943
OMB No. 1545-0035
Employer’s Annual Federal Tax Return for Agricultural Employees
Form
2015
Department of the Treasury
Information about Form 943 and its separate instructions is at
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Internal Revenue Service
Name (as distinguished from trade name)
Employer identification number (EIN)
Type
Trade name, if any
or
If address is
Print
different from
Address (number and street)
prior return,
check here.
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City or town, state or province, country, and ZIP or foreign postal code
If you do not have to file returns in the future, check here
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1
1
Number of agricultural employees employed in the pay period that includes March 12, 2015
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2
Total wages subject to social security tax
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2
3
Social security tax (multiply line 2 by 12.4% (.124)) .
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3
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4
Total wages subject to Medicare tax .
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5
Medicare tax (multiply line 4 by 2.9% (.029))
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5
6
Total wages subject to Additional Medicare Tax withholding .
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6
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7
Additional Medicare Tax withholding (multiply line 6 by 0.9% (.009))
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8
Federal income tax withheld
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8
9
Total taxes before adjustments. Add lines 3, 5, 7, and 8
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9
10
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Current year’s adjustments .
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11
Total taxes after adjustments (line 9 as adjusted by line 10)
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11
12
Total deposits for 2015, including overpayment applied from a prior year and Form 943-X .
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12
13a Reserved .
13a
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b Reserved .
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13b
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14
Reserved .
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15
Balance due. If line 11 is more than line 12, enter the difference and see the instructions
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16
Overpayment. If line 12 is more than line 11, enter the difference
$
Check one:
Apply to next return.
Send a refund.
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• All filers: If line 11 is less than $2,500, do not complete line 17 or Form 943-A.
• Semiweekly schedule depositors: Complete Form 943-A and check here
• Monthly schedule depositors: Complete line 17 and check here
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Monthly Summary of Federal Tax Liability. (Do not complete if you were a semiweekly schedule depositor.)
17
Tax liability for month
Tax liability for month
Tax liability for month
A January .
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F
June .
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K November .
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B February .
G July .
L
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December .
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C March
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H August
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M Total liability for
year (add lines A
D April .
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I
September .
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through L)
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E May .
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J
October .
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Third-
Do you want to allow another person to discuss this return with the IRS (see separate instructions)?
Yes. Complete the following.
No.
Party
Personal identification
Designee’s
Phone
Designee
number (PIN)
name
no.
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Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge
Sign
and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Here
Print Your
Signature
Name and Title
Date
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Print/Type preparer’s name
Preparer’s signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm’s name
Firm’s EIN
Use Only
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Firm’s address
Phone no.
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943
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Form
(2015)
Cat. No. 11252K