Reminder:
Internal Revenue Manual Part 3. Submission Processing · 2026-10-03 edition · updated 2026-10-04 · United States
Use these instructions for form revision 2023 only.
Qualified health plan expenses allocable to qualified family leave wages reported on line 25 from Form 943, Line 26
Enter the amount from column (w) box 1 through 5 of Sch R and/or box 1 through 8 of Sch R Continuation Sheet for form revision 2023.
LN nn Col w- Form 943-X Line 34
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