Form Schedule A (Form 9 Schedule A (Form 9 Multi-State Employer and Credit Reduction Information

Version B, Cycle 2
Fillable Field Color: Black; Checkmark=Cross

Schedule A (Form 940) for 2011:

860311

Multi-State Employer and Credit Reduction Information

OMB No. 1545-0028

Department of the Treasury — Internal Revenue Service

DRAFT AS OF
August 16, 2011

Employer identification number (EIN)

—

Name (not your trade name)

About this schedule:

• You must fill out Schedule A (Form 940) if you were required to pay your state unemployment tax in more than one state or if you
paid wages in any state that is subject to credit reduction.
• File Schedule A (Form 940) as an attachment to your Form 940.

Part I

Part II

Fill out this part if you were required to pay state unemployment taxes in more than on state (including
more information,
read
the and
Instructions
forVirgin
Schedule
A (FormIf940)
the back.
the District For
of Columbia,
Puerto
Rico,
the U.S.
Islands).
anyon
states
do NOT apply to you,
leave them blank. Check the box of every state in which you were required to pay state unemployment
tax this year. For a list of state names and their abbreviations, see the instructions for Schedule A (Form 940).
Fill out this part to tell us about wages you paid in any state (including the District of Columbia, Puerto
Rico, and the U.S. Virgin Islands) that is subject to credit reduction. If any lines do NOT apply, leave
them blank.

Part I Line 1
Postal
Abbreviation
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO

Part 2 Line 2a
Total FUTA
Reduction
Taxable Wage
Rate
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
Sub total line 2a

3 Total credit reduction (Lines 2b + 2d + 2f = line 3)

Total
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
.

.

.

Part 1 Line 1
Postal
Abbreviation
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
VI
UT
VA
WA
WV
WI
WY

Part 2 Line 2b
Reduction
Total FUTA
Rate
Taxable Wage
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
0.00
x.00x
Sub total line 2b
Total credit reduction (Lines 2a + 2b)

.

.

.

.

.

.

.

.

.

.

.

3

Total

.

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

Enter the amount from line 3 onto line 11 of Form 940.
For Privacy Act and Paperwork Reduction Act Notice, see back of Form 940-V.

Cat. No. 16997C

Schedule A (Form 940) 2011

Version B, Cycle 2

Instructions for Schedule A (Form 940) for 2011:

860411

Multi-State Employer and Credit Reduction Information
Specific Instructions: Completing Schedule A (Form 940)

Part 1: Fill out this part if you were required to pay
state unemployment taxes in more than one
state (including the District of Columbia,
Puerto Rico, and the U.S. Virgin Islands).

Part 2: Fill out this part to tell us about wages you paid
in any state (including the District of Columbia,
Puerto Rico, and the U.S. Virgin Islands) that is
subject to credit reduction.

1. Check the box for every state (including the District of
Columbia, Puerto Rico, and the U.S. Virgin Islands) in
which you were required to pay state unemployment
taxes this year.

2. You are subject to credit reduction if you paid wages in
any state listed that has a credit reduction rate.

Note. Make sure that you have applied for a state
unemployment number for your business. If you do not have
an unemployment account number from a state in which you
paid wages, contact the state office to receive one. For a
listing of states and contact information, see page 12 of the
2011 Instructions for Form 940.
For ease of reference, here is a list of the states and their
2-letter postal abbreviations.
State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri

Postal
Abbreviation

State

Postal
Abbreviation

If you paid wages in any states that are subject to credit
reduction, find the lines where the states are listed.
In the first box, enter the total taxable FUTA wages that you
paid in that state. (Note that the FUTA wage base for all
states is $7,000.) Do not use your state unemployment
wages here.
Then multiply the total taxable FUTA wages by the credit
reduction rate.
Enter your total in the box at the end of the line.
3. Total credit reduction

DRAFT AS OF
August 16, 2011
AL
AK
AZ
AR
CA
CO
CT
DE
DC

Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota

MT
NE
NV
NH
NJ
NM
NY
NC
ND

FL
GA
HI
ID
IL
IN
IA
KS
KY

Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee

OH
OK
OR
PA
PR
RI
SC
SD
TN

LA
ME
MD
MA
MI
MN
MS
MO

Texas
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

TX
VI
UT
VT
VA
WA
WV
WI
WY

To calculate the total credit reduction,
line 2a
+ line 2b
line 3

Then enter the amount from line 3 onto line 11 of Form 940.
Example:

You paid $20,000 in wages to each of 3 employees in State A. State
A is subject to credit reduction at a rate of .003 (.3%). Because you
paid wages in a state that is subject to credit reduction, you must fill
out Part 2 of Schedule A (Form 940).
Total payments to all employees subject to unemployment
insurance in State A
.
.
.
.
.
.
.
$60,000

Payments exempt from FUTA tax

.

.

.

.

.

Total payments made to each employee in
excess of $7,000
.
.
.
.
.

.

.

.

$39,000

Total taxable FUTA wages you paid in State A listed on line
(3 × $7,000)
.
.
.
.
.
.
.
.
.
$21,000
Credit reduction rate for State A
Total credit reduction (line 2b)

.

.

.

.

.

.

.003

.

.

.

.

.

$63

Caution. Do not include on line 2a or 2b wages in excess of the
$7,000 wage base for each employee subject to unemployment
insurance in the credit reduction state. The credit reduction applies
only to taxable FUTA wages.
In this case, you would write $63.00 on line 3 and then enter that
amount on line 11 of Form 940.

Attach Schedule A (Form 940) to Form 940 when you file
your return.

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