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. FICA Yes Benefit Information Health Insurance Life Insurance Long-term Care FSA 401(k) Gym Exclude: Federal Yes Yes Yes Yes Yes No Yes Yes Yes NO NO Owner's name: Toni Prevosti Address: 820 Westminster Road, Bridgewater, VT 05520. Phone: 802-673-2636 Number of employees: 8 Gross quarterly wages: $32,085.15 Federal income tax withheld: $628.00 401(k) contributions: $1,259.90 Insurance withheld: $4,080.00 Gym membership: $90.00 (For the pay-period completed till March 23). Monthly Deposits Month 1 Month 2 Month 3 Amount $ 0 $ 2,008.18 $ 2,904.72 Required: Complete Form 941 for Prevosti Farms and Sugarhouse. Prevosti Farms and Sugarhouse was assigned EIN 22-6654454. 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 return is $100,000 or more, you must provide a record of your federal tax liability. If you are a monthly schedule depositor, complete the deposit schedule below; if you are a semiweekly schedule depositor, attach Schedule B (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 liability 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 Form 941. Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank. 17 If your business has closed or you stopped paying wages Check here, and 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 Check here. Part 4: May we speak with yo third-party designee? Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions for details. Designee's name and phone number Yes. No. Select a 5-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, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Sign your name here Print your name here Print your title here Date (mm/dd/yyyy) 04/10/2019 Best daytime phone (XXX-XXX-XXXX) Paid Preparer Use Only Check if you are self-employed PTIN Preparer's name Preparer's signature Date (mm/dd/yyyy) Firm's name (or yours if self-employed) EIN Address Phone City State (NN) ZIP code Page 2 Form 941 (Rey 1.2019) Form 941 for 2019: Employer's QUARTERLY Federal Tax Return Department of the Treasury - Internal Revenue Service Employer identification number (EIN) Name (not your trade name) Trade name (if any) Address Number 950117 OMB No. 1545-0029 Report for this Quarter 2019 (Check one.) January, February, March April, May, June 1: 2: 3: July, August, September Street Suite or room number 04: October, November, December City State (NN) ZIP code Instructions and prior-year forms are available at www.irs.gov/form941. 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: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 2 Wages, tips, and other compensation 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. 5e 5f 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 x 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 5f Section 3121(a) Notice and Demand - Tax due on unreported tips (see instructions) 6 Total taxes before adjustments. Add lines 3, 5e, and 5f 7 Current quarter's adjustments for fractions of cents 8 Current quarter's adjustments for sick pay 9 Current quarter's adjustments for tips and group-term life insurance 10 Total taxes after adjustments. Combine lines 6 through 9 11 Qualified small business payroll tax credit for increasing research activites. Attach Form 8974 12 Total taxes after adjustments and credits. Subtract line 11 from line 10 13 Total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form 941-X, 941-X (PR), 944-X, 944-X (PR), or 944-X (SP) filed in the current quarter 14 Balance due. If line 12 is more than line 13, enter the difference and see instructions 7 8 9 10 11 12 13 14 15 Overpayment. If line 13 is more than line 12, enter the difference Check one: Apply to next return Send refund. You MUST complete both pages of Form 941 and SIGN it. Next 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. FICA Yes Benefit Information Health Insurance Life Insurance Long-term Care FSA 401(k) Gym Exclude: Federal Yes Yes Yes Yes Yes No Yes Yes Yes NO NO Owner's name: Toni Prevosti Address: 820 Westminster Road, Bridgewater, VT 05520. Phone: 802-673-2636 Number of employees: 8 Gross quarterly wages: $32,085.15 Federal income tax withheld: $628.00 401(k) contributions: $1,259.90 Insurance withheld: $4,080.00 Gym membership: $90.00 (For the pay-period completed till March 23). Monthly Deposits Month 1 Month 2 Month 3 Amount $ 0 $ 2,008.18 $ 2,904.72 Required: Complete Form 941 for Prevosti Farms and Sugarhouse. Prevosti Farms and Sugarhouse was assigned EIN 22-6654454. 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 return is $100,000 or more, you must provide a record of your federal tax liability. If you are a monthly schedule depositor, complete the deposit schedule below; if you are a semiweekly schedule depositor, attach Schedule B (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 liability 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 Form 941. Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank. 17 If your business has closed or you stopped paying wages Check here, and 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 Check here. Part 4: May we speak with yo third-party designee? Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions for details. Designee's name and phone number Yes. No. Select a 5-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, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Sign your name here Print your name here Print your title here Date (mm/dd/yyyy) 04/10/2019 Best daytime phone (XXX-XXX-XXXX) Paid Preparer Use Only Check if you are self-employed PTIN Preparer's name Preparer's signature Date (mm/dd/yyyy) Firm's name (or yours if self-employed) EIN Address Phone City State (NN) ZIP code Page 2 Form 941 (Rey 1.2019) Form 941 for 2019: Employer's QUARTERLY Federal Tax Return Department of the Treasury - Internal Revenue Service Employer identification number (EIN) Name (not your trade name) Trade name (if any) Address Number 950117 OMB No. 1545-0029 Report for this Quarter 2019 (Check one.) January, February, March April, May, June 1: 2: 3: July, August, September Street Suite or room number 04: October, November, December City State (NN) ZIP code Instructions and prior-year forms are available at www.irs.gov/form941. 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: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) 2 Wages, tips, and other compensation 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. 5e 5f 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 x 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 5f Section 3121(a) Notice and Demand - Tax due on unreported tips (see instructions) 6 Total taxes before adjustments. Add lines 3, 5e, and 5f 7 Current quarter's adjustments for fractions of cents 8 Current quarter's adjustments for sick pay 9 Current quarter's adjustments for tips and group-term life insurance 10 Total taxes after adjustments. Combine lines 6 through 9 11 Qualified small business payroll tax credit for increasing research activites. Attach Form 8974 12 Total taxes after adjustments and credits. Subtract line 11 from line 10 13 Total deposits for this quarter, including overpayment applied from a prior quarter and overpayments applied from Form 941-X, 941-X (PR), 944-X, 944-X (PR), or 944-X (SP) filed in the current quarter 14 Balance due. If line 12 is more than line 13, enter the difference and see instructions 7 8 9 10 11 12 13 14 15 Overpayment. If line 13 is more than line 12, enter the difference Check one: Apply to next return Send refund. You MUST complete both pages of Form 941 and SIGN it. Next
