Form 945 - Annual Return Of Withheld Federal Income Tax - 2001
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1
2945
Annual Return of Withheld Federal Income Tax
OMB No. 1545-1430
Form
For withholding reported on Forms 1099 and W-2G.
2001
See separate instructions. For more information on income tax withholding, see Circular E and Pub. 15-A.
Department of the Treasury
Please type or print.
Internal Revenue Service
IRS USE ONLY
Name (as distinguished from trade name)
Employer identification number
Enter state code
T
for state in
FF
which deposits
Trade name, if any
FD
were made only
if different from
FP
state in address
Address (number and street)
City, state, and ZIP code
I
to the right
T
(see page 3 of
instructions).
1
1
1
1
1
1
1
1
1
1
2
3
3
3
3
3
3
3
3
4
4
4
5
5
5
If address is
different
from prior
return, check
here
6
7
8
8
8
8
8
8
8
8
9
9
9
9
10
10
10
10
10
10
10
10
10
10
If you do not have to file returns in the future, check here
and enter date final payments paid
1
1
Federal income tax withheld from pensions, annuities, IRAs, gambling winnings, etc.
2
2
Backup withholding
3
3
Adjustment to correct administrative errors (see instructions)
4
4
Total taxes. If $2,500 or more, this must equal line 8M below or line M of Form 945-A
5
5
Total deposits for 2001 from your records, including overpayment applied from a prior year
6
6
Balance due (subtract line 5 from line 4). See instructions
7
Overpayment. If line 4 is less than line 5, enter overpayment here
$
and check if to be:
Applied to next return
OR
Refunded
● All filers: If line 4 is less than $2,500, you need not complete line 8 or Form 945-A.
● Semiweekly schedule depositors: Complete Form 945-A and check here
● Monthly schedule depositors: Complete line 8, entries A through M, and check here
8
Monthly Summary of Federal Tax Liability. Do not complete if you are a semiweekly schedule depositor.
Tax liability for month
Tax liability for month
Tax liability for month
A
January
F
June
K
November
B
February
G
July
L
December
C
March
H
August
M
Total
liability
for
D
April
I
September
year (add entries A
May
J
October
through L)
E
Do you want to allow another person to discuss this return with the IRS (see separate instructions)?
Yes. Complete the following.
No
Third
Party
Person’s
Phone
Personal identification
Designee
name
no.
(
)
number (PIN)
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.
Here
Print Your
Signature
Name and Title
Date
945
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Cat. No. 14584B
Form
(2001)
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