Read the separate instructions before you complete Form 941. Type or print within the boxes. 1 Number of employees who received wages, tips, or other compensation for the pay period including: Mar. 12 (Quarter 1)... 2 Wages, tips, and other compensation. 3 Federal income tax withheld from wages, tips, and other compensation. 1 2 4 If no wages, tips, and other compensation are subject to social security or Medicare tax Check and go to line 6. Column 1 Column 2 Sa Taxable social security wages.. x 0.124- Sa (i) Qualified sick leave wages.. Sa (4) Qualified family leave wages.. 5b Taxable social security tips.... Sc Taxable Medicare wages & tips... x 0.062- x 0.062- x 0.124- x 0.029- 5d Taxable wages & tips subject to Additional Medicare Tax withholding x 0.009- Se Total social security and Medicare taxes. Add Column 2 from lines Sa. 5a). 5a). 5b, 5c. and 5d. 5f Section 3121(a) Notice and Demand-Tax due on unreported tips (see instructions). 6 Total taxes before adjustments. Add lines 3. Se, and Sf. 7 Current quarter's adjustment for fractions of cents. 8 Current quarter's adjustment for sick pay.. 9 Current quarter's adjustments for tips and group-term life insurance. 10 Total taxes after adjustments. Combine Ines 6 through 9. Se 5f 7 8 10 11a Qualified small business payroll tax credit for increasing research activities. Attach Form 6974.. 11b Nonrefundable portion of credit for qualified sick and family leave wages for leave taken before April 1, 2021.. 11a 11b 11c Reserved for future use.. 11c Search