950424
Schedule R (Form 941):                   Allocation Schedule for Aggregate Form 941 Filers                                                                          Report for calendar year:
(Rev. March 2024)                        Department of the Treasury — Internal Revenue Service               OMB No. 1545-0029
Employer identification number (EIN)                    —                                                                                                       Check the quarter (same as Form 941):
                                                                                                                                                                    1: January, February, March
Name as shown on Form 941                                                                                                                                                                                                   This Schedule R is 
                                                                                                                                                                    2: April, May, June                                     attached to:
Type of filer (check one):         Section 3504 Agent             CPEO               Other Third Party                                                              3: July, August, September                                   Form 941
Read the instructions before you complete Schedule R. Type or print within the boxes. Complete a separate line for the amounts                                      4: October, November, December                               Form 941-X
allocated to each of your clients. The term “client” as used on this form includes the term “customer.” See the instructions.
      (a) Client’s EIN        (b) Type of wages (c) Form 941, line 1         (d) Form 941, line 2      (e) Form 941, line 3         (f) Form 941-X, lines 9         (g) Form 941, lines 5a          (h) Form 941, line 5c,       (i) Form 941, line 5e
                                 (CPEO only)                                                                                             and 10, column     1, total     and 5b, column     2, total     column     2                            
1                                                                                          .                              .                           .                                .                          .                            .
2                                                                                          .                              .                           .                                .                          .                            .
3                                                                                          .                              .                           .                                .                          .                            .
4                                                                                          .                              .                           .                                .                          .                            .
5                                                                                          .                              .                           .                                .                          .                            .
6 Subtotals for clients. Add lines 1 through 5                                             .                              .                           .                                .                          .                            .
7 Enter the combined subtotal from line 9 of  
  all Continuation Sheets for Schedule R                                                   .                              .                           .                                .                          .                            .
8 Enter Form 941 amounts for your employees                                                .                              .                           .                                .                          .                            .
9 Totals. Add lines 6, 7, and 8.                                                           .                              .                           .                                .                          .                            .
    (j) Form 941, line 5f         (k) Form 941, line 11       (l) Form 941-X, lines 17         (m) Reserved for           (n) Form 941-X, lines 18b        (o) Form 941-X, lines 18c           (p) Form 941-X, line 18d,    (q) Form 941, line 12
                                                              and 25, column      1, total         future use                  and 26b, column     1, total     and 26c, column     1, total             column 1                                
1                      .                          .                          .                               .                                   .                               .                                                             .
2                      .                          .                          .                               .                                   .                               .                                                             .
3                      .                          .                          .                               .                                   .                               .                                                             .
4                      .                          .                          .                               .                                   .                               .                                                             .
5                      .                          .                          .                               .                                   .                               .                                                             .
6                      .                          .                          .                               .                                   .                               .                                                             .
7                      .                          .                          .                               .                                   .                               .                                                             .
8                      .                          .                          .                               .                                   .                               .                                                             .
9                      .                          .                          .                               .                                   .                               .                                                             .
    (r) Form 941, line 13           (s) Reserved for              (t) Reserved for         (u) Form 941-X, lines 28             (v) Reserved for           (w) Form 941-X, lines 35            (x) Form 941-X, lines 36     (y) Form 941-X, lines 38 
                                        future use                    future use               and 29, column     1, total          future use              and 37, column     1, total          and 39, column     1, total     and 40, column     1, total
1                      .                          .                                                          .                                   .                               .                              .                              .
2                      .                          .                                                          .                                   .                               .                              .                              .
3                      .                          .                                                          .                                   .                               .                              .                              .
4                      .                          .                                                          .                                   .                               .                              .                              .
5                      .                          .                                                          .                                   .                               .                              .                              .
6                      .                          .                                                          .                                   .                               .                              .                              .
7                      .                          .                                                          .                                   .                               .                              .                              .
8                      .                          .                                                          .                                   .                               .                              .                              .
9                      .                          .                                                          .                                   .                               .                              .                              .
For Paperwork Reduction Act Notice, see the separate instructions.                                     www.irs.gov/Form941                                          Cat. No. 49301K                      Schedule R (Form 941) (Rev. 3-2024)

Page         of                                                                                                                                                                                                                                         950524
Continuation Sheet for Schedule R (Form 941)                                                                                                                         Report for calendar year:
(Rev. March 2024)
Employer identification number (EIN)                     —                                                                                                       Check the quarter (same as Form 941):
                                                                                                                                                                     1: January, February, March
Name as shown on Form 941                                                                                                                                                                                                    This Schedule R is 
                                                                                                                                                                     2: April, May, June                                     attached to:
Type of filer (check one):         Section 3504 Agent             CPEO                Other Third Party                                                              3: July, August, September                                   Form 941
                                                                                                                                                                     4: October, November, December                               Form 941-X

         (a) Client’s EIN    (b) Type of wages   (c) Form 941, line 1        (d) Form 941, line 2       (e) Form 941, line 3         (f) Form 941-X, lines 9         (g) Form 941, lines 5a          (h) Form 941, line 5c,       (i) Form 941, line 5e
                                  (CPEO only)                                                                                             and 10, column     1, total     and 5b, column     2, total     column     2                            
1                                                                                          .                               .                           .                                .                          .                            .
2                                                                                          .                               .                           .                                .                          .                            .
3                                                                                          .                               .                           .                                .                          .                            .
4                                                                                          .                               .                           .                                .                          .                            .
5                                                                                          .                               .                           .                                .                          .                            .
6                                                                                          .                               .                           .                                .                          .                            .
7                                                                                          .                               .                           .                                .                          .                            .
8                                                                                          .                               .                           .                                .                          .                            .
9 Subtotals for clients. Add lines 1 through 8. 
  Include the subtotals from this line on 
  Schedule R, Page 1, line 7.                                                              .                               .                           .                                .                          .                            .
       (j) Form 941, line 5f      (k) Form 941, line 11       (l) Form 941-X, lines 17          (m) Reserved for           (n) Form 941-X, lines 18b        (o) Form 941-X, lines 18c           (p) Form 941-X, line 18d,    (q) Form 941, line 12
                                                               and 25, column      1, total         future use                  and 26b, column     1, total     and 26c, column     1, total             column 1                                
1                         .                         .                        .                                .                                   .                               .                                                             .
2                         .                         .                        .                                .                                   .                               .                                                             .
3                         .                         .                        .                                .                                   .                               .                                                             .
4                         .                         .                        .                                .                                   .                               .                                                             .
5                         .                         .                        .                                .                                   .                               .                                                             .
6                         .                         .                        .                                .                                   .                               .                                                             .
7                         .                         .                        .                                .                                   .                               .                                                             .
8                         .                         .                        .                                .                                   .                               .                                                             .
9                         .                         .                        .                                .                                   .                               .                                                             .
       (r) Form 941, line 13        (s) Reserved for              (t) Reserved for         (u) Form 941-X, lines 28              (v) Reserved for           (w) Form 941-X, lines 35            (x) Form 941-X, lines 36     (y) Form 941-X, lines 38 
                                          future use                  future use                and 29, column     1, total          future use              and 37, column     1, total          and 39, column     1, total     and 40, column     1, total
1                         .                         .                                                         .                                   .                               .                              .                              .
2                         .                         .                                                         .                                   .                               .                              .                              .
3                         .                         .                                                         .                                   .                               .                              .                              .
4                         .                         .                                                         .                                   .                               .                              .                              .
5                         .                         .                                                         .                                   .                               .                              .                              .
6                         .                         .                                                         .                                   .                               .                              .                              .
7                         .                         .                                                         .                                   .                               .                              .                              .
8                         .                         .                                                         .                                   .                               .                              .                              .
9                         .                         .                                                         .                                   .                               .                              .                              .
                                                                                                                                                                                                          Schedule R (Form 941) (Rev. 3-2024)