Form 945

Department of the Treasury 

Internal Revenue Service 

Annual Return of Withheld Federal Income Tax

▶ For withholding reported on Forms 1099 and W-2G.

▶ For more information on income tax withholding, see Pub. 15 and Pub. 15-A.

▶ Information about Form 945 and its separate instructions is at www.irs.gov/form945.

OMB No. 1545-1430

2016

Type 

or 

Print 

Name (as distinguished from trade name) Employer identification number (EIN)

Trade name, if any

Address (number and street)

City or town, state or province, country, and ZIP or foreign postal code

If address is 

different 

from prior 

return, check

here. ▶

A If you don't have to file returns in the future, check here ▶ and enter date final payments made. ▶

1 Federal income tax withheld from pensions, annuities, IRAs, gambling winnings, etc. . . . . . 1

2 Backup withholding . . . . . . . . . . . . . . . . . . . . . . . . . . 2

3 Total taxes. If $2,500 or more, this must equal line 7M below or Form 945-A, line M . . . . . 3

4 Total deposits for 2016, including overpayment applied from a prior year and overpayment applied

from Form 945-X . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

5 Balance due. If line 3 is more than line 4, enter the difference and see the separate instructions . 5

6 Overpayment. If line 4 is more than line 3, enter the difference ▶ $ 

Check one: Apply to next return. Send a refund.

• All filers: If line 3 is less than $2,500, don't complete line 7 or Form 945-A.

• Semiweekly schedule depositors: Complete Form 945-A and check here . . . . . . . . . . . . . . . . ▶

• Monthly schedule depositors: Complete line 7, entries A through M, and check here . . . . . . . . . . . . ▶

7 Monthly Summary of Federal Tax Liability. (Don't complete if you were a semiweekly schedule depositor.)

 Taxliability for month 

A January . . .

B February . .

C March . . .

D April . . . .

E May . . . .

 Taxliability for month 

F June . . . . .

G July . . . . .

H August . . . .

I September . . .

J October . . . .

 Taxliability for month 

K November . .

L December . .

M Total liability for 

year (add lines A

through L ) . .

ThirdParty 

Designee

Do you want to allow another person to discuss this return with the IRS? See separate instructions. Yes. Complete the following. No.

Designee’s 

name ▶

Phone 

no. ▶

Personal identification 

number (PIN) ▶

Sign 

Here

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. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.

Signature ▶

Print Your 

Name and Title ▶ Date ▶

Paid 

Preparer 

Use Only

Print/Type preparer’s name Preparer’s signature Date Check if 

self-employed 

PTIN

Firm’s name ▶

Firm’s address ▶

Firm’s EIN ▶

Phone no. 

For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Cat. No. 14584B Form 945 (2016)
Form 945-V, 

Payment Voucher

Purpose of Form

Complete Form 945-V if you're making a payment with 

Form 945. 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 945

To avoid a penalty, make your payment with your 2016 

Form 945 only if:

• Your total taxes for the year (Form 945, line 3) are less 

than $2,500 and you're paying in full with a timely filed 

return, or

• You're a monthly schedule depositor making a payment 

in accordance with the Accuracy of Deposits Rule. See 

section 11 of Pub. 15 for details. In this case, the amount 

of your payment may be $2,500 or more.

Otherwise, you must make deposits by electronic funds 

transfer. See section 11 of Pub. 15 for deposit 

instructions. Don't use Form 945-V to make federal tax 

deposits.

▲!

CAUTION

Use Form 945-V when making any payment

with Form 945. However, if you pay an amount 

with Form 945 that should've been deposited, 

you may be subject to a penalty. See Deposit

Penalties in section 11 of Pub. 15.

Specific Instructions

Box 1—Employer identification number (EIN). If you 

don't have an EIN, you may apply for one online. Go to 

IRS.gov and type “EIN” in the search box. You may also 

apply for an EIN by faxing or mailing Form SS-4 to the 

IRS. If you haven't received your EIN by the due date of 

Form 945, write “Applied For” and the date you applied in 

this entry space.

Box 2—Amount paid. Enter the amount paid with Form 

945.

Box 3—Name and address. Enter your name and

address as shown on Form 945.

• Enclose your check or money order made payable to 

“United States Treasury.” Be sure to enter your EIN, 

“Form 945,” and “2016” on your check or money order. 

Don't send cash. Don't staple Form 945-V or your 

payment to the return (or to each other).

• Detach Form 945-V and send it with your payment and 

Form 945 to the address provided in the Instructions for 

Form 945.

Note: You must also complete the entity information

above line A on Form 945.

✁ ▼ Detach Here and Mail With Your Payment and Form 945. ▼

✃

Form 945-V

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

▶ Don't attach this voucher or your payment to Form 945.

OMB No. 1545-1430

2016

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 or town, state or province, country, and ZIP or foreign postal code.