Check my work 6 The first quarter tax return needs to be filed for Prevosti Farms and Sugarhouse by April 15, 2019. For the purpose of the taxes, assume the second February payroll amounts were duplicated for the March 9 and March 23 payroll periods and the new benefit elections went into effect as planned. The form was completed and signed on April 10, 2019. The gym membership is for a dedicated facility for employees and spouses, 10 points Exclude: Federal Yes Yes Yes Yes Yes No Benefit Information Health Insurance Life Insurance Long-term Care FSA 401(k) Gym eBook FICA Yes Yes Yes Yes NO No Print References Owner's name: Toni Prevosti Address: 820 Westminster Road, Bridgewater, VT 05520 Phone: 802-673-2636 Number of employees: 8 Gross quarterly wages: $37,739.85 Federal income tax withheld: $1,132.00 401(k) contributions: $1,509.59 Insurance withheld: $4.906.00 Gym membership: $90.00 Monthly Deposits Month 1 Month 2 Month 3 Amount $ 0.00 $ 2,641.79 $ 3,513.80 Required: Complete Form 941 for Prevosti Farms and Sugarhouse. Prevosti Farms and Sugarhouse was assigned EIN 22-6654454 -(NOTE): Instructions on format can be found on certain cells within the forms. Delow. 941 PG 1 941 PG 2 Page 1 of Form 941. (Round your answers to 2 decimal places.) Form 941 for 2019: Employer's QUARTERLY Federal Tax Return 950117 Department of the Treasury - Internal Revenue Service OMB No. 1545-0029 Employer identification number (EIN) Report for this Quarter 2019 (Check one.) Name (not your trade name) 01 January, February, March Trade name (if any) ) 102 April May June Address 03 July, August September Number Street Suite or room number 04: October, November December City State (NN) ZIP code Instructions and prior-year forms are available at Foreign country name Foreign Province/county Foreign Postal code www.irs.gov/form941 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: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 1 2 Wages, tips, and other compensation 3 3 Federal income tax withheld from wages, tips, and other compensation 4 If no wages, tips, and other compensation are subject to social security or Medicare tax Check and go to line 6. Column 1 Column 2 5a Taxable social security wages x 0.124 x 0.124 5b Taxable social security tips x 0.029 5c Taxable Medicare wages & tips 5d Taxable wages & tips subject to Additional Medicare Tax x 0.009 withholding 5e 5e Add Column 2 from lines 5a, 5b, 5c, and 5d feas inetnutiny 5 Bantin 9494 Natin snd omad Tau Hunn Ravertina E Check my work 6 ints eBook Print 6 Foreign country name Foreign Province/county Foreign Postal code www.irs.gov/form941 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: Mar 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 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 and go to line 6 Column 1 Column 2 5a Taxable social security wages X 0.124 5b Taxable social security tips x 0.124 5c Taxable Medicare wages & tips + * 0.029 5d Taxable wages & tips subject to Additional Medicare Tax withholding x 0.009 5e Add Column 2 from lines 5a, 5b, 5c, and 5d 5e 5f Section 3121(a) Notice and Demand - Tax due on unreported tips (see instructions) SF 6 Total taxes before adjustments. Add lines 3, 5e, and St 7 7 Current quarter's adjustments for fractions of cents 8 8 8 Current quarter's adjustments for sick pay 9 9 Current quarter's adjustments for tips and group-term life insurance 10 10 Total taxes after adjustments Combine lines 6 through 9 Attach Form 8974 11 Qualified small business payroll tax credit for increasing research activites Subtract line 11 from line 10 12 12 Total taxes after adjustments and credits. 13 Total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form 941-X, 341. 13 X (PR), 944-X, 944-X (PR), or 944-X (SP) filed in the current quarter 14 14 Balance due. If line 12 is more than line 13, enter the difference and see instructions Check on Apply to next Send a refund retum 15 Overpayment If line 13 is more than line 12, enter the difference Next You MUST complete both pages of Form 941 and SIGN it. Cat No. 170012 Form 941 (Rev. 1-2019) For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. 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 2020 McGraw-Hill Education References 11 Check my work 6 Name (not your trade name) Employer identification number (EIN) nts Part 2: Tell us about your deposit schedule and tax liability for this quarter. If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see section 11 of Pub. 15. 16 Check one: Line 12 on this return is less than $2,500 or line 12 (line 10 if the prior quarter was the fourth quarter of 2019) on the return for the prior quarter was less than $2,500, and you did not incur a $100.000 next day deposit obligation during the current quarter. If line 12 (line 10 if the prior quarter was the fourth quarter of 2018) for the prior quarter was less than $2,500 but line 12 on this retum is $100,000 or more, you must provide a record of your federal tax liability. If you are a monthly schedule depositos complete the deposit schedule below if you are a semiweekly schedule depositor, attach Schedule 8 (Form 941) Go to Part 3 You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liabuty for the quarter, then go to Part 3 Tax liability Month 1 Month 2 Month 3 Total liability for quarter Total must equal line 12 You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B (Form 941), Report of Tax Liability for Semiweekly Schedule Depositors, and attach it to Form 941 . eBook Print References Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank. Check here, and Check here 17 If your business has closed or you stopped paying wages enter the final date you paid wages (mm/dd/yyyy) 18 If you are a seasonal employer and you do not have to file a return for every quarter of the year a Part 4: May we speak with your third-party designee? Do you want to allow antployee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions for details. Yes. Designee's name and phone number No. Select a S-digit Personal Identification Number (PIN) to use when talking to IRS Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN it. 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 is true comect and complete Check my work 6 Select a 5-digit Personal Identification Number (PIN) to use when talking to RS Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN it. 10 points Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge 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 complett Sign your name here Print your name here Print your litle here eBook Date (mm/dd/yyyy) 04/10/2019 Best daytime phone xxx-xxx-xxxx) Paid Preparer Use Only Print Preparer's name Preparer's signature Check if you are seit-employed PTIN Date (mm/ddiyyyy) EIN References Firm's name for yours if self-employed) Address Phone City State (NN) ZIP code Form 941 (Rev. 1-2019) Page 2 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 2020 McGraw-Hill Education. Check my work 6 ints eBook Print 6 Foreign country name Foreign Province/county Foreign Postal code www.irs.gov/form941 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: Mar 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 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 and go to line 6 Column 1 Column 2 5a Taxable social security wages X 0.124 5b Taxable social security tips x 0.124 5c Taxable Medicare wages & tips + * 0.029 5d Taxable wages & tips subject to Additional Medicare Tax withholding x 0.009 5e Add Column 2 from lines 5a, 5b, 5c, and 5d 5e 5f Section 3121(a) Notice and Demand - Tax due on unreported tips (see instructions) SF 6 Total taxes before adjustments. Add lines 3, 5e, and St 7 7 Current quarter's adjustments for fractions of cents 8 8 8 Current quarter's adjustments for sick pay 9 9 Current quarter's adjustments for tips and group-term life insurance 10 10 Total taxes after adjustments Combine lines 6 through 9 Attach Form 8974 11 Qualified small business payroll tax credit for increasing research activites Subtract line 11 from line 10 12 12 Total taxes after adjustments and credits. 13 Total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form 941-X, 341. 13 X (PR), 944-X, 944-X (PR), or 944-X (SP) filed in the current quarter 14 14 Balance due. If line 12 is more than line 13, enter the difference and see instructions Check on Apply to next Send a refund retum 15 Overpayment If line 13 is more than line 12, enter the difference Next You MUST complete both pages of Form 941 and SIGN it. Cat No. 170012 Form 941 (Rev. 1-2019) For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. 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 2020 McGraw-Hill Education References 11 Check my work 6 Name (not your trade name) Employer identification number (EIN) nts Part 2: Tell us about your deposit schedule and tax liability for this quarter. If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see section 11 of Pub. 15. 16 Check one: Line 12 on this return is less than $2,500 or line 12 (line 10 if the prior quarter was the fourth quarter of 2019) on the return for the prior quarter was less than $2,500, and you did not incur a $100.000 next day deposit obligation during the current quarter. If line 12 (line 10 if the prior quarter was the fourth quarter of 2018) for the prior quarter was less than $2,500 but line 12 on this retum is $100,000 or more, you must provide a record of your federal tax liability. If you are a monthly schedule depositos complete the deposit schedule below if you are a semiweekly schedule depositor, attach Schedule 8 (Form 941) Go to Part 3 You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liabuty for the quarter, then go to Part 3 Tax liability Month 1 Month 2 Month 3 Total liability for quarter Total must equal line 12 You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B (Form 941), Report of Tax Liability for Semiweekly Schedule Depositors, and attach it to Form 941 . eBook Print References Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank. Check here, and Check here 17 If your business has closed or you stopped paying wages enter the final date you paid wages (mm/dd/yyyy) 18 If you are a seasonal employer and you do not have to file a return for every quarter of the year a Part 4: May we speak with your third-party designee? Do you want to allow antployee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions for details. Yes. Designee's name and phone number No. Select a S-digit Personal Identification Number (PIN) to use when talking to IRS Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN it. 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 is true comect and complete Check my work 6 Select a 5-digit Personal Identification Number (PIN) to use when talking to RS Part 5: Sign here. You MUST complete both pages of Form 941 and SIGN it. 10 points Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge 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 complett Sign your name here Print your name here Print your litle here eBook Date (mm/dd/yyyy) 04/10/2019 Best daytime phone xxx-xxx-xxxx) Paid Preparer Use Only Print Preparer's name Preparer's signature Check if you are seit-employed PTIN Date (mm/ddiyyyy) EIN References Firm's name for yours if self-employed) Address Phone City State (NN) ZIP code Form 941 (Rev. 1-2019) Page 2 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 2020 McGraw-Hill Education.