Use a separate form 941-X for each quarter that needs correction. Type or print within the boxes. You MUST complete all three pages. Don't attach this form to form 941 or You're Correcting ..Check the type of return you're the ONE quarter you're : January, February, March2: April, May, June3: July, August, September4: October, November, DecemberEnter the calendar year of the quarter you're correcting.

Form 941-X: (Rev. April 2017) Adjusted Employer's QUARTERLY Federal Tax Return or Claim for Refund Department of the Treasury — Internal Revenue Service

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