Instructions For Form 941 - Employer'S Quarterly Federal Tax Return

information about payments made under the accuracy of

amount entered on this line, or file form 941-X to report the

deposits rule.

amount for the prior quarter of the current year.

You may pay the amount shown on line 14 using EFTPS,

12b. Number of individuals provided

a credit or debit card, a check or money order, or electronic

COBRA premium assistance on line 12a

funds withdrawal (EFW). Do not use a credit or debit card or

Enter the total number of assistance eligible individuals

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

provided COBRA premium assistance reported on line 12a.

more information on electronic payment options, visit the

IRS website at

Count each assistance eligible individual who paid a

reduced COBRA premium in the quarter as one individual,

If you pay by EFTPS, credit or debit card, or EFW, file

whether or not the reduced premium was for insurance that

your return using the Without a payment address on page 5

covered more than one assistance eligible individual. For

and do not file Form 941-V, Payment Voucher.

example, if the reduced COBRA premium was for coverage

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

for a former employee, spouse, and two children, you would

the “United States Treasury.” Enter your EIN, Form 941, and

include one individual in the number entered on line 12b for

the tax period on your check or money order. Complete

the premium assistance. Further, each individual is reported

Form 941-V and enclose with Form 941.

only once per quarter. For example, an assistance eligible

individual who made monthly premium payments during the

If line 10 is $2,500 or more and you have deposited all

quarter would only be reported as one individual.

taxes when due, the balance due on line 14 should be zero.

Lines 12c – 12e only apply to the second quarter of

If you do not deposit as required and, instead, pay

2010. These lines are used to determine the number

the taxes with Form 941, you may be subject to a

of qualified employees, amount of exempt wages/

penalty.

CAUTION

tips, and amount of employer social security tax exemption

15. Overpayment

as if the exemption were allowed for the first quarter of

2010. An employer is allowed to treat this exemption as a

If line 13 is more than line 10, write the difference on line 15.

payment credited against deposit requirements for

Never make an entry on both lines 14 and 15.

employment taxes due for the second quarter 2010. If any of

If you deposited more than the correct amount for the

these lines are completed for any quarter other than the

quarter, you can choose to have the IRS either refund the

second quarter of 2010, Form 941 may be considered

overpayment or apply it to your next return. Check only one

incomplete and subject to correction and penalties.

box on line 15. If you do not check either box or if you check

12c. Number of qualified employees paid

both boxes, generally we will apply the overpayment to your

account. We may apply your overpayment to any past due

exempt wages/tips March 19–31

tax account that is shown in our records under your EIN.

Complete this line when filing Form 941 for the 2nd quarter

If line 15 is under $1, we will send a refund or apply it to

of 2010 only. Enter on line 12c the number of qualified

your next return only if you ask us in writing to do so.

employees paid exempt wages/tips from March 19, 2010,

through March 31, 2010. Include only qualified employees

Complete both pages.

for whom you are claiming the social security tax exemption.

You must complete both pages of Form 941 and sign on

For the definition of qualified employee, see the instructions

page 2. An incomplete return may delay processing.

for line 6a on page 6.

Part 2: Tell us about your deposit

12d. Exempt wages/tips paid to qualified

employees March 19–31

schedule and tax liability for this

Complete this line when filing Form 941 for the 2nd quarter

quarter.

of 2010 only. Enter the amount of exempt wages/tips paid

March 19, 2010, through March 31, 2010, to all qualified

employees reported on line 12c. For the definition of exempt

16. State abbreviation

wages/tips, see the instructions for line 6a on page 6.

In the spaces provided, write the two-letter U.S. Postal

12e. Social security tax exemption for

Service abbreviation for the bank branch in the state where

March 19–31

you deposit your taxes using Form 8109 or initiate EFTPS

transfers. The IRS uses the state shown to determine

Multiply the amount of exempt wages/tips reported on line

banking days for purposes of deposit due dates. Official

12d by .062 and enter the result on line 12e.

state holidays for the state shown are not counted as

banking days. If you deposit in multiple states, enter “MU” in

The amount reported on line 12e is treated as a

the spaces provided.

deposit of taxes on April 1, 2010, and must not be

used to adjust line 17 or Schedule B (Form 941).

When you deposit in multiple states, the IRS cannot

CAUTION

determine what portion of your liability was affected by a

13. Total deposits and credits

state holiday and may propose a deposit penalty for one or

Add lines 11, 12a, and 12e.

more of the states where you made deposits. If you receive

a notice and your deposit due date was extended because

14. Balance due

of a state bank holiday, respond to the notice citing the state

holiday and applicable deposit amount.

If line 10 is more than line 13, write the difference on line 14.

Otherwise, see Overpayment below. You do not have to

17. Tax liability for the quarter

pay if line 14 is under $1. Generally, you should have a

•

balance due only if your total taxes after adjustment for

If line 10 is less than $2,500 or line 10 on the preceding

advance EIC (line 10) for the current quarter or preceding

quarterly return was less than $2,500, and you did not incur

quarter are less than $2,500, and you did not incur a

a $100,000 next-day deposit obligation during the current

$100,000 next-day deposit obligation during the current

quarter, check the appropriate box in line 17 and go to Part

quarter. However, see section 11 of Pub. 15 (Circular E) for

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Instructions For Form 941 - Employer'S Quarterly Federal Tax Return - 2010 Page 9

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