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Form 4219: Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
IRS Form 4219 is a Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes that details tax obligations under Section 3505 of the Internal Revenue Code. This form must be filed in duplicate and relates to employer liability.
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IRS Form 4219 - Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes
IRS Form 4219 is a Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes that details tax obligations under Section 3505 of the Internal Revenue Code. This form must be filed in duplicate and relates to employer liability.
Risk Radar
Scan points- 1Failing to pay on or before the employer's due date will trigger interest charges at the IRS-established annual rate.
- 2Filing without listing the correct Employer identification number (Item 2) on Form 4219.
- 3Entering the wrong date in Item 4, which must be the last day of the calendar quarter wages were paid.
- 4Not calculating Item 18 correctly as the lesser of Item 17 or 25 percent of Item 13.
- 5Failing to sign the declaration by the lender, surety, or other person.
Plain English
This form proves to the IRS that you are responsible for certain withholding taxes even if another company paid them. You use it when you lend money or guarantee payments to an employer whose employees received wages. It helps document your financial responsibility for these withheld employee taxes.
Submission Date
- Filing date: 2014-05-29 00:00:00
- Preparation window: collect IDs, supporting records, and signatures in advance.
- Final review: verify names, dates, and required fields before submission.
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What this form is for
- Use this form when you are a lender, surety, or other person who incurred liability under Section 3505 of the Internal Revenue Code by paying wages directly to employees or supplying funds for wage payments to another employer.
- Do not use Form 4219 if you are an employer within the meaning of code section 3401 (d)(1) or (d)(2) and need to report income tax withholding.
- Check Form 1041 instead when reporting income tax withholding as an employer.
Form selector
Use this form or another form?
You are a surety who paid wages for another company
Liability arises because you paid wages directly or supplied funds to the other employer.
✓ Check Item 18/20 calculations.
You provided working capital loans, but part of the money is used for wages
Section 3505(b) applies unless it's an ordinary working capital loan, even if wage payment is known.
✓ Ensure you document this specific condition.
The employer paid the taxes, but you want to show your liability anyway
You must still file Form 4219 to declare your liability under Section 3505 of the Internal Revenue Code.
✓ Verify Item 18/20 is calculated correctly based on the lesser amount.
You are a lender supplying funds for wages, and the employer *will* pay taxes timely
Liability still exists if you have actual notice or knowledge that the employer does not intend to make timely payment.
✓ Use Item 18/20 calculations based on this knowledge.
Deadline or filing window
Payment of the liability must occur on or before the specific due date of the employer's Federal employment tax return. Item 4 requires specifying the last day of the calendar quarter when wages were actually paid. The source does not specify an extension period, but payment by the deadline avoids interest accumulation.
Checklist
What you need before filling it out
Item 13 (Gross Amount Supplied)
Gross amount supplied for wage payment · Item 13 of Form 4219
Item 18/20 (Liability)
Lesser of Item 17 or 25% of Item 13 · Items 17 & 13 on Form 4219
Filer Status
Lender, Surety, or Other Person (must meet Section 3505 criteria) · General Instructions (p.2)
Payment Amount
Item 23 Total liability (Sum of Items 21 & 22) · Item 23 on Form 4219
Date Quarter Ended
Last day of the calendar quarter wages were paid/supplied for · Item 4 on Form 4219
Before you submit
- 1Ensure the form is filled out in duplicate.
- 2Confirm that Item 4 reflects the last day of the calendar quarter wages were actually paid (or supplied for).
- 3Verify that Item 18/20 is correctly calculated as the lesser of Item 17 or 25 percent of Item 13.
- 4Check that Item 23 accurately sums Items 21 and 22 to determine total liability.
- 5Confirm the signature block includes the Title, Date, and Signature of the lender, surety, or other person.
- 6Verify the preparer's name/signature is included if the preparer is not the taxpayer.
- 7Ensure a remittance (check or money order) for the amount in Item 23 is included with the filing.
How to file this form
- 1Complete all required information on Form 4219, ensuring you fill out a separate form for each employer and each calendar quarter.
- 2Calculate the Total Liability (Item 23) by summing the total liability for withholding taxes (Item 21) and interest liability (Item 22).
- 3Include a remittance, payable to the United States Treasury, matching the amount shown in Item 23 with each Form 4219.
- 4File the completed Form 4219 (in duplicate) with the Internal Revenue Service office where the employer files Federal employment tax returns, obtaining proof of filing.
Known limitations
- 1An employer that meets the definition of an employer under Internal Revenue Code section 3401 (d)(1) or (d)(2) should not use Form 4219 to report income tax withholding.
- 2A separate Form 4219 must be submitted for each employer and for each calendar quarter where liability under Section 3505 is incurred.
- 3If the taxes shown on Form 4219 are paid by either the employer or the lender, surety, or other person, that payment satisfies the liability.
Field map
Compact field-by-field guide
General Info
2 items
Full legal name and taxpayer identification number (SSN or EIN).
Current mailing address.
Details
2 items
Complete all applicable sections of this form according to the official IRS instructions.
Enter the relevant dollar amount if this form involves tax calculation.
Certification
1 items
Read and acknowledge any certifications required by this form.
Signatures
1 items
Sign and date. Unsigned forms cannot be processed.
Almost done reviewing the fields?
Fillable formOpen in Editor->The current edition available is Revision 5-2014, dated May 2014. The source does not point to a specific 'latest information' page but provides the full details for this revision.
What changed or needs a fresh check
- Edition date — confirm Revision 5-2014 (May 2014)
- Catalog Number — confirm 41456S
- Filing requirement — confirm the form must be filed in duplicate
- Payment due date — confirm payment should be made on or before the employer's due date to avoid interest
- OMB Number — confirm 1545-2254
Quick Facts
Downloads
After you file
- 1Keep a copy of the filed Form 4219.
- 2Include a remittance (check or money order) for the amount shown in item 23 with each Form 4219, payable to the United States Treasury.
- 3If liability is paid after the due date of the employer's Federal employment tax return, interest will be charged at the annual rate established under Internal Revenue Code section 6621(a) (subject to adjustments per section 6621(b)).
- 4Books and records relating to Form 4219 or its instructions must be retained as long as their contents may become material in the administration of any Internal Revenue law.
Sources
- SRCForm 4219 is titled Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes and governs liability under Section 3505 of the Internal Revenue Code. [Form p.1]
- SRCThe form must be filed in duplicate. [Form p.1]
- SRCA separate Form 4219 is required for each employer and for each calendar quarter where liability under Section 3505 is incurred. [Form p.2]
- SRCFile Form 4219 with the IRS office where the employer files Federal employment tax returns. [Form p.2]
- SRCInclude a remittance (check or money order) for the amount shown in item 23, payable to the United States Treasury. [Form p.2]
- SRCThe form determines liability for a lender, surety, or other person who paid wages directly to employees of another employer. [Form p.2]
Common confusion points
Who needs to file this form?
A lender, surety, or other person files Form 4219 if they paid wages directly to employees of another employer or supplied funds for that purpose and incurred liability under Section 3505.
→ Confirm the filer is a lender, surety, or other person incurring liability.
Do I need to file this form for every single thing?
A separate Form 4219 must be submitted for each employer and for each calendar quarter where liability exists.
→ Check if you are filing for one employer across multiple quarters, or multiple employers in one quarter.
Where exactly do I send it?
File Form 4219 with the IRS office where the employer (the borrower) files their Federal employment tax returns.
→ Verify the specific address/service center based on the employer's filing location.
What about income tax withholding?
If you are an employer under code section 3401 (d)(1) or (d)(2), do not use Form 4219 to report that income tax withholding.
→ Confirm your status: Are you a lender/surety, or the direct employer?
What if I pay late?
If the liability is paid after the due dates of the employer's Federal employment tax return, interest will be charged at the annual rate established under Internal Revenue Code section 6621(a).
→ Check item 23 to confirm the exact amount being remitted.
Do I need to provide my ID number?
Section 6109 requires the filer to provide their identification number.
→ Ensure Item 2 is filled out correctly for the employer/borrower.
Workflow map
Related forms and next steps
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⚠ If something goes wrong
- Failure to provide requested information in a timely manner or providing false/fraudulent info can subject the filer to penalties (Section 6011).
Questions about IRS Form 4219
What is IRS Form 4219 used for?
This form proves to the IRS that you are responsible for certain withholding taxes even if another company paid them. You use it when you lend money or guarantee payments to an employer whose employees received wages. It helps document your financial responsibility for these withheld employee taxes.
Who must file IRS Form 4219?
A lender, surety, or other person must file Form 4219 if they have incurred liability under section 3505 of the Internal Revenue Code because they either paid wages directly to an employer's employees or supplied funds for those wage payments.
What information does IRS Form 4219 require?
The form collects information about the Employer (Borrower) on Item 1, such as their name and EIN. It details liability amounts in sections like Item 18 (Liability for withholding taxes), which is calculated as the lesser of Item 17 or 25 percent of Item 13.
When is IRS Form 4219 due?
To avoid interest charges, payment must be made on or before the due date of the employer's Federal employment tax return. Item 4 requires entering the last day of the calendar quarter during which wages were actually paid.
Where do I file IRS Form 4219?
The source directs filers to see 'Where to File?' in the instructions for Form 4219, but it also lists a mailing address: Internal Revenue Service, Tax Products Coordinating Committee, SE:W: CAR:MP:T:M:S, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224.
How do I complete IRS Form 4219?
The preparer must complete the required information regarding the Employer and the specific liability amounts. The lender, surety, or other person must sign the declaration, and a preparer signature is needed if it is not the same as the taxpayer's signature. The form must be filed in duplicate.
What happens if IRS Form 4219 is filed incorrectly?
If interest is charged because the liability payment occurs after the due date of the employer's Federal employment tax return, it will be assessed at the annual rate established under Internal Revenue Code section 6621(a), subject to adjustments in section 6621(b).
Who needs to file this form?
A lender, surety, or other person files Form 4219 if they paid wages directly to employees of another employer or supplied funds for that purpose and incurred liability under Section 3505. Confirm the filer is a lender, surety, or other person incurring liability.
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