943-A
Agricultural Employer’s Record of
Form
Federal Tax Liability
OMB No. 1545-0035
(Rev. May 2006)
Department of the Treasury
File with Form 943.
Internal Revenue Service
Name (as shown on Form 943)
Employer identification number (EIN)
You must complete this form if you are required to deposit on a semiweekly schedule, or if your tax liability during any month
was $100,000 or more. Show tax liability here, not deposits. (The IRS gets deposit data from FTD coupons or EFTPS.)
January Tax Liability
February Tax Liability
March Tax Liability
1
16
1
16
1
16
2
17
2
17
2
17
3
18
3
18
3
18
4
19
4
19
4
19
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20
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20
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20
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12
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12
27
13
28
13
28
13
28
14
29
14
29
14
29
15
30
15
15
30
31
31
A Total liability for month
B Total liability for month
C Total liability for month
April Tax Liability
May Tax Liability
June Tax Liability
1
16
1
16
1
16
2
17
2
17
2
17
3
18
3
18
3
18
4
19
4
19
4
19
5
20
5
20
5
20
6
21
6
21
6
21
7
22
7
22
7
22
8
23
8
23
8
23
9
24
9
24
9
24
10
25
10
25
10
25
11
26
11
26
11
26
12
27
12
27
12
27
13
28
13
28
13
28
14
29
14
29
14
29
15
30
15
30
15
30
31
D Total liability for month
E Total liability for month
F Total liability for month
complete and file Form 943-A with Form 943, the IRS may
General Instructions
propose an “averaged” failure-to-deposit penalty. See
Purpose of form. Use this form to report your tax liability
Deposit Penalties in section 7 of Pub. 51 (Circular A) for more
(federal income tax withheld plus both employee and
information.
employer social security and Medicare taxes minus any
Who must file. Semiweekly schedule depositors are required
advance earned income credit payments) on a daily basis.
to complete and file Form 943-A with Form 943, Employer’s
Do not show federal tax deposits here.
Annual Tax Return for Agricultural Employees. Monthly
Do not report taxes on wages paid to nonfarm workers on this
schedule depositors who accumulate $100,000 or more
form. Taxes on wages paid to nonfarm workers are reported on
during any month become semiweekly schedule depositors
Form 941/941-SS, Employer’s QUARTERLY Federal Tax Return,
on the next day and must also complete and file Form
or Form 944/944-SS, Employer’s ANNUAL Federal Tax Return.
943-A. Do not file this form if you were a monthly schedule
Do not attach Form 943-A to your Form 941/941-SS or Form
depositor for the entire year or if your net taxes for the year
944/944-SS. Instead, use Schedule B (Form 941) or Form 945-A.
(line 11, Form 943) are less than $2,500.
Caution. Form 943-A is used by the IRS to determine if you
Note. If you use this form, do not complete line 15 on Form
have timely deposited your Form 943 tax liabilities. If you are
943.
a semiweekly schedule depositor and you do not properly
943-A
For Privacy Act and Paperwork Reduction Act Notice, see the separate Instructions for Form 943.
Cat. No. 17030C
Form
(Rev. 5-2006)