Karen Kluster opened Lube and Wash on January 1, 2016. The business is subject to FICA taxes. At the end of the first quarter of 2016, Kluster, as president of the company, must file Form 941, Employer's Quarterly Federal Tax Return. Using Form 941 (Parts 1 through 5), reproduced on pages 3-43 and 3-44 (given below), prepare, sign, and date the return on the basis of the information shown below.
Employer's address: 234 Oak, Austin, TX 78711-0234
Employer's ID number: 00-0005874
Phone number: (512) 555-1111
Each employee is paid semimonthly on the 15th and last day of each month. Shown below is the payroll information for the first quarter of 2016. All pay periods were the same.

None of the employees reported tips during the quarter.

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PAYROLL INFORMATION FOR IANUARY-MARCH Federal Income Tax QuarterlyOASDI Total Employee SSN Wage Tax HI Tax Net Pay Deducions Paul Purso 000-00-7233 $12,000.00 744.00 $174.00 $1,260.00 $2,178.00 9,822.00 Matt Dirkson 000-00-8451 12,600.00 781.20 182.70 1,200.00 2,163.90 10,436.10 oan Howard 000-00-3668 2,500.00 775.02 181.26 080.00 2,036.28 10,463.72 8,833.80 $47,900.00 $2,969.82 $694.56 $4,680.00 $8,344.38 $39,555.62 Dorrie Smith 000-00-6527 10,800.00 669.60 156.60 1,140.00 1,966.20 Totals Employer's FICA taxes for the quarter $694.55 $2969.80 OASDI HI The total taxes per payday are: Employees' FICA Tax-OASDI Employer's FICA Tax-OASDI Employees' FICA Tax-HI Employer's FICA Tax-HI Employees' FIT $494.97 494.97 115.76 115.76 780.00 Total $2,001.46 x 6 deposits $12,008.76 for the quarter Fom 941 for 20-: Employer's QUARTERLY Federal Tax Return Januay Dopartmant of tha Treasury-Inbaral Flavenua Sarvos OMB No. 1545-0020 Report for this Quarter of 20- 1:January, February, March 2: April, May, June Namo ot your trado namaj KAREN KLUSTER namo any) LUBE AND WASH July, August, September 4: Octaber, November,Decembe available at www.irs.gowlform941 Addross 234 OAK Instructions and prior year AUSTIN TX 78711-0234 Read the separate Instructions betore you complete Form 941. Type or print within the boxes. Part1: Answer these questions for this quarter Number of employees who recelved wages, tips, or other compensation for the pay period Including: Mar. 12 (Quarter , June 12 (Quarter 2, Sept 12 (Quarter 3, or Dec. 12 (Quarter 4 1 1 2 Wages, tips, and other compensation 3 Federal Income tax withhekd trom wages, tips, and other compensation 4 tf no wages, tips, and other compensation are subject to social security or Medicare tax check and go to e 6. Column 1 Column 2 5a Taxable soclal security wages Eb Taxable social security tips. . 5c Taxable Medicare wages &tips. - 5d Taxable wages &tips subject to x.124 x.124 x029 Adaltional Medicare Tax wtthholding x .009 5e Add Column 2 from IInes 5a, 50, 5c, and 5d 5 Section 3121(4) Notice and Demand-Tax due on unreported tips (see Instructions) 6 Total taxes before adjustments. Add lInes 3, 5e, and 6t 7 Current quarter's adjustment for tractions of cents 8 Current quarter's adjustment for sick pay 9 Current quarter's adjustments for tps and group-term Ife Insurance 10 Total taxes arter adjustments. Combine lInes 6through9 11 Total deposits for this quarter, Including overpayment applled trom a prior quarter and 5e 51 10 overpayments applled from Form 941-X, 941-X (PR), 944-x, 944-X (PRI, or 944-X (SP) led n the current quarter 12 Balance due. It Ine 10 is more than Ine 11, enter the dimerence and see Instructions 12 13 Overpayment. ine 11 is more than Ine 10, enter the diterence You MUST complete both pages of Form 941 and SIGN lt. For Privacy Act and Paperwork Roduction Act Notice, soo the back of the Payment Vouchar Cat. No. 170012 Form 941 (Rav. 1-2015 your AREN KLUSTER 00-0005874 Part 2: Tell us about your deposit schedule and tax llabillty for this quarter If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see Pub. 15 Circular E), section 11 LIine 10 on this ratun is lass than $2.500 or Ina 10 on the raturn for the prtor 100,000naxt-day daposit obligation during tha curront quarter. If Ina 10 for he prior quartar was las than $2500 but ine 10 on this ratum 匕$100,000 σ mora, you must prove racord of your tadarz/ tu liblity. If yu|re a monthly schedule dapostor, oomplato te d post schadule balow ityou ara a samiwoakty schedule dapostior, attach Schodulia B Fo941 Go to Part a was less than $2,500, and you did not nour a You were a monthly schedule depositor for the entire quarter. Enter your tax Fability for each month and total liability for the quarter, then go to Part 3 Month 1 Month 2 Month 3 Total liability for quarter Tax liability: Total must equal line 10 You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B (Form 941). Report of Tax Liability for Seniweekly Schedule Depositors, and attach it to Form 941. Part 3: Tell us about your business. If a question does NOT apply to your business, leave It blank If your business has closed or you stopped paying wages enter the final date you paid wages 15 Check here, and 6 If you are a seasonal employer and you do not have to file a return for every quarter of the year Check here. Part 4: May we speak with your third-party designee? Do you want to allow an employe, a paid tax proprer, or another person to discuss this ratum with the IRS? Sea thฉ nstructions for dotails. Yes, Designee's name and phone number Select a 5-digit Personal Identification Number (PIN) to use when talking to the IRS. No. Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN It. Undar ponaitios of parjury, I declaro that I hava cxamhed thls rotum, Including accompanyig schodules and statemants, and to te bot of my knowlodgo and bollad, It is true, comact, and complata. Deciaration of proparor fothor tthan taxpayor) is basod on all Infomation of whlch praparo has any knowldga. Print your name here Sign your name here Print your itle here Date Beat daytime phone Preparer Use Only Check if you are self-emplayed Proparor's nama Preparer's signature Firm's namo (pr Date EIN Address Phone City State ZIP codo Paga Form 941 Fav. 1-2013