Form 940for 2012: Employer's Annual Federal Unemployment (FUTA) Tax Return

Department of the Treasury — Internal Revenue Service

850112

OMB No. 1545-0028

Employer identification number 

(EIN) 

—

Name (not your trade name)

Trade name (if any)

Address

Number Street Suite or room number

City State ZIP code

Read the separate instructions before you complete this form. Please type or print within the boxes.

Type of Return 

(Check all that apply.)

a. Amended

b. Successor employer

c. No payments to employees in 

2012

d. Final: Business closed or 

stopped paying wages

Instructions and prior-year forms are 

available at www.irs.gov/form940.

Part 1: Tell us about your return. If any line does NOT apply, leave it blank.

1a If you had to pay state unemployment tax in one state only, enter the state abbreviation . 1a 

1b If you had to pay state unemployment tax in more than one state, you are a multi-state 

employer . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 

Check here. 

Complete Schedule A (Form 940).

2 If you paid wages in a state that is subject to CREDIT REDUCTION . . . . . . . . 2 Check here. 

Complete Schedule A (Form 940).

Part 2: Determine your FUTA tax before adjustments for 2012. If any line does NOT apply, leave it blank. 

3 Total payments to all employees . . . . . . . . . . . . . . . . . . . 3 .

4 Payments exempt from FUTA tax . . . . . . . 4 .

Check all that apply: 4a Fringe benefits 

4b Group-term life insurance 

4c Retirement/Pension 

4d Dependent care 

4e Other 

5 Total of payments made to each employee in excess of 

$7,000 . . . . . . . . . . . . . . . . 5 .

6 Subtotal (line 4 + line 5 = line 6) . . . . . . . . . . . . . . . . . . . . 6 .

7 Total taxable FUTA wages (line 3 – line 6 = line 7) (see instructions) . . . . . . . . 7 .

8 FUTA tax before adjustments (line 7 x .006 = line 8) . . . . . . . . . . . . . 8 .

Part 3: Determine your adjustments. If any line does NOT apply, leave it blank. 

9 If ALL of the taxable FUTA wages you paid were excluded from state unemployment tax, 

multiply line 7 by .054 (line 7 × .054 = line 9). Go to line 12 . . . . . . . . . . . 9 . 10 If SOME of the taxable FUTA wages you paid were excluded from state unemployment tax, 

OR you paid ANY state unemployment tax late (after the due date for filing Form 940), 

complete the worksheet in the instructions. Enter the amount from line 7 of the worksheet . . 10 .

11 If credit reduction applies, enter the total from Schedule A (Form 940) . . . . . . . 11 . Part 4: Determine your FUTA tax and balance due or overpayment for 2012. If any line does NOT apply, leave it blank. 

12 Total FUTA tax after adjustments (lines 8 + 9 + 10 + 11 = line 12) . . . . . . . . . 12 .

13 FUTA tax deposited for the year, including any overpayment applied from a prior year . 13 . 14 Balance due (If line 12 is more than line 13, enter the excess on line 14.) 

• If line 14 is more than $500, you must deposit your tax. 

• If line 14 is $500 or less, you may pay with this return. (see instructions) . . . . . . . 14 . 15 Overpayment (If line 13 is more than line 12, enter the excess on line 15 and check a box 

below.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . ▶ You MUST complete both pages of this form and SIGN it. Check one: Apply to next return. Send a refund.

Next ■▶

For Privacy Act and Paperwork Reduction Act Notice, see the back of Form 940-V, Payment Voucher. Cat. No. 11234O Form 940 (2012) 
850212

Name (not your trade name) Employer identification number (EIN) 

Part 5: Report your FUTA tax liability by quarter only if line 12 is more than $500. If not, go to Part 6. 

16 Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had no liability for

a quarter, leave the line blank. 

16a 1st quarter (January 1 – March 31) . . . . . . . . . 16a .

16b 2nd quarter (April 1 – June 30) . . . . . . . . . . 16b .

16c 3rd quarter (July 1 – September 30) . . . . . . . . 16c .

16d 4th quarter (October 1 – December 31) . . . . . . . 16d .

17 Total tax liability for the year (lines 16a + 16b + 16c + 16d = line 17) 17 . Total must equal line 12.

Part 6: May we speak with your third-party designee? 

Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions 

for details. 

Yes. Designee’s name and phone number 

Select a 5-digit Personal Identification Number (PIN) to use when talking to IRS 

No. 

Part 7: Sign here. You MUST complete both pages of this form and SIGN it. 

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 made to employees. Declaration of preparer (other than 

taxpayer) is based on all information of which preparer has any knowledge. 

✗ Sign your 

name here 

Date / / 

Print your 

name here 

Print your 

title here 

Best daytime phone 

Paid Preparer Use Only Check if you are self-employed . . .

Preparer’s name 

Preparer’s 

signature 

Firm’s name (or yours 

if self-employed) 

Address 

City State 

PTIN 

Date / / 

EIN 

Phone 

ZIP code 

Page 2 Form 940 (2012)
Form 940-V, 

Payment Voucher 

Purpose of Form 

Complete Form 940-V, Payment Voucher, if you are 

making a payment with Form 940, Employer's Annual 

Federal Unemployment (FUTA) Tax Return. We will use 

the completed voucher to credit your payment more 

promptly and accurately, and to improve our service to 

you.

Making Payments With Form 940 

To avoid a penalty, make your payment with your 2012 

Form 940 only if your FUTA tax for the fourth quarter 

(plus any undeposited amounts from earlier quarters) is 

$500 or less. If your total FUTA tax after adjustments 

(Form 940, line 12) is more than $500, you must make 

deposits by electronic funds transfer. See When Must 

You Deposit Your FUTA Tax? in the Instructions for Form 

940. Also see sections 11 and 14 of Pub. 15 (Circular E), 

Employer's Tax Guide, for more information about 

deposits.

Caution. Use Form 940-V when making any payment with 

Form 940. However, if you pay an amount with Form 940 

that should have been deposited, you may be subject to a 

penalty. See Deposit Penalties in section 11 of 

Pub. 15 (Circular E).

Specific Instructions

Box 1—Employer Identification Number (EIN). If you do 

not have an EIN, you may apply for one online. Go to 

IRS.gov and click on the Apply for an EIN Online link 

under Tools. You may also apply for an EIN by calling 

1-800-829-4933, or you can fax or mail Form SS-4, 

Application for Employer Identification Number. If you 

have not received your EIN by the due date of Form 940, 

write "Applied For" and the date you applied in this entry 

space.

Box 2—Amount paid. Enter the amount paid with 

Form 940. 

Box 3—Name and address. Enter your name and 

address as shown on Form 940.

• Enclose your check or money order made payable to 

the "United States Treasury." Be sure to enter your EIN, 

"Form 940," and "2012" on your check or money order. 

Do not send cash. Do not staple Form 940-V or your 

payment to Form 940 (or to each other).

• Detach Form 940-V and send it with your payment and 

Form 940 to the address provided in the Instructions for 

Form 940.

Note. You must also complete the entity information 

above Part 1 on Form 940.

✁ ▼ Detach Here and Mail With Your Payment and Form 940. ▼

✃

Form 940-V

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

▶ Do not staple or attach this voucher to your payment.

OMB No. 1545-0028

2012

1 Enter your employer identification number (EIN). 2

Enter the amount of your payment. ▶

Make your check or money order payable to “United States Treasury”

Dollars Cents

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

Enter your address.

Enter your city, state, and ZIP code.
Form 940 (2012) 

Privacy Act and Paperwork Reduction Act Notice. 

We ask for the information on this form to carry out the 

Internal Revenue laws of the United States. We need it 

to figure and collect the right amount of tax. Chapter 

23, Federal Unemployment Tax Act, of Subtitle C, 

Employment Taxes, of the Internal Revenue Code 

imposes a tax on employers with respect to employees. 

This form is used to determine the amount of the tax that 

you owe. Section 6011 requires you to provide the 

requested information if you are liable for FUTA tax under 

section 3301. Section 6109 requires you to provide your 

identification number. If you fail to provide this 

information in a timely manner or provide a false or 

fraudulent form, you may be subject to penalties and 

interest. 

You are not required to provide the information 

requested on a form that is subject to the Paperwork 

Reduction Act unless the form displays a valid OMB 

control number. Books and records relating to a form or 

instructions must be retained as long as their contents 

may become material in the administration of any Internal 

Revenue law. 

Generally, tax returns and return information are 

confidential, as required by section 6103. However, 

section 6103 allows or requires the IRS to disclose or 

give the information shown on your tax return to others 

as described in the Code. For example, we may disclose 

your tax information to the Department of Justice for civil 

and criminal litigation, and to cities, states, the District of 

Columbia, and U.S. commonwealths and possessions to 

administer their tax laws. We may also disclose this 

information to other countries under a tax treaty, to 

federal and state agencies to enforce federal non-tax 

criminal laws, or to federal law enforcement and 

intelligence agencies to combat terrorism. 

The time needed to complete and file this form will vary 

depending on individual circumstances. The estimated 

average time is: 

Recordkeeping . . . . . . . . . . 9 hr., 19 min.

Learning about the law or the form . . 1 hr., 23 min.

Preparing, copying, assembling, and 

sending the form to the IRS . . . . . 1 hr., 36 min.

If you have comments concerning the accuracy of 

these time estimates or suggestions for making 

Form 940 simpler, we would be happy to hear from 

you. You can email us at taxforms@irs.gov. Enter 

“Form 940” on the subject line. Or write to: Internal 

Revenue Service, Tax Products Coordinating Committee, 

SE:W:CAR:MP:T:M:S, 1111 Constitution Avenue, NW, 

IR-6526, Washington, DC 20224. Do not send Form 940 

to this address. Instead, see Where Do You File? in the 

Instructions for Form 940.