-
Title
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EWP 4-14 1948-1956 WithholdingTax 9
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Description
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Notice from the IRS to Employers of change in Reporting and Depositing of taxes on wages paid on or after January 1, 1950.
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Tag
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Taxes, wages
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income tax, withholding, employer, employee, wages, Federal Insurance Contributions Act, deposits, taxes, Federal Depositary Receipt, identification number
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Place
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Virginia
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Identifier
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1036997
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Is Version Of
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1036997_EWP_4-61948-1956WitholdingTax_9.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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7cbae125542cca3bb9fbfdcb9aa446a484696b55c1a18445c96a75131acb0322
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Source
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/Volumes/T7 Shield/EWP/Elements/EWP_Files/Access Files/Upload temp/1036997_EWP_4-61948-1956WitholdingTax_9.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_9.pdf
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extracted text
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+>+>+>+D#)##>).
U. S. TREASUNY DEPARTMENT
.
INTERNAL REVENUE SENVICE
Itotice to Employers of
Change in Reportirg and Depositing
;:
jlT,TJ:;,:j,H-T*T:;Hiffi :;::;tj;Tj?-'"T;ff
+>+>+>)#)#+D*DDlDlD*D
A new procedure will cpply {or moking monthly deposits oI
ioxeg on woges pcid on or qlter lonuory 1, 1950.
pro-The
ce<iure will cppiy boih io income tox withheld fr& wcges
oad to the employers' tcx and employees' tox under the
Federcl Insuronce Contributions Act.
Employers should note thcrt deposits, pcyments, cnd returns
of toxes on wcrges paid prior to Ionucry l, 1950, should be
made under the previous instructions cpplicable to Form
W-l (incorne tcx withhoiding) cnd Form SS-lo. (F. I. C. A.
toxes).
Tbe new depository procedure is described below crnd on
the bock ol the enclosed Federel Depository Receipt, Form
450. Wben such receipts ore validoted os describe-d below,
employers will need to ottcch (not stcrple) them to their future
reiurns on Form 941, the new form which will be substituted
lor form W-I ond Form SS-Ia. Form 94I ond c new
circulor ol instructions v/itl be {urnished employers on or
obout Morch 31, 1950.
,&vfu
Commissioner oI Internql Revenue.
WHO SHOULD MAKE DEPOSITS
Beginuing with the-lcxes on woges pcid to your employees
in lonuory 1950, cnd in eoch month thereofter, you sh6uld
odd together the aaount of employer tcx AND employee tcx
under lhe Federal Insurance Contributions Acf lor such
month AND the qmount of income tox withheld in such month.
II the total for cny month (except the third month oI o quorter)
is na.ore tLo.n $10O you should deposit the totcl ombunt o{
such toxes lor such month.
Exurnples; If during the month of lonuary you withhold
$89.35 ol income tox, cnd iI the toxes under the Federcl In.
suronce Contributions Acl on your Jonuory pay roll cmount to
$27.12, you should deposit the entire $116.47. Similorln iI
no income tcx is withheld lrom your employees' woges, but
the tcxes uuder the Federol Insuronce Coniributions-Act ex.
ceed $100 for lhe month, you should deposit the entire omount
of the Federql fnsurq.nce ContributionJ Act tcxes. Likewise,
il no liobility lor Federol fnsuronce Contributions Act taxes
is incurred, but you wiihhold more thcn $lOO oI income tcx
during the month, you should deposit the cmount of such
income tqx,
An employer whose monthly totci of these toxes cmounts to
$I00 or less is not required to moke rnonthly deposits but moy
do so
if
he so
desires, Likewise, cny employer who wishes to
mcke c deposit o{ lbe taxes lor the third month of o qucrter
mcy do so.
HOW TO MAKE DEFOSITS
To make y_our {irst depos'l of to_xes with respect lo wages
poid on or clter lonuory l, 1950, IiU in the enclosed Fedeial
Depository Receipt, Form 45Q in o.ccordo.nce with instructions
appecrring on the reverse of the
lorm.
Send or take.the Iorm,
with your remittonce oI the totol omount oI tqxes to be deposited, to the Federai Reserve Bonk which serves your.district. There ore 12 such Bonks in the United Stotes. The od-
dress oI the Federol Reserve Bank with which you should moke
deposits is shown in the list on bock of this notice. II you
prefer, you mcy send or toke the lorm, with remittonce, to o
commericcl bonk which hos been outhorized to accept such
deposits lor trq.nsmittal to the Federcl Beserve Bon[.
For deposits sent &rectly to c Federal Reserve Bcnk, checks
or money orders should be mcde poyable to "Federal Reserve
Bcnk of
. . . , , . .," If deposits ore made through <r
commerciol bcnk, checks or money orders should be rncde
poyable to the commerciol bonk.
Soon cfter receipt oI your Form 450 ond remittonce, the
Federal Beserve Bonk will vqlidote the receipt ond return it
to you by mail. The Federal Reserve Bonk olso wili enclose c
blonk receipt lorm for your use in mcrking your next deposit.
Eoch Form 450 lurnished by the Federol Reserve Bcnli will
contoin certoin prepunched ioentifying inlormation ond ony
exchonge of lorms with cther employers mcy result in your
not receiving proper credit for your deposit.
WIIAT TO DO IryITH THE VAI.IDATED REGEIPTS
You will need the volidoted receipts when you file quorterly
tox returns. Your return lor lhe first quarter oI 1950 cnd
subsequenl quorters will be mcde on Form 94I. (Form W-I
ond Form SS-Icr will be combined into this new return lorm.)
When lilling in Form 941 you will mcke seporcte conputctions
#i:lJ3;@
<+<+<f <<<<+K+<+<<<<<<+<+<+<+
of the income tox withheld ond ol the tcxes under the Federel
Insurcnce Contributions Act, (I{ you ore lioble only lor one
clcss oI such toxes, you will comfute only the tqx I'or which
you cre liable.) Then you will show the.totcl amount oI tqx
or toxes lor the quorter. From this totcrl cmount deduct ihe
cmount previously deposited, cs shown on vour validcted
receipts. The remoinder is due with the return. Send the
relurn, the volidoted receipt or receipts, and your remittonce
oI the remoinder to the Collector oI internol heveoo".
As soon os you- receive ct volidated receipt, you should
make q record ol it, showing the seriol numb6t, dcte oI
dep_osit os evidenced by the Federol Reserve Bank vclidotioa,
qnd omount of deposit to enoble you lo identily such receipi
in the event of loss. Please do not fold or mutitirte the receilt
Iorms.
WIIEN TO MtrKE DEPOSITS
Your deposit or deposits coverinq lncome taxes withheld
and toxes under lhe Federol Insurairce Contributions Act for
the first 2 months oI cny calendq.r quorter should be mode
within l5 doys cfter the blose of eocf such month.
If you choose io mcke c deposit for lhe lost month of o
quorler, you should moke sure thct you do so in sufficient
time Io enable lhe Federcl Beserve Bonk to return the volidcted receipt to you so thct it can be cttached to cnd filed
with your qucrterly return on Form 941 on or before the lost
dcy of the month lollowing the qucrrter.
If y-ou h_cve not_been cssigned on identification number,
you shouJd nevertheless mcke deposits at the proper time.
Do not delay deposits while owciting on identi.ficclioi number.
INQUIRIES f,ND REQUESTS FOR REPTASEMENT OF
IOST V}II.I'DATED RECEIPTS
Inquiries concerninq deposits cnd requests lor issuance of
replocement receipts for lost vclidoted receipts should be
directed to the Federol Reserve Bonk or throush the commerciol bonk with which you mode the deposit oI toxes. AII
such inquiries should stote your nome, cddress, crnd identiJication number, the amount oI ihe deposit, and the serial number
ond Federol Reserve Bonk validotion dote os shown on lhe
receipl, II the volidction dote is unknown, grive ony other
identifying informotion, including the dote ol t[e checli, bonk
o_n wl'ich drawn, bonk in which deposited, etc. Such inquiries
should not be mode oI Collectors oI Interaol Revenuel Replccement receipts will be issued by the Federol Reserve
Bcnk which validoted ihe originol receipt.
WHERE TO OBTAINITDDITIONAI. BI.f,NK TEDERE!.
DEPOSITARY RECEIPTS, nORMS 450
The enclosed Federol Deposilcry Receipt, Form 45O whicb
hcrs been preoddressed, is the only such lcrm you will ieceive
from the Collector oI Interncl Revenue. In the future, blcnk
receipt forms will be moiled to you by lhe Federal Reserve
Bank receiving your deposit. If you need aciditionql Forms
450 you should moke requests io the Federol Reserve Bank
which receives your deposits. Such requests should stote
(l) your employer's identificotion numbef cnd (2) the ncme
and address of the bonk upo_n which you normally drow your
ehecks. In th.e event you moke deposiis throuqh o com-eiciol
bonk which hos been cruthorized cs o depositcry lor Federcrl
toxes, such requests also shouid stote the nq.me o.nd qddress
of ihe commerciol bqnk.
IMPORTANCE OF IMPI.OYER,'S IT'ENTITICATIOIS
NUMAER
Your employer's identificotion number is the 9-diqit number
(for excrn_ple,_ 76-5198667) oppeoring with the employer's
no.me cnd cddress on the lace of the quorterly tox reiurn.
Be sure to use your employer's identificotion number on:
(l) ecch Federcl Depository Receipt, Form 450; (2) on ony
correspondence witb the federol Reserve Bqnk or cuthorized
conmelsql bonk in regcrd to such deposits; ond (3) on your
qucrterly Federal tox returns on Form g4I.
If you do not hove cn employer's identilicotion number
ond hqve no1 opplied lor one, you should promptly notify the
Collector of Internol Revenue lor your distict. Do not cielcty
deposits while owoiting ossignment of your identificction
number.
- In the event cu employer's bronch ollices make tcx deposits,
the employer's identificotion number to be entered on the
Federol Depositary Beceipt lis
the
number which will
oppeor on the return to be filed by the employer. The address to be entered on the depository receipt, however,
sbould be the addrees to which the validated receipt should
be returned by tbe Federol Beser?e Bcnk.
t6-60roa-r
Incorne Tqx
Drnployerte Ldcntilicction
t{urmber
Withheld
Should be lhe $digit .nnmber
<rppeoriag with tlie €mployer's
4one ond od&ece ol the toce
of the quorterly tor retura.
income lor witLbld
by employel ftom
Anouat oL
employees' woges.
.
RA,L
5s
=g
F
a
89
F. t. c. A.
2?
\
at
J2
on
TOTAL
TAXES
N8Y
EIPLOVER'S
2e
t0EtrlrFtc^flot
xtfll€i.
G $r
(PRINT-Do
t H
1l
TTIPIOIER
Nor'wFllrEl
FoR
I
*l
u
E
ol
lg
rxls iEcErPt
lrE
I
F
INIERML
?0
8E
TAXES
Ez
o
OF
FOR
TAX
l^r'ITHHELO
lrst
o
-I
8Y
DEPOSIT RECEIVED:
I ('
I
o!
j
2894 Eldorada
I
EE
oO
ttt
_69
r$
3H
G.s
!li
5
Street
Ilashington
.tr
o
f
rsrrED_tuR ClrECtG VALID
3?lr0
tI
S'HEN FUNOS ARE COLLECIEO
G
FOR
m
t
I
B E 202tn24242528
r
rrhrr.brrg nhr
Gt6!66
Nrrne ot
Enployer
Street Addreac, CllYt
Poatol Zonez cnd Stnte
DcDoEnt
{
rq
feceived
Fe&ral Begerve Bqlk
will be ncde in thia oreo,
gubiect to collectioa ot
enployer'a checL
quorterly
tqr
r
Volidotior ol receipt bY
Uee nqme
qc ii oppeor8
oo lhe
Use oddregs
lo which receipt
is io be retumed
olter vclidotion by the
Federql Reserve Bqnlc
Reserve Bolk ot ti-e ol validotioa.
Employera sbould mole record oI thir
sunber lor use ia the eveat oI loef atolea,
or destroyed volidoted receipta
8
ttl
2329 30 3t
Seriol ltlrrrnber
Thir sunber will be ossigaed by Federol
o
T
I
D.C.
SEE REVERSE OF THIS
a
!2
In
o
Iv
oz
I
-
.i'
RECETPT
TARY
D
INCOME
o
I
Total Taxes
Com$iued !o!or oI . co. a9
tar withheld oudl'. I C. A.
toree. (Should oqree wi{h
ahoua't' oI remitt<rncb.) :
return
Ir{Tfinilff,-n[uEiluE c0LL[GTIoil DIST$trS Rilll FEI]Enru nESEnlE Bflilns
Federol Reserwe Banks,
where detsits shosld
benod.e
Ilternal-Revenue Gollection
Dfutdcte. where Federql
tax relulrns ore liled
. Atlcnto
AIABAMA
ARIZONA:
Counties oi Cochise, Grohom,
Piaq, Sontq Cruz.
A1l othEr cou4ties .
ARKANSAS
CALIFORNIA (All districts)
COLORADO
CONNECTICUT:
Greealee,
)oorus
3, Gc.
13,
KANSA$ CITI:
Te:.
New York 45, N. Y.
Bosloa 6, Moss,
Shilodelphio I, Pc.
DETAWABE
FLORIDA
GEORGIA
Atloato 3, Go.
Atloatc 3, Go.
Sqa Frqncisco 20, Colil.
Squ Frqncisco 20, Colii-
I1AWAII
IDAHO
. . .
lqx telurns cre filed
MISSOURI:
. Soa Froucisco 20, Colil. St. Louis 2, Mo.
. Sou Frqnciseo 20, Colif.
. Kqlee City 18, Mo.
Foirtield CountY .
All other counties .
Tederal Reserwe Bonls'
where detDsits should
be mqde
lntsraLn.c@nre Gollectiort
Itistrictr, where federol
Chicoso 90, Ill.
Couties oI Aadrew, Atchisor, Bcrtoa,
Botes, BucLorcu, Coe, Clcy, Clintol,
De&clb, Gertry, FIoI!, Jocksoa, fospEr, lroo*" city re, !,ro.
MdiDmcld. Nerlu, Nodowon Plotte,
Vqnoa, Worth.
I
All otLs ouuties. , .
.
.
.
,
MONTANA .
MBRASKA .
NEVADA
NSIAI HAMPSSNE
NEW
,
St. Louis 2, Mo.
St- Iouis 2, Mo.
.
sT. LOUrS
.
.
,
.
.
Minoeopohs 2, Mina.
Kcnsqs City 18, Mo.
Son Frarcisco 20, Colifi.
Boetoa 6, Moss.
IEA"SEY:
CAMDEN:
Monmouth
. . New York 45, N. Y.
... . Philodelphio l, Po.
. . . New York 45, N. Y.
County .
NEWARK
NEW MEJf,ICO:
Couutie ol Benolillo, Colfor, Hordiag,
McKialey, Moro. Rio Aribo, SondovoI,
Soa luoo. Sor Miguel Sonto Fe, Tooe,
Udo4 Voleacio.
oiher
All other oulies
NEW YORE (AI1 districis)
NORTH CABOIJNA.
NORTH DATOTA
OHIO (Atl districts)
l.:-J-
couBUeE
Ioclson, IeIterea,
Knox, Loweae,
Louis 2, Mo,
Mortia, Orqage, Perry, Pike, Posey, Scolt, I St.
Speacer, Sullivon, Switzerlqnd, Vonder- |
burqh, Woffick, Woshiugton.
,
Chiccgo 90, Ill.
All other courti€s .
Chicogo 90, Ill.
IOWA
. . . Kqnsos City 18, Mo.
KANSAS
KENTUCKY:
Couuties oI Botb, Bell, Bone, Bourbon,
Boyd, BrqcLen, Breathill, Conpbell, Cor-
Horlql, Horrisou, Iockson. Jessamine,
Johnsoa, Keatoa, Knoti, Knox, Lourel,
Louence, Lee, Leslie, Letcher, Lewis,
Lircolo, McCreory, Modison, Mogoflin,
Morlia, Moson, Menilee, Montgomery,
Morgqn, Nicholqs, Owgley, Peadleiou,
Boberton,
Perry, Pile, Powell, Puloski,
'Whitley,
1, Ohio.
Boalon 6,-M-oas'
Bicl'-oud-13,-Vo.
MiaaoPolie 2. Miu.
I
TENNESSEE:
Counties of Benton, Corroll, Chesier,
VIRGINIA
WeSgDIefOl (iacludias ALASKA)
Dollcs 13, Teros.
VIRGIMA:
WEST
"C""tu""
Atlonto 3, Gc.
WISCONSIN:
"b1""U."
oI
Bichmoad 13, Vo.
Chicogo 90,
Bro-oke,-
i
lst. Louis z, Mo.
J
Miu.
il.
A8ooto 3, Go.
Dallog 13, Ter.
Sca Frarcieo 20, Coht.
Bostou 6, Mosg.
Richmond 13, Vo.
Sor froacisco 20. Colil.
.
Hcncock, Morsholl, ]Clevelcnil I, Ohio.
Auo"li?,?:il#"":"l.
Boston 6, Moss.
.
.
.
oI Ashlord, Bonon, Boyfield,
BuIIolo. Eurnetl, Chippewo, Douglos,
Duan. ilou Cloire, Florence, Foteet, Iron,
Lo Crosse, Ijacoln, Oueidq, PePia,
Pierce. Polk, Price, Rusk, St. Croir'
Sowyer, Tcitor, TremPecleou, Vilcs,
Woshbun.
AII olher coulties
WYOMING
.r;.;;;;,u".
I*"*n"u"
.J"*."n"*, *.
.
Kqnsos City I8' Mo.
St. Louis 2, Mo.
Federol Resewe Boa! oI
--------------(Cityt-
Withheld Tor DePortneat
Webster,
All other
counties .
2, Mun.
Bo*s relolinE
Aay nqil seal lo ot" oI t!" 12 federol Re*re
Beceipts should be qddressed qe Iollows:
b ir;,i.;;lb;;;iiory
Bolivor,
Noxubee,
' '
..
. .
UTAH
Miauecpolis 2, Minn.
Couaties
r, lo.
Clevelord l. Ohio.
Philcdelpbig r, Po.
)ptuoa"rnrio
VENMONT
Miuoeopolis 2,
Oatoaogoa,
18, Mo.
Soa Frcrcieco 2Q Colil.
eon. HEnn, Loke, Iauderdole, McNoiry, I
Boeton 6, Moss.
Keweenow,
ccneroa. clec.fidd,
Mcilison, Obioa, Shelbn Tiptor, llleollev.
Allolhercouoties. . . .
TEXAS (All districts)
St. Louis 2, Mo.
Porishes ol Bieaville, Bossier, Coddo. Ccldwell, Cotohoulo, Cloiborae, Concordia,
DeSoto, Eost Corroll, fro*lia, Grcnt,
Jockeon, LoSclle, Lincoln, Mcd,isoa, Morehouse, Notchitoches, Ouochito, Red River,
Bichloud, Sobine, Tensos, Uaiou, Webster, West Corroll. Wina.
All other polishes
MAINE
MARYLAND
DISTruCT OF
*fii5i:*""*"o,
Kouoe City
PhilodelpLio I' Pc.
.
PITTSBURGII:
Crcckett, Decolut, Dver, Fovette, Gibson,
Hardemol, Hcrdia, HaYwood, Header-
Wolle,
.
I
ONEGON
PENNSYLVANUI:
-Flrnionr^pnre
counties
SCRANTON
RHODE ISLAND
-'OUtttCenOlwA
EOfmf oefofA
ler, Clork, Cloy, Elliott, Estill, Fcyette,
Rockcostle, Fowoa, Scott,
'Woodlord,
aotohq.
All other couties
A1l other
plghing, floyd, Gcrrcrd, Gront, Greeaup,
All other counties
LOIISIANA:
MiaaeopoliE 2, Miu.
ClEvElond l. Ohio.
Iobaslo4 Mc€urtoia, Moreholl Push' Ioquos t3, Ter.
I
I
Dollos 13, Ter.
New YorL 45, N. Y.
Bichaoad 13, Vo.
. . . '
. .
OKLAHOMA:
Couties of Atokc, Bryou, Chmtow, Coql,
Counties oI Clort, Crowlord, Dcvies, Du- l
bois, Floyd, Gibson, Greene, Horriaon,
KoasoE City 18, Mo.
(Poatol Zoue)
Atlonto 3, Go
16-6ol0s-l
*
u. s. GoVERNMENT PI?|NTIN6 OFFICE:
l94FO-857937
(Stote)
.<7
-/
J
FEDERAL RESERVE BANK OF RICHMOND
Rrcsnaono 13, Vrne tNla
Febnrary
6,
1}5A
I'{iss Buth I{. Enerlck, C1erk,
Loudoun County SchooL Boe-rd,
Leesburg, Virgi-aia.
Dear i'ladam:
"t'
He are returning herevith a Federal Depositary Recelpt
inscribed in the nene of toudoun County School Board, Leesburg,
Virginia, as employer, shorring total taxes amounting to *2rA,59.2A,
vhich we received in your letter dated Febmary 3. l{o fora of
payment accompanied this receipt and as it is not exactly elear
why you sent it to us ve thought it best to return it to you.
It appears that the emount shown on this recelpt represeats Federal taxes rithheld by the toudoun County Sehool Board
from vages pal"d to enployees during the month of January, and if
this is the case the amount shoul-d be deposited r+ith us, or with
a conmercial bank whlch has quallfied to receive such delrcsits.
In either event the d.eposit shoul-d be accompanied with tb.e enclosed
i
I
receipt.
Tt is probable that you intended to deposit thls amount
rith us and if thls is the case, please returtr the reeei.pt to us
wlth your check, or draft, paya.ble to our order for the amor:nt,
in which event we wLll validate tbe receipt a:rd returr lt to you
along with a blank reeeipt fo::n to be used ln rnaking your next
q
4
deposit.
Very
truly yours,
B. M. Blnford,
Bank Aeeouats Department.
E$B:l{R
Enc.
:'
J
8r3H";L$%I;l'-ti.u4 nE00ilclg.lATl{}il 0Ewgsffi
raturnar*evenueservico
.',
,
tr".
Tcn{xl ilmlber
boHnng
rffi #lf,ffFlflE"fi rR0M tyAGES
as lexgfted 0n Emlbyef's orarterly Fedelal fax.flMin4norm 941) wi&
lmsme tax $rfrMf, as &0m or Withilfimry Sftdgnenb (FurmsY-20
E. f,dilst imme iar cpithheli[ horn wcges durhrg &e yecl
€s S{r!flil lir k € llf Scwrs 9t1!.r
L2
Quutter rsndled Ma*t{r 31----- {)raanter'eredted hme 30--------.-__:0Quarte sded S*tsnb€r 30-__m.
of ooffli€s o{ wilh(Fcnns W-2a)
*oiffih
t*onsmitted h€rcryilh-
DUPilcATE
-*- ------
-.--
--
--
2. Totc1 lncome tax withheld "from
'wlrges dminE the yecr qs shown
by copies oI withholding *atemerrts-(forrrsW-2") ----- -----* 5
-
56'1?5"110
Qucrte#dDec€rnber EL
te)
TO{'A&__-_*
ReeoxtaiiEqlion
yrrr
f or
colenilct
re ribmrr or odgind.
NOTE
Any fisorepancy between lhc
amoffib dlrown ,om LirFs (fi) ard
(8) m$bef#ytxdaildham
afimhd shtemenl {w in$r'wtions on reYsrse).
(Euployer's aame, cddress, cnd identificction
nuber
qs ghom
m oriqfu'nl.)
TI{TS TffiV ffiUST BE
MgT II{fiT' EY EMPLOYER
to-czsoz-g
r?
cro
I2 t\)
RECEIPT
-:2,\FOR REGISTERED ARTICTE l.Io.
Fee paiil ---1--u-/-1rr(-Z------, ts b- 3
Class postage
Declared value, s.
-
$- -.-
-
4l
paiil
-
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Fom 94L (Rev. Jan. 1952)
U. S. TBEASURY DEPANTMENT
f nteraol Bevenue Semice
DUPLIGIlTE
EMPI.OYER'S OUftRTERIY FEDERAT TAX RETI'RII
!, federol fncorne Tcx Withheld frorn
be retoined b3r t.axttcyer
sl,8!00
Wuges (II not reguired to withhold, write
2, Adjustment for preceding quqrter(s) of cclendcr yeor, (Attach explanation. See instructions)
$
3. Income tox withheld, os adjusted--Enter Adiu3ted Totul
Federcl fnsurcnce Gontributioni Act Tcxes (If no tcxoble woges paid, w:ite 'Nonei')
4. Number of employees listed in Schedule A
5. Total tcxqble Wcgcs pcid (from Item 21)
;:
t
i
dggee__ xo
6. 3Vo of wages in llem 5 O%To employer lcrx and L/zVo employee tox)--------------:--------------7. Credit or adjustment. (Aftcrch explonction, See instructions)
8. F.I.C.A. tcxes (Item 6 os cdjusied by ltem 7)----------- EnterAdiustedTotolHere.*
9. Totcl lcxes (ltem 3 plus Item 8), See Depositcry Beceipt Record on hn alt
Rehrn lor Cqleadcr Quarter
(Etrter quoll€r os showa on
(ir
this apcce employe/e aooe. oddress, cad ideutillcction
excctly os shown otr oriEinal,
00
g?,
2
II q bueiaees is eold or troufened by oc
euployer to cnother. eoch employer must file a
a€pqrote return. Such o trclsler occurs, for
excmple, iI there is o chcngre in membership of
oa ordinory portaersLip, or iI o gole propriEtor
Ioma o pcrtnership or q corrrorqtioa, Nellher
enployer sbould report wqges pdid by tle other
employer. I{ lhe new employer does not hqve oa
identificqtion nunber, he ehould lot use the
identificoff.ou number ossigned to the previous
employer, but must file qa qpplicotior on form
SS-4 Ior q new number Ior himsEll. (See Itema
15 ond 16 below.)
originol)
or plint
sa9go
tprl.l
0lrrk Sch' Soard
10, Type
$-
auler
SCIIEDUT.E A_QUARTERI.Y NDPORT Of Wf,GES TAXAELE UNDDR THE TEDERtrf, INSURAIVCE GOITITRIBUTIONS AGT
tist for eoch employee the WAGES toxoble under lhe
quqrter, If you poy
on employee more thcn $3,600 in o colendar yeo!,
woges were not loxcble under the F.I.C.A., nrake no entries below except
12.
THIS C[}PY MUST BE IGPT BY EMPI.IIYER
?otol
poges
cif
eE-
13.
This copy, together with o copy of eoch related schedule or stctement which the employer is required
lo keep, must be ccrefully preseryed by the employer ot his principcrl ploce oI business, crnd should crt oll
times be ovciloble for inspection by olficers oI lhe Burequ oI Iaterirol Revenue.
thts
ds
14.
t
15. Do yop expect to pcy toxoble wdges in the lulure to qny eEployoe i!
e business, ogriculturol, governmeatol, or nonprofil octivity?
v^:
les flLl
rr_ f---l
rte
[l
16. HoE c change oI omerahip, or other
Write "Final Beturn" ot the top of thia page.
lrcosfer, oI the busluesg tqten
Attoch statemert showi4q (o) iustodion oad loco6ou oI records, (b) dcle of losl poymert of toxable wcges to sucb
employees, and (c) whether or lot you will poy toxoble wog€s iu the fuiure to household enployees.
If NNo"
Check reoson, in cppropricte block below, Ior
I
I
I
Sole ot buslnese
to successor .[
Business discontinued
tilirg lrnol retun,
ploce during lhe qucrter?
Yesn NoE
ff "Yes,"
Dischciged oll:enlloyeer, brit gtill iu bueinese
cttcch-
showlng
-stolementyour
uqme oud addreEg
of
n otne; 6eealyl:l-- .--------
ceeeor og predecessor.
auc-
Fomed aew pcrtnership
EMPI.OYEE'S ACCOUNT NUMBEN
see C,lroulcr E or A
Toxoble WAGES Paid to
Eaplolree Duing Quorter
(Before deduciions)
NAI,'E OT EMPLOYEE
(Fiecse iype or priai)
Il nuabe is urkaown,
(te)
000
oo
o000
Dollcrs
----------------Iltbere is not euough spcce to liet cll employees cbove, use Schedule A conflnuction
Totol waoes reDorted in Column 19 on this
gheets
--
Fon 94lq
s
Darde
2I. TOTAI fOR THIS RETURN-Totql taxoble
t-
CeatE
wages poid during qucrter------------------- s
f Enter thia totcl ta
-----------------i IteE 5 qbove,
ctr-16 --6{ta44-5
DNPOSITARY RECEIPT RECORD
rl
tt
Sericl No, of Form
This spcrce is to be used only by employers
450
fed.
in occordqnce with Circulor E.
Such deposits for the third month of cny
gucrter, ond deposits of $I00 or less, ore
perrnissible but not required. Eoch deposit
should be occompcnied by cr Beceipt.Form
450 which will be volidated by the Federol
Reserve Bank crnd returned to employer.
Vqlidated receipts should be listed in this
space qnd submitted with this return, together with such other remittonces os moy
be necesscrry to poy totol toxes shown in
Item 9 on other side of this form.
Amount
Bes, Vcrlidcrlion Dote
who mcke deposits of income tox withheld
and F.LC.A. to.xes. Every employer who
is lioble for more than $100 of these taxes
during a month should deposit such taxes in
o Federol Reserve Bo.nk or an authorized
-
!t
-- ----*S?8r-S0-'---
- ---t!fitr&'---
-*€ffis8o --
loc<rl bonk
Totol ol oll Depositcry Receipts-------Total ol other remittonces (such os cosh, check, M. O., etc.)-,.
Totol
as Item 9 on other
$-l,g$sors
GENERAL INSTRUGTTONS
The instructions below tell you details for prepcrrinq ond filing
Form
If the preoddressed form is lost, o new one should be requested. I{ nec-
941. Additionol instructions cre contqined in Circulor E or in a brief essory lo use o form not preoddressed, type or print in Ilems lO and
ll the employe!'s nd.me ond identilication number exoctly qs shown
pomphlet for formers, Circulor A.
Circulcr E contcins instructions qs to both (o) income iax with- on his previous returns, Do not use the identi{icotion number ossigned
hotding from woges, ond (b) toxes under ihe Federol Insurqnce to c prior owner'
Conlributions Act. Circulor A is avoiloble for use.by .employers An employer liable lor toxes under the Federcl Insuronce Contribuwho hqve only ogriculturol employees cnd who cre liqble only lor
tions Act who has not opplied lor cn identi{ication number should lile
F.I.C.A. toxes, Employers should relbr to such circulqrs lor.informa- with the Collector an opplicction on Form SS*4. Such lorm moy be
tion qs to the employers qnd employees who are liable. for these obtoined from the Collector or Irom ony Social Security Administrotcxes, the types of poyments defined by low cs "woges," the com' fion field office.
puting cnd deducting of toxes lrom wcges, how to odiust errorg, cnd
An employer lioble for incorne tox withheld from wcges, but not
other Iacts employers need to know in order to comply with the law.
ossioned on
of circular E or circulor A mcy be obioined lrom the subject to the Federol Insurcrnce contributions Act, will be
copies
Collector of Internol Revenue upon request. Bmployers olso mcy
obtoin copies of Circulor H, "Household Employer's Social Securit,
Tox Guide." Speciol instructions for employers or ogri"oiiorot orri
household employees appeor on the bock oI the origincl ol this return.
Puqroee ol Form 941.-This lorm comblnes the reporting of
income tox withheld from woges ond the toxes under the Federal
Insurance Contributions Act. II you hove only one ol these tqxes to
report, you should lill in only the portions which cre cppliccble to you.
lilho rnust file.-If you hove one or more employees you must
moke cr return lor the first qucrter in which you cre required to
withhold income tox from wcges, or in which you pay wcges toxoble
uader the Federol Insuronce Contributions Act, crnd lor eoch quorter
lherecfter.
roentificotion number by the Collector without
em.ployer hoving only household employees
"*U
cotion lor on identilicotion nunrber'
"4
cpp"
";'it!llT#F
Thelowprovidesopenclty oIhom\/61o25/eof
thetox,butnotless
Penolties aleo ore imposed by lcw for willful lqilure to poy, colleci,
or fuuthfuliy occount for ond pay over tox, furnish statemeats lo
employees, keep records, mcke returns, or lor folse or fraudulent
rot""itt"=,]ffiil';-ffi :n::lfi:I"r1J,:1ff:*:1':1*lj}:ff::til::iliff$ff
ocrober, November,
belore
An;fi; --l"l;l;"
O"ii". af
Due oa or
Decenber
rJ;;;;i
ltem 7. Creilil or qdingtment ol laxer under federel rnsur.
cnc6 Gonrriburions acr.-Entries in ltem z shourd be mode lor the
correction of underpcymentg or overpcyments of F.I'C.A. icrx crs
on c prior return' or credits lor overpcvme4ts of pencltv or
ft:n"d
ffi'jl1Tj.$H"jff::f j:",il:J"tfifli";1'J':.T;,tlllH;fi:
only i{, the return is occomponied by depositcry dillerence between the two should be eniered in Item 7. llny crnrounl
However,
receipls, Form 450, showing tirrely deposits in full pcyment oI the
cnlcred ln ltcrn ? musl be explalned by o slaiemenl nttcched
if,
<rnd
tqxes due lor the entire colendor quorter, the return rncy be filed on
or belore the tenth doy ol the second month lollowing the qucrter for
which it is made.
Unless olreody shown on the lorm received from the Collector, enter
in the spoces ot the right o{ the employer's nome the months ond yeor
oI the colendcr quorter lor which the return is filed.
I{ you no longer expect to pcy woges subjecl to ony oI the tqxes on
thig lorm you must {ile o "Finol Return." Such return is due not later
than the 30th dcy olter the dote ol the lost poyment of toro.ble wcges
oE shown in ihe stotement colled for in Item 15 of ihe reluru.
Where io file.-The origincl of this form is lo be senl to the United
Stctes Collector of Internol Revenue for the district in which the
employer's principol plqce of business is locqted. The duphcqte is to
be kept by the employer.
to lhe relurn. This stotement
must be occomponied by
or
must set lorth:
,-\
E*-r---r-- ^r rL^--^ which the entry is intended to correct;
the error
1o) Explonotion of
ft) The particulor return period or periods to which the error relqtes;
(c) The crmount chcrgecble to eoch such period;
(d) The tqx-return period in which the error wos crscertoined;
i")
Tbe loqt thot the employer repcrid F.I.C,A. tcx overcollected
from on employee, il the enhy corrects cn gvercollection of lqx
so
repcid; cnd
(f) It the entry corrects F.I.C.A. tax overcollected lrom on
employee in o prior yeor, the fcct thot the employer hos
obtoined lron ihe employee o written slatement thot the
employee hos not cloimed ond will not clqim relund or credit
of the amount ol such overcoilection.
II erroneous omounts of woges were reported lor employees on prior
returns, stcte:
remiicombinqtion
oI these) for the total loxes reporled in Item 9. If poyment is mode
pcrtly or wholly by depository receipts, Form 450, fill in tbe depository
receipt record on ihe back of the origincl and ot the top ol this poge.
Ernployer's ;rcrme, cddress, cnd identificotion nurnber.Forms 941 preoddressed by Collectors should be used in liling returns.
Pcyrnenl of lax.-Eoch reiurn
tcrnce (cash, check, money order, depositcry receipt,
r
than $5, Ior lote filing unless reosonable cq.use is shown for the delcy.
If you cre unovoidobly lote in lilinq o return, send o full explonotion
in writing olong 'with yout return.
returng.
covered
Icnucry, Februory, Morch
April, Moy, Iune
Iuln August, September
:
Perrclties cnd interest,-Avoid penolties and interesi by filinq
correct returns on time, and by poying the tox with the relurns.
If yorr tempororily discontinue poyinq woqes (for exompie, seosono.l ltern 2. Adiustment of incorne tdx withhetd"-Itenr 2 of this
octivities) you must nevertheless file returns. In cose of o chonge of
return is to be used {or the correciion oI errors in the omount of income
ownership or other rronsrer of the business during ;.";;#'0""
rhe ord qnd new emproyer must {irereturns,
wogee paid by the other'
a slcrlertenl cltached lo the relurn. This stotement must set lorih:
After you hove once liled o return, the Collector wiII mcil you a
(o) Explcnation oI the error which the entry is intended to correst;
blonk forro every three months. If the form should foil to r"""u vo",
(b) Theporticulcrrelurnperiodorperiodstowhichtheerrorrelotes;
request o Form 941 lrom the collector so that yoo-"oo;;k";"";
(c) The omount chqrgeqble to eqch such period; ond
return on time.
(d) The monner in which the employer ond employee hove settled
Qucrlerly retgrns crad due dcter,-A return must be filed {or
cny overcollection or undercollection of income tox withheld'
eoch guorter oI the cqlendor yecr oe lollows:
euqrrer
I
(o) The nome
<rnd occount number of eoch employee whose wcges
were erroneously reported;
(b) The omount of wcges erroneously reported lor eoch qucrter lor
eoch employee (iI none, so stote); ond
(c) The omount of wcges which should hove been reported lor eoch
qucrter for eoch employee (il none, so stote).
(seedcothe.rn:x':"T;i:::,;."J"*::il;:**'"',
i