OMB No. 1545-1110

Employer’s Annual Federal

Unemployment (FUTA) Tax Return

Form 940-EZ

Department of the Treasury

Internal Revenue Service

Name (as distinguished from trade name) Calendar year FF

FD If incorrect,

make any

necessary

changes.

Trade name, if any FP ©

Address and ZIP code Employer identification number

–

Follow the chart under “Who Can Use Form 940-EZ” on page 2. If you cannot use Form 940-EZ, you must use Form 940 instead.

A Enter the amount of contributions paid to your state unemployment fund. (See instructions for line A on page 4.) ©

B (1) Enter the name of the state where you have to pay contributions ©

(2) Enter your state reporting number(s) as shown on state unemployment tax return. ©

If this is an Amended Return check here ©

Taxable Wages and FUTA Tax

1 Total payments (including payments shown on lines 2 and 3) during the calendar year for services of employees 1

Amount paid

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 

3

3

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

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

6 FUTA tax. Multiply the wages on line 5 by .008 and enter here. (If the result is over $100, also complete Part II.) 6

7 Total FUTA tax deposited for the year, including any overpayment applied from a prior year (from your records) 7

8 Amount you owe (subtract line 7 from line 6). This should be $100 or less. Pay to “Internal Revenue Service” © 8

9 Overpayment (subtract line 6 from line 7). Check if it is to be: Applied to next return, or Refunded © 9

Record of Quarterly Federal Unemployment Tax Liability (Do not include state liability.) Complete only if line 6 is over $100.

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

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 ©

DO NOT DETACH

940-V-EZ 1991 Form 940-EZ Payment Voucher (Rev. January 1992) (If any of the preprinted information is incorrect, make the changes on Form 940-EZ, not on the payment

voucher.) Department of the Treasury

Internal Revenue Service

Form

● Make check or money order payable to the

Internal Revenue Service. Do not send cash.

● If payment is over $100 you must deposit

the amount due.

● Enclose but do not staple your payment with

this return.

Form 940-EZ (1991)

T

I

T

If you will not have to file returns in the future, check here (see Who Must File a Return on page 2) complete, and sign the return ©

$

Part I

Part II

Cat. No. 10983G
Form 940-EZ (1991) Page 2

Count all regular, temporary, and parttime employees. A partnership should not

count its partners. If a business changes

hands during the year, each employer

meeting test (1) or (2) above must file.

Neither should report wages paid by the

other.

Paperwork Reduction Act Notice.—We

ask for the information on this form to

carry out the Internal Revenue laws of the

United States. You are required to give us

the information. We need it to ensure that

you are complying with these laws and to

allow us to figure and collect the correct

tax.

Did you pay

unemployment

contributions to only one

state?

No ©

Yes

Household Employers.—File a FUTA tax

return ONLY if you paid cash wages of

$1,000 or more in any calendar quarter in

1990 or 1991 for household work in a

private home, local college club, or a local

chapter of a college fraternity or sorority.

The time needed to complete and file

this form will vary depending on individual

circumstances. The estimated average time

is:

Ä

Did you pay all state

unemployment

contributions by the due

date of Form 940-EZ?

No ©

Recordkeeping 5 hr., 20 min.

Learning about the

law or the form 7 min.

Note: See Pub. 926, Employment Taxes

for Household Employers, for more

information.

Yes

Preparing and sending

the form to IRS 26 min.

Ä

Agricultural Employers.—File a FUTA tax

return if either of the following applies: Were all wages that were

taxable for FUTA tax also

taxable for your state’s

unemployment tax? If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form more

simple, we would be happy to hear from

you. You can write to both the Internal

Revenue Service, Washington, DC 20224,

Attention: IRS Reports Clearance Officer,

T:FP; and the Office of Management and

Budget, Paperwork Reduction Project

(1545-1110), Washington, DC 20503. DO

NOT send the form to either of these

offices. Instead, see Where To File.

No ©

(1) You paid cash wages of $20,000 or

more to farmworkers during any calendar

quarter in 1990 or 1991; or

(2) You employed 10 or more

farmworkers during some part of a day

(whether or not at the same time) for at

least 1 day during any 20 different weeks

in 1990 or 1991.

Yes

Ä

Ä You cannot use Form

940-EZ; use Form 940

instead.

You can use Form

940-EZ.

Count aliens admitted to the United

States temporarily to do farmwork to see if

you met either of the above tests.

However, wages paid to these aliens are

not subject to FUTA tax before 1993.

Note: Do not file Form 940-EZ if you have

already filed Form 940 for 1991.

General Instructions

Who May Use Form 940-EZ.—You may

use Form 940-EZ if:

Purpose of Form.—The Federal

Unemployment Tax Act (FUTA), together

with state unemployment systems,

provides for payments of unemployment

compensation to workers who have lost

their jobs. Most employers pay both

Federal and state unemployment taxes.

Use this form for your annual FUTA tax

report. Only the employer pays this tax.

Nonprofit Organizations.—Religious,

educational, charitable, etc., organizations

described in section 501(c)(3) of the

Internal Revenue Code and exempt from

tax under section 501(a) are not subject to

FUTA tax and are not required to file.

(1) You paid unemployment taxes

(“contributions”) to only one state;

(2) You paid these taxes by the due date

of Form 940-EZ; and

(3) All wages that were taxable for FUTA

tax were also taxable for your state’s

unemployment tax. Otherwise, use Form

940. For example, if you paid wages to

corporate officers (these wages are taxable

for FUTA tax) in a state that exempts these

wages from its unemployment taxes, you

cannot use Form 940-EZ.

Completing Form 940-EZ.—If your FUTA

tax for 1991 (line 6) is $100 or less,

complete only Part I of the form. If your

FUTA tax is over $100, complete Parts I

and II. See the instructions for Part II for

information on FUTA tax deposits.

Who Must File

General Rule (household and agricultural

employers see next column).—File a

FUTA tax return if either of the following

applies:

Filing Hint.—You can help avoid IRS

contacts for missing information and

delays in processing your return by making

sure you fill in all the lines that apply to

you. And, if you are not using a

preaddressed Form 940-EZ, be sure you fill

in the name lines exactly as they were

shown on your Form SS-4, Application for

Employer Identification Number.

(1) You paid wages of $1,500 or more in

any calendar quarter in 1990 or 1991; or

(2) You had at least one employee for

some part of a day in any 20 different

weeks in 1990 or 1991.

(Instructions continued on next page.)

The following chart will lead you to the

right form to use.

Who May Not Use Form 940–EZ.—

If you pay any wages that are subject to

the unemployment compensation laws of

the state of Michigan, you must file Form

940, instead of Form 940-EZ.
OMB No. 1545-1110

Employer’s Annual Federal

Unemployment (FUTA) Tax Return

Form 940-EZ

Department of the Treasury

Internal Revenue Service

Name (as distinguished from trade name)

If incorrect,

make any

necessary

changes.

Trade name, if any ©

Address and ZIP code Employer identification number

–

Employer’s Name, Address, and

Identification Number.—If you are not

using a preaddressed Form 940-EZ, type

or print your name, trade name, address,

and employer identification number (EIN)

on Form 940-EZ.

If You Are Not Liable for FUTA Tax.—If

you receive Form 940-EZ and are not liable

for FUTA tax for 1991, write “Not Liable”

across the front of the form, sign the

return, and return it to the IRS. Note: If you

will not have to file returns in the future,

check the box on the line below B(2),

complete and sign the return.

Identifying Your Payments.—When you

pay any amount you owe to the IRS (line 8)

or make Federal tax deposits, write on

your check or money order: Your EIN,

“Form 940-EZ,” and the tax period to

which the payment applies. This helps

make sure we credit your account

properly.

See Pub. 583, Taxpayers Starting a

Business, for details on how to make tax

deposits, file a return, etc., if these are due

before you get your EIN.

Due Date.—Form 940-EZ for 1991 is due

by January 31, 1992. However, if you

deposited all tax due on time, you have 10

more days to file.

Follow the chart under “Who Can Use Form 940-EZ” on page 2. If you cannot use Form 940-EZ, you must use Form 940 instead.

A Enter the amount of contributions paid to your state unemployment fund. (See instructions for line A on page 4.) ©

B (1) Enter the name of the state where you have to pay contributions ©

(2) Enter your state reporting number(s) as shown on state unemployment tax return. ©

If this is an Amended Return check here ©

Taxable Wages and FUTA Tax

1 Total payments (including payments shown on lines 2 and 3) during the calendar year for services of employees 1

Amount paid

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 

3

3

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

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

6 FUTA tax. Multiply the wages on line 5 by .008 and enter here. (If the result is over $100, also complete Part II.) 6

7 Total FUTA tax deposited for the year, including any overpayment applied from a prior year (from your records) 7

8 Amount you owe (subtract line 7 from line 6). This should be $100 or less. Pay to “Internal Revenue Service” © 8

9 Overpayment (subtract line 6 from line 7). Check if it is to be: Applied to next return, or Refunded © 9

Record of Quarterly Federal Unemployment Tax Liability (Do not include state liability.) Complete only if line 6 is over $100.

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

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 ©

If you will not have to file returns in the future, check here (see Who Must File a Return on page 2) complete, and sign the return ©

$

Part I

Part II
Form 940-EZ (1991) Page 4

Where To File

If your principal business,

office, or agency is

located in:

File with the

Internal Revenue

Service Center at:

Florida, Georgia, South Carolina Atlanta, GA 39901

New Jersey, New York (New

York City and counties of

Nassau, Rockland, Suffolk,

and Westchester)

Holtsville, NY 00501

New York (all other counties),

Connecticut, Maine,

Massachusetts, New

Hampshire, Rhode Island,

Vermont

Andover, MA 05501

Illinois, Iowa, Minnesota,

Missouri, Wisconsin Kansas City, MO 64999

Delaware, District of

Columbia, Maryland,

Pennsylvania, Puerto Rico,

Virginia, Virgin Islands

Philadelphia, PA 19255

Indiana, Kentucky, Michigan,

Ohio, West Virginia Cincinnati, OH 45999

Kansas, New Mexico,

Oklahoma, Texas Austin, TX 73301

Alaska, Arizona, California

(counties of Alpine, Amador,

Butte, Calaveras, Colusa, Contra

Costa, Del Norte, El Dorado,

Glenn, Humboldt, Lake, Lassen,

Marin, Mendocino, Modoc, Napa,

Nevada, Placer, Plumas,

Sacramento, San Joaquin,

Shasta, Sierra, Siskiyou, Solano,

Sonoma, Sutter, Tehama, Trinity,

Yolo, and Yuba), Colorado, Idaho,

Montana, Nebraska, Nevada,

North Dakota, Oregon, South

Dakota, Utah, Washington,

Wyoming

Ogden, UT 84201

California (all other counties),

Hawaii Fresno, CA 93888

Alabama, Arkansas,

Louisiana, Mississippi, North

Carolina, Tennessee

Memphis, TN 37501

If you have no legal residence or principal place

of business in any IRS district, file with the Internal

Revenue Service Center, Philadelphia, PA 19255.

Penalties and Interest.—Avoid penalties

and interest by making tax deposits when

due, filing a correct return, and paying all

taxes when due. There are penalties for

late deposits and late filing unless you can

show reasonable cause. If you file late,

attach an explanation to the return.

There are also penalties for willful failure

to pay tax, keep records, make returns,

and for filing false or fraudulent returns.

Credit for Contributions Paid Into State

Funds.—You get a credit for amounts you

pay to a state (including Puerto Rico and

the Virgin Islands) unemployment fund by

the due date of Form 940-EZ. This credit is

reflected in the tax rate (.008) shown on

line 6.

“Contributions” are payments that a

state requires you, as an employer, to

make to its unemployment fund for the

payment of unemployment benefits.

However, contributions do not include:

● Any payments you deducted or are

deductible from your employees’ pay.

● Penalties, interest, or special

administrative taxes which are not included

in the contribution rate the state assigned

to you.

● Voluntary contributions you paid to get a

lower assigned rate.

Note: Be sure to enter your state reporting

number(s) on line B(2) at the top of the

form. We need this to verify your state

contributions.

Special Credit for Successor

Employers.—If you are claiming special

credit as a successor employer, you must

use Form 940.

Amended Returns.—Use a new Form

940-EZ to amend a previously filed Form

940-EZ. Check the Amended Return box

above Part I, enter the amounts that

should have been on the original return,

and sign the amended return. Explain why

you are amending Form 940-EZ.

If you were required to file Form 940 but

filed Form 940-EZ instead, file the

amended return on Form 940. See Form

940 and the instructions for information.

Specific Instructions

You must complete lines A and B and

Part I. If your FUTA tax (line 6) is over

$100, you must also complete Part II.

Please remember to sign the return.

Line A.—Enter the dollar amount of state

unemployment contributions. However, if

your state has given you a 0% experience

rate, so that there are no required

contributions, write “0% rate” in the space.

Part I. Taxable Wages and FUTA Tax

Line 1—Total payments.—Enter the total

payments you made to employees during

the calendar year, even if they are not

taxable. Include salaries, wages,

commissions, fees, bonuses, vacation

allowances, amounts paid to temporary or

part-time employees, and the value of

goods, lodging, food, clothing, and

noncash fringe benefits. Also include the

amount of tips reported to you in writing

by your employees. Enter the amount

before any deductions.

How the payments are made is not

important to determine if they are wages.

Thus, you may pay wages for piecework or

as a percentage of profits. You may pay

wages hourly, daily, weekly, monthly, or

yearly. You may pay wages in cash or

some other way, such as goods, lodging,

food, or clothing. For items other than

cash, use the fair market value when paid.

Line 2—Exempt payments.—“Wages”

and “employment” for FUTA purposes do

not include every payment and every kind

of service an employee may perform. In

general, payments that are not wages and

payments for services that are not

employment are not subject to tax. You

may deduct these payments from total

payments only if you explain them on line

2.

Enter such items as the following:

(1) Agricultural labor, if you did not meet

either of the tests in Agricultural

Employers on page 2.

(2) Benefit payments for sickness or

injury under a worker’s compensation law.

(3) Household service if you did not pay

cash wages of $1,000 or more in any

calendar quarter in 1990 and 1991.

(4) Certain family employment.

(5) Certain fishing activities.

(6) Noncash payments for farmwork or

household services in a private home that

are included on line 1. Only cash wages to

these workers are taxable.

(7) Value of certain meals and lodging.

(8) Cost of group-term life insurance.

(10) Any other exempt service or pay.

For more information, see Circular E,

Employer’s Tax Guide.

Line 3—Enter the total amounts over

$7,000 you paid each employee. For

example, if you have 10 employees to

whom you paid $8,000 each during the

year, enter $80,000 on line 1 and $10,000

on line 3. Do not include any exempt

payments from line 2 in figuring the

$7,000.

Part II. Record of Quarterly Federal

Unemployment Tax Liability

Complete this part only if your FUTA tax

on line 6 is over $100. To figure your FUTA

tax liability, multiply by .008 that part of

the first $7,000 of each employee’s annual

wages you paid during the quarter. Enter

the result in the space for that quarter.

Your total liability must equal your total

tax. If not, you may be charged a failure to

deposit penalty figured on your average

liability.

Record your liability based on when you

pay the wages, not on when you deposit

the tax. For example, assume that you pay

wages on March 29 and your FUTA tax

liability on those wages is $200. You

deposit the $200 by April 30. You would

include that $200 in the first quarter, not

the second.

Depositing FUTA Tax.—Generally, FUTA

taxes are deposited quarterly. If your

liability for any of the first 3 quarters of

1991 (plus any undeposited amount of

$100 or less from any earlier quarter) is

over $100, deposit it by the last day of the

month after the end of the quarter. If it is

$100 or less, carry it to the next quarter; a

deposit is not required. If your liability for

the 4th quarter (plus any undeposited

amount from any earlier quarter) is over

$100, deposit the entire amount by

January 31, 1992. If it is $100 or less, you

can either make a deposit or pay it with

your Form 940-EZ by January 31.

Note: The total amount of all deposits must

be shown on line 7.

If you deposited the right amounts,

following these rules, the amount you owe

with Form 940-EZ will never be over $100.

Deposit FUTA tax in an authorized

financial institution or the Federal Reserve

bank for your area. To avoid a possible

penalty, do not mail deposits directly to

the IRS. Records of your deposits will be

sent to the IRS for crediting to your

business accounts. See Identifying Your

Payments.

You must use Form 8109, Federal Tax

Deposit Coupon, when making tax deposits.

IRS will send you a book of deposit coupons

when you apply for an EIN. Follow the

instructions in the coupon book. If you do not

have coupons, see Circular E.

(9) Payments attributable to the

employee’s contributions to a sick pay

plan.