Form 940for 2011: Employer's Annual Federal Unemployment (FUTA) Tax Return

Department of the Treasury — Internal Revenue Service

850111

OMB No. 1545-0028

(EIN) 

Employer identification number

—

Name (not your trade name)

Trade name (if any)

Number Street Suite or room number

City State ZIP code

Read the separate instructions before you complete this form. Please type or print within the boxes.

Address

Type of Return 

(Check all that apply.)

a. Amended

b. Successor employer

c. No payments to employees in 

2011

d. Final: Business closed or 

stopped paying wages

Prior-year forms are available at 

www.irs.gov/form940.

Part 1: Tell us about your return. If any line does NOT apply, leave it blank.

1a If you had to pay state unemployment tax in one state only, enter the state abbreviation . 1a 

1b If you had to pay state unemployment tax in more than one state, you are a multi-state 

employer . . . . . . . . . . . . . . . . . . . . . . . . . . . 1b 

Check here. 

Complete Schedule A (Form 940).

2 If you paid wages in a state that is subject to CREDIT REDUCTION . . . . . . . . 2 Check here. Complete 

Schedule A (Form 940). 

Part 2: Determine your FUTA tax before adjustments for 2011. If any line does NOT apply, leave it blank. 

3 Total payments to all employees . . . . . . . . . . . . . . . . . . . 3 .

4 Payments exempt from FUTA tax . . . . . . . 4 .

Check all that apply: 4a Fringe benefits 

4b Group-term life insurance 

4c Retirement/Pension 

4d Dependent care 

4e Other 

5 Total of payments made to each employee in excess of 

$7,000 . . . . . . . . . . . . . . . . 5 .

6 Subtotal (line 4 + line 5 = line 6) . . . . . . . . . . . . . . . . . . . . 6 .

7 a Total taxable FUTA wages (line 3 – line 6 = line 7a) (see instructions) . . . . . . . . 7a .

7 b Line 7a FUTA wages paid before 7/1/2011 7b . x .008 = 7c .

7 d Line 7a FUTA wages paid after 6/30/2011 7d . x .006 = 7e .

8 FUTA tax before adjustments (line 7c + line 7e = line 8) . . . . . . . . . . . . 8 .

Part 3: Determine your adjustments. If any line does NOT apply, leave it blank. 

9 If ALL of the taxable FUTA wages you paid were excluded from state unemployment tax, 

multiply line 7a by .054 (line 7a × .054 = line 9). Go to line 12 . . . . . . . . . . 9 . 10 If SOME of the taxable FUTA wages you paid were excluded from state unemployment tax, 

OR you paid ANY state unemployment tax late (after the due date for filing Form 940), 

complete the worksheet in the instructions. Enter the amount from line 7 of the worksheet . . 10 .

11 If credit reduction applies, enter the amount total from Schedule A (Form 940) . . . . . 11 . Part 4: Determine your FUTA tax and balance due or overpayment for 2011. If any line does NOT apply, leave it blank. 

12 Total FUTA tax after adjustments (lines 8 + 9 + 10 + 11 = line 12) . . . . . . . . . 12 .

13 FUTA tax deposited for the year, including any overpayment applied from a prior year . 13 . 14 Balance due (If line 12 is more than line 13, enter the excess on line 14.) 

• If line 14 is more than $500, you must deposit your tax. 

• If line 14 is $500 or less, you may pay with this return. (see instructions) . . . . . . . 14 . 15 Overpayment (If line 13 is more than line 12, enter the excess on line 15 and check a box 

below.) . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15 . ▶ You MUST complete both pages of this form and SIGN it. Check one: Apply to next return. Send a refund.

Next ■▶

For Privacy Act and Paperwork Reduction Act Notice, see the back of Form 940-V, Payment Voucher. Cat. No. 11234O Form 940 (2011) 
850211

Name (not your trade name) Employer identification number (EIN) 

Part 5: Report your FUTA tax liability by quarter only if line 12 is more than $500. If not, go to Part 6. 

16 Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had no liability for

a quarter, leave the line blank. 

16a 1st quarter (January 1 – March 31) . . . . . . . . . 16a .

16b 2nd quarter (April 1 – June 30) . . . . . . . . . . 16b .

16c 3rd quarter (July 1 – September 30) . . . . . . . . 16c .

16d 4th quarter (October 1 – December 31) . . . . . . . 16d .

17 Total tax liability for the year (lines 16a + 16b + 16c + 16d = line 17) 17 . Total must equal line 12.

Part 6: May we speak with your third-party designee? 

Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions 

for details. 

Yes. Designee’s name and phone number 

Select a 5-digit Personal Identification Number (PIN) to use when talking to IRS 

No. 

Part 7: Sign here. You MUST complete both pages of this form and SIGN it. 

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 made to employees. Declaration of preparer (other than 

taxpayer) is based on all information of which preparer has any knowledge. 

✗ Sign your 

name here 

Date / / 

Print your 

name here 

Print your 

title here 

Best daytime phone 

Paid preparer use only Check if you are self-employed . . .

Preparer’s name 

Preparer’s 

signature 

Firm’s name (or yours 

if self-employed) 

Address 

City State 

PTIN 

Date / / 

EIN 

Phone 

ZIP code 

Page 2 Form 940 (2011)
Form 940-V, 

Payment Voucher 

What Is Form 940-V? 

Form 940-V is a transmittal form for your check or 

money order. Using Form 940-V allows us to process 

your payment more accurately and efficiently. If you 

have any balance due of $500 or less on your 2011 

Form 940, fill out Form 940-V and send it with your 

check or money order. 

Note. If your balance is more than $500, see When 

Must You Deposit Your FUTA Tax? in the Instructions 

for Form 940. 

How Do You Fill Out Form 940-V? 

Type or print clearly. 

Box 1. Enter your employer identification number (EIN). 

Do not enter your social security number (SSN). If you do 

not have an EIN, you may apply for one online. Go to 

IRS.gov and click on the Apply for an Employer

Identification Number (EIN) Online link. You may also 

apply for an EIN by calling 1-800-829-4933, or you can 

fax or mail Form SS-4, Application for Employer 

Identification Number. If you have not received your EIN 

by the due date of Form 940, write “Applied For” and the 

date you applied in this entry space. 

Box 2. Enter the amount of your payment. Be sure to 

put dollars and cents in the appropriate spaces. 

Box 3. Enter your business name and complete 

address exactly as they appear on your Form 940. 

How Should You Prepare Your Payment? 

• Make your check or money order payable to the United 

States Treasury. Do not send cash. 

• On the memo line of your check or money order, 

write: 

— your EIN, 

— Form 940, and 

— 2011. 

• Carefully detach Form 940-V along the dotted line. 

• Do not staple your payment to the voucher. 

• Mail your 2011 Form 940, your payment, and Form 

940-V to the address shown in the table in the 

Instructions for Form 940.

✁ ▼ Detach Here and Mail With Your Payment and Form 940. ▼

✃

Form 940-V

Department of the Treasury 

Internal Revenue Service 

Payment Voucher

▶ Do not staple or attach this voucher to your payment.

OMB No. 1545-0028

2011

1 Enter your employer identification number (EIN). 2

Enter the amount of your payment. ▶

Dollars Cents

3 Enter your business name (individual name if sole proprietor).

Enter your address.

Enter your city, state, and ZIP code.
Form 940 (2011) 

Privacy Act and Paperwork Reduction Act Notice. 

We ask for the information on this form to carry out the 

Internal Revenue laws of the United States. We need it 

to figure and collect the right amount of tax. Chapter 

23, Federal Unemployment Tax Act, of Subtitle C, 

Employment Taxes, of the Internal Revenue Code 

imposes a tax on employers with respect to employees. 

This form is used to determine the amount of the tax that 

you owe. Section 6011 requires you to provide the 

requested information if you are liable for FUTA tax under 

section 3301. Section 6109 requires you to provide your 

identification number. If you fail to provide this 

information in a timely manner or provide a false or 

fraudulent form, you may be subject to penalties and 

interest. 

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 and records relating to a form or 

instructions must be retained as long as their contents 

may become material in the administration of any Internal 

Revenue law. 

Generally, tax returns and return information are 

confidential, as required by section 6103. However, 

section 6103 allows or requires the IRS to disclose or 

give the information shown on your tax return to others 

as described in the Code. For example, we may disclose 

your tax information to the Department of Justice for civil 

and criminal litigation, and to cities, states, the District of 

Columbia, and U.S. commonwealths and possessions to 

administer their tax laws. We may also disclose this 

information to other countries under a tax treaty, to 

federal and state agencies to enforce federal non-tax 

criminal laws, or to federal law enforcement and 

intelligence agencies to combat terrorism. 

The time needed to complete and file this form will vary 

depending on individual circumstances. The estimated 

average time is: 

Recordkeeping . . . . . . . . . . 9 hr., 19 min.

Learning about the law or the form . . 1 hr., 23 min.

Preparing, copying, assembling, and 

sending the form to the IRS . . . . . 1 hr., 36 min.

If you have comments concerning the accuracy of 

these time estimates or suggestions for making 

Form 940 simpler, we would be happy to hear from 

you. You can email us at taxforms@irs.gov. Enter 

“Form 940” on the subject line. Or write to: Internal 

Revenue Service, Tax Products Coordinating Committee, 

SD:W:CAR:MP:T:M:S, 1111 Constitution Avenue, NW, 

IR-6526, Washington, DC 20224. Do not send Form 940 

to this address. Instead, see Where Do You File? in the 

Instructions for Form 940.