OMB No. 1545-0028 Employer’s Annual Federal

Unemployment (FUTA) Tax Return Form 940

Department of the Treasury

Internal Revenue Service © For Paperwork Reduction Act Notice, see separate instructions.

T

FF

FD If incorrect,

make any

necessary

change.

FP

I

T

Yes No

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

Computation of Taxable Wages

1 Total payments (including exempt payments) during the calendar year for services of employees 1

Amount paid Exempt payments. (Explain each exemption shown, attach additional

sheets if necessary.) ©

2

2

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

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

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

wage base may be different. Do not use the 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 (1992)

©

Part I

If this is an Amended Return, check here ©

6

6

A Are you required to pay unemployment contributions to only one state?

B

C

D

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

–

Additional tax resulting from credit reduction for unrepaid advances to the State of Michigan.

Enter the wages included on line 5 for Michigan and multiply by .011. (See the separate

Instructions for Form 940.) Enter the credit reduction amount here and in Part II, line 5:

Michigan wages 3 .011 = ©

Did you pay all state unemployment contributions by February 1, 1993? (If a 0% experience rate is granted

check “Yes.”) 

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

Did you pay all wages in a state other than Michigan?

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. You can get Form 940-EZ by calling

1-800-TAX-FORM (1-800-829-3676).

Yes No

Yes No

Yes No
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

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

Total FUTA tax (subtract line 6 from line 1)

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

5

6

Balance due (subtract line 8 from line 7). This should be $100 or less. Pay to the Internal Revenue

Service ©

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 Tax Liability for Unemployment Tax (Do not include state liability)

Quarter First Second Third Fourth Total for year

Liability for quarter

(a)

Name

of

state

(i)

Contributions

actually paid

to state

(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

From To

Totals ©

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

Form 940 (1992) Page 2

Part III

Computation of tentative credit:

3a

3b

4

9

4

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 ©

Enter the amount from Part I, line 6 

8

5

9

Credit allowable (subtract line 5 from line 4). (If zero or less, enter 0.)

10

10

Part II
OMB No. 1545-0028 Employer’s Annual Federal

Unemployment (FUTA) Tax Return Form 940

Department of the Treasury

Internal Revenue Service © For Paperwork Reduction Act Notice, see separate instructions.

Yes No

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

Computation of Taxable Wages

1 Total payments (including exempt payments) during the calendar year for services of employees 1

Amount paid Exempt payments. (Explain each exemption shown, attach additional

sheets if necessary.) ©

2

2

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 (1992)

Part I

If this is an Amended Return, check here ©

6

6

A Are you required to pay unemployment contributions to only one state?

B

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

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

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

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

Additional tax resulting from credit reduction for unrepaid advances to the State of Michigan.

Enter the wages included on line 5 for Michigan and multiply by .011. (See the separate

Instructions for Form 940.) Enter the credit reduction amount here and in Part II, line 5:

Michigan wages 3 .011 = ©

Did you pay all state unemployment contributions by February 1, 1993? (If a 0% experience rate is granted

check “Yes.”) 

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

Did you pay all wages in a state other than Michigan?

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. You can get Form 940-EZ by calling

1-800-TAX-FORM (1-800-829-3676).

Yes No

Yes No

Yes No

C

D
Note: You must keep this copy and a copy of each related schedule or statement for 4 years after the date the tax is due or paid,

whichever is later. These copies must be available for inspection by the IRS. See Circular E, Employer’s Tax Guide, and Pub. 937,

Employment Taxes and Information Returns, for more information. Household employers should see Pub. 926, Employment Taxes for

Household Employers.

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

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

Total FUTA tax (subtract line 6 from line 1)

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

5

6

Balance due (subtract line 8 from line 7). This should be $100 or less. Pay to the Internal Revenue

Service ©

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 Tax Liability for Unemployment Tax (Do not include state liability)

Quarter First Second Third Fourth Total for year

Liability for quarter

(a)

Name

of

state

(i)

Contributions

actually paid

to state

(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

From To

Totals ©

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

Form 940 (1992) Page 4

Part III

Computation of tentative credit:

3a

3b

4

9

4

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 ©

Enter the amount from Part I, line 6 

8

5

9

Credit allowable (subtract line 5 from line 4). (If zero or less, enter 0.)

10

10

Part II