COMPANY	GROSS	OASDI	HI	FIT	SIT	401K	life ins	CHARITABLE	other w/h	NET	fit taxable	oasdi tax	hi taxable
1st Qtr	$ 89,933.09	$ 5,535.53	$1,294.67	$ 15,190.24	$ 4,131.92	$6,644.04		$520.00	$ 741.00	$ 55,615.69	$ 82,639.05	$ 89,283.09	$ 89,283.09
2nd Qtr	$ 89,933.09	$ 5,535.53	$1,294.67	$ 15,190.24	$ 4,131.92	$6,644.04		$ 520.00	$ 741.00	$ 56,525.69	$ 82,639.05	$ 89,283.09	$ 89,283.09
3rd Qtr	$ 89,933.09	$ 3,089.63	$ 1,294.67	$ 15,190.24	$3,901.92	$6,644.04		$520.00	$ 741.00	$ 59,201.59	$ 82,639.05	$ 49,833.09	$ 89,283.09
4th Qtr	$ 93,419.09	$ 2,096.75	$1,440.62	$ 15,517.24	$4,306.53	$6,644.04		$ 550.00	$ 762.00	$ 62,772.91	$ 86,125.05	$ 33,819.09	$ 92,769.09
GR TOTALS	363,218.36	$ 16,257.44	$ 5,324.63	$ 61,087.96	$ 16,472.29	$ 26,576.16		$2,110.00	$ 2,985.00	$ 234,115.88	$ 334,042.20	$ 262,218.36	$ 360,618.36

Using the above data complete a Payroll Form 940 (section 2, 3 and 4 only).

3 Total payments to all employees ................... 3 . 4 Payments exempt from FUTA tax ....... 4 . Check all that apply: 4a Fringe benefits 4b Group-term life insurance 4c Retirement/Pension 4d Dependent care 4e Other 5 Total of payments made to each employee in excess of $7,000 ................ 5 . 6 Subtotal (line 4 + line 5 = line 6) .................... 6 . 7 Total taxable FUTA wages (line 3 line 6 = line 7) (see instructions) ........ 7 . 8 FUTA tax before adjustments (line 7 x .006 = line 8) ............. 8 . Part 3: Determine your adjustments. If any line does NOT apply, leave it blank. 9 If ALL of the taxable FUTA wages you paid were excluded from state unemployment tax, multiply line 7 by .054 (line 7 .054 = line 9). Go to line 12 ........... 9 . 10 If SOME of the taxable FUTA wages you paid were excluded from state unemployment tax, OR you paid ANY state unemployment tax late (after the due date for filing Form 940), complete the worksheet in the instructions. Enter the amount from line 7 of the worksheet .. 10 . 11 If credit reduction applies, enter the total from Schedule A (Form 940) ....... 11 . Part 4: Determine your FUTA tax and balance due or overpayment. If any line does NOT apply, leave it blank. 12 Total FUTA tax after adjustments (lines 8 + 9 + 10 + 11 = line 12) ......... 12 . 13 FUTA tax deposited for the year, including any overpayment applied from a prior year . 13 . 14 Balance due (If line 12 is more than line 13, enter the excess on line 14.) If line 14 is more than $500, you must deposit your tax. If line 14 is $500 or less, you may pay with this return. (see instructions) ....... 14 . 15 Overpayment (If line 13 is more than line 12, enter the excess on line 15 and check a box below.) ............................ 15 . Thanks!