Form 944 Employer's ANNUAL Federal Tax Return

Form

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944 for 2009:

Employer’s ANNUAL Federal Tax Return
Department of the Treasury — Internal Revenue Service

(77)

OMB No. 1545-2007

Who Must File Form 944

—

Employer identification number (EIN)
Name (not your trade name)
Trade name (if any)
Address

Number

Street

You must file annual
Form 944 instead of filing
quarterly Forms 941
only if the IRS notified
you in writing.

Suite or room number

City

State

ZIP code

Read the separate instructions before you complete Form 944. Type or print within the boxes.
Part 1: Answer these questions for 2009.

1

Wages, tips, and other compensation

1

2

Income tax withheld from wages, tips, and other compensation

2

.
.

3
4

If no wages, tips, and other compensation are subject to social security or Medicare tax
Taxable social security and Medicare wages and tips:
Column 1
Column 2

3

Check and go to line 5.

4a Taxable social security wages
4b Taxable social security tips
4c Taxable Medicare wages & tips

.
.
.

 .124 =
 .124 =
 .029 =

.
.
.

4d Total social security and Medicare taxes (Column 2, lines 4a + 4b + 4c = line 4d)
5

Total taxes before adjustments (lines 2 + 4d = line 5)

5

6

Current year’s adjustments (see instructions)

6

7

Total taxes after adjustments. Combine lines 5 and 6

7

8

Advance earned income credit (EIC) payments made to employees

8

9

Total taxes after adjustment for advance EIC (line 7 – line 8 = line 9)

9

10

.
.
.
.
.
.
.
.

4d

Total deposits for this year, including overpayment applied from a prior year and
10
overpayment applied from Form 944-X or Form 941-X

11a COBRA premium assistance payments (see instructions)
11b Number of individuals provided COBRA premium assistance
reported on line 11a

11a
11b

.
.

12

12

Add lines 10 and 11a

13

Balance due. If line 9 is more than line 12, write the difference here. For information on how to
13
pay, see the instructions

14

Overpayment. If line 12 is more than line 9, write the difference here

14

.

Check one

Apply to next return.
Send a refund.

 You MUST complete both pages of Form 944 and SIGN it.
Next 
For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher.

Cat. No. 39316N

Form

944

(2009)

Form

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944 for 2009:

Employer’s ANNUAL Federal Tax Return
Department of the Treasury — Internal Revenue Service

(77)

OMB No. 1545-2007

Who Must File Form 944
You must file annual
Form 944 instead of filing
quarterly Forms 941
only if the IRS notified
you in writing.

Read the separate instructions before you complete Form 944. Type or print within the boxes.
Part 1: Answer these questions for 2009.

1

Wages, tips, and other compensation

1

2

Income tax withheld from wages, tips, and other compensation

2

.
.

3
4

If no wages, tips, and other compensation are subject to social security or Medicare tax
Taxable social security and Medicare wages and tips:
Column 1
Column 2

3

Check and go to line 5.

4a Taxable social security wages
4b Taxable social security tips
4c Taxable Medicare wages & tips

.
.
.

 .124 =
 .124 =
 .029 =

.
.
.

4d Total social security and Medicare taxes (Column 2, lines 4a + 4b + 4c = line 4d)
5

Total taxes before adjustments (lines 2 + 4d = line 5)

5

6

Current year’s adjustments (see instructions)

6

7

Total taxes after adjustments. Combine lines 5 and 6

7

8

Advance earned income credit (EIC) payments made to employees

8

9

Total taxes after adjustment for advance EIC (line 7 – line 8 = line 9)

9

10

.
.
.
.
.
.
.
.

4d

Total deposits for this year, including overpayment applied from a prior year and
10
overpayment applied from Form 944-X or Form 941-X

11a COBRA premium assistance payments (see instructions)
11b Number of individuals provided COBRA premium assistance
reported on line 11a

11a
11b

.
.

12

12

Add lines 10 and 11a

13

Balance due. If line 9 is more than line 12, write the difference here. For information on how to
13
pay, see the instructions

14

Overpayment. If line 12 is more than line 9, write the difference here

14

.

Check one

Apply to next return.
Send a refund.

 You MUST complete both pages of Form 944 and SIGN it.
Next 
For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher.

Cat. No. 39316N

Form

944

(2009)

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Name (not your trade name)

Employer identification number (EIN)

Part 2: Tell us about your tax liability for 2009.
15 Check one:

Line 9 is less than $2,500. Go to Part 3.

Line 9 is $2,500 or more. Enter your tax liability for each month. If you are a semiweekly depositor or you accumulate
$100,000 or more of liability on any day during a deposit period, you must complete Form 945-A instead of the boxes below.
Apr.
Jul.
Oct.
Jan.
15a
Feb.
15b
Mar.
15c

.
.
.

15d

15g

15j

May

Aug.

15e

15h

Nov.

15k

Jun.

Sep.

15f

15i

Dec.

15l

Total liability for year. Add lines 15a through 15l. Total must equal line 9.

15m

.
.
.
.

If you made deposits of taxes reported on this form, write the state abbreviation for the state where you
made your deposits OR write MU if you made your deposits in multiple states.

16

Part 3: Tell us about your business. If question 17 does NOT apply to your business, leave it blank.
17 If your business has closed or you stopped paying wages...
Check here and enter the final date you paid wages.

/

/

Part 4: 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 5: Sign here. You MUST complete both pages of Form 944 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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Print your
name here

Sign your
name here

Date

Print your
title here
/

Best daytime phone (

/

Paid preparer’s use only

Preparer’s
SSN/PTIN

Preparer’s signature

Date

Firm’s name (or yours
if self-employed)

EIN

Address

Phone

Page

State

2

–

Check if you are self-employed

Preparer’s name

City

)

/

(

/

)

–

ZIP code

Form

944

(2009)

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Form 944-V,
Payment Voucher
Purpose of Form

Complete Form 944-V, Payment Voucher, if you are
making a payment with Form 944, Employer’s ANNUAL
Federal Tax Return. We will use the completed voucher
to credit your payment more promptly and accurately,
and to improve our service to you.
If you have your return prepared by a third party and
make a payment with that return, please provide this
payment voucher to the return preparer.

Caution. Use Form 944-V when making any payment
with Form 944. However, if you pay an amount with
Form 944 that should have been deposited, you may
be subject to a penalty. See Deposit Penalties in
section 11 of Pub. 15 (Circular E).

Specific Instructions

Making Payments With Form 944

Box 1—Employer identification number (EIN). If you
do not have an EIN, apply for one on Form SS-4,
Application for Employer Identification Number, and
write “Applied For” and the date you applied in this
entry space.

To avoid a penalty, make your payment with your 2009
Form 944 only if one of the following applies.

Box 2—Amount paid. Enter the amount paid with
Form 944.

● Your net taxes for the year (line 9 on Form 944) are
less than $2,500 and you are paying in full with a
timely filed return.

Box 3—Name and address. Enter your name and
address as shown on Form 944.

● You already deposited the taxes you owed for the
first, second, and third quarters of 2009, and the tax
you owe for the fourth quarter of 2009 is less than
$2,500, and you are paying, in full, the tax you owe for
the fourth quarter of 2009 with a timely filed return.
● You are a monthly schedule depositor making a
payment in accordance with the Accuracy of Deposits
Rule. See section 11 of Pub. 15 (Circular E),
Employer’s Tax Guide, for details. In this case, the
amount of your payment may be $2,500 or more.

● Enclose your check or money order made payable to
the “United States Treasury” and write your EIN, “Form
944,” and “2009” on your check or money order. Do
not send cash. Do not staple Form 944-V or your
payment to Form 944 (or to each other).
● Detach Form 944-V and send it with your payment
and Form 944 to the address provided in the
Instructions for Form 944.
Note. You must also complete the entity information
above Part 1 on Form 944.

Otherwise, you must deposit your payment at an
authorized financial institution or by using the
Electronic Federal Tax Payment System (EFTPS). See
section 11 of Pub. 15 (Circular E) for deposit
instructions. Do not use Form 944-V to make federal
tax deposits.





Payment Voucher

OMB No. 1545-2007

Do not staple this voucher or your payment to Form 944.

2009

Form

Department of the Treasury
Internal Revenue Service (77)

1 Enter your employer identification
number (EIN).

✃

✁
944-V

Detach Here and Mail With Your Payment and Form 944.



Dollars

2

Enter the amount of your payment.



3 Enter your business name (individual name if sole proprietor).

Enter your address.

Enter your city, state, and ZIP code.

Cents

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Form 944-V,
Payment Voucher
Purpose of Form

Complete Form 944-V, Payment Voucher, if you are
making a payment with Form 944, Employer’s ANNUAL
Federal Tax Return. We will use the completed voucher
to credit your payment more promptly and accurately,
and to improve our service to you.
If you have your return prepared by a third party and
make a payment with that return, please provide this
payment voucher to the return preparer.

Making Payments With Form 944

To avoid a penalty, make your payment with your 2009
Form 944 only if one of the following applies.
● Your net taxes for the year (line 9 on Form 944) are
less than $2,500 and you are paying in full with a
timely filed return.
● You already deposited the taxes you owed for the
first, second, and third quarters of 2009, and the tax
you owe for the fourth quarter of 2009 is less than
$2,500, and you are paying, in full, the tax you owe for
the fourth quarter of 2009 with a timely filed return.
● You are a monthly schedule depositor making a
payment in accordance with the Accuracy of Deposits
Rule. See section 11 of Pub. 15 (Circular E),
Employer’s Tax Guide, for details. In this case, the
amount of your payment may be $2,500 or more.



Caution. Use Form 944-V when making any payment
with Form 944. However, if you pay an amount with
Form 944 that should have been deposited, you may
be subject to a penalty. See Deposit Penalties in
section 11 of Pub. 15 (Circular E).

Specific Instructions

● Enter on the voucher the amount paid with
Form 944.
● Enclose your check or money order made payable to
the “United States Treasury.” Be sure also to enter
your EIN, “Form 944,” and “2009” on your check or
money order. Do not send cash. Do not staple Form
944-V or your payment to Form 944 (or to each other).
● Detach Form 944-V and send it with your payment
and Form 944 to the address in the Instructions for
Form 944. Do not send a photocopy of Form 944-V
because your payment may be misapplied or delayed.
If any of the preprinted information is incorrect, make
changes on the top of Form 944, not on the payment
voucher. If you change any of the preprinted
information on the voucher, your payment may be
misapplied or delayed.

Detach Here and Mail With Your Payment and Form 944.


Department of the Treasury
Internal Revenue Service

✃

✁

Otherwise, you must deposit your payment at an
authorized financial institution or by using the
Electronic Federal Tax Payment System (EFTPS). See
section 11 of Pub. 15 (Circular E) for deposit
instructions. Do not use Form 944-V to make federal
tax deposits.


OMB No. 1545-2007

2009

Form 944-V, Payment Voucher

Do not staple this voucher or your payment to Form 944.

Enter the amount of
your payment

Dollars


Cents

Form 944 (2009)

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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. Subtitle C,
Employment Taxes, of the Internal Revenue Code
imposes employment taxes on wages, including income
tax withholding. This form is used to determine the
amount of the taxes that you owe. Section 6011
requires you to provide the requested information if the
tax is applicable to you. Section 6109 requires filers and
paid preparers to provide their identification numbers. If
you fail to provide this information in a timely manner,
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 for use in
administering their tax laws. We may also disclose this
information to other countries under a tax treaty, to
federal and state agencies to enforce federal nontax
criminal laws, or to federal law enforcement and
intelligence agencies to combat terrorism.
The time needed to complete and file Form 944 will
vary depending on individual circumstances. The
estimated average time is:

Recordkeeping
Learning about the law or the form
Preparing the form
Copying, assembling, and sending
the form to the IRS

12 hrs., 12 min.
40 min.
1 hr., 49 min.
16 min.

If you have comments concerning the accuracy of
these time estimates or suggestions for making Form
944 simpler, we would be happy to hear from you. You
can write to: Internal Revenue Service, Tax Products
Coordinating Committee, SE:W:CAR:MP:T:T:SP, 1111
Constitution Ave. NW, IR-6526, Washington, DC
20224. Do not send Form 944 to this address. Instead,
see Where Should You File? on page 4 of the
Instructions for Form 944.

Printed on recycled paper