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7. Value of certain meals and lodging. (See section 5

employee’s annual wages you paid during the quarter.

in Circular E.)

Enter the result in the space for that quarter. Your “Total

8. Cost of group-term life insurance.

for year” must equal your total FUTA tax shown on

9. Payments attributable to the employee’s

line 6.

contributions to a sick-pay plan.

Record your FUTA tax based on when you pay wages,

10. Employer contributions to a SIMPLE retirement

not on when you deposit it. For example, if you pay

account (other than elective salary reduction

wages on March 29, your FUTA tax on those wages is

contributions) and employer contributions to a 401(k)

$200, and you deposit the $200 on April 30, you would

plan (if included on line 1).

record that $200 in the first quarter, not in the second.

11. Employer payments to an Archer MSA.

Example. You had two employees and paid each

12. Benefits excludable under a section 125

employee $4,000 in the first quarter, $5,000 in the

(cafeteria) plan.

second quarter, $5,000 in the third quarter, and $5,000 in

13. Certain statutory employees. (See section 1 in

the fourth quarter. (None of the payments were exempt

Pub. 15-A.)

from FUTA tax.) For the first quarter, multiply .008 x

14. Services performed by an inmate of a penal

$8,000 (the amount paid to both employees), and enter

institution.

$64 in the space for the first quarter. For the second

15. Employer reimbursements (including payments to a

quarter, multiply .008 only by $6,000 ($3,000 for each

third party) for qualified moving expenses, to the extent

employee — the amount remaining to reach the $7,000

such expenses would otherwise be deductible by the

maximum amount subject to FUTA tax for each

employee. (See Pub. 521, Moving Expenses.)

employee), and enter $48 in the space for the second

16. Any other exempt service or pay.

quarter. Because you paid each employee more than

For more information, see section 15 in Circular E or

$7,000 by the end of the second quarter, enter zero in

section 15 in Circular A, Agricultural Employer’s Tax

the space for the third and fourth quarters. Enter $112 in

Guide (Pub. 51).

the “Total for year” space.

Line 3 — Payments of more than $7,000 for services.

Enter the total of amounts over $7,000 you paid each

Privacy Act and Paperwork Reduction Act Notice.

employee during 2001 after subtracting any exempt

We ask for the information on this form to carry out the

payments shown on line 2. For example, you had 10

Internal Revenue laws of the United States. We need it to

employees and paid each $9,000 during the year,

figure and collect the right amount of tax. Chapter 23,

including $500 of exempt payments per employee. Enter

Federal Unemployment Tax Act, of Subtitle C,

$15,000 on line 3, computed as follows:

Employment Taxes, of the Internal Revenue Code

imposes a tax on employers with respect to employees.

Total payments (10 x $9,000) . . . . . . . . . . . . . . $90,000

This form is used to determine the amount of the tax that

you owe. Section 6011 requires you to provide the

Less: Exempt payments (10 x $500) . . . . . . . . . ($5,000)

requested information if you are liable for FUTA tax under

Less: Total wage base amount (10 x $7,000) . . . ($70,000)

section 3301. Section 6109 requires you to provide your

employer identification number (EIN).

Amount reported on line 3 . . . . . . . . . . . . . . . $15,000

Routine uses of this information include giving it to the

Only the first $7,000 paid to each employee is

Department of Justice for civil and criminal litigation, and

subject to FUTA tax. Do not use the state wage base

to cities, states, and the District of Columbia for use in

for this entry. The state wage base may be different

administering their tax laws. If you fail to provide this

from the Federal wage base of $7,000. Do not include

information in a timely manner, you may be subject to

any exempt payments from line 2 in figuring the

penalties and interest.

$7,000.

You are not required to provide the information

Line 8 — Balance due. Make your check or money

requested on a form that is subject to the Paperwork

order payable to the “United States Treasury.” Write

Reduction Act unless the form displays a valid OMB

your EIN, “Form 940-EZ,” and “2001” on your check or

control number. Books or records relating to a form or its

money order. Enter the amount of the payment on Form

instructions must be retained as long as their contents

940-EZ(V) at the bottom of Form 940-EZ. If the employer

may become material in the administration of any Internal

information is not preprinted on the payment voucher,

Revenue law. Generally, tax returns and return

enter the requested information. ( Make certain that the

information are confidential, as required by section 6103.

entity information above line A is properly completed.)

The time needed to complete and file this form will

If the amount on line 8 is under $1, you do not have to

vary depending on individual circumstances. The

pay it. For payments over $100, see Depositing FUTA

estimated average time is: Recordkeeping, 7 hr., 8 min.;

Tax on page 3.

Learning about the law or form, 1 hr., 5 min.;

Line 9 — Overpayment. If the amount on line 9 is

Preparing and sending the form to the IRS, 1hr. 5 min.

under $1, we will send a refund or apply it to your next

If you have comments concerning the accuracy of

return only on written request.

these time estimates or suggestions for making this form

simpler, we would be happy to hear from you. You can

Part II — Record of Quarterly Federal

write to the Tax Forms Committee, Western Area

Unemployment Tax Liability

Distribution Center, Rancho Cordova, CA 95743-0001.

Do not send the form to this office. Instead, see Where

Complete this part only if your FUTA tax on line 6 is

To File on page 2.

over $100. To figure your FUTA tax for each quarter,

multiply by .008 that part of the first $7,000 of each

-5-

Instructions For Form 940-Ez - Employer'S Annual Federal Unemployment (Futa) Tax Return - Internal Revenue Service - 2001 Page 5

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