Employer's Quarterly Federal Tax Return Revision Date 06/22/2022

• Issuer: Treasury Department
• Section: Treasury Department

Form 941 for 2024:

(Rev. March 2024)

Employer’s QUARTERLY Federal Tax Return

Department of the Treasury — Internal Revenue Service

950124

OMB No. 1545-0029

Employer identification number (EIN)

—

Name (not your trade name)

Trade name (if any)

Address

Number Street Suite or room number

City State ZIP code

Foreign country name Foreign province/county Foreign postal code

Report for this Quarter of 2024

(Check one.)

1: January, February, March

2: April, May, June

3: July, August, September

4: October, November, December

Go to www.irs.gov/Form941 for

instructions and the latest information.

Read the separate instructions before you complete Form 941. Type or print within the boxes.

Part 1: Answer these questions for this quarter. Employers in American Samoa, Guam, the Commonwealth of the Northern

Mariana Islands, the U.S. Virgin Islands, and Puerto Rico can skip lines 2 and 3, unless you have employees who are

subject to U.S. income tax withholding.

1

Number of employees who received wages, tips, or other compensation for the pay period

including: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4)

1

2 Wages, tips, and other compensation ................. 2.

3 Federal income tax withheld from wages, tips, and other compensation ...... 3.

4 If no wages, tips, and other compensation are subject to social security or Medicare tax Check here and go to line 6.

Column 1 Column 2

5a Taxable social security wages . . .× 0.124 = .

5b Taxable social security tips ... .× 0.124 = .

5c Taxable Medicare wages & tips. . .× 0.029 = .

5d Taxable wages & tips subject to

Additional Medicare Tax withholding .× 0.009 = .

5e

Total social security and Medicare taxes. Add Column 2 from lines 5a, 5b, 5c, and 5d

.... 5e .

5f Section 3121(q) Notice and Demand—Tax due on unreported tips (see instructions) . . 5f .

6 Total taxes before adjustments. Add lines 3, 5e, and 5f ............ 6.

7 Current quarter’s adjustment for fractions of cents ............. 7.

8 Current quarter’s adjustment for sick pay ................ 8.

9 Current quarter’s adjustments for tips and group-term life insurance ....... 9.

10 Total taxes after adjustments. Combine lines 6 through 9 ........... 10 .

11

Qualified small business payroll tax credit for increasing research activities. Attach Form 8974

11

12 Total taxes after adjustments and nonrefundable credits. Subtract line 11 from line 10 . . 12 .

13 Total deposits for this quarter, including overpayment applied from a prior quarter and

overpayments applied from Form 941-X, 941-X (PR), or 944-X filed in the current quarter 13 .

14 Balance due. If line 12 is more than line 13, enter the difference and see instructions . . . 14 .

.

15

Overpayment. If line 13 is more than line 12, enter the difference

.Check one:

Apply to next return.

Send a refund.

You MUST complete both pages of Form 941 and SIGN it.

For Privacy Act and Paperwork Reduction Act Notice, see separate instructions. Cat. No. 17001Z Form 941 (Rev. 3-2024)