Instructions For Schedule H (Form 1040) 2003 Page 6
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8SCHEDULE H
OMB No. 1545-0074
Household Employment Taxes
2003
(Form 1040)
(For Social Security, Medicare, Withheld Income, and Federal Unemployment (FUTA) Taxes)
Attach to Form 1040, 1040NR, 1040-SS, or 1041.
Attachment
Department of the Treasury
44
See separate instructions.
Sequence No.
Internal Revenue Service
Name of employer
Social security number
0 0 0 1 1 1 1 1 1
Employer identification number
Susan Green
0 0 1 2 3 4 5 6 7
A
Did you pay any one household employee cash wages of $1,400 or more in 2003? (If any household employee was your
spouse, your child under age 21, your parent, or anyone under age 18, see the line A instructions on page H-3 before you
answer this question.)
Yes. Skip lines B and C and go to line 1.
No. Go to line B.
Part I
Social Security, Medicare, and Income Taxes
2, 3 0 0 0 0
1
1
Total cash wages subject to social security taxes (see page H-3)
2 8 5 2 0
2
2
Social security taxes. Multiply line 1 by 12.4% (.124)
2, 3 0 0 0 0
3
3
Total cash wages subject to Medicare taxes (see page H-3)
6 6 7 0
4
4
Medicare taxes. Multiply line 3 by 2.9% (.029)
5
5
Federal income tax withheld, if any
3 5 1
9 0
6
6
Total social security, Medicare, and income taxes (add lines 2, 4, and 5)
7
7
Advance earned income credit (EIC) payments, if any
3 5 1 9 0
8
8
Net taxes (subtract line 7 from line 6)
9
Did you pay total cash wages of $1,000 or more in any calendar quarter of 2002 or 2003 to household employees?
(Do not count cash wages paid in 2002 or 2003 to your spouse, your child under age 21, or your parent.)
No.
Stop. Enter the amount from line 8 above on Form 1040, line 59. If you are not required to file Form 1040, see the
line 9 instructions on page H-3.
H-6
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