Prior Period Adjustment Example. Summary: This is a portion of Form 941 (Revision 1-2005) to illustrate the adjustment of tax liability reported by the employer
                  with items
                  included as described in the text. Additionally, these line items are completed:
               
               
                  
                     | “Check one: Monthly schedule depositors: Complete line 17, columns (a) through (d), and check here” checkbox checked | 
                  
                     | “17(c) Third month liability” field contains 4500.00 | 
                  
                     | “17(d) Total liability for quarter” field contains 8500.00 |