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pdfVersion B, Cycle 8
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Form
940 for 2011:
Employer's Annual Federal Unemployment (FUTA) Tax Return
Department of the Treasury — Internal Revenue Service
(EIN)
—
Employer identification number
850111
OMB No. 1545-0028
Type of Return
(Check all that apply.)
Name (not your trade name)
a. Amended
Trade name (if any)
b. Successor employer
Address
c. No payments to employees in
2011
d. Final: Business closed or
stopped paying wages
Number
Street
Suite or room number
City
State
Prior-year forms are available at
www.irs.gov/form940.
ZIP code
Read the separate instructions before you complete this form. Please type or print within the boxes.
Part 1:
Tell us about your return. If any line does NOT apply, leave it blank.
1a
1b
If you had to pay state unemployment tax in one state only, enter the state abbreviation .
1a
If you had to pay state unemployment tax in more than one state, you are a multi-state
employer . . . . . . . . . . . . . . . . . . . . . . . . . . .
1b
2
If you paid wages in a state that is subject to CREDIT REDUCTION .
Part 2:
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Check here. Complete
Schedule A (Form 940), Part 2.
2
Determine your FUTA tax before adjustments for 2011. If any line does NOT apply, leave it blank.
3
Total payments to all employees .
4
Payments exempt from FUTA tax .
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DRAFT AS OF
August 17, 2011
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4
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4c
Check all that apply: 4a
Fringe benefits
Group-term life insurance
4b
4d
Total of payments made to each employee in excess of
$7,000 . . . . . . . . . . . . . . . .
5
4e
Retirement/Pension
Dependent care
Other
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6
Subtotal (line 4 + line 5 = line 6) .
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7a
Total taxable FUTA wages (line 3 – line 6 = line 7a) (see instructions) .
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7a
7b
Line 7a FUTA wages paid before 7/1/2011
7b
7d
Line 7a FUTA wages paid after 6/30/2011
7d
8
FUTA tax before adjustments (line 7c + 7e = line 8)
Part 3:
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x .006 = 7e
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8
Determine your adjustments. If any line does NOT apply, leave it blank.
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11
If credit reduction applies, enter the amount from Schedule A (Form 940), line 3
Part 4:
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11
Determine your FUTA tax and balance due or overpayment for 2011. If any line does NOT apply, leave it blank.
12
Total FUTA tax after adjustments (lines 8 + 9 + 10 + 11 = line 12) .
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FUTA tax deposited for the year, including any overpayment applied from a prior year
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14
Balance due (If line 12 is more than line 13, enter the excess on line 14.)
• If line 14 is more than $500, you must deposit your tax.
• If line 14 is $500 or less, you may pay with this return. (see instructions) .
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x .008 = 7c
If ALL of the taxable FUTA wages you paid were excluded from state unemployment tax,
multiply line 7a by .054 (line 7a × .054 = line 9). Go to line 12 . . . . . . . . . .
9
If SOME of the taxable FUTA wages you paid were excluded from state unemployment tax,
OR you paid ANY state unemployment tax late (after the due date for filing Form 940),
complete the worksheet in the instructions. Enter the amount from line 7 of the worksheet . .
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Check here.
Complete Schedule A.
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Overpayment (If line 13 is more than line 12, enter the excess on line 15 and check a box
below.) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
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▶ You MUST complete both pages of this form and SIGN it.
Check one:
Apply to next return.
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Send a refund.
Next ■▶
For Privacy Act and Paperwork Reduction Act Notice, see the back of Form 940-V, Payment Voucher.
Cat. No. 11234O
Form
940
(2011)
Version B, Cycle 8
850211
Name (not your trade name)
Employer identification number (EIN)
Report your FUTA tax liability by quarter only if line 12 is more than $500. If not, go to Part 6.
Part 5:
16 Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had no liability for
a quarter, leave the line blank.
17
16a 1st quarter (January 1 – March 31) .
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16a
16b 2nd quarter (April 1 – June 30) .
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16b
16c 3rd quarter (July 1 – September 30)
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16c
16d 4th quarter (October 1 – December 31)
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16d
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Total tax liability for the year (lines 16a + 16b + 16c + 16d = line 17) 17
Part 6:
Total must equal line 12.
May we speak with your third-party designee?
Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions
for details.
Yes.
Designee’s name and phone number
Select a 5-digit Personal Identification Number (PIN) to use when talking to IRS
No.
Part 7:
DRAFT AS OF
August 17, 2011
Sign here. You MUST complete both pages of this form and SIGN it.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the
best of my knowledge and belief, it is true, correct, and complete, and that no part of any payment made to a state unemployment
fund claimed as a credit was, or is to be, deducted from the payments made to employees. Declaration of preparer (other than
taxpayer) is based on all information of which preparer has any knowledge.
✗
Sign your
name here
Date
Print your
name here
Print your
title here
/
Best daytime phone
/
Paid preparer use only
Preparer’s name
PTIN
Preparer’s
signature
Date
Firm’s name (or yours
if self-employed)
EIN
Address
Phone
City
Page 2
Check if you are self-employed
State
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ZIP code
Form 940 (2011)
Version B, Cycle 8
Form 940-V,
Payment Voucher
What Is Form 940-V?
Form 940-V is a transmittal form for your check or
money order. Using Form 940-V allows us to process
your payment more accurately and efficiently. If you
have any balance due of $500 or less on your 2011
Form 940, fill out Form 940-V and send it with your
check or money order.
Note. If your balance is more than $500, see When
Must You Deposit Your FUTA Tax? in the Instructions
for Form 940.
How Do You Fill Out Form 940-V?
Type or print clearly.
Box 1. Enter your employer identification number (EIN).
Do not enter your social security number (SSN). If you do
not have an EIN, you may apply for one online. Go to
IRS.gov and click on the Apply for an Employer
Identification Number (EIN) Online link. You may also
apply for an EIN by calling 1-800-829-4933, or you can
fax or mail Form SS-4, Application for Employer
Identification Number. If you have not received your EIN
by the due date of Form 940, write “Applied For” and the
date you applied in this entry space.
Box 2. Enter the amount of your payment. Be sure to
put dollars and cents in the appropriate spaces.
Box 3. Enter your business name and complete
address exactly as they appear on your Form 940.
How Should You Prepare Your Payment?
• Make your check or money order payable to the United
States Treasury. Do not send cash.
• On the memo line of your check or money order,
write:
— your EIN,
— Form 940, and
— 2011.
• Carefully detach Form 940-V along the dotted line.
• Do not staple your payment to the voucher.
• Mail your 2011 Form 940, your payment, and Form
940-V to the address shown in the table in the
Instructions for Form 940.
DRAFT AS OF
August 17, 2011
Form
▼
Detach Here and Mail With Your Payment and Form 940.
940-V
Department of the Treasury
Internal Revenue Service
1 Enter your employer identification number (EIN).
▼
Payment Voucher
▶ Do
2011
Dollars
Enter the amount of your payment. ▶
3
OMB No. 1545-0028
not staple or attach this voucher to your payment.
2
Enter your business name (individual name if sole proprietor).
Enter your address.
Enter your city, state, and ZIP code.
✃
✁
Cents
Version B, Cycle 8
Form 940 (2011)
Privacy Act and Paperwork Reduction Act Notice.
We ask for the information on this form to carry out the
Internal Revenue laws of the United States. We need it
to figure and collect the right amount of tax. Chapter
23, Federal Unemployment Tax Act, of Subtitle C,
Employment Taxes, of the Internal Revenue Code
imposes a tax on employers with respect to employees.
This form is used to determine the amount of the tax that
you owe. Section 6011 requires you to provide the
requested information if you are liable for FUTA tax under
section 3301. Section 6109 requires you to provide your
identification number. If you fail to provide this
information in a timely manner or provide a false or
fraudulent form, you may be subject to penalties and
interest.
You are not required to provide the information
requested on a form that is subject to the Paperwork
Reduction Act unless the form displays a valid OMB
control number. Books and records relating to a form or
instructions must be retained as long as their contents
may become material in the administration of any Internal
Revenue law.
Generally, tax returns and return information are
confidential, as required by section 6103. However,
section 6103 allows or requires the IRS to disclose or
give the information shown on your tax return to others
as described in the Code. For example, we may disclose
your tax information to the Department of Justice for civil
and criminal litigation, and to cities, states, the District of
Columbia, and U.S. commonwealths and possessions to
administer their tax laws. We may also disclose this
information to other countries under a tax treaty, to
federal and state agencies to enforce federal non-tax
criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism.
The time needed to complete and file this form will vary
depending on individual circumstances. The estimated
average time is:
Recordkeeping . . . . . . . . . . 9 hr., 19 min.
Learning about the law or the form
. . 1 hr., 23 min.
Preparing, copying, assembling, and
sending the form to the IRS . . . . . 1 hr., 36 min.
If you have comments concerning the accuracy of
these time estimates or suggestions for making Form 940
simpler, we would be happy to hear from you. You can
email us at [email protected]. Enter “Form 940” on the
subject line. Or write to: Internal Revenue Service, Tax
Products Coordinating Committee, SE:W:CAR:MP:T:SP,
1111 Constitution Avenue, NW, IR-6526, Washington,
DC 20224. Do not send Form 940 to this address.
Instead, see Where Do You File? in the Instructions for
Form 940.
DRAFT AS OF
August 17, 2011
| File Type | application/pdf |
| File Title | Summary of Changes |
| Author | 94vdb |
| File Modified | 2011-09-07 |
| File Created | 2011-09-07 |