Employer’s Annual Federal OMB No. 1545-1110

Unemployment (FUTA) Tax Return Form 940-EZ

Department of the Treasury

Internal Revenue Service

Name (as distinguished from trade name) Calendar year FF

FD

Trade name, if any FP

Address and ZIP code Employer identification number

T

I

T

Answer the questions under Who May 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 separate instructions.) ©

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

(2) Enter your state reporting number as shown on your 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

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. The $7,000

amount is the Federal wage base. Your state wage base may be different. Do not

use your 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

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 7

8 Balance due (subtract line 7 from line 6). Pay to the “United States Treasury” © 8

9 Overpayment (subtract line 6 from line 7). Check if it is to be: 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 ©

Form 940-EZ (1998)

If you will not have to file returns in the future, check here (see Who must file in separate instructions) and complete and sign the return. ©

$

Part I

Part II

Cat. No. 10983G

(99)

Form 940-EZ(V)

Department of the Treasury

Internal Revenue Service

Form 940-EZ Payment Voucher

DETACH HERE

OMB No. 1545-1110

Use this voucher only when making a payment with your return.

Complete boxes 1, 2, 3, and 4. Do not send cash, and do not staple your payment to this voucher. Make your check or money order payable to the

“United States Treasury.” Be sure to enter your employer identification number, “Form 940-EZ”, and “1998” on your payment.

© For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.

Applied to next return or Refunded ©

1998

1998

If you owe more than $100, see Depositing FUTA tax in separate instructions.

See separate Instructions for Form 940-EZ for information on completing this form.

Enter the amount of the payment you are making Enter the first four letters of your last name

(business name if partnership or corporation)

1 2

4 Enter your name (individual name for sole proprietors)

© $ .

3 Enter your employer identification number

Enter your address

Enter your city, state, and ZIP code

Instructions for Box 2

—Individuals (sole proprietors, trusts, and estates)—

Enter the first four letters of your last name.

—Corporations and partnerships—Enter the first four

characters of your business name (omit “The” if

followed by more than one word).
Form 940-EZ (1998) Page 2

Who May Use Form 940-EZ

*If you deposited all FUTA tax when due, you may answer “Yes” if you

paid all state unemployment contributions by February 10.

The following chart will lead you to the right form to use. However, do not file Form 940-EZ if you

have already filed Form 940 for 1998.

Did you pay

unemployment

contributions to only one

state?

Did you pay all state

unemployment

contributions by

January 31?*

Were all wages that were

taxable for FUTA tax also

taxable for your state’s

unemployment tax?

You may use

Form 940-EZ.

You must use

Form 940

instead.

Also, do not file Form 940-EZ if–

● You owe FUTA tax only for household work in a private home. See Schedule H (Form 1040).

● You are a successor employer claiming a credit for state unemployment contributions paid by a

prior employer. File Form 940.

Ä

Yes

Ä

Yes

Ä

Yes

©

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No

No ©

No ©