Form 940 - Employer'S Annual Federal Unemployment (Futa) Tax Return - 2012 Page 3

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Form 940-V,
Payment Voucher
Purpose of Form
Specific Instructions
Box 1—Employer Identification Number (EIN). If you do
Complete Form 940-V, Payment Voucher, if you are
not have an EIN, you may apply for one online. Go to
making a payment with Form 940, Employer's Annual and click on the Apply for an EIN Online link
Federal Unemployment (FUTA) Tax Return. We will use
under Tools. You may also apply for an EIN by calling
the completed voucher to credit your payment more
1-800-829-4933, or you can fax or mail Form SS-4,
promptly and accurately, and to improve our service to
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
Making Payments With Form 940
To avoid a penalty, make your payment with your 2012
Box 2—Amount paid. Enter the amount paid with
Form 940 only if your FUTA tax for the fourth quarter
Form 940.
(plus any undeposited amounts from earlier quarters) is
Box 3—Name and address. Enter your name and
$500 or less. If your total FUTA tax after adjustments
address as shown on Form 940.
(Form 940, line 12) is more than $500, you must make
deposits by electronic funds transfer. See When Must
• Enclose your check or money order made payable to
You Deposit Your FUTA Tax? in the Instructions for Form
the "United States Treasury." Be sure to enter your EIN,
940. Also see sections 11 and 14 of Pub. 15 (Circular E),
"Form 940," and "2012" on your check or money order.
Employer's Tax Guide, for more information about
Do not send cash. Do not staple Form 940-V or your
payment to Form 940 (or to each other).
Caution. Use Form 940-V when making any payment with
• Detach Form 940-V and send it with your payment and
Form 940. However, if you pay an amount with Form 940
Form 940 to the address provided in the Instructions for
that should have been deposited, you may be subject to a
Form 940.
penalty. See Deposit Penalties in section 11 of
Pub. 15 (Circular E).
Note. You must also complete the entity information
above Part 1 on Form 940.
Detach Here and Mail With Your Payment and Form 940.
Payment Voucher
OMB No. 1545-0028
Department of the Treasury
Do not staple or attach this voucher to your payment.
Internal Revenue Service
1 Enter your employer identification number (EIN).
Enter the amount of your payment.
Make your check or money order payable to “United States Treasury”
3 Enter your business name (individual name if sole proprietor).
Enter your address.
Enter your city, state, and ZIP code.


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