943 Form 2015

Enclose your check or money order made payable to United States Treasury. Be sure to enter your EIN Form 943 and 2015 on your check or money order. Total taxes after adjustments line 9 as adjusted by line 10. Total deposits for 2015 including overpayment applied from a prior year and Form 943-X 13a Reserved. PTIN Phone no. Cat. No. 11252K 943 2015 Form 943-V Payment Voucher Purpose of Form Specific Instructions Complete Form 943-V if you are making a payment with Form 943. To avoid a penalty make your payment with your 2015 Form 943 only if Your total taxes after adjustments for the year Form 943 line 11 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 Type or Print Employer identification number EIN Trade name if any If address is different from prior return check here. Address number and street City or town state or province country and ZIP or foreign postal code If you do not have to file returns in the future check here. Number of agricultural employees employed in the pay period that includes March 12 2015 Total wages subject to social security tax. Social security tax multiply line 2 by 12. 4. 124. Medicare tax multiply line 4 by 2. 9. 029. Additional Medicare Tax withholding multiply line 6 by 0. 9. 009. Federal income tax withheld. Total taxes before adjustments. Add lines 3 5 7 and 8. Current year s adjustments. Information about Form 943 and its separate instructions is at www*irs*gov/form943. Name as distinguished from trade name OMB No* 1545-0035 Employer s Annual Federal Tax Return for Agricultural Employees. 13b 13a Reserved. Balance due. If line 11 is more than line 12 enter the difference and see the instructions. Overpayment. If line 12 is more than line 11 enter the difference Check one Apply to next return* Send a refund. All filers If line 11 is less than 2 500 do not complete line 17 or Form 943-A. Semiweekly schedule depositors Complete Form 943-A and check here Monthly schedule depositors Complete line 17 and check here Monthly Summary of Federal Tax Liability. Do not complete if you were a semiweekly schedule depositor. Tax liability for month A B C D E January. February. March. April. May. F G H I J June. July. August. September October. K L November. 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 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. Paid Preparer Use Only name Print Your Name and Title Preparer s signature Firm s name Firm s address Date Check if self-employed Firm s EIN For Privacy Act and Paperwork Reduction Act Notice see the separate instructions.