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Title
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EWP 4-14 1948-1956 Withholding Tax 39
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Description
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IRS Form 941, Employer’s Quarterly Federal Tax Return
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Tag
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Taxes
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Form 941, Employer's Quarterly Federal Tax Return, IRS, Federal Income Tax, FICA Taxes, Tax Regulations, Compliance, Penalties.
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Place
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Virginia
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Identifier
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1036982
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Is Version Of
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1036982_EWP_4-61948-1956WitholdingTax_39.pdf
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Date Created
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2024-01-07 22:26:40 +0000
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Format
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.pdf
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Number
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fb459309b95cf2dc1e433c3c581469b4c8648aba2966eca842c504a58901537f
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Source
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/Volumes/T7 Shield/EWP/Elements/EWP_Files/Access Files/Upload temp/1036982_EWP_4-61948-1956WitholdingTax_39.pdf
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Publisher
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Digitized by Edwin Washington Project
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Rights
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Loudoun County Public Schools
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Language
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English
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Replaces
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/Volumes/T7 Shield/EWP/Elements/EWP_Files/source/Ingest Two/EWP 4-6 Payroll and Taxes/WithholdingTax/EWP_4.6 1948-1956 Witholding Tax_39.pdf
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extracted text
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FORM 941 (Ror. Jar.1355)
E]I,IPTOYER'S OUARIERLY FEDERAI TA)( RETIJR]I
U, S. Tlearury Depaftment
lnternal Ravonre Scrulcc
GOPY FOR EMPLOYEN
1. Federal Income Tax lTithheld From \fages (If not required to withhold, write "None")
2. Adjustment for preceding quarter(s) of calendar year. (Attach explanation. See instructions)
l. Income tax wjthhelci, as adjusted. (For fourth quarter of, 6nal teturn, fill in Schedule C) . Entel
Federal Insurance Contributions Act Taxes (If no taxable wages paid, write "None")
4. Number of employees listed in Schedule A ---------------. 5. Total tarable wages paid (from Item 21)
t
6. 4% of. wages in ltem 5 (2/o employer tax and 2/o employee tax)
$
7. Credit or adjustment. (Attach explanation. See instructions)
. EntcrAdiu3tedTotal
8. F.I.C,A. taxes, as adjusted. .
9. Total taxes (Item 3 plus Item s). If deposits of taxes are made, fill in Schedule B on other side
Clerk School
_tu
lp|rll I
Eoard
Return for Caleadar Quartet
(Eatcr quarter rs shown on otigiaal)
5
TMPORTANT
Keep this copy at your princiPal
place of business, together with a
copy of each related schedule or
statemetrt.
Before filing the return be sure to
enter on this copy your namq address, and identification number, and
10. Type or print in this space employer's identification numbct, nane, and address
exactly as shown on original
period for which the returo is filed.
Schedule A-QUARTERLY REPORT OF WAGES TAXABLE UNITER THE FEDERAL I]{SURAI{CE CONTRIBUTIONS ACT
List for each employee, except agricultural employees, the $7AGES taxable under the Federal Insurance Contributions Act which were paid duting the
qualter. If ybu pay an employee more tha; $4,2oo ir a calendar year, report ONLY THE FIRST $4200 of such wages. If wages were not trxable
under the F.I.C.A., make no entries below except in Items 11 and 16. See instructions on back of ofiginal,
a business is sold or transferred by one employer to another, each employer
Such a transfer occurs, for examplq if a sole proprietor forms a partnership or a
or uansfer of business.-If
SaIe
must 6le a separate
return.
corporation. Neither employer should report wages paid by the other employer.
If
the new employer does
not have an identification number, he should not use the identifcation number assigned to the previous employer,
but must 6le an application on Form S9-4 for a new number for himself. (See Items 15 and 16 below.)
72. Total pages of this
retun. including
this page and any
pages of Form 941a
13. Total nmbet of
enployees
listed
(sme as Item 4)
of Dersons
employed
duing
Day Deriod end-
14, Number
ins nCarest lrth of
third month in
quarter scept agai-
oltural
hold
lJ. If
there has been a change of ownership or other transfer of the business during the quarter, give the name
partnership, or corporation) and the date the change took place -----------
aod houseemployees . .
o{ the present owner (individual,
16. Do you expect to pay taxable wages in the future to any employee (other than an agricultural or household.employee) ? '
If "No," write "Final Return" at the top of this page, check appropriate block, and furnish the information requested below.
! Discharged all employees, but still in business
L Sale of business to successor fl Formed partnership
I
I
Business discontinued
Formed corporation
n
Other (specify) --------
Date of final payment of taxable wages to employees (other than agricultural or household
Records
will
employees)
--------, 195
be kept by ---------
Do you expect to pay taxable ;ages within the next 6 months to a household employee
?
Yes
NAME OF EMPLOYEE
(Please type or print)
EMPLOYEE'S ACCOUNT NUMBER
number is unknown, see Circular E)
(lf
fl No E
ot an agricultural ernploye-e ? Yes
TAXABLE UNDER F.I.C.A.
Paid to Emoloyee in Quartel
WAGES
(Before deductions)
If
00
there is not enough space to
Dollars
0000
list all
Total wages reported in column lp
employees above, use Schedule
A continuation
E No !
State, Possession, or
Territory of Employment
(or "outside U, S.")
(20)
oe)
000
Yesn Non
Ccnts
sbeets, Form 941a.
on this page
$--------
21. TOTAL \TAGES TAXABLE TJNDER F.I.C.A,, PAID DI.JRING QUARTER
-(Total of such wages in column 19 of this page and on any continuation sheets)
16-6983+'3
Schadule C-RECONCILIATION OF INCOME TAX WITHHELD
(Ose
or if tiling final return)
for tourth
on back ol
c
Schedule B-DEPOSITARY RECEIPT RECORD
(See Schedule B lnstructions on back
.
of Deposit
Date
Serial No, of Form 450
ol original)
Amount
(List in date order)
n6n
s-gglrSr-?o-----5166&,80-.
cr 2.t6
of withholdiag
statements (Forms \X/-2)
1. Total number
tax
transmitted herewith.
2. Total
income tax withheld from
wages during the year as shown
lrt
2rvJz tvtt
by withholding tax
statements
A)
(Forms \f-2) .
as
the
year
wages
during
from
income
tax
withheld
Total
3.
shown in Item 3 of Forms 941 :
Quarter
Quarter
Quarter
Quarter
ended March 3L...... $-------------.
ended June 30... ....
ended September 30..
ended December 3l ..
Total. ..
$
Total of all
Total of otherremittances
(such as cash, check, M. O., etc.)
Total payments (same as Item 9
of
Avoid penalties by transmitting Copy A
each \fl-2 to the district director.
oD other side)
Any discrepancy between the amounts
shown on lines (A) and (B) must be
fully explained in an attached
statement'
GENERAL INSTRUGTIONS
The instructions below relate to the preparing and frling of Form 94t,
Additional instructions are contained in Circular E. Special instructions
for employers of agricultural and household employees also appear on thq
back of the
oiginal of this return.
Circular E relates to (a) income tax withholding from wages, (b)
taxes under the Federal fnsurance Contributions Act (for old-age and
survivors insurance), and (c) the Federal unemployment tax on employers of eight or more employees. Employers should refer to such
circular for information as to the employers and employees who are liable
fot these taxes, the types of payments defined by law as "wages," the
computing and deducting of taxes from wages, how to adjust errors, and
other facts employers need to know in order to comply with the law.
Circular E may be obtained from the District Director of
request. Employers also may obtain Circular H, "Household Employer's Social Security Tax Guide," and Circular A, "Agricultural Employer's Social Security Tax Guide,"
Internal
Revenue upon
Purpose of Form 941.---This foim combines the reporting of income
tax withheld from wages and the taxes under the Federal Insurance Contributions Act. If you have only one of these taxes to report, you should
fill in only the portions which are applicable to you.
\fho
file.-If
you have one or more employees you must make a
return for the first quarter in which you are required to withhold income
tax from wages, or in which you pay wages taxable under the Federal
fnsurance Contributions Act, and for each quarter drereafter.
must
If you temporarily discontinue paying wages (for example, seasonal
activities), you must nevertheless file returns. If you no longer expect
to pay wages subject to any of the taxes reportable on this form you must
file a "Final Return." If a business is sold or transferred by one employer
to another, both the old and the new employer must 6le returns, but
form is lost, request another. If a non-preaddressed form
must be used, type or print in Items 10 and 11 the employer's identification number and name exactly as shown on his previous feturns. Do
not use the identification number assigned to a prior owner.
preaddressed
An employer who is tequired to report F.I.C.A' taxes on Forn 941 and
who has not applied for an identification number should file with the
District Director an application on Form SS-4. Such form may be
obtained from the District Dirbctor or from any Social Security Administration ofice. An employer who is liable for income tax withheld from
wages, but who is not liable for F.I.C'A. taxes, will be assigned an identification number by the District Director without application.
Penalties and iflterest.-Avoid penalties and interest by making timely
returns and payments of tax. The law provides penalties for late 6ling of
a retuin ot for late monthly deposits unless reasonable cause is shown for
the delay,
request a Fotm 94L so that you can make your return on time.
Quarterly returfls and due dates.-A retum must be 6led for
as follows:
quarter of the calendar year
Quarter
covered
lantary, February, March
April, May, June
.
September
October, November, December
July, August,
each
..
Due on or before
April
July
30
31
October
31.
lanuary 3l
However, if the return is accompanied by depositary receipts, Form 450,
showing timely. deposits in full payment of the taxes due for the entire
calendar quarter, the teturn may be filed on or before the tenth day of
the second month following the quarter.
Unless already shown on the form received from the District Director,
you are late in filing a return or in making a monthly
full explanation in writing with your return.
Penalties also are imposed by law for willful failure to pay, collect, or
truthfully account for and pay over tax, furnish statements to employees,
keep records, make returns, or for false or fraudulent returns.
Item 2. Adjustment of income tax withheld.-Item 2 should be used
for the correction of errors made in connection with the withholding of
income tax from wages paid in the preceding quarters of the same calendar year. (Consult the District Director before cotrecting a priotyear
etror.) Any amount in Item 2 must be explained by a statement
return. fhis statement must set forth:
attached to the
(a) .Explanation of the error vrhich the entry is intended to correct;
(b) The particular return period or periods to which the error relates;
(c) The amount chargeable to each such period; and
(d) The manner in which the employer and employee have settled any
overcollection or undercollection of income tax withheld'
neither should report wages paid by the other.
After you have once 6led a return, the District Director will mail you a
Fotm 941 every three months. If the form should fail to reach you,
If
deposit, send a
Item7. Credit or adjustment of taxes under Federal fnsurance Con'
tributions Act.-Entries in Item 7 should be made for the correction of
underpayments or overpayments of F.I.C.A. tax as reported on a ptior
return, or credits for overpayments of penalty or interest paid with respect
to such tax for prior periods. If there are both an underpayment aird an
overpayment to be reported, only the difference between the two should
be entered in Item 7. Any amount entered in Item 7 must be explAined
by a statement attached to the return. This statement must set forth:
(a) Explanation of the error which the entry is intended to coffect;
(b) The particular return period or periods to which the error relates;
(c) The amount chatgeable to each such period;
(d) The tax-return period in which the error was ascertained;
(e) The fact that the employer repaid F.I.C.A. tax overcollected ftom
an employeq if the entry corrects an overcollection of tax so
repaid; and
(f
) If the entry coffects F.I.C.A. tax overcollected from an employee
a pior
in
yeat, the fact that the employer has obtained from the
a c'ri*en
cfafphehl
+lna+ +ha pmnlnrrce
hac nnt
clcineA
-re-
Schedule G-RECONCTLIATION OF INCOME TAX WITHHELD
(Ose
or if liling tlnal return)
for tourth
on back ot
c
Schedule B-DEPOSITARY REOEIPT RECORD
(see Schedute B lnstructions on back ol ortglhal)
Date
Serial No. of Form 450
of Deposit
Amount
(List in date order)
r?$a
$
9#h3.as
-
of withholding
statements (Forms \X/-2)
1. Total number
tax
transmitted herewith.
-----$166&"80-.
2. Total
income tax withheld from
wages during the year as shown
C 2qt^ 2^
TrvJl.vv
by withholding tax
statements
A)
(Forms \f-2) .
as
the
year
wages
during
tax
from
income
withheld
3. Total
shown in Item 3 of Forms 941 :
ended March 3L...... $-------.-----ended June 30. .. .....
Quarter
Quarter
Quarter
Quarter
ended Septembet
ended December
Total.
Total of all
30..
.. .
(such as cash, check, M. O., etc.)
Total payments (same as ltem 9
of
Avoid penalties by ttansmitting Copy A
each W-2 to the district director.
oD other side)
(B
$
receipts
Total of otherremittances
.
3L...
Any discrepancy between the amounts
(A) and (B) must be
shown on lines
fully explained in an attached
statement.
GENERAL INSTRUCTIONS
The itrstructions below relate to the preparing and f,ling of Form 94!.
Additional instructions are contained in Circular E. Special instructions
for employers of agricultural and household employees also appear on thq
back of the original of this return.
Circular E relates to (a) income tax withholding from wages, (b)
taxes under the Federal fnsurance Contribuiions Act (for old-age and
survivors insurance), and (c) the Federal unemployment tax on employers of eight or more emplbyees. Employers should refer to such
circular for information as to the employers and employees who are liable
for these taxes, t-he types of payments defined by law as "wages," the
computing and deducting of taxes from wages, how to adjust errors, and
other facts employers need to know in order to comply with the law.
Citcttlar E may be obtained from the District Director of Internal
request. Employers also may obtain Circular lI, "Household Employer's Social Security Tax Guidg" and Circular A, "Agricultural Employer's Social Security Tax Guide."
Revenue upon
Purpose of Form 941.-This foim combines the reporting of income
tax withheld from wages and the taxes under the Federal fnsurance Contributions Act. If you have only one of these taxes to report, you should
fill in only the portions which are applicable to you.
$fho must file.-If
you have one or more employees you must make a
return for the first quarter in which.you are required to withhold income
tax from wages, or in which you pay wages taxable undet the Federal
Insurance Contributiogrp Act, and for each quarter thereafter.
If you temporarily discontinue paying wages (for example, seasonal
activities), you must nevertheless file teturns. If you no longer expect
to pay wages subject to any of the taxes repottable on this form you must
file a "Final Return." If a business is sold or transferred by one employer
to another, both the old and the new employer must 6le returns, but
neither should report wages paid by the other.
After you have once 6led a return, the District Director will mail you a
Eorm 94L every three months. If the form should fail to reach you,
fequest a Fotm 941 so that you can make your return on time.
Quartedy returns and due dates.-A .returo must be 6led for each
quarter of the calendar year
QuaiteJ
as
follows:
covered
,
March
April, May, June
July, August, September
October, November, December
lanuary, February,
Due on or befote
April
July
30
31
October 31
January 3L
lfowever, if the retutn is accompanied by depositary receipts, Form 450,
showing timely. deposits in full payment of the taxes due for the entire
calendar quarter, the return may be filed on or before the tenth day of
the second month following the quarter.
form is lost, request another. If a non-preaddressed form
must be used, type or print in ltems 10 and 11 the employer's identification number and name exactly as shown on his previous returns. Do
not use the identification number assigned to a prior owner.
preaddressed
An employer who is required to report F.I.C.A. taxes on Form 941 and
who has not applied for an identification numbel should file with the
District Director an application on Form S$-4. Such form may be
obtained from the District Dirbctor or from any Social Security Administration office. An employer who is liable for income tax withheld from
wages, but who is not liable for F.LC.A. taxes, will be assigned an identification number by the District Director without application. :
Penalties and interest.-Avoid pen4lties and interest by making timely
returns and payments of tax. The law provides penalties for late filing of
a return or fol late monthly deposits unless reasonable cause is shown for
the delay.
Item 2. Adiustment of iocome tax withheld.-Item 2 should be used
for the correction of errors made in connection with the withholding of
income tax from wages paid in the preceding quarters of the same calendar year. (Consult the District Director before correcting a prioryear
States
District Director of Internal Revenue for the district in which the
employer's principal place of business is located, or, if the employer -has
no principal place of business in an internal revenue district of the United
States, with the District Director of Internal Revenue, Baltimore 2, Md.
Payment of tax.-Each return should be accompanied by remittance
(cash, check, money order, depositary receipt, or combination of these)
for the total taxes reported in Item 9.
Employer's identification number, name, and addtess.-Forms p41
District Directors should be used in filing returns. If a
preaddressed by
(See also the
error.) Any amount in ltem 2 must be explained by a statement
return. This statement must set forth:
attached to the
(a) .Explanation of the error which the entry is intended to correct;
(b) The particular return period or periods to which the error relates;
(c) The amount chargeable to each such period; and
(d) The manner in which the employer and employee have settled any
overcollection or undercollection
return, or credits for overpayments of penalty or interest paid with respect
to such tax for prior periods. If there are both an underpayment aird an
overpayment to be reported, only the difference between the two should
be entered in Item 7. Any amount entered in Item 7 must be explAined
by a statement attached to the return. This statement must set forth:
(a) Explanation of the error which the entry is intended to coffect;
(b) The patticular retutn period or periods to which the error relates;
(c) The amount chargeable to each such period;
(d) The tax-return period in which the error was ascettained;
(e) The fact that the employer repaid F.I.C.A. tax overcollected from
an employee, if the entry corrects an overcollection of tax so
repaid; and
) If the entry coffects F.I.C.A. tax overcollected from an employee
covERNUENT pRrNrtNG
in
a prior year, the fact that the employer has obtained from the
employee a vr'ritten statement that the employee has not claimed
and will not claim refund or credit of the amount of such over-
collection.
If
\
amounts of wages v/ere erroneously reported or omitted for emprior returns, include in the statement, or on a Form 941c:
ployees on
(a) The
name and account number of each employee whose wages
were erroneously reported or omitted;
(b) The amount of wages, if any, erroneously reported for each quarter
for each employee (if none, so state); and
(c) The amount of wages, if any, which should have been reported for
each quarter for each employee (if nonq so state).
Forms 941c,
if
desired, may be obtained from the District Director.
tnstructions on the back of'the original of this torm)
u. s.
of income tax withheld'
Item 7. Credit ot adjustment of taxes under Federal Insurance Con'
uibutions Act.-Entries in Item 7 should be made for the correction of
underpayments or overpayments of F.I.C.A. tax as reported on a prior
Unless already shown on the form received from the District Director,
enter in the spaces at the right of the employbl's name the months and
year of the calendar quarter for which the return is fiIed.
the United
you are late in filing a return or in making a monthly
full explanation in writing with your retutn.
Penalties also are imposed by law for willful failure to pay, collect, or
truthfully account for and pay over tax, furnish statements to employees,
keep records, make returns, or for false or fraudulent returns.
(f
\fhere to file.-The original of this form is to be sent to
If
deposit, send a
oFEtcE 16-69832-3
_
--
:lr-Schedule G-RECONCILIATION OF INCOME TAX WITHHELD
(Ose
or if tiling tlnal return)
tor fourth
on back ol
c
Schedule B-DEPOSITARY RECEIPT REGORD
(See Schedule B lnstructions on back
Date
Serial No. of Form 450
of origlhal)
of Deposit
-
Amount
(List in date order)
I?6P
s'-f$bl--to----
68eet
:.---t@,go".
L. Total number
tax
of
withholding
statements (Forms \$7-2)
transmitted herewith.
2. Total
C
lqtll
income tax withheld from
wages during the year as shown
lA
TrvJ/.vv
by withholding tax
statements
A)
(Forms \f-2) .
as
the
year
wages
during
from
income
tax
withheld
Total
3.
shown in Item 3 of Forms 941 :
ended March 3t....,.
ended June 30. .......
Quarter
Quarter
Quarter
Quarter
ended September
ended December
30..
3L...
Total
$
Total of all depositary
Total of otherremittances
(such as cash, check, M. O., etc.)
Total payments (same as liem 9
of
.
Avoid penalties by transmitting Copy A
each W-2 to the district director.
oD other side)
Any discrepancy between the amounts
shown on lines (A) and (B) must be
fully explained in an attached
statement.
GENERAL INSTRUCTIONS
The ihstructions below relate to the preparing and fling of Form 941.
Additional instructions are contained in Circular E. Special instructions
for employers of agricultural and household employees also appear on thg
back of the original of this return.
Circalar E relates to (a) income tax withholding from wages, (b)
taxes under the Federal fnsurance Contributions Act (for old-age and
survivors insurance), and (c) the Federal unemployment tax on employers of eight or more employees. Employers should refer to such
circular for information as to the employers and employees who are liable
for these taxes, the types of payments defined by law as "wages," the
computing and deducting of taxes from wages, how to adjust etrots, and
other facts employers need to know in order to comply with the law.
Circular E may be obtained from the District Director of Internal
Revenue upon request. Employers also may obtain Circular H, "Household Employer's Social Security Tax Guide," and Circular A, "Agricultural Employer's Social Security Tax Guide."
Purpose of Form 941.-This foim combines the reporting of income
tax withheld from wages and the taxes under the Federal fnsurance Contributions Act, If you have only one of these taxes to report, you should
fill in only the portions which are applicable to you.
$fho must
file.-If
you have one or more employees you must make a
return for the first quarter in which.you are. required to withhold income
tax from wages, or in which you pay wages taxable undet the Federal
fnsurance Contributions Act, and for each quarter t}:ereafter.
If you temporarily riliscontinue paying wages (for example, seasonal
activities), you must nevertheless file teturns. If you no longer expect
to pay s/ages subject to any of the taxes reportable on this form you must
file a "Final Return." If a business is sold or transferred by one employer
to another, both the old and the new employer must 6le returns, but
form is lost, request another. If a non-preaddressed form
must be used, type or print in ltems 10 and 11 the employer's identificaiion number and name exactly as shown on his previous returns. Do
not use the identification number assigned to a prior owner.
preaddressed
An employer who is required to report F.I.C.A' taxes on Form 947 and
who has not applied for an identification number should file with the
District Director an application on Form S$-4. Such form may be
obtained from the District Dirbctor or from any Social Security Administration office. An employer who is liable for income tax withheld from
wages, but who is not liable for F.I.C.A. taxes, will be assigned an identification number by the District Director without application. :
Penalties and interest.-Avoid pen4lties and interest by making timely
returns and payments of tax. The law provides penalties for late filing of
a teturn or fol late monthly deposits unless reasonable cause is shown for
the delay.
request a Eorm 941 so that you can make your return on time.
Quartedy returns and due dates.-A fetum must be filed for
quarter of the calendar year
as
each
follows:
Quatet covered
January, February,
.
March
April, May, June
July, August, September
October, November, December
Due on ot befo&
April
July
30
31
October 31
January 3l
However, if the return is accompanied by depositary receipts, Form 4)0,
showing timely. deposits in full payment of the taxes due fot the entire
calendar quarte! the return may be filed on or before the tenth day of
t-he second month
following the quarter.
Item 2. Adjustment of income tax withheld.-Item 2 should be used
for the correction of errors made in connection with the withholding of
income tax from wages paid in the preceding quarters of the same calendar year. (Consult the District Director before correcting a ptioryear
error.) Any amount in Item 2 must be explained by a statement
return. This statement must set forth:
attached to the
(a) .Explanation of the error which the entry is intended to correct;
(b) The particular return period or periods to which the error relates;
(c) The amount chargeable to each such period; and
(d) The manner in which the employer and employee have settled any
overcollection or undercollection
return, or credits for overpayments of penalty or interest paid with respect
to such tax for prior periods. If there are both an underpayment aid an
overpayment to be reported, only the difference between the two should
be entered in Item 7. Any amount entered in Item 7 must be explLined
by a statement attached to the return. This statement must set forth:
(a) Explanation of the error which the entry is intended to coffect;
(b) The pafticular teturn period or periods to which the error relates;
(c) The amount chargeable to each such period;
(d) The tax-retum period in which the error was ascertained;
(e) The fact that the employer repaid F.I.C.A. tax overcollected from
an employeg if the entry corrects an overcollection of tax so
repaid; and
) If the entry coffects F.I.C.A. tax overcollected from an employee
year, the fact that the employer has obtained from the
employee a written statement that the employee has not claimed
and wi.ll not claim refund or credit of the amount of such over-
collection.
If
amounts of wages vrere erroneously reported or omitted for emprior returns, include in the statement, or on a Form 941c:
no principal place of business in an internal revenue district of the United
with the District Director of Internal Revenue, Baltimore 2, Md.
(a) The name and account
Payment of tax.-Each return should be accompanied by remittance
(cash, check, money order, depositary receipt, or combination of these)
for the total taxes reported in Item 9.
(b)
Employer's identification gumber, name, and addtess.-Forms 941
District Directors should be used in 6ling returns. If a
(See also the
(c)
number of each employee whose wages
were effoneously reported or omitted;
The amount of wages, if any, erroneously reported for each quarter
for each employee (if none, so state); and
The amount of wages, if any, which should have been reported for
each quarter for each employee (if nonq so state).
Forms 941c,
if
desired, may be obtained from the District Director.
lnstructions on the back of the original of thls form)
U.
s.
GoVERNUENT
PRINTING
\
ployees on
States,
preaddressed by
in
a pior
Unless already shown on the form received from the District Director,
enter in the spaces at the right of the employbr's name the months and
year of tlle calendar quarter for which the return is fiIed.
to file.-The original of this form is to be sent to the United
States District Director of Internal Revenue for the district in which the
employer's principal place of business is located, or, if the employer -has
of income tax withheld.
Item 7. Credit or adjustment of taxes under Federal Insurance Con'
uibutions Act.-Entries in Item 7 should be made for the correction of
underpayments or overpayments of F.I.C.A. tax as reported on a prior
(f
SThere
you are late in filing a return or in making a monthly
full explanation in writing with your retutn.
Penalties also are imposed by law for willful failure to pay, collect, or
truthfully account for and pay over tax, furnish statements to employees,
keep records, make returns, or for false or fraudulent returns.
neither should report wages paid by the other.
After you have once filed a return, the District Director will mail you a
Form 94L every three months. If the form should fail to reach you,
If
deposit, send a
OFFICE 1G-6S832.S