Form 940 preprinted voucher

Form 940-V,
Payment Voucher
Purpose of Form

Specific Instructions

Complete Form 940-V, Payment Voucher, if you are
making a payment with Form 940, Employer's Annual
Federal Unemployment (FUTA) Tax Return. We will use
the completed voucher to credit your payment more
promptly and accurately, and to improve our service to
you.

Box 1—Employer Identification Number (EIN). If you do
not have an EIN, you may apply for one online. Go to
IRS.gov and click on the Apply for an EIN Online link
under Tools. 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—Amount paid. Enter the amount paid with
Form 940.
Box 3—Name and address. Enter your name and
address as shown on Form 940.

To avoid a penalty, make your payment with your 2012
Form 940 only if your FUTA tax for the fourth quarter
(plus any undeposited amounts from earlier quarters) is
$500 or less. If your total FUTA tax after adjustments
(Form 940, line 12) is more than $500, you must make
deposits by electronic funds transfer. See When Must
You Deposit Your FUTA Tax? in the Instructions for Form
940. Also see sections 11 and 14 of Pub. 15 (Circular E),
Employer's Tax Guide, for more information about
deposits.
Caution. Use Form 940-V when making any payment with
Form 940. However, if you pay an amount with Form 940
that should have been deposited, you may be subject to a
penalty. See Deposit Penalties in section 11 of
Pub. 15 (Circular E).

Form



d

• Enclose your check or money order made payable to
the "United States Treasury." Be sure to enter your EIN,
"Form 940," and "2012" on your check or money order.
Do not send cash. Do not staple Form 940-V or your
payment to Form 940 (or to each other).
• Detach Form 940-V and send it with your payment and
Form 940 to the address provided in the Instructions for
Form 940.
Note. You must also complete the entity information
above Part 1 on Form 940.

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).

d

Payment Voucher
a Do

2

2012
Dollars

Make your check or money order payable to “United States Treasury”

3

OMB No. 1545-0028

not staple or attach this voucher to your payment.

Enter the amount of your payment. a
Enter your business name (individual name if sole proprietor).
Enter your address.

Enter your city, state, and ZIP code.



Making Payments With Form 940

Cents

Form 940 (2012)

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:M:S, 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.