Reminder:

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

Use these instructions for form revision 2020 only.

Qualified health plan expenses allocable to wages reported on Line 21 from Form 941, Line 22

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

LN nn Col w- Form 941-X Total Lines 35 and 37 Col 1

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▸Contents — Internal Revenue Manual Part 3. Submission Processing

Internal Revenue Manual Part 3. Submission Processing

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