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Federal forms, ICRs, and supporting documents

OMB control number

Employment Tax Adjustments and Rules Relating to Additional Medicare Tax

OMB 1545-2097 ยท TREAS/IRS.

OMB 1545-2097

This information is required to verify compliance with return requirements under section 6011, employment tax adjustments under section 6205 and 6413, and claims for refund of overpayments of employment taxes under section 6402 and 6414.

The latest form for Employment Tax Adjustments and Rules Relating to Additional Medicare Tax expires 2026-05-31 and can be found here.

Latest Forms, Documents, and Supporting Material
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Supporting Statement A
All Historical Document Collections
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 Extension without change of a currently approved collection 2023-02-28
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 Extension without change of a currently approved collection 2019-12-27
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 Extension without change of a currently approved collection 2016-07-29
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 Revision of a currently approved collection 2013-12-05
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 Revision of a currently approved collection 2013-03-21
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 Extension without change of a currently approved collection 2011-03-28
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 Revision of a currently approved collection 2010-06-03
Preapproved
 New collection (Request for a new OMB Control Number) 2008-03-14
OMB Details

Employment Tax Adjustments

Federal Enterprise Architecture: General Government - Taxation Management