Form 943 - Employer'S Annual Federal Tax Return For Agricultural Employees - 2010
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1
2943
OMB No. 1545-0035
Employer’s Annual Federal Tax Return for Agricultural Employees
Form
2010
See the separate instructions for Form 943 for information on completing this return.
Department of the Treasury
Internal Revenue Service
Enter state code
for state in which
deposits were
Name (as distinguished from trade name)
Calendar year
made only if
If address is
different from
different from
state in address
Trade name, if any
Employer identification number (EIN)
to the right
prior return,
(see the separate
check here.
instructions).
Address (number and street)
City, state, and ZIP code
If you do not have
to file returns in the
future, check
here
1
Number of agricultural employees employed in the pay period that includes March 12, 2010
1
*Report wages, including those paid to qualified new employees, on lines 2 and 4. The social security tax exemption on wages
will be figured on line 7c and will reduce the tax on line 7d (see instructions).
2
2
Total wages subject to social security tax* (see separate instructions)
3
3
Social security tax (multiply line 2 by 12.4% (.124))
4
4
Total wages subject to Medicare tax* (see separate instructions)
5
5
Medicare tax (multiply line 4 by 2.9% (.029))
6
6
Federal income tax withheld (see separate instructions)
See instructions for definitions
7a
7a Number of qualified employees paid wages after March 31, 2010
of qualified employee and
7b
exempt wages.
7b Exempt wages paid to qualified employees after March 31, 2010
7c
7c
Social security tax exemption (multiply line 7b by 6.2% (.062))
7d
7d
Total taxes before adjustments (lines 3 + line 5 + line 6 – line 7c)
8
8
Current year’s adjustments (see separate instructions)
9
9
Total taxes after adjustments (line 7d as adjusted by line 8)
10
10
Advance earned income credit (EIC) payments made to employees, if any (see separate instructions)
11
11
Net taxes (subtract line 10 from line 9)
12
12
Total deposits for 2010, including overpayment applied from a prior year and Form 943-X
13a
13a COBRA premium assistance payments (see instructions)
13b
13b Number of individuals provided COBRA premium assistance
13c
13c Number of qualified employees paid exempt wages March 19-31
13d
13d Exempt wages paid to qualified employees March 19-31
13e
13e
Social security tax exemption (multiply line 13d by 6.2% (.062)
14
14
Add lines 12, 13a, and 13e
15
Balance due. If line 11 is more than 14, write the difference here. For information on how to pay,
see the instructions
15
16
Overpayment. If line 14 is more than line 11, enter here
and check if to be:
Applied to next return or
Refunded.
$
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
17
Monthly Summary of Federal Tax Liability. (Do not complete if you were 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 year
D
April
I
September
(add lines A
October
through L)
E
May
J
Third-
Do you want to allow another person to discuss this return with the IRS (see separate instructions)?
Yes. Complete the following.
No.
Party
Designee’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 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.
Sign
Here
Print Your
Signature
Name and Title
Date
Print/Type preparer’s name
Preparer’s signature
Date
PTIN
Paid
Check
if
self-employed
Preparer
Firm’s name
Firm’s EIN
Use Only
Firm’s address
Phone no.
943
For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions.
Cat. No. 11252K
Form
(2010)
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