$941$ PG $1941$ PG $2$

Page $1$ of Form $941.$

Note: Round your final answers to $2$ decimal places.

Form $941$ for $2022$:

Employer's QUARTERLY Federal Tax Return

$950120$

Department of the Treasury $-$ Internal Revenue Service OMB No$.1545-0029$

Employer identification number $($EIN$)22-6654454$ Report for this Quarter of $2022($Check one.$)$

Name $($not your trade name$)$ Toni Prevosti $1$:radio button checked$1$ of $4$ January, February, March

Trade name $($if any$)$ Prevosti Farms and Sugarhouse $2$:radio button unchecked$2$ of $4$ April, May, June

Address $820$ Westminster Road $3$:radio button unchecked$3$ of $4$ July, August, September

Number Street Suite or room number

Bridgewater VT $055204$:radio button unchecked$4$ of $4$ October, November, December

City State $($NN$)$ ZIP code

Instructions and prior$-$year forms are available at www$.$irs.gov$/$form$941.$

Foreign country name Foreign Province$/$county Foreign Postal code

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

Part $1$:

Answer these questions for this quarter.

$1$ Number of employees who received wages, tips, or other compensation for the pay period including: June $12($Quarter $2),$ September $12($Quarter $3),$ or December $12($Quarter $4)$

$18$

$2$ Wages, tips, and other compensation $229,140\mathrm{.}32$

$3$ Federal income tax withheld from wages, tips, and other compensation $3414\mathrm{.}00$

$4$ If no wages, tips, and other compensation are subject to social security or Medicare tax Check and go to line $6.$checkbox unchecked$1$ of $1$

Column $1$ Column $2$

$5$a Taxable social security wages x $0\mathrm{.}1240\mathrm{.}00$

$5$a$($i$)$ Qualified sick leave wages x $0\mathrm{.}0620\mathrm{.}00$

$5$a$($ii$)$ Qualified family leave wages x $0\mathrm{.}0620\mathrm{.}00$

$5$b Taxable social security tips x $0\mathrm{.}1240\mathrm{.}00$

$5$c Taxable Medicare wages & tips x $0\mathrm{.}0290\mathrm{.}00$

$5$d Taxable wages & tips subject to Additional Medicare Tax withholding x $0\mathrm{.}0090\mathrm{.}00$

$5$e Total social security and Medicare taxes. Add Column $2$ from lines $5$a$,5$a$($i$),5$a$($ii$),5$b$,5$c$,$ and $5$d $5$e $0\mathrm{.}00$

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

$6$ Total taxes before adjustments. Add lines $3,5$e$,$ and $5$f $6414\mathrm{.}00$

$7$ 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 $910414\mathrm{.}00$

$11$a Qualified small business payroll tax credit for increasing research activities. Attach Form $897411$a

$11$b Nonrefundable portion of credit for qualified sick and family leave wages from Worksheet $111$b

$11$c Nonrefundable portion of employee retention credit from Worksheet $111$c

$11$d Total nonrefundable credits. Add lines $11$a$,11$b$,$ and $11$c $11$d $0\mathrm{.}00$

$12$ Total taxes after adjustments and nonrefundable credits. Subtract line $11$d from line $1012414\mathrm{.}00$

$13$a Total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form $941-$X$,941-$X $($PR$),944-$X$,$ or $944-$X $($SP$)$ filed in the current quarter

$13$a

$13$b Reserved for future use $13$b

$13$c Refundable portion of credit for qualified sick and family leave wages from Worksheet $113$c

$13$d Refundable portion of employee retention credit from Worksheet $113$d

$13$e Total deposits and refundable credits. Add lines $13$a$,13$b$,13$c$,$ and $13$d $13$e $0\mathrm{.}00$

$13$f Total advances received from filing Form$($s$)7200$ for the quarter $13$f

$13$g Total deposits and refundable credits less advances. Subtract line $13$f from line $13$e $13$g $0\mathrm{.}00$

$14$ Balance due. If line $12$ is more than line $13$g$,$ enter the difference and see instructions $14414\mathrm{.}00$

$15$ Overpayment. If line $13$g is more than line $12,$ enter the difference $0\mathrm{.}00$ Check one: Apply to next returncheckbox unchecked$1$ of $2$ Send a refund.checkbox unchecked$2$ of $2$

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

For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Cat. No$.17001$Z Form $941($Rev$.3-2022)$

THIS FORM IS A SIMULATION OF AN OFFICIAL U$.$S$.$ TAX FORM. IT IS NOT THE OFFICIAL FORM ITSELF. DO NOT USE THIS FORM FOR TAX FILINGS OR FOR ANY PURPOSE OTHER THAN EDUCATIONAL. $2023$ McGraw$-$Hill Education.