943 Form 2012

Enclose your check or money order made payable to the United States Treasury. Be sure to enter your EIN Form 943 and 2012 on your check or money order. Total taxes after adjustments line 7 as adjusted by line 8. Total deposits for 2012 including overpayment applied from a prior year and Form 943-X 11a COBRA premium assistance payments see separate instructions. No. PTIN Phone no. Cat. No. 11252K 943 2012 Form 943-V Payment Voucher Purpose of Form Specific Instructions Complete Form 943-V Payment Voucher if you are making a payment with Form 943 Employer s Annual Federal Tax Return for Agricultural Employees. You must also complete the entity information above line 1 on Form 943. To avoid a penalty make your payment with your 2012 Form 943 only if Your total taxes after adjustments for the year Form 943 line 9 are less than 2 500 and you are paying in full with a timely filed return or You are a monthly schedule depositor making a payment in accordance with the Accuracy of Deposits Rule. Form Department of the Treasury Internal Revenue Service Calendar year Trade name if any Employer identification number EIN Address number and street Type or Print Information about Form 943 and its separate instructions is at www.irs.gov/form943. Name as distinguished from trade name City state and ZIP code If you do not have to file returns in the future check here OMB No. 1545-0035 Employer s Annual Federal Tax Return for Agricultural Employees. If address is different from prior return check here. Number of agricultural employees employed in the pay period that includes March 12 2012 For 2012 the employee social security tax rate is 4. Form Department of the Treasury Internal Revenue Service Calendar year Trade name if any Employer identification number EIN Address number and street Type or Print Information about Form 943 and its separate instructions is at www*irs*gov/form943. Name as distinguished from trade name City state and ZIP code If you do not have to file returns in the future check here OMB No* 1545-0035 Employer s Annual Federal Tax Return for Agricultural Employees. If address is different from prior return check here. Number of agricultural employees employed in the pay period that includes March 12 2012 For 2012 the employee social security tax rate is 4. 2 and the Medicare tax rate is 1. 45. The employer social security tax rate is 6. 2 and the Medicare tax rate is 1. 45. Total wages subject to social security tax see separate instructions Social security tax multiply line 2 by 10. 4. 104. Medicare tax multiply line 4 by 2. 9. 029. Federal income tax withheld see separate instructions. Total taxes before adjustments. Add lines 3 5 and 6. Current year s adjustments see separate instructions. 11b Number of individuals provided COBRA premium assistance. 11b 11a Add lines 10 and 11a. Balance due. If line 9 is more than 12 enter the difference and see the instructions. Overpayment. If line 12 is more than line 9 enter the difference Check one Appy to next return* Send a refund.