This form contains 70 fields organized into 11 sections. Below is a complete list of every field, its type, and what information is expected.

Field Name Type Description
Balance Due
topmostSubform[0].Page1[0].f1_15[0 Text
Enter the balance due if the total tax is more than the deposits.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].D[0].f1_25[0 Text
Enter the balance due for federal income tax withheld.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].D[0].f1_26[0 Text
Enter the number of months for which there is a balance due.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].L[0].f1_41[0 Text
Enter the balance due for the year if the total tax is greater than the total deposits.
Business Information
Enter your business name (individual name if sole proprietor) Text
Enter the name of your business. If you are a sole proprietor, enter your individual name.
Enter your address Text
Enter the complete address of your business, including street name and number.
Max length: 70 characters
Enter your city or town, state or province, country, and ZIP or foreign postal code Text
Enter the city or town, state or province, country, and ZIP or foreign postal code of your business address.
Max length: 70 characters
Deposits
4 Text
Enter the total deposits made for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].C[0].f1_23[0 Text
Enter the total amount of deposits made for federal income tax withheld.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].C[0].f1_24[0 Text
Enter the number of deposits made for federal income tax withheld.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].K[0].f1_39[0 Text
Enter the total deposits made for the year towards federal income tax withheld.
Financial Information
Dollars Text
Enter the dollar amount of the total taxes reported.
Cents Text
Enter the cents amount of the total taxes reported.
Max length: 2 characters
Monthly Summary
1 bef3 Text
Enter the total federal income tax withheld for the first month. This field has a maximum length of 3 characters.
Max length: 3 characters
2 Text
Enter the total federal income tax withheld for the second month.
2 1cb9 Text
Enter the total federal income tax withheld for the second month. This field has a maximum length of 3 characters.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].A[0].f1_19[0 Text
Enter the monthly summary of federal tax liability for January.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].A[0].f1_20[0 Text
Enter the monthly summary of federal tax liability for February.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].B[0].f1_22[0 Text
Enter the number of months for which federal income tax was withheld.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].F[0].f1_30[0 Text
Enter the month number (01-12) for which the federal income tax liability is being reported.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].G[0].f1_32[0 Text
Enter the month number (01-12) for which the federal income tax liability is being reported.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].H[0].f1_34[0 Text
Enter the month number (01-12) for which the federal income tax liability is being reported.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].I[0].f1_36[0 Text
Enter the month number (01-12) for which the federal income tax liability is being reported.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].J[0].f1_38[0 Text
Enter the month number (1-12) for the monthly summary of federal tax liability.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].K[0].f1_40[0 Text
Enter the month number (1-12) for the monthly summary of federal tax liability.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].L[0].f1_42[0 Text
Enter the month number (1-12) for the monthly summary of federal tax liability.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].M[0].f1_44[0 Text
Enter the month number (1-12) for the monthly summary of federal tax liability.
Max length: 3 characters
Overpayment
5 Text
Enter the amount of overpayment if the deposits are more than the total tax.
5 5fb1 Text
Enter the amount of overpayment if the deposits are more than the total tax.
Max length: 3 characters
6 Overpayment. If line 4 is more than line 3, enter the difference Text
Enter the amount of overpayment if line 4 is more than line 3.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].E[0].f1_27[0 Text
Enter the total overpayment of federal income tax withheld.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].E[0].f1_28[0 Text
Enter the number of months for which there was an overpayment.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7K-M[0].M[0].f1_43[0 Text
Enter the overpayment amount if the total deposits are greater than the total tax.
Signatures
Print Your Name and Title Text
Print your name and title as the taxpayer signing this form.
Print/Type preparer's name Text
Print or type the name of the preparer who completed this form.
topmostSubform[0].Page1[0].c1_7[0]_1 CheckBox
Check this box if the preparer is self-employed.
PTIN Text
Enter the Preparer Tax Identification Number (PTIN) of the preparer.
Max length: 11 characters
Firm's name Text
Enter the name of the firm that the preparer is associated with.
Firm's address Text
Enter the address of the firm that the preparer is associated with.
Firm's EIN Text
Enter the Employer Identification Number (EIN) of the firm that the preparer is associated with.
Max length: 10 characters
Phone no Text
Enter the phone number of the firm that the preparer is associated with.
Tax Reporting
1 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings.
3 Total taxes. If $2,500 or more, this must equal line 7M below or Form 945-A, line M 3 Text
Enter the total taxes. If the amount is $2,500 or more, this must equal line 7M below or Form 945-A, line M.
Taxpayer Information
Name (as distinguished from trade name) Text
Enter the name of the taxpayer as it is officially recognized, distinct from any trade name.
topmostSubform[0].Page1[0].f1_2[0 Text
Enter the taxpayer's identification number. This field has a maximum length of 2 characters.
Max length: 2 characters
topmostSubform[0].Page1[0].f1_3[0 Text
Enter the taxpayer's employer identification number (EIN). This field has a maximum length of 7 characters.
Max length: 7 characters
Trade name, if any Text
Enter the trade name of the business, if applicable.
topmostSubform[0].Page1[0].f1_5[0 Text
Enter the address of the taxpayer, including city or town, state or province, country, and ZIP or foreign postal code. This field has a maximum length of 70 characters.
Max length: 70 characters
City or town, state or province, country, and ZIP or foreign postal code Text
Enter the city or town, state or province, country, and ZIP or foreign postal code. This field has a maximum length of 70 characters.
Max length: 70 characters
1 Enter your employer identification number (EIN) Text
Enter your Employer Identification Number (EIN).
Max length: 2 characters
9b Text
Enter the remaining digits of your Employer Identification Number (EIN).
Max length: 7 characters
Third-Party Designee
topmostSubform[0].Page1[0].c1_1[0]_1 CheckBox
Check this box if the taxpayer is a third-party designee.
topmostSubform[0].Page1[0].c1_2[0]_1 CheckBox
Check this box if the taxpayer is not a third-party designee.
topmostSubform[0].Page1[0].f1_7[0 Text
Enter the name of the third-party designee, if applicable.
topmostSubform[0].Page1[0].c1_3[0]_1 CheckBox
Check this box if you want the IRS to discuss this return with the third-party designee.
topmostSubform[0].Page1[0].c1_3[1]_2 CheckBox
Check this box if you want the IRS to discuss this return with the third-party designee.
topmostSubform[0].Page1[0].BulletedList[0].Bullet2[0].c1_4[0]_1 CheckBox
Check this box if you want the IRS to discuss this return with the third-party designee.
topmostSubform[0].Page1[0].BulletedList[0].Bullet3[0].c1_5[0]_1 CheckBox
Check this box if you want the IRS to discuss this return with the third-party designee.
topmostSubform[0].Page1[0].c1_6[0]_1 CheckBox
Check this box if you are designating a third party to discuss this return with the IRS.
topmostSubform[0].Page1[0].c1_6[1]_2 CheckBox
Check this box if you are designating a third party to discuss this return with the IRS.
Designee's name Text
Enter the name of the third-party designee who is authorized to discuss this return with the IRS.
Phone no Text
Enter the phone number of the third-party designee.
topmostSubform[0].Page1[0].PINComb[0].f1_47[0 Text
Enter the 5-digit Personal Identification Number (PIN) of the third-party designee.
Max length: 5 characters
Total Taxes
352d Text
Enter the total amount of federal income tax withheld from pensions, annuities, IRAs, and gambling winnings.
Max length: 3 characters
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7A-E[0].B[0].f1_21[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].F[0].f1_29[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].G[0].f1_31[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].H[0].f1_33[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].I[0].f1_35[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.
topmostSubform[0].Page1[0].TagCorrectingSubform[0].Table_7F-J[0].J[0].f1_37[0 Text
Enter the total federal income tax withheld from pensions, annuities, IRAs, and gambling winnings for the year.