rom 940 for 2021: Employer's Annual Federal Unemployment (FUTA) Tax Return 850113 Deparment of the Testun — Internal Revenue See (OMB No. 1545-0028 sll4]-[s]is]e] [Je ][el[s ew (Chock ll that appt) Cla Amended Name nt your trade name) [Bobby Morgan ‘Trade name ff any) Lb. successor employer Le Na paymerts to employees in ‘Address [795 MAGNOLIA AVE APT 10 oe eee nee rar Sie wren nr Seer inane 0 to ww.is.gov/Form940 for [PASADENA, cA 91106 Instetions and the lates Information Read the separate instructions before you compete ths form. Please type or print within the boxes. ‘Tell us about your return. If any line does NOT apply, leave it blank. See instructions befare completing Part 1 ‘1a Ifyou had to pay state unemployment tax in one state only, enter the state abbreviation. 1a| © | | A 1b Ifyou had to pay state unemployment tax in more than one state, you are a multi-state aetiee employer ‘th [1] Complete Schedule A (Form 840) 2 Ifyou paid wages in a state that is subject to CREDIT REDUCTION 2 1 checkhere. Sort Sete Am on, [RIES_Dstermine your FUTA tax before adjustments, Itany ine does NOT apply, leave R blank. 3 Total payments to all employees 3 25,000, 00 4 Payments exempt from FUTA tax 4 00, 00 Cheek all th apply: 4a [_] Fringe benefits 4c []RetiremenvPension —_4e [] other rm life insurance 4d [_] Dependent care. 4b L] Grou 5 Tolalotpayments made to each employe i excess of Tow. 0 6 Subtotal ine 4 + line 5 = line 6) 6 21,000, 00 7 Total taxable FUTA wages (ine 3 - ine 6 =line 7) See instructions 7 4,000, 00 8 FUTA tax before adjustments (ine 7x 0.008 = line 8) 8 24, 00 ERXEN Determine your adjustments, Wany line does NOT apply, leave R blank, ALL of the taxable FUTA wages you paid were excluded from state unemployment tax, tltipl ine 7 by 6.054 {Ine 7x 9.094 = line, Go to line 12, ° 90.00 10 If SOME of the taxable FUTA wages you paid were excluced from state unemployment tax, OR you paid ANY state unemployment tax late {arter the due date for fling Form 940) compl worksheet in the instructions. Enter the amount from line 7 of the worksheet 10 oo, 00 11 _ If credit reduction applies, enter the total from Schedule A (Form 940) a 00, 00 [RIEHE_Determine your FUTA tax and balance due or overpayment. any Une does NOT apply, leave RBIAnK: 12 Total FUTA tax after adjustments (lines 8 +9 + 10 + line 12) 12 24. 00 13 FUTA tax deposited for the year, including any overpayment applied from a prior year 13, 00. 00 14 Balance due. Iline 12 is more than line 13, enter the excess on line 14 + If line 14is more than $500, you must deposit your tax + fling 14 is $500 or less, you may pay with this return. See instructions “ 24, 00 15 Overpayment. I line 13 is more than line 12, enter the excess online 15 and check a box below 15 oO. 00 > You MUST complete both pages of this form and SIGN it. Check one: Clappiy to next return. C) Send a refung For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Gu Ne. EMO Ferm 940 (2021)asoa12 Tare ft your rade rae) Bobby Morgan Enpoyeriaeiiicavon purer EN) $4.5537365 Report your FUTA tax labiliy by quarter only line 12s more than $500, Nnot, goto Part. 16 Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had ne liability for ‘a quarter, leave the line blank, 46a. tst quarter (January 1 March 31) 466 2nd quarter (April 1~ June 30) 46. Srd quarter (uly September 30) 16d. Ath quarter (October 1 - December 31) 17, Total tax liability for the year fines 162 ~ 16b + 16c + 16 a 06, 00) A 06,00) Fa 06, 00 Feel 06, 00) ine 17) 17 24+ 00} Total must equal tine 12. [XEN Way we speak with your tire: 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, Les. _Designee’s name and phone number Selecta 5-cigit personal identification number (PIN) to use when taking tothe IRS. Dine. Sign here, You MUST complete both pages ofthis form and SIGN R. Under penaties of perry, | dectare that | have examined this return, inclucing accompanying schedules and statements. and to the best of my knowledge and belie, tis true, correct, and complete, and that no part of any payment made (0 a state unemployment fund claimed as a credit was, oi to be, deducted trom the payments made to employees. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge, Print your Sign your name here name here =n int your tile here pate | Best daytime phone Paid Preparer Use Only Check it you are self-employed [] Proparer's name PTW Preparer's signature Date so Firm's name (or yours if self-employed) EIN Address Phone city State ZIP code| Page Form 940 023)Form 940-V, Payment Voucher Purpose of Form Complete Form 940-V if you're making a payment with Form 940. 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 940 To avoid a penalty, make your payment with your 2021 Form 940 only if your FUTA tax for the fourth quarter (plus any undeposited amounts from earlier quarters) is ‘$500 or less. If your total FUTA tax after adjustments (Form 940, line 12) is more than $500, you must make deposits by electronic funds transfer, See When Must You Deposit Your FUTA Tax? in the Instructions for Form 940. Also see sections 11 and 14 of Pub. 15 for more information about deposits, ‘Use Form 940-V when making any payment with Form 940. However, if you pay an amount with Form 940 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 by visiting the IRS website at www.irs.gov/EIN, 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 940, write "Applied For” and the date you applied in this entry space, Box 2— Amount pai Form 940, Box 3—Name and address. Enter your name and address as shown on Form $40, * Enclose your check or money order made payable to “United States Treasury.” Be sure to enter your EIN, Form 940," and “2021” on your check or money order. Don't send cash. Don’t staple Form 940-V or your payment to Form 940 (or to each other). = Detach Form 940-V and send it with your payment and Form 940 to the address provided in the Instructions for Form 940. |. Enter the amount paid with Note: You must also complete the entity information above Part 1 on Form 940. Payment Voucher > Don't staple or attach this voucher to your payment. rer your employer enticnion ber EN [2 Enter the amount of your payment. > sk you eck ot more ord pajanata ned States Tres 24] 0] 54-$537365 Dats Erie yor Baars arte [RONTUAT TATE Fae OPT Bobby Morgan 795 MAGNOLIA AVE APT 10 ‘Er you ey sale, a ZF cea our a TOGR COM Tae, IE OTTERS, ETO PHT OR PASADENA, CA 91106Fom9co ort) 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 Fequested 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, You're 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 nontax 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 Shr. 19 min Learning about the law or the form 1 br, 23 min, Preparing, copying, assembling, and ‘sending the form to the IRS 1 hr, 36 min. Ifyou 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 send us comments from wwi.jrs.gov/FormComments. Or you can send your comments to Internal Revenue Service, Tax Forms and Publications Division, 1111 Constitution Ave. NW, IR-6526, Washington, DC 20224. Don't send Form 940 to this address. Instead, see Where Do You File? in the Instructions for Form 940,