Form 943-A

OMB No. 1545-0035

Agricultural Employer’s Record of

(Rev. April 1996) Federal Tax Liability

Name as shown on Form 943 Employer identification number

You must complete this form if you are required to deposit on a semiweekly basis, or if your tax liability on any day

is $100,000 or more. Show tax liability here, not deposits. (The IRS gets deposit data from depositary tax payments.)

Recordkeeping 8 hr., 22 min.

General Instructions

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 right amount of tax.

Preparing and sending

the form to the IRS 8 min.

If you have comments concerning the

accuracy of these time estimates or

suggestions for making this form

simpler, we would be happy to hear from

you. You can write to us at the address

listed in the Form 943 instructions under

Paperwork Reduction Act Notice.

The time needed to complete and file

this form will vary depending on

individual circumstances. The estimated

average time is:

Cat. No. 17030C Form 943-A (Rev. 4-96)

A. Daily Tax Liability—January

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A Total liability for month ©

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B. Daily Tax Liability—February C. Daily Tax Liability—March

B Total liability for month © C Total liability for month ©

D. Daily Tax Liability—April

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D Total liability for month ©

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E. Daily Tax Liability—May F. Daily Tax Liability—June

E Total liability for month © F Total liability for month ©

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Purpose of Form.—Use this form to

report your tax liability (income tax

withheld plus both employee and

employer social security and Medicare

taxes minus any advance earned income

credit payments) on a daily basis. Do

not show Federal tax deposits here.

Deposit information is obtained from

© File with Form 943.

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Department of the Treasury

Internal Revenue Service

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 or records

relating to a form or its instructions must

be retained as long as their contents

may become material in the

administration of any Internal Revenue

law. Generally, tax return and return

information are confidential, as required

by Code section 6103.
Form 943-A (Rev. 4-96) Page 2

Specific Instructions

Attach this form (or a statement giving

the same information) to Form 943 if you

are required to deposit in accordance

with the semiweekly schedule depositor

rules, or if you become a semiweekly

schedule depositor due to an

accumulation of tax liability of $100,000

or more. If you use this form, do not

complete line 15 on Form 943.

Who Must File.—Semiweekly schedule

depositors are required to complete and

attach Form 943-A to Form 943,

Employer’s Annual Tax Return for

Agricultural Employees. Monthly

schedule depositors who accumulate

$100,000 or more on any day (after

which they become a semiweekly

schedule depositor) must also complete

and attach Form 943-A. Do not file this

form if you are a monthly schedule

depositor for the entire year or if your

total tax liability for the year (line 11,

Form 943) is less than $500.

The total tax liability for the year (line

M) must equal net taxes on Form 943

(line 11). If not, you may be charged a

penalty. The dates and amounts of your

deposits are obtained from depositary

tax payments.

For each month of the year, show the

amount of tax liability accrued on a daily

basis. Accruals occur on each payday.

Enter the monthly totals on lines A, B,

C, D, E, F, G, H, I, J, K, and L. Enter the

total for the year on line M.

G. Daily Tax Liability—July

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G Total liability for month ©

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H. Daily Tax Liability—August I. Daily Tax Liability—September

H Total liability for month © I Total liability for month ©

J. Daily Tax Liability—October

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J Total liability for month ©

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K. Daily Tax Liability—November L. Daily Tax Liability—December

K Total liability for month © L Total liability for month ©

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M Total for year (add lines A through L) ©

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See Deposit Rules on page 4 of Form

943 and in Circular A, Agricultural

Employer’s Tax Guide, for more

information.

Printed on recycled paper

Example: Employer F is a semiweekly

schedule depositor. Employer F

accumulated a tax liability of $3,000 on

its January 11 and January 25 paydays.

In the January column, Employer F must

enter $3,000 on lines 11 and 25.

depositary tax payments. Do not report

wages paid to nonfarm workers on this

form. Wages paid to nonfarm workers

are reported on Form 941, Employer’s

Quarterly Federal Tax Return.