Semimonthly Paydays	Gross and Taxable Wages	FICA Withheld OASDI	FICA Withheld HI	Federal Income Tax Withheld
1/15	$24,400	$1,512.80	$353.80	$3,188.00
1/31	23,855	1,479.01	345.90	3,099.00
2/15	25,280	1,567.36	366.56	3,407.00
2/28	25,630	1,589.06	371.64	3,504.00
3/15	24,950	1,546.90	361.78	3,380.00
3/29	25,100	1,556.20	363.95	3,753.00
	$149,215	$9,251.33	$2,163.63	$20,331.00

Use this schedule to show your TAX LIABILITY for the quarter; don't use it to show your deposits. When you file this form with Form 941 or Form 941-SS, don't change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this form and attach it to Form 941 or Form 941-SS if you're a semiweekly schedule depositor or became one because your accumulated tax liability on any day was $100,000 or more. Write your daily tax liability on the numbered space that corresponds to the date wages were paid. See Section 11 in Pub. 15 for details.

Month 1
1	fill in the blank 3	9	fill in the blank 4	17	fill in the blank 5	25	fill in the blank 6	Tax liability for Month 1
2	fill in the blank 7	10	fill in the blank 8	18	fill in the blank 9	26	fill in the blank 10	fill in the blank 11
3	fill in the blank 12	11	fill in the blank 13	19	fill in the blank 14	27	fill in the blank 15
4	fill in the blank 16	12	fill in the blank 17	20	fill in the blank 18	28	fill in the blank 19
5	fill in the blank 20	13	fill in the blank 21	21	fill in the blank 22	29	fill in the blank 23
6	fill in the blank 24	14	fill in the blank 25	22	fill in the blank 26	30	fill in the blank 27
7	fill in the blank 28	15	fill in the blank 29	23	fill in the blank 30	31	fill in the blank 31
8	fill in the blank 32	16	fill in the blank 33	24	fill in the blank 34
Month 2
1	fill in the blank 35	9	fill in the blank 36	17	fill in the blank 37	25	fill in the blank 38	Tax liability for Month 2
2	fill in the blank 39	10	fill in the blank 40	18	fill in the blank 41	26	fill in the blank 42	fill in the blank 43
3	fill in the blank 44	11	fill in the blank 45	19	fill in the blank 46	27	fill in the blank 47
4	fill in the blank 48	12	fill in the blank 49	20	fill in the blank 50	28	fill in the blank 51
5	fill in the blank 52	13	fill in the blank 53	21	fill in the blank 54	29	fill in the blank 55
6	fill in the blank 56	14	fill in the blank 57	22	fill in the blank 58	30	fill in the blank 59
7	fill in the blank 60	15	fill in the blank 61	23	fill in the blank 62	31	fill in the blank 63
8	fill in the blank 64	16	fill in the blank 65	24	fill in the blank 66
Month 3
1	fill in the blank 67	9	fill in the blank 68	17	fill in the blank 69	25	fill in the blank 70	Tax liability for Month 3
2	fill in the blank 71	10	fill in the blank 72	18	fill in the blank 73	26	fill in the blank 74	fill in the blank 75
3	fill in the blank 76	11	fill in the blank 77	19	fill in the blank 78	27	fill in the blank 79
4	fill in the blank 80	12	fill in the blank 81	20	fill in the blank 82	28	fill in the blank 83
5	fill in the blank 84	13	fill in the blank 85	21	fill in the blank 86	29	fill in the blank 87
6	fill in the blank 88	14	fill in the blank 89	22	fill in the blank 90	30	fill in the blank 91
7	fill in the blank 92	15	fill in the blank 93	23	fill in the blank 94	31	fill in the blank 95
8	fill in the blank 96	16	fill in the blank 97	24	fill in the blank 98

b. Using the calendar below, list the due dates of each deposit in the first quarter. \begin{tabular}{l|r} \multicolumn{1}{c}{ Paydays } & Deposit Due Dates \\ \hline January 15 & - \\ January 31 & \\ February 15 & \\ February 28 & \\ March 15 & \\ March 29 & \end{tabular}