OMB No. 1545-0028 Employer’s Annual Federal

Unemployment (FUTA) Tax Return Form 940

Department of the Treasury

Internal Revenue Service © See separate instructions for information on completing this return.

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Yes No

If you will not have to file returns in the future, check here, and complete and sign the return ©

Computation of Taxable Wages

1

Total payments (including payments shown on lines 2 and 3) during the calendar year for

services of employees

1

Exempt payments. (Explain all exempt payments, attaching additional

sheets if necessary.) ©

2

2

Payments for services of more than $7,000. Enter only amounts over the

first $7,000 paid to each employee. Do not include any exempt payments

from line 2. The $7,000 amount is the Federal wage base. Your state

wage base may be different. Do not use your state wage limitation

3

3

4 Total exempt payments (add lines 2 and 3) 4

5 Total taxable wages (subtract line 4 from line 1) © 5

Form 940 (1998)

Part I

If this is an Amended Return, check here ©

A Are you required to pay unemployment contributions to only one state? (If “No,” skip questions B and C.)

B

C

Be sure to complete both sides of this return, and sign in the space provided on the back.

Name (as distinguished from trade name) Calendar year

Trade name, if any

Address and ZIP code Employer identification number

Did you pay all state unemployment contributions by February 1, 1999? ((1) If you deposited your total FUTA

tax when due, check “Yes” if you paid all state unemployment contributions by February 10. (2) If a 0%

experience rate is granted, check “Yes.” (3) If “No,” skip question C.)

Were all wages that were taxable for FUTA tax also taxable for your state’s unemployment tax?

If you answered “No” to any of these questions, you must file Form 940. If you answered “Yes” to all the

questions, you may file Form 940-EZ, which is a simplified version of Form 940. (Successor employers see

Special credit for successor employers on page 3 of the instructions.) You can get Form 940-EZ by calling

1-800-TAX-FORM (1-800-829-3676) or from the IRS’s Internet Web Site at www.irs.ustreas.gov.

Yes No

Yes No

Cat. No. 11234O

Form 940-V

Department of the Treasury

Internal Revenue Service

Form 940 Payment Voucher

DETACH HERE

OMB No. 1545-0028

Use this voucher only when making a payment with your return.

Complete boxes 1, 2, 3, and 4. Do not send cash, and do not staple your payment to this voucher. Make your check or money order payable to the

“United States Treasury”. Be sure to enter your employer identification number, “Form 940”, and “1998” on your payment.

(99)

1998

1998

Enter the amount of the payment you are making Enter the first four letters of your last name

(business name if partnership or corporation)

1 2

4 Enter your business name (individual name for sole proprietors)

© $ .

3 Enter your employer identification number

Enter your address

Enter your city, state, and ZIP code

Instructions for Box 2

—Individuals (sole proprietors, trusts, and estates)—

Enter the first four letters of your last name.

—Corporations and partnerships—Enter the first four

characters of your business name (omit “The” if

followed by more than one word).

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Tax Due or Refund

1 Gross FUTA tax. Multiply the wages in Part l, line 5, by .062 1

2 Maximum credit. Multiply the wages in Part l, line 5, by .054 2

3

Total FUTA tax (subtract line 6 from line 1). If the result is over $100, also complete Part III

Total FUTA tax deposited for the year, including any overpayment applied from a prior year

5

Balance due (subtract line 8 from line 7). Pay to the “United States Treasury”. If you owe more

than $100, see “Depositing FUTA Tax” on page 3 of the instructions ©

6

7

Overpayment (subtract line 7 from line 8). Check if it is to be: Applied to next return

or Refunded ©

7

Record of Quarterly Federal Unemployment Tax Liability ( Do not include state liability. ) Complete only if

line 7 is over $100. See page 6 of the instructions.

Quarter First (Jan. 1–Mar. 31) Second (Apr. 1–June 30) Third (July 1–Sept. 30) Fourth (Oct. 1–Dec. 31) Total for year

Liability for quarter

(a)

Name

of

state

(i)

Contributions

paid to state by

940 due date

(h)

Additional credit

(col. (f) minus col.(g)).

If 0 or less, enter -0-.

(g)

Contributions

payable at experience

rate (col. (c) x col. (e))

(f)

Contributions if

rate had been 5.4%

(col. (c) x .054)

(e)

State experience

rate

(b)

State reporting number(s)

as shown on employer’s

state contribution returns

(c)

Taxable payroll

(as defined in state act)

(d)

State experience rate period

From To

Totals ©

Total tentative credit (add line 3a, columns (h) and (i) only—for late payments also see the instructions for

Part II, line 6 ©

Form 940 (1998) Page 2

Part III

Computation of tentative credit (Note: All taxpayers must complete the applicable columns.)

3a

3b

4

9

8

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, and that no part of any payment made to a state unemployment fund claimed as a credit was, or is to be, deducted from the payments to employees.

Signature © Title (Owner, etc.) © Date ©

8

9

Credit: Enter the smaller of the amount in Part II, line 2 or line 3b; or amount from the worksheet

in the line 6 instructions

10

10

Part II

6