Instructions For Form 943 - 2011 (Page 5 of 8) in pdf

(line 15) or Form 943-A, Agricultural Employer’s Record

to pay taxes that were required to be deposited. For more

of Federal Tax Liability. For details on how to report

information on paying your taxes with a credit or debit

adjustments on the Monthly Summary of Federal Tax

card, see Credit or debit card payments, earlier.

Liability, see the instructions for line 15. For details on

If you pay by electronic funds transfer or credit or debit

how to report adjustments on Form 943-A (for use by

card, file your return using the Without a payment

semiweekly depositors only), see the Form 943-A

address under Where to File, earlier. Do not file Form

instructions.

943-V, Payment Voucher.

If you pay by check or money order, make it payable

Line 9. Total Taxes After Adjustments

to the United States Treasury. Enter your EIN, Form 943,

Combine lines 7 and 8; enter the result on line 9.

and the tax period on your check or money order.

Complete Form 943-V and enclose with Form 943.

Line 10. Total Deposits

If you did not make deposits as required and

Enter your total Form 943 deposits for the year, including

instead pay the taxes with Form 943, you may be

any overpayment that you applied from filing Form 943-X

subject to a penalty.

CAUTION

and any overpayment that you applied from your 2010

return.

Line 14. Overpayment

Line 11a. COBRA Premium

If you deposited more than the correct amount for the

year, you can have the overpayment refunded or applied

Assistance Payments

to your next return by checking the appropriate box on

Report on this line 65% of the COBRA premiums for

line 14.

assistance eligible individuals. Take the COBRA

If line 14 is under $1, we will send you a refund or

premium assistance credit on this line only after the

apply it to your next return only on written request.

TIP

assistance eligible individual’s 35% share of the premium

has been paid. For COBRA coverage provided under a

self-insured plan, COBRA premium assistance is treated

Line 15. Monthly Summary of Federal

as having been made for each assistance eligible

individual who pays 35% of the COBRA premium. Do not

Tax Liability

include the assistance eligible individual’s 35% of the

premium in the amount entered on this line. For more

This is a summary of your yearly tax liability, not a

information on the COBRA premium assistance credit,

summary of deposits made. If line 9 is less than $2,500,

visit IRS.gov and enter the keyword COBRA.

do not complete line 15 or Form 943-A.

The amount reported on line 11a is treated as a

Complete line 15 only if you were a monthly

deposit of taxes on the first day of your return

schedule depositor for the entire year and line 9 is

period and must not be used to adjust line 15 or

CAUTION

$2,500 or more. The amount entered on line 15M must

Form 943-A.

equal the amount reported on line 9. See section 7 of

Pub. 51 (Circular A) for details on the deposit rules. You

Line 11b. Number of Individuals

are a monthly schedule depositor for the calendar year if

Provided COBRA Premium

the amount of your Form 943 taxes (line 9) reported for

the lookback period is not more than $50,000. The

Assistance on Line 11a

lookback period is the second calendar year preceding

Enter the total number of individuals provided COBRA

the current calendar year. For example, the lookback

premium assistance payments reported on line 11a.

period for 2012 is 2010.

Count each assistance eligible individual who paid a

If you were a semiweekly schedule depositor

reduced COBRA premium during the year as one

during any part of the year, do not complete line

individual, whether or not the reduced premium was for

15. Instead, complete Form 943-A.

CAUTION

insurance that covered more than one assistance eligible

Reporting adjustments on line 15. If your net

individual. For example, if the reduced COBRA premium

was for coverage for a former employee, spouse, and

adjustment during a month is negative and it exceeds

two children, you would include one individual in the

your total liability for the month, do not enter a negative

number entered on line 11b for the premium assistance.

amount for the month. Instead, enter “-0-” for the month

Further, each individual is reported only once per year.

and carry over the unused portion of the adjustment to

For example, an assistance eligible individual who made

the next month.

monthly premium payments would only be reported as

Additional Information

one individual.

Pub. 51 (Circular A) has information that you may need

Line 13. Balance Due

about social security, Medicare, federal unemployment

You do not have to pay if line 13 is under $1. Generally,

(FUTA), and withheld federal income taxes. It includes

you should show a balance due on line 13 only if your

tables showing the federal income tax to withhold from an

employee’s wages.

total taxes after adjustments for the year (line 9) is less

than $2,500. However, see section 7 of Pub. 51 (Circular

Third-Party Designee

A) regarding payments made under the accuracy of

deposits rule.

If you want to allow an employee, a paid tax preparer, or

You may pay the amount shown on line 13 using

another person to discuss your Form 943 with the IRS,

electronic funds transfer, a credit or debit card, or a

check the “Yes” box in the “Third-Party Designee”

check or money order. Do not use a credit or debit card

section. Then tell us the name, phone number, and the

-5-

Instructions for Form 943 (2011)

Instructions For Form 943 - 2011 Page 5

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