4219

Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes

Agency
IRS
Revision
Rev. May 2014
Fillable fields
31
Pages
2
Official source
IRS form page
Checked
October 21, 2026
Fill 4219 online
Page 1 of form 4219

Form 4219: Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes

Form 4219, Statement of Liability of Lender, Surety, or Other Person for Withholding Taxes, is filed under section 3505 of the Internal Revenue Code. It is not an employer's own return. The form says it is filed by a lender, surety or other person who, by paying wages directly to employees of another employer, or by supplying funds for paying those wages, has incurred liability for taxes required to be withheld.

The statement covers income tax, FICA tax and railroad retirement tax required to be withheld from those wages, plus interest. Where funds were supplied for paying wages, the form says the liability cannot exceed 25% of the amount supplied for that purpose, and section 3505(b) does not apply to ordinary working capital loans. The employer remains liable for withholding taxes the lender, surety or other person does not pay.

A separate Form 4219 is filed, in duplicate, for each employer and each calendar quarter, with payment of the amount in item 23. You can fill out Form 4219 free in your browser on this page and download the result without an account.

What's on Form 4219

Items 1 to 5: the employer (borrower)

Name as used on the employment tax return, employer identification number, trade name, date the quarter ended and address.

Items 6 to 8: the person paying or lending

Name and address of the person who paid the wages or supplied the funds, and the projects or contracts for which they did so.

Items 9 to 12: wages paid directly

Income tax, FICA tax and railroad retirement tax required to be withheld, the portion the employer paid, and the resulting liability.

Items 13 to 18: funds supplied for wages

The amount supplied, the taxes required to be withheld, the portion the employer paid, and a liability equal to the lesser of the unpaid balance or 25 percent of item 13.

Items 19 to 23: total liability

The two liabilities added together, interest liability and the total liability.

Signatures

Signature, title and date of the lender, surety or other person under penalties of perjury, and of a preparer if other than above.

How to fill out Form 4219

  1. 1

    Item 4

    Enter the last day of the calendar quarter during which the wages were actually paid. If funds were supplied, use the quarter in which the employer actually paid the wages.

  2. 2

    Item 9

    Enter in 9a, 9b and 9c the employee taxes required to be withheld as if the wages were paid by the employer.

  3. 3

    Item 13

    Enter the gross amount, without reduction for withholding taxes, supplied to the employer for paying wages that were actually paid during the quarter.

  4. 4

    Item 14

    Enter in 14a, 14b and 14c the employee taxes required to be withheld by the employer from wages paid during the quarter with the funds supplied.

  5. 5

    Items 12 and 18

    Carry item 12 to item 19. For item 18, enter the lesser of item 17 or 25 percent of item 13 and carry it to item 20.

  6. 6

    Item 22

    The form says interest is charged if the liability is paid after the due dates of the employer's federal employment tax return, at the annual rate set under section 6621(a), subject to section 6621(b).

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Where to file, payment and copies

Where to file

The form says to file Form 4219 with the IRS office where the employer for whom wages were paid or funds were supplied files federal employment tax returns.

Payment

Include a check or money order for the amount in item 23, payable to the United States Treasury. Payment by either the employer or the lender, surety or other person satisfies the liability.

Timing

The form says that to avoid the accumulation of interest, payment is made on or before the due date of the employer's (borrower's) federal employment tax return.

Copies

File it in duplicate, with a separate Form 4219 for each employer and each calendar quarter for which liability under section 3505 is incurred.

If nobody pays

If neither the employer nor the lender, surety or other person pays these taxes, the form says the U.S. Government may collect the unpaid amount by appropriate civil action.

Related forms

Who files Form 4219?

  • Lenders, sureties and other persons

    The form says to file it if you paid wages directly to employees of another employer, or supplied funds for paying them, and incurred liability under section 3505 for taxes required to be withheld.

  • Funds supplied with notice

    Section 3505(b), as quoted on the form, applies when funds are supplied with actual notice or knowledge that the employer does not intend, or will not be able, to pay or deposit the withheld taxes on time.

  • A preparer, if any

    The form has a second signature line for a preparer other than the lender, surety or other person, with title and date.

  • Not for the employer itself

    The form says an employer within the meaning of section 3401(d)(1) or (d)(2) does not use Form 4219 to report income tax withholding. The employer files its own employment tax return.

The form is completed by a third party that paid or financed another employer's payroll, not by the employer or its employees.

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Questions about Form 4219

Who files Form 4219?

A lender, surety or other person who paid wages directly to another employer's employees, or supplied funds for paying them, and incurred liability under section 3505 of the Internal Revenue Code.

Does the employer use Form 4219?

No. The form says an employer within the meaning of section 3401(d)(1) or (d)(2) does not use it to report income tax withholding. The employer stays liable for taxes not paid and files its employment tax return.

Is there a cap on the liability?

For funds supplied for paying wages, the form says the liability under section 3505(b) cannot exceed 25% of the amount supplied for that purpose.

Does it cover the employer's share of FICA?

No. The form says the liability does not extend to the employer's taxes under the Federal Insurance Contributions Act or the Railroad Retirement Tax Act.

Do ordinary business loans count?

The form says section 3505(b) does not apply to ordinary working capital loans to employers, even when it is known that part of the funds will be used to pay wages.

How many copies are filed?

A separate Form 4219, in duplicate, for each employer and each calendar quarter in which liability is incurred.