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COBRA Recipients [Line 12b].

Note:

Internal Revenue Manual Part 3. Submission Processing · 2026-10-03 edition · updated 2026-10-04 · United States

nn will display as the actual line number according to the form revision. (i.e. LN 1 Col h, LN 2 Col h, etc.)

Wages subject to Additional Medicare Tax withholding allocated to the listed client EIN from Form 943, Line 6

Enter the amount from column (h) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revisions 2020 and Later.

LN nn Col i- Fed Wthld (form revisions 2020 and Later)

LN nn Col f - Fed Wthld (form revision 2017)

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