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Illinois Department of Revenue |
*70712211W* |
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Form IL-941-X |
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2021 Amended Illinois Withholding Income Tax Return |
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Important Information
Electronically file this form on MyTax Illinois at mytax.illinois.gov or using an IDOR approved Tax-Prep software program, OR
Mail this form and any required support to: ILLINOIS DEPARTMENT OF REVENUE, PO BOX 19052, SPRINGFIELD IL 62794-9052
Attach a completed Schedule P and if required, a Schedule WC. Note: Do not attach additional correspondence.
Step 1: Provide your information
___ ___ ___ ___ ___ ___ ___ ___ ___ |
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Federal employer identification number (FEIN) |
Seq. number |
____________________________________________________________
Business name
____________________________________________________________
C/O
____________________________________________________________
Mailing address
______________________________ |
_______ |
__________________ |
City |
State |
ZIP |
Check this box if your
business name has changed.
Check this box if you have an address change.
Reporting Period
Check the quarter you are amending.
1st (January, February, March)
2nd (April, May, June)
3rd (July, August, September)
4th (October, November, December)
Step 2: Tell us about your business
A1 |
Enter the total number of Forms W-2 reporting Illinois withholding you issued for the entire year.* |
A1 ________________ |
A2 |
Enter the total number of Forms 1099 reporting Illinois withholding you issued for the entire year.* |
A2 ________________ |
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*Only complete Lines A1 and A2 when you file your 4th quarter or final return. |
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B |
If your business has permanently stopped withholding because it has closed, or you |
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Month Day |
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no longer pay Illinois wages or withhold Illinois taxes from other payments, check the box |
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and enter the date you stopped withholding. This is considered your final return. Do not file future |
B |
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returns unless you resume withholding Illinois income tax. |
__ __ / __ __ / 2021 |
Step 3: Tell us about the amount subject to withholding |
Corrected amount |
1 Enter the total dollar amount subject to Illinois withholding tax this reporting |
1 __________________ |
period, including payroll, compensation, and other amounts. See instructions. |
Step 4: Tell us about the amount withheld and previous overpayments
2Enter the exact amount of Illinois Income Tax you actually withheld from your employees or others on the day you paid the compensation. Only enter amounts on days you made withholding - leave the remaining “Day” lines blank. If you withheld no Illinois Income Tax during the month, enter “0” on the corresponding “Total” line - Line 2a, 2c, or 2d (noted by “
”).
2a First month of quarter (i.e., January for 1st quarter; April for 2nd quarter; July for 3rd quarter; and October for 4th quarter)
Day Amount |
Day Amount |
Day Amount |
Day Amount |
1 ____________.___ |
9 ____________.___ |
17 ____________.___ |
25 ____________.___ |
2 ____________.___ |
10 ____________.___ |
18 ____________.___ |
26 ____________.___ |
3 ____________.___ |
11 ____________.___ |
19 ____________.___ |
27 ____________.___ |
4 ____________.___ |
12 ____________.___ |
20 ____________.___ |
28 ____________.___ |
5 ____________.___ |
13 ____________.___ |
21 ____________.___ |
29 ____________.___ |
6 ____________.___ |
14 ____________.___ |
22 ____________.___ |
30 ____________.___ |
7 ____________.___ |
15 ____________.___ |
23 ____________.___ |
31 ____________.___ |
8 ____________.___ |
16 ____________.___ |
24 ____________.___ |
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Total Illinois Income Tax withheld this month. (Add Section 2a, Lines 1-31.) |
2a ____________.___ |
Printed by the authority of the State of Illinois - web only, 1 copy
IL-941-X Front (R-12/20) Return address updated 01/22
This form is authorized under the Income Tax Act. Disclosure of this information is required. Failure to provide information may result in this form not being processed and may result in a penalty.
2b ____________.___
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*70712212W* |
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Step 4: Continued |
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2b Enter the amount from Page 1, Step 4, Line 2a.
2c Second month of quarter (i.e., February for 1st quarter; May for 2nd quarter; August for 3rd quarter; and November for 4th quarter)
Day Amount |
Day Amount |
Day Amount |
Day Amount |
1 ____________.___ |
9 ____________.___ |
17 ____________.___ |
25 ____________.___ |
2 ____________.___ |
10 ____________.___ |
18 ____________.___ |
26 ____________.___ |
3 ____________.___ |
11 ____________.___ |
19 ____________.___ |
27 ____________.___ |
4 ____________.___ |
12 ____________.___ |
20 ____________.___ |
28 ____________.___ |
5 ____________.___ |
13 ____________.___ |
21 ____________.___ |
29 ____________.___ |
6 ____________.___ |
14 ____________.___ |
22 ____________.___ |
30 ____________.___ |
7 ____________.___ |
15 ____________.___ |
23 ____________.___ |
31 ____________.___ |
8 ____________.___ |
16 ____________.___ |
24 ____________.___ |
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Total Illinois Income Tax withheld this month. (Add Section 2c, Lines 1-31.) |
2c ____________.___ |
2d Third month of quarter (i.e., March for 1st quarter; June for 2nd quarter; September for 3rd quarter; and December for 4th quarter)
Day Amount |
Day Amount |
Day Amount |
Day Amount |
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1 ____________.___ |
9 ____________.___ |
17 ____________.___ |
25 ____________.___ |
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2 ____________.___ |
10 ____________.___ |
18 ____________.___ |
26 ____________.___ |
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3 ____________.___ |
11 ____________.___ |
19 ____________.___ |
27 ____________.___ |
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4 ____________.___ |
12 ____________.___ |
20 ____________.___ |
28 ____________.___ |
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5 ____________.___ |
13 ____________.___ |
21 ____________.___ |
29 ____________.___ |
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6 ____________.___ |
14 ____________.___ |
22 ____________.___ |
30 ____________.___ |
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7 ____________.___ |
15 ____________.___ |
23 ____________.___ |
31 ____________.___ |
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8 ____________.___ |
16 ____________.___ |
24 ____________.___ |
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Total Illinois Income Tax withheld this month. (Add Section 2d, Lines 1-31.) |
2d ____________.___ |
Add Lines 2b, 2c, and 2d and enter the total amount here. This is the total dollar amount of |
Illinois Income Tax actually withheld from your employees or others for this quarter. |
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Note: If you are reducing your tax based on Form W-2c, see instructions. |
2 _________________ |
3If your original return or previously filed IL-941-X resulted in a credit that you were previously allowed to use, any IDOR-approved credit for the period, or a refund you
have already received, please enter this amount. See instructions. |
3 _________________ |
4 Add Lines 2 and 3 and enter the total amount here. |
4 _________________ |
Step 5: Tell us about your payments and credits
5 Enter the amount of credit from the Schedule WC you are using this period. See instructions. |
5 _________________ |
6Enter the total dollar amount of withholding payments you made to the Illinois Department of
Revenue (IDOR) for this period. This includes all IL-501 payments (electronic and paper |
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coupons). Do not estimate this amount. |
6 _________________ |
7 Add Lines 5 and 6 and enter the total amount here. |
7 _________________ |
Step 6: Figure your balance
8If Line 4 is greater than Line 7, subtract Line 7 from Line 4. This is your remaining balance due. Make your payment electronically or make your remittance payable to “Illinois Department of
Revenue.” (Semi-weekly payers must pay electronically.) |
8 _________________ |
9 If Line 7 is greater than Line 4, subtract Line 4 from Line 7. This amount is your overpayment. |
9 _________________ |
Step 7: Sign here Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete.
Sign |
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Check if the Department |
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Here |
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may discuss this return with the |
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Signature |
Date (mm/dd/yyyy) Title |
Phone |
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paid preparer shown in this step. |
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Paid |
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Check if |
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Paid preparer’s name |
Paid preparer’s signature |
Date (mm/dd/yyyy) |
self-employed |
Paid Preparer’s PTIN |
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Preparer |
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Use Only |
Firm’s name |
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Firm’s FEIN |
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Firm’s address |
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Firm’s phone |
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NS |
IR |
DR |
IL-941-X Back (R-12/20) |
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Reset |
Print |
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