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COBRA Recipients [Line 12b].

Reminder:

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

Use these instructions for form revisions 2021 and 2022 (Rev. Mar 2022) only.

Total reported on Form 941, Lines 19 and 20, from Form 941

Enter the amount from column (u) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revisions 2021 and 2022 (Rev. Mar 2022).

LN nn Col u- Wages Ret Cr

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