Instructions For Form 943 - 2011 Page 8

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Form 943-V,
Payment Voucher
Purpose of Form
Caution. Use Form 943-V when making any payment with
Form 943. However, if you pay an amount with Form 943
Complete Form 943-V, Payment Voucher, if you are
that should have been deposited, you may be subject to a
making a payment with Form 943, Employer’s Annual
penalty. See Deposit Penalties in section 7 of Pub. 51
Federal Tax Return for Agricultural Employees. We will
(Circular A).
use the completed voucher to credit your payment more
promptly and accurately, and to improve our service to
Specific Instructions
you.
Box 1—Employer identification number (EIN). If you do
If you have your return prepared by a third party and
not have an EIN, you may apply for one online. Go to
make a payment with that return, please provide Form
IRS.gov and click on the Apply for an Employer
943-V to the return preparer.
Identification Number (EIN) Online link. You may also
apply for an EIN by calling 1-800-829-4933, or you can
Making Payment With Form 943
fax or mail Form SS-4, Application for Employer
To avoid a penalty, make your payment with your 2011
Identification Number. If you have not received your EIN
Form 943 only if:
by the due date of Form 943, write “Applied For” and the
date you applied in this entry space.
• Your total taxes after adjustments for the year (line 9 on
Form 943) are less than $2,500 and you are paying in full
Box 2—Amount paid. Enter the amount paid with Form
with a timely filed return, or
943.
• You are a monthly schedule depositor making a
Box 3—Name and address. Enter your name and
payment in accordance with the Accuracy of Deposits
address as shown on Form 943.
Rule. See section 7 of Pub. 51 (Circular A), Agricultural
• Enclose your check or money order made payable to
Employer’s Tax Guide, for details. In this case, the
the “United States Treasury.” Be sure to enter your EIN,
amount of your payment may be $2,500 or more.
“Form 943,” and “2011” on your check or money order.
Otherwise, you must make deposits by electronic funds
Do not send cash. Do not attach Form 943-V or your
transfer. See section 7 of Pub. 51 (Circular A) for deposit
payment to Form 943 (or to each other).
instructions. Do not use Form 943-V to make federal tax
• Detach Form 943-V and send it with your payment and
deposits.
Form 943 to the address provided in the Instructions for
Form 943.
Note. You must also complete the entity information
above line 1 on Form 943.
Detach Here and Mail With Your Payment and Form 943.
943-V
Payment Voucher
OMB No. 1545-0035
Form
2011
Do not attach this voucher or your payment to Form 943.
Department of the Treasury
Internal Revenue Service
2
Dollars
Cents
1 Enter your employer identification number (EIN).
Enter the amount of your payment
. .
Enter your business name (individual name if sole proprietor).
3
Enter your address.
Enter your city, state, and ZIP code.

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