Form 940 (1984)

Page 4

Computation of Tentative Credit (Complete if You Checked the “No” Box in Either Question A or B on Page 1—See Instructions)

Name [State reporting numbers)] Taxable payroll [stateex-] Contributionsif | Contributions | Additional credit | Contributions
of | as shown on employer's | (as defined in state act) State experience rate period —_| perience | rate had been 2.7% | Payableatexperience | (col. 6 minus col.7)| actually paid to
state | state contribution returns —_ 4 rate |” (col.3x2.7%) | rate (col. 3xcol.5) | IfOorless,enter0.| state
1 2 3 From— To— 5 6 7 8 | 9
10 Totals...
11 Total tentative credit (add line 10, columns 8 and 9—see instructions for limitations) > I

Part l.—Computation of Taxable Wages
and Credit Reduction

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, and clothing. Enter the
amount before any deductions.

How the payments are made is not important
in determining if they are wages. Thus, you may
pay wages for piecework or as a percentage of
profits, and 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 at the time of payment.
Line 2—Exempt payments.— '‘Wages’’ and
“employment” as defined for FUTA purposes do
not include every payment and every kind of service
an employee may perform. In general, payments
excluded from wages and payments for services
excepted from 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 (a) did not pay
cash wages of $20,000 or more for such labor for
any calendar quarter in 1983 or 1984 AND did
not employ 10 or more farmworkers during any
part of a day during any 20 different weeks in
1983 or 1984, or (b) paid wages to aliens
admitted to the United States on a temporary
basis to perform farmwork before 1986.

(2) Benefit payments for sickness or injury
under a worker's compensation law, insurance
plan, and certain employer plans.

(3) Household service if you did not pay cash
wages of $1,000 or more in any calendar quarter
in 1983 and 1984

(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) Any other exempt service or pay.

For more information, see Circular E,
Employer's Tax Guide
Line 3.—Enter the total amounts of more than
$7,000 you paid each employee. For example, if
you.have 10 employees whom you paid $8,000
each during the year, enter $80,000 on line 1 and
$10,000 on line 3. The $7,000 wage limitation is
for FUTA purposes only. Do not use the state
wage limitation for this entry.

Line 5—Total taxable wages.—If any part of
these wages is exempt from state unemployment
taxes, you must fill out Parts Ill and V, even if you
checked “‘Yes"’ on questions A and B.

Line 6.—Enter any wages included on line 5
subject to the unemployment compensation laws
of the states listed. (If in doubt, ask your local IRS
office.) Multiply the wages by the appropriate

rate. This adjustment is required by section
3302(c)(2) of the Code when a state has not
made repayments on time of advances from the
Federal unemployment tax account. The
adjustment reduces the credit otherwise
allowable against the FUTA tax for contributions
made to state unemployment funds. If no wages
are subject, write “‘none”’ on line 7.

Part Il.—Tax Due or Refund

Use this part if you made payments to only one
state by the due date of Form 940, and all your
wages shown on line 5 of Part I are subject to the.
state’s unemployment fund taxes. The tax rate of
.008 gives you credit for your payments to your
state’s unemployment fund.

Part IIl.—Tax Due or Refund

Use this part if you do not qualify for Part Il.
Line 3.—Enter the smaller of (1) Part V,
line11—Total tentative credit, or (2) Part III, line
2—2.7% of taxable FUTA wages. This is the
maximum credit allowable for your payments to
the state unemployment fund.

Line 4.—Enter the amount from Part, line 7.
Subtract this amount from Part Ill, line 3. The
result on line 5 is your allowable credit for
payments to the state.

Part IV.—Record of Federal Tax Liability

Complete this part if your total tax (Part Il, line 3
or Part Ill, line 6) is over $100. To figure your
FUTA tax liability for each of the first 3 quarters
of 1984, multiply by .008 that part of the first
$7,000 of each employee's annual wages you
paid during the quarter. Enter this amount under
that quarter.

Your liability for the 4th quarter is the total
tax (Part ll, line 3 or Part Ill, line 6) minus your
liability for the first 3 quarters of the year. If
this plus any undeposited amount from earlier
quarters is over $100, deposit the entire amount
by January 31 in a qualified depositary. If it is
$100 or less, you can either make a deposit or
pay it with your Form 940 by January 31.

The total liability must equal your total tax.
Otherwise you may be charged a failure to deposit
penalty figured on your average liability.

If the amount subject to deposit (plus any
undeposited amount of $100 or less for any
earlier quarter) is more than $100, deposit it by
the last day of the first month following the close
of the quarter.

If you deposited the correct amounts,
following these rules, the balance due with Form
940 will never be more than $100.

Deposit Federal unemployment 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 IRS.
Records of your deposits will be sent to IRS for
crediting to your business accounts.

You must use deposit coupons from Form
8109, Federal Tax Deposit Coupon Book, when
making your tax deposits. IRS will send you
deposit coupons when you apply for an employer
identification number. Darken the “940” box on
the coupon and include a coupon with each
deposit you make.

Taxpayers who willfully claim credit for
deposits not made are subject to fines and other
criminal penalties.

Part V.—Computation of Tentative
Credit

Complete this schedule if: (1) You made
payments to the unemployment fund of more
than one state; (2) You did not make all your state
payments by the due date of Form 940; or (3) Any
wages subject to Federal unemployment tax were
exempted from state unemployment taxes. If you
have a state experience rate lower than 2.7% for
all or part of the year, use columns 1 through 9. If
you have no experience rate, use columns 1, 2, 3,
and 9 only. If you have a rate of 2.7% or higher,
use columns 1, 2, 3, 4, 5, and 9 only. If you were
granted an experience rate for only part of the
year or the rate was changed during the year,
enter in the appropriate columns the period each
separate rate applied to, your payroll rate, and
required contributions for each period.

Column 1.—Enter the name of the state or
states (including Puerto Rico and the U.S. Virgin
Islands) that you were required to pay
contributions to.

Column 2.—Enter the state reporting number
that was assigned to you when you registered as
an employer with each state.

Column 3.—Enter the taxable payroll on which
you must pay taxes to the unemployment fund of
each state in column 1. If your experience rate is
zero, enter the amount of wages that you would
have had to pay on if the rate had not been granted.

Columns 4 and 5.—Your state experience rate is
the rate at which the state taxes your payroll for
state unemployment purposes. This rate may be
adjusted from time to time based on your
“experience”’ with the state fund, that is,
unemployment compensation paid to your former
employees and other factors. If you do not know
your rate, contact your state unemployment
security agency.

Column 8.—Subtract column 7 from column 6. If
zero or less, enter “‘0."”

Column 9.—Enter contributions actually paid
into the state fund by the due date of Form 940.
Do not include any special assessments, surtaxes,
surcharges, etc., used by the state to pay interest
on unrepaid advances from the Federal
government.

Line 11.—Add line 10, columns 8 and 9. The
allowable credit for state contributions you make
after the due date (or extended due date) for filing
Form 940 may not be more than 90% of the
credit that would have been allowed if you had
paid the state contributions by the due date. For
example, if $1,500 of state contributions were
paid on time, and $1,000 was paid after the due
date for filing Form 940, the total tentative credit
on line 11 (assuming no additional credit (column
8)) would be $2,400 ($1,500 + $900 (90% of
$1,000)),

Note: /f you are receiving additional credit
(column 8) because your state experience rate is
less than 2.7%, the additional credit is not subject
to the 90% limitation.


940 Employer’s Annual Federal | OMB No. 1545-0028 _
Form Unemployment (FUTA) Tax Return 1 fo} 8 4

Department of the Treasury

Internal Revenue Service > For Paperwork Reduction Act Notice, see page 2.
Name (as distinguished from trade name) Calendar Year 7 FF
(>)
; 1984
If incorrect,
make any » Trade name, if any Employer identification number FP
necessary |
change. Address and ZIP code T
L a
A Did you pay all required contributions to your state unemployment fund by the due date of Form 940? (If none required, check “No."). . © Yes (J No

If you checked the “Yes” box, enter amount of contributions paid to your state unemployment fund .
B_ Are you required to pay contributions to only one state?

Ifyou checked the “Yes” box, (1) Enter the name of the state where you are required to pay contributions .
(2) Enter your state reporting number(s) as shown on state unemployment tax return _.

ror Computation of Taxable Wages and Credit Reduction (To Be Completed by ‘Al Taxpayers)

Total payments (including exempt payments) during the calendar year for services of employees... 1
‘Amount paid

2 Exempt payments. (Explain each exemption shown, attaching additional sheets if
necessary) >

2
3. Payments for services of more than $7,000. Enter only the excess over the first $7,000
paid to indvidual employees not including exempt amounts shown online 2, Do not use
he state wage limitation. , cee Dee ee ee LS Uh

4 Total exempt payments (add lines 2 and 3) .
5 Total taxable wages (subtract line 4 from line 1). (If any partis exempt from state contributions, see instructions) > 5
6 Credit reduction for unrepaid advances to the states listed (by 2-letter Postal Service abbreviations). Enter the wages included on line 5 above for each state and

multiply by the rate shown. Mlle X.007 eee eee Wee X.006 Looe
(e) MN
(ht) NIL Outside the United States
() OH (nr) PR x.006 .
@) PA. (o.) VE eee x.009 __ .
@u (KX
Total credit reduction (add lines rough 6(0) and enter in Part I, line 2orPart I ine 4)». _. 17 |
Tax Due or Refund ‘Gomplate if You Checked the “Yes” Boxes in Both Ttems Aand B Above)
1 FUTAtax. Multiply the wages in Part, line 5, by.008andenterhere . 2 5 1 2 2 ee eee ee LO
2 Enteramount fromPartlline7 6 ee ee ee ee LB
3° TotalFUTAtax(addlinesland2) . . . . |_3_
4 Less: Total FUTA tax deposited for the year, including any overpayment applied from a prior year (from your 1 records). a
5 Balance due (subtract line 4 from line 3—if over $100, see Part IV instructions). Pay toIRS. 2 LS
6 _ Overpayment (subtract line 3 from line 4). Check if it isto be:(_) Applied to next return, orl_| Refunded... -m| 6
Fart 1 Mes Due or Refund (Complete if You Checked the “No” Box in Either Item A or Item B Above. Also complete Part V)
1 Gross FUTA tax. Multiply the wages in Partl,line5,by.035. 6 2 2. ee ee ee LE
2 Maximum credit. Multiply the wages in PartI,line5,by.027. . . . .... . [2

YY Y
3 Enter the smaller of the amount in Part V, line 11, or Partlll,line2 . . 2 2 2. 3 V7

Mh

4 Enter amount from Part |, line 7 4
5 Credit allowable (subtract line 4 from line 3) (ifzeroor or less, enter) . 5
6 Total FUTA tax (subtract line 5 from line 1) . 6
7 Less: Total FUTA tax deposited for the year, including any overpayment applied froma s prior year (from your records). 7
8 Balance due (subtract line 7 from line 6—if over $100, see Part IV instructions). PaytoIRS_. - - + >| 8

Overpayment (subtract line 6 from line 7).Check if itis tobe: L_]_ Applied to next return, or{_] Refunded. . >| 9
Feartiv| Record of Quarterly Federal Tax Liability for Unemployment Tax (Do not include State liability)

Quarter First, | Second Third Fourth Total for Year

Liability for quarter

If you will not have to file returns in the future, write “Final” here (see general instruction “Who Must File”) and sign the return >

Under penalties of perjury, | declare that | have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, itis true, correct, and
complete, and that no part of any payment made to a state unemployment fund claimed as a credit was or 1s to be deducted from the payments to employees.

Signature > Title (Owner, etc.) Date >

Form 940 (1984)


Form 940 (1984) Page 2
idm Computation of Tentative Credit (Complete if You Checked the “No” Box in Either Question A or B on Page 1—See Instructions)
Name|State reporting number(s)] Taxable payroll State ex-] Contributionsit | Contributions | Additionalcredit ) Contributions

of | as shown on employer's | (as defined in state act) State experience rate period _| perience | rate had been 27% | payableat experience | (col. 6minuscol.7)| actually paid to
state | state contribution returns 4 rate | (col.3x2.7%) | rate (col. 3xcol. 5) | IfOorless, enter0. state

1 2 3 From— To— 5 6 Z L 8 9

|

10 Totals a

11 Total tentative credit (add line 10, columns 8 and 9—see instructions for limitations) .

> | I

Paperwork Reduction Act Notice. —We ask for
this information to carry out the Internal Revenue
laws of the United States. We need it to ensure that
taxpayers are complying with these laws and to
allow us to figure and collect the right amount of
tax. You are required to give us this information.
Changes You Should Note for 1985.—The
FUTA tax rate increases to 6.2% charged on the
$7,000 wage base. The maximum credit
allowable against the tax for contributions to state
(including Puerto Rico and the U.S. Virgin Islands)
unemployment funds increases to 5.4% of
taxable FUTA wages.

General Instructions

Purpose of Form.—Use this form for your
annual FUTA tax report. Only the employer pays
this tax. The gross tax rate is 3.5% (.035),
charged on the first $7,000 of wages paid to each
employee during 1984.

Who Must File

Household Employers.—You do not have to file
this form unless you paid cash wages of $1,000 or
more in any calendar quarter in 1983 or 1984 for
household work in a private home, local college
club, ora local chapter of a college fraternity or
sorority.

Note: See Publication 503, Child and Dependent
Care Credit and Employment Taxes for Household
Employers, for more information.

In General.—You must file this form if you were
other than a household or agricultural employer
during 1983 or 1984 and you (a) paid wages of
$1,500 or more in any calendar quarter or (b) had
‘one or more employees for some part of a day in
any 20 different weeks. Count all regular,
temporary, and part-time employees. A
partnership should not count its partners. If there
is a change in ownership or other transfer of
business during the year, each employer who
meets tests (a) or (b) above must file. Neither
should report wages paid by the other.
Organizations described in section 501(c)(3) of
the Internal Revenue Code do not have to file.
Agricultural Employers.—You must file Form
940 if either of the following apply to you:

(1) You paid cash wages of $20,000 or more
to farmworkers during any calendar quarter in
1983 or 1984.

(2) You employed 10 or more farmworkers
during some part of a day (whether or not at the
same time) for at least one day during any 20
different weeks in 1983 or 1984. Count aliens
admitted to the United States on a temporary
basis to perform farmwork to determine if you
meet either of the above tests. However, wages
paid to these aliens are not subject to FUTA tax
before 1986.

Completing Form 940

Employers Who Are Not Required to Deposit
FUTA Tax.—If your total FUTA tax for 1984 is
not more than $100, you do not have to deposit
the tax. Make your FUTA tax payment when you
file Form 940. If you do not have to deposit FUTA
tax and you

(a) made all required payments to your state
unemployment fund by the due date of Form
(b) are required to make payments to the
unemployment fund of only one state, and
(c) paid wages subject to Federal
unemployment tax that are also subject to
state unemployment tax,
complete Parts | and II. Otherwise, complete Parts
Ill, and V.
Employers Who Are Required to Deposit FUTA
Tax.—f you meet tests (a), (b), and (c) above,
complete Parts |, Il, and IV. Otherwise, complete
Parts |, lll, IV, and V.
If You Are Not Liable for FUTA Tax.—If you
receive Form 940 and are not liable for FUTA tax
for 1984, write ‘‘Not Liable” across the front and
return it to IRS. If you will not have to file returns
after this, write ‘Final’ on the line above the
signature line and sign the return.
Due Date.—Form 940 for 1984 is due by
January 31, 1985. However, if you made timely
deposits in full payment of the tax due, your due
date is February 11, 1985.

Where to File.—

If your principal File with the Internal
business, office, or Revenue Service
agency is located in Center at

Vv Vv

New Jersey, New York City and
counties of Nassau, Rockland,
Suffolk and Westchester

New York (ail other counties),
Connecticut, Maine,
Massachusetts, New Hampshire,
Rhode Island, Vermont
Delaware, District of Columbia,
Maryland, Pennsylvania
Alabama, Florida, Georgia,
Mississippi, South Carolina

Holtsville, NY 00501

Andover, MA 05501

Philadelphia, PA 19255

Atlanta, GA 31101

Ci

innati, OH 45999.
Austin, TX 73301

‘Arkansas, Kansas, Louisiana,
New Mexico, Oklahoma, Texas
Alaska, Arizona, Colorado,

Idaho, Minnesota, Montana,
Nebraska, Nevada, North Dakota,
Oregon, South Dakota, Utah,
Washington, Wyoming

Illinots, lowa,

Missouri, Wisconsin

California, Hawaii

indiana, Kentucky, North
Carolina, Tennessee,
Virginia, West Virginia

Ogden, UT 84201

Kansas City, MO 64999

Fresno, CA 93888

Memphis, TN 37501

Ifyou have no legal residence or principal place of
business in any IRS district, or if your principal place of
business 1s in Puerto Rico of the U.S. Virgin Islands, file
Form 940 with the Internal Revenue Service Center,
Philadelphia, PA 19255,
Employer's Name, Address, and Identification
Number.—Use the preaddressed Form 940
mailed to you. If you must use a nonpreaddressed
form, type or print your name, trade name,
address, and employer identification number on it.
See Publication 583, Information for Business
Taxpayers, for details on how to make tax
deposits, file a return, etc., if these are due before
you receive your number.

Penalties and Interest.—Avoid penalties and
interest by making tax deposits when due and
filing a correct return and paying the proper
amount of tax when due. The law provides
penalties for late deposits and late filing unless
you show reasonable cause for the delay. If you
file late, attach an explanation to the return. The
law also provides a penalty of 25% of the
overstatement if, without reasonable cause, you
overstate the amount you deposited.

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 can claim credit for amounts you
pay into a certified state (including Puerto Rico
and the U.S. Virgin Islands) unemployment fund
by the due date of Form 940.

“Contributions” are payments that state law
requires you to make to an unemployment fund
because you are an employer. These payments.
are “contributions” only to the extent that they
are not deducted or deductible from the
employees’ pay.

You may not take credit for voluntary
payments or for penalties or interest payments to
a state. Nor may you take credit for any special
assessment, surtax, surcharge, etc. by the state
for paying interest on unrepaid Title XII loans from
the Federal government.

If you have been granted an experience rate
lower than 2.7% (.027) by a state for the whole or
part of the year, you are entitled to an additional
credit. This credit is equal to the difference
between actual payments and the amount you
would have been required to pay at 2.7%.

The total credit allowable may not be more
than 2.7% of taxable FUTA wages.

Special Credit for Successor Employers.—if
you are claiming special credit as a successor
‘employer, see Code section 3302(e) or Circular E
for the conditions you must meet.

Amended Returns.—If you are amending a
previously filed return, complete a new Form 940,
using the amounts that should have been used on
the original return, and sign the return. Attach a
statement explaining why you are filing an
amended return. Be sure to use a Form 940 for
the year you are amending. Write “AMENDED
RETURN" at the top of the form and file it with
the Internal Revenue Service Center where you
filed the original return.

Specific Instructions

All filers must complete Questions A, B, and
Part | and must sign the return.

Use Part Il if you paid contributions to only one
state unemployment fund, you made all state
payments by the due date of Form 940, and all of
the FUTA wages are subject to the state’s
unemployment fund taxes. Otherwise, skip Part Il
and complete Parts Ill and V.

Complete Part IV if your total tax tor the year is
more than $100.

(Instructions continued on page 4.)


940 Employer’s Annual Federal |_OMB No. 1545-0028 _
Form Unemployment (FUTA) Tax Return 1 9 8 4

Department of the Treasury
Internal Revenue Service

Calendar Year

128 cum EMPLOYER'S
COPY

A__ Did you pay all required contributions to your state unemployment fund by the due date of Form 940? (If none required, check “No."). . . L] Yes L] No
If you checked the "Yes" box, enter amount of contributions paid to your state unemployment fund. . . . . . .PS
B_ Are you required to pay contributions to only one state? . sae
If you checked the “Yes” box, (1) Enter the name of the state where you are required topaycontributions. 2... 1.
ie) Enter your state reporting number(s) as shown on state unemployment tax return... >
Computation of Taxable Wages and Credit Reduction (To Be Completed by ‘All Taxpayers)
Total payments (including exempt payments) during the calendar year for services of employees... . . . - | 2
2 Exempt payments. (Explain each exemption shown, attaching additional sheets if Amount paid
necessary) >. .
2
3 t $7,000
pa to individual employees ne not Inciuang exempt amounts shown on line 2. Do not use
he state wage limitation . Soe ee ee LS Yj
4 Total exempt payments (add lines 2 and 3) . 4
5 Total taxable wages (subtract line 4 from line 1). (If any part is exempt from state ‘contributions, see instructions) >LS

6 Credit reduction for unrepaid advances to the states listed (by 2-letter Postal Service abbreviations). Enter the wages included on line 5 above for each state and

multiply by the rate shown. MI
() MN
(hn) NJ
() OH
@) PA
(e) AL. (k) wee
7 Total credit reduction (add lines 6(a) through 6(0) and enter in Part I line 2 or Part Il line 4). _. >17 1
Tax Due or Refund (Complete if You Checked the “Yes” Boxes in Both Items Aand B Above)
1 FUTA tax. Multiply the wages in Part, line 5, by.0O8andenterhere . . . 2. 1 1 ee ee es LE
2 Enter amount from Part |, line 7 2
3 Total FUTA tax (add lines 1 and 2) . 3
4 Less: Total FUTA tax deposited for the year, including any overpayment apolied froma prior year (from your 1 records), 4
5 Balance due (subtract line 4 from line 3—if over $100, see Part IV instructions). PaytoIRS. . . . . . .PLS
6 Overpayment (subtract line 3 from line 4). Check if itis to be:{_] Applied to next return, orl_] Refunded. . . »| 6
Part Ill Tax Due or Refund (Complete if You Checked the “No” Box in Either Item A or Item B Above. Also complete Part V)
1 Gross FUTA tax, Multiply the wages in PartI,line5,by.035°> 5 we ee ee LE
2 Maximum credit. Multiply the wages in Part |,line5,by.027. . . . . . . . . [2
3. Enter the smaller of the amount in Part V, line 11, or Partill,line2. . 2... . 13 MMMM Mi
4 Enter amount from Part |, line 7 4
5 Credit allowable (subtract line 4 from line 3) (lf ze10 oF or less, enter 0. ) 5
6 Total FUTA tax (subtract line 5 from line 1) . 6
7 Less: Total FUTA tax deposited for the year, including any overpayment applied froma prior year (from y your irrecords). 7
8 Balance due (subtract line 7 from line 6—if over $100, see Part IV instructions). PaytoIRS__. 2. Ls
9. Overpayment (subtract line 6 from line 7).Check if itis to be: |_| Applied to next return, orl] Refunded. . >| 9
Record of Quarterly Federal Tax Liability for Unemployment Tax (Do not include State liability)
Quarter First Second Third Fourth Total for Year
Liability for quarter
If you will not have to file returns in the future, write “Final” here (see general instruction “Who Must File”) and sign the return >

Keep This Copy for Your Records—You must keep this copy and a copy of For More Information—See Publication 15, Circular E, Employer's Tax Guide
each related schedule or statement for a period of 4 years after the date the tax and Publication 539, Employment Taxes and Information Return
is due or paid, whichever is later. These copies must be available for inspection Requirements, for more information. Household employers should see

by the Internal Revenue Service. Publication 503.