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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 e, LN 2 Col e, etc.)

Total Income Tax Withheld from wages, tips, and other compensation allocated to the listed client EIN from Form 941, Line 3

Enter the amount from:

column (e) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revisions 2020 and Later

column (d) box 1 through 10 of Sch R and/or box 1 through 23 of Sch R Continuation Sheet for form revisions 2017 and 2018

column (c) box 1 through 15 of Sch R and/or box 1 through 25 of Sch R Continuation Sheet for form revisions 2010 through 2014

LN nn Col f- Sick Lv

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