Step 4: Continued
2b Enter the amount from Page 1, Step 4, Line 2a. 2b ____________.___
2c Second month of quarter (i.e., February for 1st quarter; May for 2nd quarter; August for 3rd quarter; and November for 4th quarter)
DayAmount DayAmount DayAmount DayAmount
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 ____________.___
Total Illinois Income Tax withheld this month. (Add Section 2c, Lines 1-31.) 2c ____________.___
2d Third month of quarter (i.e.,Marchfor1stquarter;Junefor2ndquarter;Septemberfor3rdquarter;andDecemberfor4thquarter)
DayAmount DayAmount DayAmount DayAmount
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 ____________.___
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. 2 _________________
Step 5: Tell us about your payments and credits
3 Enter the amount of credit from the Schedule WC you are using this period. See instructions. 3 _________________
4 EnterthetotaldollaramountofwithholdingpaymentsyoumadetotheIllinoisDepartmentof
Revenue(IDOR)forthisperiod.ThisincludesallIL-501payments(electronicandpaper
coupons). Do not estimate this amount. 4 _________________
5 Add Lines 3 and 4 and enter the total amount here. 5 _________________
*71012232W*
Step 6: Figure your balance
6 If Line 2 is greater than Line 5, subtract Line 5 from Line 2. This is your remaining
balance due. Make your payment electronically or make your remittance payable
to “Illinois Department of Revenue.” If Line 5 is greater than Line 2, see the instructions.
(Semi-weekly payers must pay electronically.) 6 ________________
Mail to: ILLINOIS DEPARTMENT OF REVENUE
PO BOX 19052
SPRINGFIELD IL 62794-9052
NS IR DR_______________
IL-941 (R-12/23)
Step 7: Sign here Under penalties of perjury, I state that, to the best of my knowledge, this return is true, correct, and complete
Paid Preparer’s PTIN
Firm’s FEIN
Firm’s phone
( )
CheckiftheDepartmentmay
discuss this return with the paid
preparer shown in this step.
Paid
Preparer
Use Only
Firm’s name
Print/Type paid preparer’s name
Paid preparer’s signature
Date(mm/dd/yyyy)
Check if
self-employed
Sign
Here
Signature
Date(mm/dd/yyyy)
Title
Daytimephonenumber
( )
Firm’s address
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