Annual Return of Withheld Federal Income Tax

Form 945

Department of the Treasury

Internal Revenue Service Please type or print.

Employer identification number (EIN)

Name (as distinguished from trade name)

Trade name, if any

Address (number and street)

1 Federal income tax withheld from pensions, annuities, IRAs, gambling winnings, etc. 1

2 Backup withholding 2

See separate instructions. For more information on income tax withholding, see Pub. 15 (Circ. E) and Pub. 15-A.

OMB No. 1545-1430

3

4

5

3

4

5

Total taxes. If $2,500 or more, this must equal line 7M below or line M of Form 945-A

Total deposits for 2009, including overpayment applied from a prior year and overpayment

applied from Form 945-X

Balance due. If line 3 is more than line 4, write the difference here. For information on how 

to pay, see the instructions

6 Overpayment. If line 4 is more than line 3, enter overpayment here $ and check if to be:

Applied to next return or

Monthly Summary of Federal Tax Liability. (Do not complete if you were a semiweekly schedule depositor.)

Tax liability for month

A January 

B

C

D

E

F

G

H

I

J

K

L

Total liability for

year (add lines A

through L)

M

February

March 

April 

May 

June 

July

August

September 

October 

November

December

Tax liability for month Tax liability for month

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 14584B Form 945 (2009)

City, state, and ZIP code

7

Enter state code

for state in

which deposits

were made only

if different from

state in address

to the right 

(see the

instructions).

● Monthly schedule depositors: Complete line 7, entries A through M, and check here 

● Semiweekly schedule depositors: Complete Form 945-A and check here 

● All filers: If line 3 is less than $2,500, do not complete line 7 or Form 945-A.

For withholding reported on Forms 1099 and W-2G.

A and enter date final payments made. 

Designee’s

name 

Do you want to allow another person to discuss this return with the IRS (see the instructions)? ThirdParty

Designee Phone

no. ( )

Yes. Complete the following. No.

Personal identification

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 

Refunded.

If you do not have to file returns in the future, check here 

Calendar year If address is

different

from prior

return, check

here. 

2009

Date Preparer’s SSN or PTIN

Preparer’s Paid signature

Preparer’s

Use Only

Firm’s name (or

yours, if self-employed),

address, and ZIP code Phone no. ( )



EIN

Check

if selfemployed
p

Complete Form 945-V, Payment Voucher, if you are

making a payment with Form 945, Annual Return of

Withheld Federal Income Tax. We will use the

completed voucher to credit your payment more

promptly and accurately, and to improve our service to

you.

Otherwise, you must deposit your payment at an

authorized financial institution or by using the

Electronic Federal Tax Payment System (EFTPS). See

section 11 of Pub. 15 (Circular E) for deposit

instructions. Do not use Form 945-V to make federal

tax deposits.

To avoid a penalty, make your payment with your 2009

Form 945 only if:

Making Payments With Form 945

● Your total taxes for the year (line 3 on Form 945) are

less than $2,500 and you are paying in full with a

timely filed return or

● You are a monthly schedule depositor making a

payment in accordance with the Accuracy of Deposits

Rule. See section 11 of Pub. 15 (Circular E),

Employer’s Tax Guide, for details. In this case, the

amount of your payment may be $2,500 or more.

with Form 945. However, if you pay an amou

Form 945 that should have been deposited, 

be subject to a penalty. See Deposit Penaltie

section 11 of Pub. 15 (Circular E).

Specific Instructions

● Enclose your check or money order made 

the “United States Treasury.” Be sure to ente

EIN, “Form 945,” and “2009” on your check 

order. Do not send cash. Do not staple Form 

your payment to the return (or to each other)

● Detach Form 945-V and send it with your 

and Form 945 to the address provided in the

Instructions for Form 945.

Form 945-V

Department of the Treasury

Internal Revenue Service

Payment Voucher OMB No

Box 2—Amount paid. Enter the amount pai

Form 945.

Box 1—Employer identification number (E

do not have an EIN, apply for one on Form S

Application for Employer Identification Numb

write “Applied For” and the date you applied 

entry space.

Box 3—Name and address. Enter your nam

address as shown on Form 945.

1 2

3

Enter the amount of your payment Enter your employer identification number (EIN).

Enter your business name (individual name if sole proprietor).

Enter your address.

Enter your city, state, and ZIP code.

Dollars 

If you have your return prepared by a third party and

make a payment with that return, please provide Form

945-V to the return preparer.

 Detach Here and Mail With Your Payment and Form 945.  

Note. You must also complete the entity info

above line A on Form 945.

(77)

Do not attach this voucher or your payment to Form 945.

✁ 

20