Page 2 of the 2021 revision Form CT-1 is shown with all field designators.Part I: Railroad Retirement Taxes (continued)Line 30, Qualified sick leave wages for leave taken before April 1, 2021, field 19SCS.Line 31, Qualified health plan expenses for sick leave allocable to compensation reported on line 30, field 19HP1.Line 32, Qualified family leave wages for leave taken before April 1, 2021, field 19SCF.Line 33, Qualified health plan expenses allocable to compensation reported on line 32, field 19HP2.Line 34, Qualified compensation for the employee retention credit, field 19WRC.Line 35, Qualified health plan expenses for the employee retention credit, field 19HPR.Line 36, Qualified sick leave wages for leave taken after March 31, 2021, and before October 1, 2021, field 19QSW.Line 37, Qualified health plan expenses allocable to qualified sick leave wages reported on line 36, field 19QHE.Line 38, Amounts under certain collectively bargained agreements allocable to qualified sick leave wages reported on line 36, field 19CBA.Line 39, Qualified family leave wages for leave taken 31, 2021, field 19QFW.Line 40, Qualified health plan expenses allocable to qualified family leave wages reported on line 39, field 19HE1.Line 41, Amounts under certain collectively bargained agreements allocable to qualified family leave wages reported on line 39, field HE2.Line 42, Third quarter employee retention credit recovery startup amount, field 19RC3.Line 43, Fourth quarter employee retention credit recovery startup amount, field 19RC4.Part II: Record of Railroad Retirement Tax LiabilityThere is a table for a monthly summary of liability. This information is not transcribed.Below the table is an area for third party designee, with spaces for the designee’s name, phone number and Personal Identification Number, field 01CBP. There are also yes or no check boxes for allowing another person to discuss this return with the IRS.Below that is a signature area with spaces for signature, printed name and title, date and PTIN (field 01PSN).Below that, and the last item on the page, is a Paid Preparer Use Only area with spaces for the preparer’s name, signature, date and a box to check if self-employed. There are spaces for a firm’s name, address, EIN (field 01PEN) and phone number (field 01PTN).