Download - Stambaugh Ness Payroll Manual 2009 2010
PAYROLL AND PAYROLL TAX GUIDE
2009 – 2010
Presented By – Juanita Aubel, Tax Advisor E-mail: [email protected] Phone: 717.757.6999 Fax: 717.840.5975
Contact Information: www.stambaugh-ness.com Phone 1-800-745-8233
TABLE OF CONTENTS
PAGE
PART A - CHARTS AND PAYROLL SAVINGS TIPS
Charts
Payroll and Other Tax Data - 2010
Taxability of Compensation and Benefits
Withholding Requirements for Specific Payments
Household Employment Taxes
Agricultural and Household Employees
List of Helpful Government Publications
Payroll Web Sites
Essential Phone Numbers
Indexed Employee Benefit Limits
Payroll Savings Tips
Use Independent Contractors
What Factor's Determine a Worker's Classification?
File Reports on Time
Direct Deposit of Payroll
Keep Up To Date
Planning Ahead - Retirement and Social Security
Watch Wage-Hour Exemptions
Handle Garnishment Problems Smoothly
Tax Credit for FICA Paid on Tip Income
Employ Children/Spouses/Parents
Reduce the Number of Payrolls
Other Ways to Save
- Work Opportunity Credit
- PA Employment Incentive Credit
- PA Job Creation Tax Credit
- Credit for Employer-Provided Child Care Facilities
- Small Business Credit for New Retirement Plan
Expenses
- Saver's Credit
PART B - PROCESSING AND REPORTING
• Federal Tax Deposit Requirements
- Form 941 Deposit Rules
- Form 940 Deposit Rules
Federal Tax Deposit Coupon
Electronic Federal Tax Payment Systems (EFTPS)
Sample EFTPS Enrollment Form 9779
Pennsylvania Withholding Filing Requirements
PA Electronic Funds Transfers
PA Authorization Agreement for Electronic Payments
PAe-Tides
PA Credit Card Payments
Multi-State Reporting
Bonuses/Supplemental Wages
How and When to Use Cumulative Withholding
Other Benefits Exempt from Taxes
Group Term Life Insurance
Cafeteria Plans
Personal Use of Company Provided Vehicle
Sick Pay (Disability Income)
Form 1099 - Miscellaneous Income
Business Expense Reimbursements
Moving Expense Reimbursements
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-11
-13
-15
-16
-17
-18
-19
-20
-21
-23
-25
-31
-32
-35
-39
TABLE OF CONTENTS -Continued
PART C - PAYROLL START UP GUIDE: NEW EMPLOYERS - NEW EMPLOYEES
• Employer Responsibilities
• New Employer Packets
• SS-4 Instructions (Application for EIN)
• PA-100 Instructions
• State Unemployment Tax
• PA UC Withholding Tax
• Form W-5 - Earned Income Credit -
• Advance Payment Certificate
• New Hire Reporting Requirements
• Multi-State Chart
• Local Tax Enabling Act
• Local Tax Rates
• Local Services Tax
• LST Chart
• Designing the Payroll System
• Maintaining Payroll Records
• Pennsylvania Income Tax
• General Information
• Reciprocal Agreements
• PA Employer Withholding
• York Adams Earned Income Tax
PART D - PAYROLL REPORTING
•
«
4
1
<
1
1
(
> 941
> UC-2
• UC-2A
• UC-2X
. UC-2AX
• PA-W3
> 319
> 944
> W-2
• W-2, Box 12, Codes
• W-2, Box 13 - Checkboxes
• W-3
» 940
• REV 1667
• 322
• 1099 MISC
• 1096
• I-9
• PA New Hire Reporting Form
• Schedule H
• 8109-B
• Employer Deposit Statement of Withholding Tax
• W-2c
• W-3c
• W-4
. W-4V
• W-4S
• W-5
C-1
C-2
C-2
C-3
C-4
C-4
C-5
C-5
C-7
C-20
C-21
C-26
C-27
C-28
C-29
C-30
C-30
C-31
C-32
C-32
D-1
D-5
D-6
D-7
D-8
D-9
D-10
D-11
D-13
D-14
D-15
D-16
D-17
D-20
D-21
D-22
D-23
D-24
D-25
D-26
D-28
D-29
D-30
D-31
D-32
D-33
D-34
D-35
PART A
Charts And Payroll
Savings Tips
PART A - CHARTS AND PAYROLL SAVINGS TIPS
Page
Charts:
• Payroll and Other Tax Data - 2010 A -1
• Taxability of Compensation and Benefits A - 2
• Withholding Requirements for Specific Payments A - 3
• Household Employment Taxes A - 5
• Agricultural and Household Employees A - 5
• List of Helpful Government Publications A - 6
• Payroll Web Sites A-8
• Essential phone numbers A - 9
• Indexed Employee Benefit Limits A -11
Payroll Savings Tips:
• Use Independent Contractors A-12
• What Factors Determine a Worker's Classification? A -12
• File Reports on Time A-15
• Direct Deposit of Payroll A-16
• Keep Up To Date A-16
• Planning Ahead - Retirement and Social Security A -16
• Watch Wage-Hour Exemptions A-18
• Handle Garnishment Problems Smoothly A -19
• Tax Credit for FICA Paid on Tip Income A-19
• Employ Children/Spouses/Parents A-20
• Reduce the Number of Payrolls A - 20
• Other Ways to Save A-20- Work Opportunity Credit A-20- PA Employment Incentive Credit A - 21- PA Job Creation Tax Credit A-21- Credit for Employer-Provided Child Care Facilities A - 22- Small Business Credit for New Retirement Plan Expenses A - 22- Saver's Credit A-22
A - 1
PAYROLL AND OTHER TAX DATA - 2010 SOCIAL SECURITY: Wage base $106,800 6.2% Employee Max. $6,621.60 MEDICARE: Wage base - NO LIMIT 1.45% Employee Max. Unlimited Example: 2010 WAGES TAX RATES
$1 TO $106,800 7.65% OVER $106,800 1.45%
SELF-EMPLOYMENT TAX: 2010 SELF-EMPLOYMENT INCOME TAX RATES
$1 TO $106,800 15.3% OVER $106,800 2.9%
PA WITHHOLDING: 3.07% LOCAL WITHHOLDING: 1.0% - 2.0%, depending on Locality STATE UNEMPLOYMENT: Wage base PA - $8,000 per employee
Wage base MD - $8,500 per employee PA UC WITHHOLDING: 0.08% FEDERAL UNEMPLOYMENT: Wage base - $7,000
Rate - 0.8% SOCIAL SECURITY EARNINGS 62 - 65 - $ 14,160 $1 of benefits will be LIMITATIONS: withheld for every $2 in
earnings over limit.
Year of full retirement age - $37,680 ($3,140/month) Applies only Age 66 to earnings for months prior to attaining age 66.
$1 of benefits will be withheld for every $3 in earnings over limit.
Full retirement age and over - Eliminated
STANDARD DEDUCTION: Single - $5,700 MFS - $5,700
Joint and Surviving Spouse - $11,400 HOH - $8,400 PERSONAL EXEMPTION: $3,650 MINIMUM WAGE: PA - $ 7.25 MD - $ 7.25 STANDARD MILEAGE RATE: _________ per mile
TAXABILITY OF COMPENSATION AND BENEFITS
T - Taxable
E - Exempt
Company
Automobile:
Business Use
Personal Use
Awards and Prizes:
Employee Achievement
Safety/Service
(Qualified Plan)
Business Expense
Allowance: (1)
Accountable Plan
Non-Accountable Plan
Cafeteria Plan:
Pre-Tax Benefits
Group Term Life
Insurance:
Up to $50,000
Excess of $50,000
Retirement Plans:
Elective Deferrals
401(k)-403(b)
Simplified Employee
Plans (SEP)
Employer Paid
Salary Reduction
408(k)(6)
Simple Plans:
Employer 2% Match
Salary Reduction
"S" Corp Health Insurance
Premium
2% > Shareholder
Sick Pay:
Salary Continuation
Insured-Third Party
Tips:
More than $30.00
Less than $30.00
Federal &
MD In
come Tax
E
T
T
E
E
T
E
E
T
E
E
E
E
E
T
T
T
T
E
Social
Security
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T
T
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E
T
E
E
T
T
E
T
E
T
E
T
T(2)
T
E
Medicare
E
T
T
E
E
T
E
E
T
T
E
T
E
T
E
T
T(2)
T
E
PA
Income
Tax
E
E
T
E
E
T
E(3)
E
E
T
E
T
E
T
E
T
E
T
E
Local
Income
Tax
E
E
T
E
E
T
E(3)
E
E
T
E
T
E
T
E
T
E
T
E
FUTA
E
T
T
E
E
T
E
E
E
T
E
T
E
T
E
T
T(2)
T
E
State
Unemploy
ment
E
T
T
E
E
T
T
E
E
T
E
T
E
T
E
T
T
T
E
(1) See pages B-35 and B-38.
(2) Taxable only during first six months following month employee last worked.
(3) Except child care benefits.
A-2
WITHHOLDING REQUIREMENTS FOR SPECIFIC PAYMENTS
Type of Income
Adoption Assistance - Up to $11,650 expense
Advances
Aircraft - Personal Use
Athletic Facilities (On Premises)
Awards and Prizes *
Back Pay Awards & Damages
Bonuses
Business Expense Reimbursements
Commissions
Company Car - Personal Use
Death Benefits
Deceased Employee Wages - Paid
after Calendar Year of Death
Deceased Employee Wages - Paid
in Same Calendar Year as Death
Dependent Care Assistance - Up to $5,000
Directors Fees
Discounts
Dismissal or Severance Pay
Dividends
Eating Facilities
Educational Assistance - Up to $5,250
Equipment and Tool Allowances
Golden Parachute Payments
Group Legal Services
Guaranteed Wage Payments
Withholding Required
Fed IT F.I.C.A. F.U.T.A.
No
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Optional
No
No
No
No
No
No
Yes
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
No
No
Yes
No
No
No
Yes
No
No
No
No
Yes
Yes
Yes
Yes
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
No
No
Yes
No
No
No
Yes
No
No
No
No
Yes
Yes
Yes
Subject to withholding except service and safety awards up to $400 per employee,
per year under a non-qualified plan. $1600 per employee, per year, with a $400average benefit award under a qualified plan.
A-3
WITHHOLDING REQUIREMENTS FOR SPECIFIC PAYMENTScontinued
Type of Income
Holiday Gifts
Interest Free or Below Market Interest Rate
Employer Loan more than $10,000
Jury Duty Pay
Meals and Lodging for Employers
Convenience
Meeting Payments
Military Pay (For Temporary Assignments)
Moving Expenses - Qualified (See B-39)
Moving Expenses - Non-qualified (See B-39)
Out-Placement Services
Parking Expense - Up to $220/month
Probationary Pay
Retiree Consulting Fees
Retroactive Wage Increases
Royalties
Scholarships
Standby/Idle Time Pay
Supper Money
Supplemental Unemployment
Uniform Allowances
Union Payments
Vacation Pay
Workers Compensation Benefits
Withholding Required
Fed IT. F.I.C.A. F.U.T.A.
Yes
Yes
Yes
No
Yes
Yes
No
Yes
No
No
Yes
No
Yes
No
No
Yes
No
Yes
No
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
No
Yes
No
No
Yes
No
Yes
No
No
Yes
No
No
No
Yes
Yes
No
Yes
Yes
Yes
No
Yes
Yes
No
Yes
No
No
Yes
No
Yes
No
No
Yes
No
No
No
Yes
Yes
No
See Circular E for more complete information.
A-4
HOUSEHOLD EMPLOYMENT TAXES ■ SCHEDULE "H"
FORM FOR EMPLOYEES IN HOME
Schedule H, Household Employment Taxes, is used to report cash wages paid to a
person who worked in your home, and is submitted annually with Form 1040. The
schedule is used to report and pay federal income taxes withheld and to calculate
FICA, Medicare and federal unemployment taxes on wages paid to household
employees. The wage threshold for domestic employees remains unchanged at
$1,700 per year in 2010. Social security tax is not necessary for household workers
underage 18.
Household employers are required to include the social security and federal
employment taxes in their estimated tax payments.
Who is a household employee? An employer-employee relationship exists if you
control what and how work is to be done, supply the employee with tools and a place to
work and have the right to discharge the employee. Some household employees, such
as gardeners, are likely to be considered independent contractors because they use
their own tools and decide how the work is to be done. Examples of household
employees include baby-sitters, butlers, cooks, caretakers, drivers, gardeners,
housekeepers, and private-duty nurses.
AGRICULTURAL EMPLOYMENT TAXES
According to the IRS, any plot of ground or other area used primarily for the raising of
an agricultural or horticultural commodity constitutes a farm for employment tax
purposes. Only cash wages paid to employees are subject to FICA and federal income
tax withholding. Noncash items such as lodging, food, clothing, and transportation are
not subject to FICA and federal income tax withholding.
FICA and federal income tax withholding apply to cash payments if either 1) the
employee is paid $150 or more for the year, or 2) the employer's total payments to all
employees for agricultural labor is $2,500 or more for the year.
Agricultural wages are subject to FUTA and SUTA if: 1) agricultural wages of $20,000
or more are paid in any quarter in the current or preceding calendar year, or 2) 10 or
more individuals are employed in agricultural labor for some portion of a day for 20
weeks in the current or preceding calendar year.
Agricultural employers who pay wages for both agricultural and nonagricultural labor
must keep the wages separate. Agricultural wages and taxes due are reported on form
943; other wages and taxes due are reported on form 941.
A-5
LIST OF HELPFUL GOVERNMENT PUBLICATIONS
The following Publications are available from the Internal Revenue Service. You may
order them by calling 1-800-TAX-FORM (1-800-829-3676). You may also downloadsome of them from www.irs.gov:
Publication
Number
15
15-A
15-B
51
393
505
970
521
525
Title
Circular E, Employer's
Tax Guide
Employer's Supplemental
Tax Guide
Employer's Tax Guide
to Fringe Benefits
Circular A, Agricultural
Employer's Tax Guide
Federal Employment Tax
Forms
Tax Withholding and
Estimated Tax
Tax Benefits for Education
Moving Expenses
Taxable and Nontaxable
Income
Description
All employers receive a copy of this publication
automatically. This is an annual publication
that includes the current year's tax tables,
FICA rate, FUTA rate, and a general
explanation of rules for depositing federal tax
withheld.
Supplement to Circular E.
Detailed information on proper way to handle
fringe benefits.
Same as Circular E, except this is specifically foragricultural employers.
All employers receive a copy of this publication
which explains annual reporting and provides
instruction for ordering forms.
Explanation of the rules for claiming personal
exemptions on the Form W-4. Excellent guide
to assist employees in completing a new FormW-4.
Explains which educational expenses qualify for
deduction for tax purposes. This booklet may
assist the payroll practitioner in understanding
the taxability of various types of educational
expense reimbursements paid by the employer.
Essential publication for explaining the
reporting and taxation of reimbursed moving
expenses, both for the employer and the
employee.
Essential guide to understanding the taxability of
wages, salaries, fringe benefits, and other
compensation received for services as an
employee.
A-6
LIST OF HELPFUL GOVERNMENT PUBLICATIONS-continued
Title Description
Publication
Number
531 Reporting Tip Income
596 Earned Income Credit
919 How Do I Adjust My Tax
Withholdings?
1494 Table for Figuring
Amount Exempt from
Levy On Wages, Salary
& Other Income
1542 Per Diem Rates
2009 Instructions
1099-ALL
926 Household Employer's
Tax Guide
A guide to the reporting, withholding, record
keeping.
A guide to who may be eligible for the credit and
how they may apply for the credit.
Another guide to employees for completing Form
W-4.
This is a table for figuring the amount from a
levy on wages, salaries, and other compensation.
A table of the federal per diem rates for lodging,
meals and incidental expenses.
Instructions to filers of Form 1099,1098,5498 and
W-2G.
A guide to who qualifies as a household
employee and instructions on figuring the tax.
Compliance assistance information is available from the U.S. Department of Labor in regards to
the following:
Americans with Disabilities Act of 1990 (ADA)
The Davis-Bacon and Related Acts (DBRA)
The Fair Labor Standards Act (FLSA)
The Family and Medical Leave Act (FMLA)
Federal Employee' Compensation Act (FECA)
And many more
You may order by calling 717-221-4539 or 570-826-6316 or print from website
www.dol.gov/esa/regs/compliance.
A-7
ESSENTIAL PAYROLL WEB SITES
Whether you're an expert on the Web or a novice, there are some sites that you shouldvisit regularly to see what's new.
Federal Sites
EFTPS www.eftps.govInternal Revenue Service (homepage): www.irs.gov
Social Security Administration: www.ssa.gov
U.S. Department of Labor employment law site: www.dol.gov
New-hire reporting: www.acf.hhs.gov/programs/cse/newhire/employer/private/newhire.htm
State & Local Sites
PA Department of Revenue: www.revenue.state.pa.usPA Department of Revenue Business
Tax Registration: www.pa100.state.pa.usPA Department of Labor & Industry: www.dli.state.pa.usPA Department of Community and
Economic Development www.newpa.com
PA Etides: www.etides.state.pa.usMaryland Webpage www.state.md.usComptroller of Maryland www.comp.state.md.usMD Dept. of Labor, Licensing & Regulation www.dllr.state.md.usYork Adams Tax Bureau www.yatb.com
Professional Organizations
American Payroll Association (APA): www.americanpayroll.org
A-8
Essential Phone Numbers
Name
Internal Revenue Service
Business and Specialty Tax Line
Electronic Federal Tax Payment System (EFTPS) Hotline
Employee Plans Taxpayer Assistance Telephone Service
Employer identification Number (EIN) Request Number
Phone Number
Form 941 and Form 940 Filing On-Line Filling
Program /Austin Submission Center
Forms (IRS)
General IRS Tax Law Questions and Account Information
Information Reporting Program Customer Service Section
IRS Tax Fax
National Taxpayer Advocate's Help Line
Taxpayer Advocacy Panel
Telephone Device for the Deaf (TDD)
Tele-Tax System
Social Security Administration
Copy A / Form W-2 Reporting
SSA's Employer Reporting Service
General SS benefit Questions
800-829-4933
800-555-4477
877-829-5500 (toll free)
800-829-4933
Form SS-4 may be faxed to:
Holtsville, NY at 631-447-8960
Cincinnati, OH at 859-669-5760 or
Philadelphia, PA at 215-516-1040
New Toll Free Number fore-Help866-255-0654
Forms may be ordered at:
800-829-3676
800-829-1040
866-455-7438 (toll free)
703-368-9694 (non-toll-free)
This service offers faxed topical tax
information.
877-777-4778 (toll free)
888-912-1227 (toll free)
800-829-4059
800-829-4477
800-772-6270
800-772-1213
A-9
Essential Phone Numbers
Name
PA Dept. of Revenue
Fact and Information Line
e-Business Tax Unit (e-Tides Technical Assistance
Taxpayer Service and Information Center
Special Hearing or Speaking Needs (TTonly)
Taxpayers' Rights Advocate
PA Unemployment Compensation
UC Tax Information Line
UC Employer Tax Services
York and Adams Counties
Cumberland County
Lancaster County
Dauphin and Perry Counties
Franklin
Phone Number
888-PATAXES (728-2937)
717-783-6277
717-787-1064
800-447-3020
717-772-9347
866-403-6163 or
717-787-7679
717-767-7620
717-249-8211 or
717-697-1203
717-299-7606
717-787-1700
717-264-7192
A-10
INDEXED EMPLOYEE BENEFIT LIMITS
Employee Benefit Limit
Section 416 Defined Benefit Dollar Limit
IRC Sec. 416(i)(1 )(A)(i)—see Q-261
Section 415 Defined Contribution Dollar
Limit
IRC Sec. 415(c)(1)(A)-see Q-261
IRCSec.415(b)(1)(A)
*Elective Deferral Limit for 401 (k), 403(b), &
457(e) Plans and SEPs
IRC Sec. 402(g)(1)-see Qs-237, 276, 277
Beginning January 1, 2006, 401 (k) plans
may begin allowing designated ROTH
401 (k) employee contributions. Combined
401(k)/ROTH 401 (k) contribution limits
Minimum Compensation Amount for SEPs
IRC Sec. 408(k)(2)(C)-see Q-236
Maximum Compensation Limit for:
IRC Sec. 505(b)(7) SEPs
IRC Sec. 408(k)(3)(C) TSAs
IRC Sec. 403(b)(12) Qualified Plans
IRC Sees. 401 (a)(17), 404(1)
Highly Compensated Employee Definitional
Limits under 414(q)(1)(B)
ESOP Payout Limits
IRC Sec. 409(o)(1)(c)-see Q-280
'Simple Plans
Code Sec. 408(p)(2)(E)
*IRA Limit
2010
$160,000
$ 49,000
$195,000
$ 16,500
$ 16,500
$ 550
$245,000
$110,000
$195,000
$985,000
$ 11,500
$ 5,000
2009
$160,000
$ 49,000
$195,000
$ 16,500
$ 16,500
$ 550
$245,000
$110,000
$195,000
$985,000
$ 11,500
$ 5,000
Individuals 50 years of age or over may make additional
"catch up contributions" each year as follows:
ROTH 401 (k)
401 (k), 403(b), 457, SEP-408(k)
SIMPLE-408
IRA's
A-11
2010
$ 5,500
$ 5,500
$ 2,500
$1,000
USE INDEPENDENT CONTRACTORS
One way to save on payroll taxes is by using independent contractors. Independentcontractors are not employees and therefore are not covered by employment tax laws.
Use independent contractors when specialized skills are needed or a project is of alimited duration. However, employers should use caution when classifying individualsas independent contractors rather than employees. Employers may be held liable forall the employment taxes (and be assessed a penalty of 100% of the unpaid taxes) ifthey classify employees as independent contractors and there is no reasonable basisfor doing so.
Consult the following checklists to insure that you have a reasonable basis fordetermining the independent contractor status.
What Factors Determine A Worker's Classification?
When determining the proper classification of a worker, the IRS first looks at whether abusiness has the right to direct or control the means and details of the individual's work.(This is known as the common-law test.) To determine the degree of control that anemployer has, the Service uses a "20-factor" test, which has grown in recent years andnow actually includes 24 factors.
Note: The 24 factors are listed here in order of their importance, as ranked in the IRS'straining manual for employment tax auditors.
Extremely Important
1. Instructions. Employees must follow instructions as to when, where, andhow work is done; independent contractors do not.
2. Training. Company-provided training implies that work must be done in aparticular manner. Independent contractors are not given training.
3. Profit or loss. Independent contractors realize a profit or incur a loss fromtheir work; employees do not.
Very Important
4. Form W-2's. Filing a W-2 rather than a 1099 indicates that the business andthe worker believe the worker is an employee.
5. Benefits. Traditionally, only workers with employee status receive companybenefits.
6. Intent. A written agreement between a business and a worker describing theworker as an independent contractor can show that the classification wasintended by both parties.
7. Incorporation. A worker who is incorporated is usually classified as anindependent contractor.
A-12
What Factors Determine A Worker's Classification? - continued
Very Important - continued
8. Integration. If a worker's services are integrated into a business' operations,
they are usually considered important to the success of that business, and the
IRS will assume the worker is an employee under the direction and control ofthe company.
9. Personally rendered services. If services are to be performed only by the
worker, that indicates the worker is an employee under the direction and
control of the business. Independent contractors can substitute another
person's services without the approval or knowledge of the business.
10. Assistants. Independent contractors can hire, supervise, and pay their own
assistants, and are responsible for the work results. Employers hire,supervise, and pay their employees' assistants.
11. Continuing relationship. Independent contractors work by the job; a
continuing work relationship indicates that the worker is an employee. Note: A
continuing relationship may exist even if the recurring work is performed atirregular intervals.
12. Work sequence. Independent contractors can set their own work schedules.
Employees are required to perform work in a certain order or sequence.
13. Oral or written reports. A requirement that a worker give regular reports
demonstrates an employer-employee relationship. Independent contractorsusually only file a report at the end of the job.
14. Payment method. Payment by the hour, week, or month points to employee
status. Independent contractors are paid upon completion of the job or are
paid on a straight commission basis.
15. Tools and materials. Independent contractors supply their own tools andmaterials. Employees usually do not.
16. Investment. Employees tend not to make significant investments in the
facility where they work. Independent contractors will rent, own, or have some
other significant investment in the facility where they perform services forclients.
Less Important
17. Working for more than one firm. Multiple jobs can indicate an independentcontractor or an employee who is moonlighting.
18. Requirement to work set hours. A predetermined schedule, rather than adeadline, indicates an employer-employee relationship.
A-13
What Factors Determine A Worker's Classification? - continued
Less important - continued
19. Requirement to work full-time. This limits a person's options to work for
other companies and indicates an employer-employee relationship.
20. Right of employer to discharge. Generally independent contractors can't be
fired unless they fail to meet contract requirements, so this right indicates an
employer-employee relationship.
21. Services available to general public. Independent contractors advertise or
make their services available to the public.
22. Working on business's premises. A requirement that work be performed on
site indicates that a business has control over an employee especially if the
work can be done elsewhere.
23. Business and/or travel expenses. Company reimbursements paid to a
worker generally indicate an employer-employee relationship.
24. Right of worker to quit. Typically, employees do not incur any liability if they
quit. But independent contractors may be held liable for breach of contract if
they don't complete a job.
A-14
FILE REPORTS ON TIME - "AVOID PENALTIES"
One type of payroll administration expense for which there is no excuse is that resulting
from penalties and/or interest imposed because employment tax payments or returns -
federal or state - were not made or filed in a timely manner. The penalties levied by the
Internal Revenue Service can be a very significant payroll cost. Some of the commonly
incurred penalties follow:
Failure to file a return:
5% of the net amount of tax required to have been reported for each month or
fraction of a month during which the failure continues, not to exceed 25% in the
aggregate.
Failure to pay tax:
0.5% on the amount due (1% in some cases) for each month during which the
failure to pay continues, not to exceed 25% in the aggregate.
Failure to deposit taxes:
2% of any underpayment if deposit is between 1 and 5 days late
5% of any underpayment if deposit is between 6 and 15 days late.
10% of any underpayment if deposit is more than 16 days late.
15% if the tax is not deposited by the earlier of 10 days after the date of the first
delinquency notice or the day on which notice and demand for immediate paymentis given.
Failure to electronically deposit taxes:
10% failure to file electronically
2% late filing penalty
Here's the list of the services whose time stamps qualify as a postmark for purposes of
the "timely mailing and timely filing/paying" rule of IRC Sec. 7502:
. Federal Express: FedEx Priority Overnight, FedEx Standard Overnight, FedEx
2Day, FedEx Intl Priority & FedEx Intl first
. United Parcel Service: UPS Next Day Air, UPS Next Day Air Saver, UPS 2nd Day
Air, and UPS 2nd Day Air A.M., UPS Woldwide Express Plus, & UPS Woldwide
Express
CAUTION: Remember, not all the services offered by the companies qualify under
the IRS' list, just the services listed above. That means that a time stamp from
another of the company's services will not suffice as proof of timely mailing.
A-15
DIRECT DEPOSIT OF PAYROLL
Direct deposit of payroll can save time and money for the employer and employee.
On the employer side, direct deposit means that each employee's paycheck is
deposited right into the employee's personal account, eliminating costly steps in the
payroll process, including the need to stop payment on and reissue lost or stolen
checks. Direct deposit means fewer check processing charges and reconcilement
maintenance fees from the employer's financial institution. On the employee side,
there is no chance of lost or stolen checks, no two to four day waiting period for the
paycheck to clear, and employees still receive a pay receipt detailing their gross and
net pay and deductions made.
KEEP UP-TO-DATE ON "TAXABLE WAGES"
AND "EXEMPT EMPLOYEES"
Two of the most important potential tax-savings areas of which a payroll manager must
be aware involve payments that may not be subject to one or more of the federal or
state employment taxes and employees who may not be subject to them.
Keep in mind in this regard that direct tax savings will generally result only in relation to
the "social security" type employment taxes-that is, the taxes imposed under the
Federal Insurance Contributions Act (FICA), the Federal Unemployment Tax Act
(FUTA), and the various state unemployment and disability insurance laws. This is
because these are the laws that impose a tax directly on an employer, and actual tax
dollars can be saved by knowing that a particular type of payment or employee is
exempt from a particular tax.
This is not to say that the subject of taxable wages and exempt employees is
unimportant where federal and state income taxes are involved. Even though
employers have no general out-of-pocket tax liability where such taxes are concerned,
knowing what types of payments and employees are subject to withholding can save
needless bookkeeping time and the expenses of correcting situations where tax is
withheld when it should not have been, to say nothing of avoiding the penalties that
may be imposed where an uninformed payroll manager fails to withhold from a payment
or employee from whom tax should have been withheld.
PLANNING AHEAD - RETIREMENT & SOCIAL SECURITY
If you have employees who are planning to retire, now is a good time for them to
contact the Social Security Administration to see which month is best for them to claim
benefits. In some cases, the choice of retirement month could mean additional benefits
for the employee and his or her family. Depending on the person's earnings, age, and
benefit amount, it may be possible for him or her to start collecting benefits while
continuing to work.
If your employees want more information about social security, or want to arrange for
an appointment to talk with a social security representative, the Social Security
Administration advises that they should call 1-800-772-1213. The government has a
web site located at "www.ssa.gov".
A-16
PLANNING AHEAD - RETIREMENT & SOCIAL SECURITY-continued
Individuals may apply for social security benefits online by using the website
www.ssa.gov/applytoretire/, or they may apply by telephone by calling 1-800-772-1213.
The SSA website, contains a Retirement Benefits Planner. The Planner and online calculators give
estimates for disability and survivors benefits as well as your retirement benefit estimate. An
"Earnings Limit" Calculator" assists workers in computing the effect of earnings on their social
security retirement benefits.
Workers who have reached full retirement age (age 65 & 10 months in 2007, age 66 in 2008)
may work without their benefits being reduced because of the amount of their annual
earnings. Annual earnings affect the amount of Social Security benefits only until full
retirement age. After that, you can receive full benefits no matter how much you earn. Full
retirement age will gradually increase to age 67, as shown below.
The Social Security Administration has developed a unique educational tool to help Americans
understand their social security benefits so they can undertake adequate financial planning for their
future. This SSA tool is a Social Security Statement that gives workers of all ages their own
personal historical data and future benefit estimates. These Statements are mailed to workers age 25
and older. The 4-page Social Security Statement provides information for retirement, disability, and
survivors benefits that they could be eligible for now and in the future.
PAYROLL'S ROLE. The social security earnings record provided on the Social Security Statement is
based on Form W-2 information supplied by an individual's employers. Discrepancies in wage record
information - such as name/SSN mismatches - preclude wages being credited to an individual's
account. Such earnings will be placed in a suspense file and will not appear on the Social Security
Statement. Since uncredited earnings will affect an individual's future entitlement, employees who get
a Social Security Statement with earnings totals lower than they expect are going to - and should -
have questions. The most likely place for an employee to turn with a question is, of course, the
payroll department, so practitioners need to be prepared.
AGE TO RECEIVE FULL SOCIAL SECURITY BENEFITS
Note: Persons born on January 1 of any year should refer to the previous year.
Year of Birth
1937 or earlier
1938
1939
1940
1941
1942
1943-1954
1955
1956
1957
1958
1959
1960 and later
Full Retirement
Aae
65
65 and 2 months
65 and 4 months
65 and 6 months
65 and 8 months
65 and 10 months
66
66 and 2 months
66 and 4 months
66 and 6 months
66 and 8 months
66 and 10 months
67
The earliest a person can start receiving Social Security retirement benefits remains age 62.
A-17
CUT LABOR COSTS BY WATCHING WAGE-HOUR
EXEMPTIONS
For most employers the largest single statutory source of labor costs is the Fair Labor
Standards Act with its minimum wage and overtime pay requirements. Effective August
23, 2004 the Department of Labor reformed 50-year old overtime regulations and
introduced new overtime rules. In many cases, however, labor costs may be cut by
knowing exactly what it is the Fair Labor Standards Act requires, and what it does not
require. For example, there are any number of exemptions-total or partial-from the
minimum wage requirements. The Department of Labor (www.dol.gov) website
provides additional information.
Of utmost significance to most employers is the complete minimum wage and overtime
exemption extended to so-called white collar workers-administrative, executive andprofessional employees.
Keep in mind that federal wage-hour rules are not the only ones with which you should
be concerned. States also have legislated in this area, and although the state laws
may cover employees who are not covered by the federal law, the states, too, provide
exemptions with which employers must be familiar. Knowledge of these will prevent
payment of overtime rates when straight-time pay will suffice under the law and from
paying a straight-time wage rate that is higher than that required under the law.
Under the Small Business Protection Act, the federal minimum wage is currently
$7.25 as of July 24, 2009. If the state's minimum wage amount is higher, it willprevail over the less-beneficial federal minimum wage. Pennsylvania's minimumwage is $7.25 per hour.
Maryland's minimum wage is $7.25 as of July 24, 2009. Delaware's minimumwage is $7.25 as of July 24, 2009.
A-18
HANDLE GARNISHMENT PROBLEMS SMOOTHLY
A busy payroll manager has never been fond of garnishment proceedings. But with
the job protection offered an employee-debtor under the Consumer Credit Protection
Act, the payroll manager is going to have to live with the problem. Thus, the methods
by which garnishments are handled must be made as simple, efficient and economical
as possible. The U.S. Department of Labor website at www.dol.gov has very useful
information on this topic.
TAX CREDIT FOR FICA PAID ON TIP INCOME
To ease the payroll-tax burden on restaurant employers and other food and beverage
businesses where employees commonly receive tips for serving food and beverages to
customers, the Revenue Reconciliation Act of 1993 expanded the general business
credit to include an amount equal to an employer's FICA tax obligation (7.65%) on
reported tips in excess of the amount of tips treated as wages for purposes of the Fair
Labor Standards Act (FLSA). Effective January 1,1997, the tip credit was expanded to
include service and delivery of food and beverages for off-premises consumption.
Although the federal minimum wage has been increased, the Small Business and Work
Opportunity Tax Act of 2007 allows food and beverage establishments to continue to
compute the amount of the tip credit based on the federal minimum wage previously in
effect on January 1, 2007 ($5.15 per hour). Also, the credit can now offset the
alternative minimum tax.
A-19
EMPLOY CHILDREN/SPOUSES/PARENTS
Taxability of Children/Spouses Wages for Sole Proprietorship
Spouse
Child under 18
Child 18-20
Child 21 and
Over
Parents
Federal
Income
Tax
T
T
T
T
T
Social
Security
T
E
T
T
T
Medicare
T
E
T
T
T
State
Income
Tax
T
T
T
T
T
Local
Income
Tax
T
T
T
T
T
FUTA
E
E
E
T
E
State
Unemployment
E
E
T
T
E
SAVE BY REDUCING THE NUMBER OF PAYROLLS
One often overlooked way to save payroll costs is to have fewer payrolls. Many employers
pay their employees every week. By switching to bi-weekly payment these employers use
half the amount of time spent computing and processing the payroll. Additional savings
result from reducing the supplies required.
OTHER WAYS TO SAVE
• Check the computation of your unemployment compensation "experience rating."
• Review and respond to any charges against your unemployment account. Charges are
benefits paid to employees or former employees.
• Maintain a stable employee group.
• Use a "common paymaster" where employees are shared by two or more related
companies.
• Hire employees from a "Targeted" group. They may qualify the employer for certain
credits.
Under the federal Work Opportunity Tax Credit, which has been extended to cover
employees from a targeted group who begin work before 9/1/2011, employers receive
a federal tax credit for hiring from one of nine targeted groups.
- 25% credit of 120 - 400 hours paid to the worker during the first year, and
- 40% credit of first $10,000 paid to the worker during the first year, and
- 50% credit of first $10,000 paid to the worker during the second year
A-20
OTHER WAYS TO SAVE - continued
- Eligible wages include cash wages PLUS tax exempt amounts the employer
pays for health insurance coverage, dependent care assistance, and tuitionreimbursement paid under Sect. 127.
Form 8850, Pre-Screening Notice and Certification Request for Work
Opportunity Tax Credit, is used by employers to both pre-screen prospective
employees and to request certification from the State's Employment Security
Agency. This form is not filed with the IRS. Form 8850 is available by calling 1-800-829-1040 or from www.irs.gov.
Persons and corporations who employ Short-term welfare recipients or
vocational rehabilitation customers may be eligible for a Pennsylvania
"Employment Incentive Payments Credit." A completed PA Schedule W mustbe filed to claim this credit.
July 1,1996, the Pennsylvania "Job Creation Tax Credit" became effective. Up
to $1,000 is allowable for each new full-time job, paying at least one hundred fiftypercent of the federal minimum wage, created within Pennsylvania by a companythat agrees to:
1) create at least twenty-five new jobs in PA within a three-year period,
or
2) increase the number of employees in PA by at least twenty percent within athree-year period,
whichever is less.
A new, start-up company will qualify provided they meet the other requirements.
A business may apply the tax credit to 100% of the business' state corporate net
income tax, capital stock and franchise tax or the capital stock and franchise tax of
a shareholder of the business if the business is a Pennsylvania S corporation,gross premiums tax, gross receipts tax, bank and trust business shares tax, mutual
thrift institution tax, title insurance business shares tax, personal income tax or the
personal income tax of shareholders of a Pennsylvania S corporation, or any
combination thereof. Cash refunds will not be issued for unused credits. For more
details contact the Pennsylvania Department of Community and EconomicDevelopment at (717) 787-7120.
Of the 22.5 million dollars approved per year, twenty-five percent is set aside for
companies with less than one hundred employees (six new jobs), however, ifthat amount isn't used by April 30, then it becomes available to large companies.
A-21
OTHER WAYS TO SAVE - continued
FEDERAL BUSINESS CREDITS
• Credit For Employer-Provided Child Care Facilities - Employers can claim a tax
credit for 25% of qualified expenses for employee child care. Qualified expenses
include costs to acquire, construct, rehabilitate, or expand a facility for child care,
operational costs for the facility, and amounts incurred under a contract with a child
care facility to provide service to employees. A 10% credit can also be claimed for
the costs incurred under a contract to provide child care resource and referral
services to employees. The maximum credit in any year is $150,000.
• Small Business Credit For New Retirement Plan Expenses - A nonrefundable
credit is available for expenses associated with establishing a new qualified
retirement plan. The credit is equal to 50% of the first $1,000 in administrative and
retirement-education expenses for the plan for each of the first three years of the
plan. A "small business" is defined as one with no more than 100 employees having
compensation in excess of $5,000 in the preceding year, and with at least one non-
highly compensated employee.
• Saver's Credit - Each eligible individual may claim a nonrefundable credit for IRA
contributions (traditional and Roth), for elective deferrals to a section 401 (k) plan,
section 501(c)(18) plan, a governmental section 457 plan, SIMPLE plan, or SEP.
Voluntary after-tax contributions to qualified employer plans also qualify.
Eligible individuals must be 18 or older. Dependents and full-time students are not
eligible for the credit.
Up to $2,000 of annual contributions are eligible for the credit. The amount of the
credit depends upon modified AGI and filing status as shown below. Adjusted
gross income amounts are indexed for inflation as shown below:
Credit
Rate
50%
20%
10%
0%
Modified Adjusted Gross Income for 2010
Joint
$0 - $33,500
$33,501 - $36,000
$36,001 - $55,500
Over $55,500
Head of
Household
$0-$25,125
$25,126-$27,000
$27,001 -$41,625
Over $41,625
All Other
Statuses
$0-$16,750
$16,751 -$18,000
$18,001 -$27,750
Over $27,750
The credit is in addition to any allowable deduction or exclusion from income.
After-tax contributions used to claim the credit are treated as investment in the
contract.
A-22
PARTB
Processing And Reporting
PART B - PROCESSING AND REPORTING
Page
Federal Tax Deposit Requirements B -1
Form 941 Deposit Rules B -1
Form 940 Deposit Rules B - 3
Federal Tax Deposit Coupon B - 4
Electronic Federal Tax Payment Systems (EFTPS) B - 5
Sample EFTPS Enrollment Form 9779 B - 7
Pennsylvania Withholding Filing Requirements B - 9
PA Electronic Funds Transfer B -11
PA Authorization Agreement for Electronic Payments B -13
PAe-Tides B-15
PA Credit Card Payments B -16
Multi-State Reporting B-17
Bonuses/Supplemental Wages B-18
How and When to Use Cumulative Withholding B -19
Other Benefits Exempt From Taxes B - 20
Group Term Life Insurance B - 21
Cafeteria Plans B - 23
Personal Use of Company Provided Vehicle B - 25
Sick Pay (Disability Income) B - 31
Form 1099 - Miscellaneous Income B - 32
Business Expense Reimbursements B - 35
Moving Expense Reimbursements B - 39
1
x
2
$2
,071.00
2
,142.00
532.25
20.00
.654.25
FEDERAL TAX DEPOSIT RULES
FORM 941 FEDERAL TAX DEPOSITS
Calculation of the Deposit
1. Social Security taxes withheld $ 868.00
2. Medicare taxes withheld 203.00
3. Total FICA taxes withheld
(Line 1 + Line 2)
4. Multiply by 2
5. Total employer and employee FICA taxes
6. Add - federal income taxes withheld
7. Subtract - advance payments of the
earned income credit
8. Required payroll tax deposit
(Line 5 + Line 6 - Line 7)
Deposit Rules (Due to change 6/1/2011)
An employer is either a monthly depositor, a semi-weekly depositor, or an annualdepositor. This determination is made based on the aggregate amount of
employment taxes reported during a "look back" period. The regulations define a lookback period as the twelve-month period ending on the preceding June 30th. The
determination is made by the IRS prior to the beginning of each calendar year andemployers are advised if there is a change in the deposit rules they must follow.
Monthly deposit - An employer is a monthly depositor if the aggregate amount ofemployment taxes reported for the look back period is $50,000 or less. A monthlydepositor must deposit employment taxes for payments made during a calendar
month into a Federal Reserve Bank or authorized financial institution by the 15th dayof the following month. If the 15th day of the following month is not a banking day,taxes will be treated as timely deposited on the next following banking day.
Semi-weekly deposit - An employer is a semi-weekly depositor if the aggregateamount of employment taxes reported for the look back period is more than $50,000.
Under the semi-weekly deposit rule, those paying wages on Wednesday, Thursday,and/or Friday must deposit employment taxes by the next Wednesday in a FederalReserve Bank or an authorized financial institution, while those paying wages onSaturday, Sunday, Monday, and/or Tuesday are required to deposit employmenttaxes on the following Friday.
B-1
FEDERAL TAX RETURN DEPOSITS - continued
Deposit Rules - continued
If any of the three weekdays following the close of a semi-weekly period is a bank
holiday, employers will be given an additional banking day to make the deposit.
There is a special rule for a return period, either quarterly or annual, that ends during
a semi-weekly period. When it happens, an employer must complete the Federal Tax
Deposit Coupon so that it designates the return period for which the deposit is made.
If the return ends during a semi-weekly period that has two or more payment dates,
two deposit obligations may exist. For example: if one quarterly return period ends
on Thursday and a new quarterly period begins on Friday, employment taxes from
payments on Wednesday and Thursday are subject to one deposit obligation, and
taxes from payments on Friday are subject to a separate obligation. Two separate
Federal Tax Deposit Coupons are required in this case.
One-day rule - The semi-weekly or monthly deposit rules will not apply if an employer
has accumulated $100,000 or more of employment taxes. These taxes must be
deposited in a Federal Reserve Bank or authorized financial institution by the close of
the next banking day. To determine whether the $100,000 threshold is met, (1) a
monthly depositor takes into account only those employment taxes accumulated in the
calendar month in which the day occurs; and (2) a semi-weekly depositor takes into
account only those employment taxes accumulated in the Wednesday - Friday or
Saturday - Tuesday semi-weekly period in which the day occurs.
Safe harbor and de minimis rules - The deposit obligation will be satisfied if thedifference between the amount of tax that should have been deposited less the
amount of tax actually deposited (shortfall) does not exceed the greater of $100 ortwo percent of the amount required to be deposited. However, the underdeposit has
to be deposited by a specified "make-up" date. The make-up date for the monthly
depositors is the due date for the quarterly return. The make-up date for the semi-weekly depositors and those required to make accelerated deposits is the first
Wednesday or Friday (whichever is earlier), falling on or after the 15th day of the
month in which the deposit was due.
Small Employers
If the total amount of accumulated employment taxes for the quarter is less than
$2,500 for that quarter, or the previous quarter, and the amount is fully depositedor remitted with a timely filed return for the quarter, the amount deposited or
remitted will be deemed to have been timely deposited.
If the total amount of accumulated employment taxes is $1,000 or less over a
period of four quarters, the employer may wait and pay their total employment
taxes for the year when they file Form 944, Employer's Annual Federal Tax
Return. The 944 Form (and tax payment) for each calendar year is due by
January 31, of the following year.
B-2
FEDERAL TAX RETURN DEPOSITS - continued
CREDIT CARD PAYMENT
Employers filing Forms 940 and/or 941 with a balance due may pay the amount owed
by credit card. Additionally, Form 941 filers can make credit card payments for up to 3
prior quarters. A convenience fee will be charged by the service provider. Payments
are processed 24 hours a day, seven days a week, but are not effective until the date
the charge is authorized.
Please note: Federal Tax Deposits cannot be paid by credit card.
FORM 940 DEPOSIT RULES
If your FUTA tax liability for a quarter is $500 or less, you do not have to deposit the
tax. Instead, you may carry it forward and add it to the liability figured in the next
quarter to see if you must make a deposit. If your FUTA tax liability for any calendar
quarter is over $500 (including any FUTA tax carried forward from an earlier quarter),
you must deposit the tax by electronic funds transfer (EFTPS) or in an authorized
financial institution using Form 8109, Federal Tax Deposit Coupon.
When to deposit. Deposit the FUTA tax by the last day of the first month that follows
the end of the quarter.
B-3
MOMTH TAXYEAR ENDS
EMPLOYER IDENTIFICATION NUMBER
BANK NAME/
DATE STAMP
AMOUNT OF DEPOSIT (Do tJOT type, please print.)
DOLLARS
Enin1uLLJ
CENTS
_l
JName
Address .
IMS USE
ONLY
0
City_
State .ZIP.
0.
0.
0*
0*
Darken only one
TYPE OF TAX
941
1120
943
720
<y«945
0■* 1042
0* 990-T
0 ■* 990-PF
nl Darken onlv one
Id! TAX PERIOD
■ C/< Quarter
| (/< Quarter
1 /~> 3rdH (/< Quarter
I /O 4th■ (/< Quarter
t«944
Telephone number
Federal Tax Deposit Coupon
Form 8109-B (Rev.12-2006)
IICR ENCODING
SEPARATE ALONG THIS LINE AND SUBMIT TO DEPOSITABY WITH PAYMENT OMB NO. 1545-0257
What's new. The oval for Form 990-C has been deleted. Form 990-C
has been replaced by Form 1120-C, U.S. Income Tax Return for
Cooperative Associations. Filers of Form 1120-C must use the 1120 oval
when completing Form 8109-B.
The type of tax ovals for the 1120, 1042, and 944 have been moved
on the coupon. Read the type of tax to the right of the oval before youdarken the oval.
Note. Except for the name, address, and telephone number, entries must
be made in pencil. Use soft lead (for example, a #2 pencil) so that the
entries can be read more accurately by optical scanning equipment. The
name, address, and telephone number may be completed other than by
hand. You cannot use photocopies of the coupons to make your
deposits. Do not staple, tape, or fold the coupons.
The IRS encourages you to make federal tax deposits using the
Electronic Federal Tax Payment System (EFTPS), For more infoi
on EFTPS, go to www.eftps.gov or call 1-800-555-4477.
Purpose of form. Use Form 8109-B to make a tax deposit
following two situations.
1. You have not yet received your resupply of preprinti
coupons (Form 8109).
2. You are a new entity and have already b<
identification number (EIN), but you have not
of preprinted deposit coupons (Form 8109). lf|
EIN, see Exceptions below.
Note. If you do not receive your resupply of di
deposit is due or you do not receive yoi
of receipt of your EIN, call 1-800-829
How to complete the form. Enter,
or other IRS correspondence, addi
Do not make a name or address cl
Change of Address). If you are reqi
990-PF (with net investment in<
which your tax year ends in
^t using dollar signs, commas, ajjng zeros. If the deposit is for whole dollars only,
> boxes. For example, a deposit of $7,635.22
lhis: '^
example, if your tax year ends
December, enter 12. fylal
ENDS (if applicable) as
Exceptions. If^jpu h;
a deposit mustjfl'made^payment t ^or money
your name
wn on your retu
the sp
(se
990-^"ONTH TAX YEAR ENDS
. Darken on
PERIOD
period. Darkening the
R
■, enter 01; if it ends in*
for EIN and MONTH TAX
mt of deposit below,
for an EIN, have not received it, and
ie Form 8109-B. Instead, send your
'e you file your return. Make your check
to the United States Treasury and show on it
^n Form SS-4, Application for Employer
Identification NumSSHfcddress, kind of tax, period covered, and date
you applied for an EINTDo not use Form 8109-B to deposit delinquent
taxes assessed by the IRS. Pay those taxes directly to the IRS. See Pub.
15 (Circular E), Employer's Tax Guide, for information.
Amount of deposit. Enter the amount of the deposit in the space
provided. Enter the amount legibly, forming the characters as shown
below:
I2l3l4l5l6l7l8lqlol
■ace for TYPE OF TAX and only one space
gpace to the left of the applicable form and
1 space or multiple spaces may delay
your account. See below for an explanation ofTypes
the Proper Tax Period.
it's QUARTERLY Federal Tax Return (includesS 941-M, 941-PR, and 941-SS)
:r'5 Annual Tax Return for Agricultural Employees
Employer's ANNUAL Federal Tax Return (includes Forms944-PR, 944(SP), and 944-SS)
Annual Return of Withheld Federal Income Tax
Quarterly Federal Excise Tax Return
Employer's Annual Railroad Retirement Tax Return
Employer's Annual Federal Unemployment (FUTA) Tax
Return (includes Form 940-PR)
Form 1120 U.S. Corporation Income Tax Return (includes Form 1120
series of returns, such as new Form 1120-C and
Form 2438)
Form 990-T Exempt Organization Business Income Tax Return
Form 990-PF Return of Private Foundation or Section 4947(a)(1) Nonexempt
Charitable Trust Treated as a Private Foundation
Form 1042 Annual Withholding Tax Return for U.S. Source Income of
Foreign Persons
Marking the Proper Tax Period
Payroll taxes and withholding. For Forms 941, 940, 943, 944, 945,
CT-1, and 1042, if your liability was incurred during:
• January 1 through March 31, darken the 1st quarter space;
• April 1 through June 30, darken the 2nd quarter space;
• July 1 through September 30, darken the 3rd quarter space; and
• October 1 through December 31, darken the 4th quarter space.
Note. If the liability was incurred during one quarter and deposited in
another quarter, darken the space for the quarter in which the tax liability
was incurred. For example, if the liability was incurred in March anddeposited in April, darken the 1st quarter space.
Excise taxes. For Form 720, follow the instructions above for Forms
941, 940, etc. For Form 990-PF, with net investment income, follow the
instructions on page 2 for Form 1120, 990-T, and 2438.
Department of the Treasury
Internal Revenue Service
Form 8109-B (Rev. 12-2006)Cat. No. 61042S
B-4
ELECTRONIC FEDERAL TAX PAYMENT SYSTEMS (EFTPS)
The North American Free Trade Agreement includes a provision which requires many
corporations to electronically deposit backup, wage, pension and nonresident alien
withholding, along with various excise taxes and estimated income tax payments.
- Businesses with first time aggregate federal deposits exceeding $200,000
in 2006 will be mandated to use EFTPS beginning January 1, 2008.
Under these rules, a company is required to deposit electronically if its aggregate
federal deposits for the second previous year exceed $200,000.
Aggregate federal deposits include ALL federal business taxes (941,940, corporate
estimates, & excise tax deposits). When the $200,000 threshold is met, ALL federal
business taxes must be electronically deposited.
If enrolled in EFTPS through a payroll service you must file a separate enrollment form
to obtain a PIN number in order to electronically deposit "other" federal business taxes.
Before making electronic payments, taxpayers enroll with the IRS by filing Form 9779,
the EFTPS Business Enrollment Form. This enrollment process takes approximately
four to six weeks. There are two payment options:
1) EFTPS - Direct (preferred method) - funds are debited from the taxpayer's bank
account by the IRS. The taxpayer initiates payment by a telephone call (EFTPS-
Phone), through a personal computer (EFTPS-PC Software), or by using the
internet (EFTPS-OnLine), Free Windows ® - based software is available from the
IRS. Payment must be initiated by 8:00 p.m. one business day prior to date due.
The IRS provides a confirmation number. EFTPS allows taxpayers to
"warehouse" their tax payment up to 120 days in advance of the tax due date.
The payment is then automatically made on the due date.
2) EFTPS - Through Your Financial Institution - taxpayer initiates a credit
transaction through their financial institution to the IRS one business day prior to
date due. Cutoff time must be confirmed with the bank. Employer should check
with their bank for availability, deadlines, and fees. No confirmation number is
given.
IRS Offers Express EFTPS Enrollment
IRS offers EFTPS Express Enrollment for new businesses. Employers that receive a
new EIN (Employer Identification Number) and have a federal tax obligation will
automatically be pre-enrolled in the Electronic Federal Tax Payment System (EFTPS.)
After receiving their EIN, employers will receive a separate mailing containing an
EFTPS Personal Identification Number (PIN) with instructions for activating their
enrollment. New employers can then activate their enrollment by calling a toll-free
number, entering their banking information, and completing an authorization for EFTPS
to transfer funds from their account to Treasury's account for tax payments per their
instructions.
B-5
ELECTRONIC FEDERAL TAX PAYMENT SYSTEMS (EFTPS)- continued
EFTPS - OnLine: Taxpayers Can Pay All Federal Taxes On The Web
Taxpayers can enroll and pay all Federal taxes through a secure web site,
http://www.eftps.gov. The Electronic Federal Tax Payment System, (EFTPS), has been
a service that businesses and individuals can use to pay all their federal taxes
electronically, 24 hours a day, 7 days a week, via the phone or personal computer (PC)software.
EFTPS-OnLine is the same, easy to use system as the telephone and PC software
versions of EFTPS, but it also includes new features. EFTPS - On-Line users will
not only be able to pay their taxes when they want, but they can also review their
tax payment history and print out payment confirmation. Payment history can be
accessed for 16 months. By using any of the EFTPS methods to pay taxes,
taxpayers benefit from increased accuracy, easier payment and less paperwork.
With EFTPS-Direct, all three methods are interchangeable and can be used as a
backup.
For more information call:
- EFTPS Customer Service at 1-800-555-4477 (business) or 1-800-316-6541
(individual) for information and enrollment.
- Visit the IRS website at www.eftps.gov
Penalties: Ten percent failure to file electronically.
Two percent late filing penalty.
Note: If you are already enrolled in EFTPS and want to sign up for the on-line
system, you will need your original confirmation letter from the IRS. If you do
not have this you can call 1-800-555-4477 to request a new letter.
B-6
Electronic Federal Tax Payment System
Tax Form 9779 with Instructions Department of the Treasury
BUSJnSSS EtirOllmSt EFTPS "~ This form contains instructions to complete the Electronic Federal Tax Payment System(EFTPS) Enrollment Form for Business Taxpayers. It is to be used either for initial enrollment in the system or to add financial institution information. If you wish touse multiple accounts in one financial institution, or accounts in multiple financial insLiiuLions, you will need to provide multiple copies of the enrollment form.
For questions regarding EFTPS or this Enrollment Form please call:
Visit our web site at www.EFTPS.aov to enroll online.
24 hours a day, 7 days a week
EFTPS Customer Service
For TDD (hearing impaired) support
en espanol
1-800-555-4477
1-800-733-4829
1-800-244-4829
When your form is completed, please mail\o: EFTPS Enrollment Processing Center
P.O. Box 173788
Denver, Colorado 80217-3788
You should receive void Confirmation/Update Foi m and iiistnictious on using EFTPS approximately two to fooi weeks, after we receive your Eniollmeiit Form
INSTRUCTIONS
1. Employer Identification Number
(EIN). Enter your nine-digit Employer
Identification Number. Enter the EIN on
the back it'tlu farm in the upper rightcorner as well.
Note to Sole Proprietors: if you are a
Sole Proprietor business, without
employees, you need to enroll as an
Individual (Tax Form 9783) and use your
Social Security Number as your Taxpayer
Identification Number.
2. Business Taxpayer Name. Print your
business name exactly as it appears on
the tax return. Sole Proprietors should
use the individual owners name rather
than the DBA name. The only valid
characters are A-2,0-9. •, 8, and blank.
3. Business Address. This address
should be the address as it appears on
the business tax return.
ji) IjofalllkiatfosshssfBeiipre-prinled and .is incorrect, it| ia/ionly be'■ changed by submitting anIRS Change of Address (Form 8822)
to the Internal Revenue Sen/Ice. The
address on yoiififftS enrollmentwill automatically be updated when
Form 8S22 is submitted. See the
back of Form 882? lo determine
where ihelorm should be mailed.
4. Primary Contact Name. Print the
name of a person, company, or third
party who can be contacted in the event
questions arise regarding this enrollment
or tax payments. All EFTPS mailings will
be sent to your primary contact.
5-6. Primary Contact Mailing Address
and Phone Number (if different from #3
above). You need not complete the
address area il your contact's address is
the same as the business address. If an
address is provided here, it will be used
to mail confirmation materials and
instruction booklets
7. Primary contact E-mail Address.
(optional)
Marking Instructions: • Use black or blue ink only.
• Please print legibly. Use one character per block. Use
only capital letters. Keep all printing within the boxes.
♦ Do not make any stray marks on this form.
Taxpayer Information
Stale
MARKING EXAMPLE:
Zip Code
1. Employer Identification Number (EIN) - (Please enter EIN on reverse side also.)
i | I :..
2. Business Taxpayer Name:
3. Business Street Address:
City: State: ZIP Code:
ITTTTInternational: Province, Country, and Postal Code:
; i 1 i I 1i ■ f ■; i .! .
j ill! i i 111 ii i ! ! j ti i [ ;
Contact Information4. Primary Contact Name:
mr 1 i ! i i i ! 1 j j i
5. Primary Contact Mailing Street Address (if different from #3 above):
1 ' i :
1 L MCity:
Ll! !Internationa
I i \
: i ! |s ! i j i
i I Li M U_: Province, Country, and Postal Code:
i ; ■ < \ ' ! ! • ';
! i !! ■■ I
1 ' ': ' i
[j
i
!
1 ;
j i
j 1
, , \ '■■
1 1
I i =
State:
1 i 1! !
i i ! i
1 i I !Zip Code
1 i ! :
j
!
!
j i
i i
H ;
6. Primary Contact Phone Number:US Area Code
_L!/L: L H lL: j °11"7. Primary Contact E-mail Address (use as many spaces as needed up to 60):
International Country Code City Code
_J_j L1...L.-L.J L.
(over)
B-7
(continued)
8. Payment Method. Choose the
payment mothodfs) by placing an "X" in
the box(es). The options available
are: EFTPS using the Internet or
phone and EFTPS through a Financial
Institution. Both EFTPS input methods
are interchangeable: Internet and phone.
For side 2 please fill inEmployer Identification Number (EIN)
BIN:
Payment Information8. Payment Method
Q EFTPS (by Internet and/or phone): check here if you will instruct EFTPS to transfer payment from your account.
Q EFTPS (through a Financial Institution): check here if you will instruct your financial institution to forward the payment to EFTPS.You must check with your financial institution to determine if they are capable of providing this service.
NOTE: If you will only be using EFTPS through your Financial Institution as a payment method, skip to item #23.
iG) Alofe.-'Fo*: EFTPS (using the Internet orp\mm), complete the additional Information required about your linancial institution. Enrollment will automaticallyenroll you tor EFrPSthrougti a Financial Institution as well as Same-Day Payment "'/ .;.• 7■■/;-;,-: .v''■.'■'■■:■'■■ ■■>''■.■' ■
fiw EFTPS (throiigh a Financial Institution), you initiate a tax payment through a linancial imtltutldn. You must contact your financial institution to insure theinsliiutimis capable ot malting ah EFTPS payment through the Automated Charing House (ACH) or a Same-Day Payment method. It you enroll lor EFTPS througha financial Institution or Same-pay Payment,- you may also enroll tor EFTPS using the Internet or phone by providing the financial institution Inlormationrequested on items 19,ifirougU 23. : v; - :-". ■ . : V ■ v,1 :: : ■
9-18. Optional Tax Form Payment
Amount Limits (For EFTPS using the
Internet or phone only)
This section Is optional. You may set
amount limits for each tax type to
prevent an overpayment. The system will
compare your payment amount against
your stated limit and provide a warning if
you exceed the limit. You may override
the warning if you wish.
(19 through 24 must be completed il
EFTPS. using the Internet or phone will
be used)
19. RTN. This is the nine-digit number
associated with your financial institution.
You may contact your financial institution
to verify this number.
20. Account Number. Enter the number
ot the account you will use to pay your
taxes.
21. Type. Please mark one box to indicate
whether the account is a checking or
savings account
22. Slate and ZIP Code. Use the two-
cliaracter-letter abbreviation for the stale
your linancial institution is located in and
indicate ZIP Code.
23. Authorization. This section authorizes
a Financial Agent ol the U.S. Treasury to
initiate tax payments from the accounts)
you designate.
24. Taxpayer Signalure. The laxpayer
must.sign this section to authorize
participation in EFTPS. tf there is no
signature, a form will be returned.
This section also provides authorization
to share the information provided with
youj financial institution: required for the
processing of the Electronic Federal Tax
Payment System.
II signed by a corporate officer, partner,
or fiduciary on behalf of the taxpayer,
the signer certifies that they have the
authority 1o execute this authorization on
behalf of the taxpayer.
Remember to sign and mail your
enrollment form to the address on
reverse side.
FOPm Payment AmOUnt UmitS (EFTPS using the Internet or phone only)
iioveriitTteiH Priming Office:
•ic: :>:S16U
Financial Institution Information (to be completed if EFTPS using the Internet or phone will be used)
19. RTN:
I
I :I ;
22. State:
"""p
i f •i i i ! i I
20. Account Number:
j j | i |
ZIP Code:
111 m■n
| I ' i i ! 1 ! |
TD
21. Type:
[ "| Checking
[H Savings
Authorization
23. For both payment methods: Please read the following Authorization Agreement:
I (as defined as the taxpayer whose signature is below) hereby authorize the contact person (listed In item #4 of this form) and the financial institutions involved
in the processing ot my Electronic Federal Tax Payment System (EFTPS) payments to receive confidential information necessary to effect enrollment in EFTPS,electronic payment of taxes, and answer inquiries and resolve issues related to enrollment and payments. This information includes, but is not limited to, passwords,
payment instructions, taxpayer name and identifying number, and payment transaction details. If signed by a corporate officer, partner, or fiduciary on behalf of
the taxpayer, I certify that I have the authority to execute this authorization on behalf of the taxpayer. This authorization is to remain in full force and effect until
the designated Financial Agents of the U.S. Treasury have received notification from me of termination in such time and in such manner to afford a reasonableopportunity to act on it.
Only EFTPS using the Internet or phone: Please read the following Authorization Agreement:
By completing the information in boxes 19-22 and signing below, I hereby authorize designated Financial Agents of the U.S. Treasury to initiate EFTPS debit
entries to the financial institution account indicated above, for payment of Federal taxes owed to the IRS upon request by taxpayer or his/her representative, using
the Electronic Federal Tax Payment System (EFTPS). I further authorize the financial institution named above to debit such entries to the financial institution
account indicated above. All debits initiated by the U.S. Treasury designated Financial Agents pursuant to this authorization shall be made under U.S. Treasuryregulations. This authorization is to remain In full force and effect until the designated Financial Agents of the U.S. Treasury have received written notificationfrom me of termination in such time and in such manner as to afford a reasonable opportunity to act on it.
24. Taxpayer Signature
Taxpayer Signature
Print Name
Date .
Title.
Paperwork Reduction Act Notice: in accordance with Ihe Paperwork Reduction Act ot 1995. we ask to trie inlormation in the Electronic federal Tax Payment System (EFTPS) Enrollment 1:orni in order to tarry out the requirements of 26 United
States Code 6001.6011. and 6109. You m not required to provide information requested oil a form thai is subject to We Paperwork Jlouuciiofi Ad unless We lonn displays a valid OMB control number Soaks or records retaliriD to a form or itsinstructions must be retained as long as itieir contents may become material In the administration o! any internal Revenue law. Generally, lax returns and return Normal ion are ronlirtenttal. as required by Code section 6103. This Information isused by the Internal Revenue Service to assure that payments) are property credited to the appropriate account(s). Your response is mandatory N you are required by regulations to use Electronic Funds Transfer to make your frtderal Tax Deposits.Ttie lime needed (o provide this information will vary ifopumJinp, on individual circumstances. The osiimalBd average time is ten minutes. II you have comrntuils concerning trie accuracy ol this lime estimate or sugoesiions for reducing thisburden, we would be happy lohBailrom you. You can write to the IPS Tax Products Coordinatino Committee, SE:W:CAfl:MP:TT:SP. 1111 ConstiliilionAve.NW. Washington. DC 20224. Please do not send the anrollmeni lotm to this address.
The Privacy Act ol 1974 requires that when we ask individuals lor information about thnmselves, we slate our legal right to ask lor Ihe information, why we are askinp. lor the inlormation. and tow it win be used. We must also tell you what co»Mhappen il we do not rocerve all oi part ol it, and wlraflieryoui response is voluntaiy, required to obtain a benelfl. or mandatory. Our legal right to ask to information is S U.S.C. 301 and Internal Revenue Codo sections 6001.6011. 6012, andapplicable regulations. The information will be used lo enroll you in the Becbwic Federal Tax Payment System {EFTPS). The information may not be disclosed except as provided by suction 6103 ol the Internal Revenue Code. We may give theinformation to the Department oi Justice and to other federal agencies, as provided by law. We may also give it to cities, stales, the District o! Columbia, and U.S. commonwealths or possessions to cany out their laws. We may oive it to foreigngovernments because of tax treaties they have with the United Slates. Your response is mandatory i[ you arc required by regulations to use elndronic funds transfer to make your deposits. If you arc not required by regulations lo use electronic
funds transfer, your response is voluntary. II you do not provide all or pan of Ihe information, you may not be eligible to participate in Hie EFTPS. If you are required to use electronic lunds transfer by reputation, you msy be subject to penalties. Ifyou are not required to use electronic funds Iransfer to pay taxes owed, you need to pay the taxes due by another method.
Form 9779 (2/07)
B-8
PENNSYLVANIA WITHHOLDING FILING REQUIREMENTS
Starting in 2006, - Employers were required to "file" their returns electronically.
The Dept. of Revenue is encouraging employers to remit PA Withholding
electronically. Taxpayers have the option of mailing payments.
The withholding tax must be remitted to the Department of Revenue quarterly, monthly
or semi-monthly. The payment schedule is determined by the following:
Filing Status
Semimonthly
Monthly
Due Date
Within three banking days of the
15th of the month and the last dayof the month if amount withheld is
$1,000 or more a quarter.
By the 15th of the next month if
amount withheld is $300 but less
than $1,000 a quarter. Return for
December is due January 31.
Quarterly By January 31, April 30, July 31,
and October 31 if amount withheld
is less than $300 a quarter.
Quarterly
Reconciliations
For semimonthly and monthly filers.
By January 31, April 30, July 31
and October 31.
Annual
Reconciliation
Wage and Tax
Statement
By January 31 with Forms W-2.
To employees by January 31 or
within 30 days of termination.
Electronic funds transfer. Tax payments of $20,000 or more per payment are
required to be deposited via electronic funds transfer. See page B-11 for more
information.
The amount of Pennsylvania withholding tax to be remitted is the higher of:
- Gross Wages X 3.07% or current PA tax rate, or
- Amount actually withheld.
B-9
PENNSYLVANIA WITHHOLDING FILING REQUIREMENTS- continued
INTEREST
If any amount of tax required to be withheld is not reported and paid in full on or
before the due date, simple interest will be charged daily from the date the tax is due
and payable to date of payment. The rate of interest will be announced annually by
the PA Department of Revenue. This interest rate will continue for the calendar year
regardless of subsequent change in the federal interest rate in such calendar year.
Interest is computed by multiplying the late paid or unpaid tax X days delinquent X
daily interest rate. The daily interest rate for 2009 was .000137. The 2010 interest
rate is not yet available.
PENALTIES
Failure to file a quarterly return may result in the imposition of additional tax of five
percent per month or fraction thereof of the amount shown on the return less any part
of the tax paid prior to the due date of the return (minimum penalty five dollars,
maximum penalty twenty-five percent).
Failure to pay withheld tax to the PA Department of Revenue on or before the due
date for filing the quarterly reconciliation return will result in an additional tax of five
percent per month of the underpayment for each month or fraction thereof (maximum
penalty of fifty percent).
If any part of any underpayment of tax required to be shown on a return is due to
fraud, an amount equal to fifty percent of the underpayment will be added to the tax.
B-10
PA ELECTRONIC FUNDS TRANSFER
Overview
The Pennsylvania Department of Revenue requires taxpayers remitting a payment of
$20,000 or more for any of the following taxes to make payment by Electronic Funds
Transfer (EFT):
Sales and Use Public Utility Realty
Employer Withholding Motor Carrier
Corporate Net Income Fuel Use
Capital Stock/Franchise Oil Company Franchise
Mutual Thrift Institutions Liquid Fuels
Bank Shares Malt Beverage
Title Insurance and Trust Shares Unemployment Compensation
Gross Receipts Cigarette Stamp Agents
Insurance Premiums Marine Insurance Premiumstar
Requirements for Enrollment in the EFT Program
An EFT Authorization Agreement must be completed for each type of tax. The
required forms should be received automatically from the Commonwealth. If you are
required to use EFT and do not receive the required forms, go to the website at
www.revenue.state.pa.us.. business taxpayers, electronic funds.
If a payment of $20,000 or greater is not made by an approved EFT method, the
account is subject to a three percent penalty up to $500.
Payment Methods
The EFT program offers three electronic payment methods:
1. Automated Clearing House Debit (ACH Debit)
Transaction in which the Commonwealth, through its designated depository
bank originates an ACH transaction debiting the taxpayer's bank account and
crediting the Department's bank account for the amount of the payment due.
Call the Department's Data Collection Center by 1:00 p.m. one business day
before the payment due date.
Provide the appropriate tax payment information.
A 4-digit verification code will be issued. Retain this 4-digit code in the event
there is a problem with the transfer.
The next business day the amount you owe is debited from your bank account
and transferred electronically to the Commonwealth's account.
B -11
PA ELECTRONIC FUNDS TRANSFER - continued
Payment methods - continued
A service known as warehousing is available to taxpayers using the ACH Debit
payment method. Warehousing allows you to initiate your electronic tax
payment up to 365 days in advance of the payment due date. Warehousing
stores the transaction so that your bank account will not be debited until the
specified payment due date.
2. Automated Clearing House Credit (ACH Credit)
Before selecting this method verify that your financial institution can properly
handle this type of transaction and the approximate costs.
Transaction in which the taxpayer, through its own bank, originates an entry
crediting the Commonwealth's bank account and debiting its own bank
account for the amount of the payment due.
You are required to perform a pre-notification test through your financial
institution against the Commonwealth's bank account established for EFT
payment deposits. The Department's bank account number and transit
routing number, to perform this test, will be provided upon receipt of your EFT
Authorization Agreement.
Please keep in mind that for ACH debit and credit transfers, there is a 1-day lag
between the date on which payment is authorized and the date on which the transfer
is executed. So, all ACH transactions must be initiated at least one business daybefore the applicable due date.
3. Federal Reserve Wire Transfer (FedWire)
FedWire payment is now only available in emergency situations with prior
Department approval. (Limited to two per year)
4. Certified/Cashier's Check Payment Method
A taxpayer may satisfy the obligation to remit a payment by EFT by hand
delivering a certified or cashier's check, with the appropriate return or deposit
statement, to the following address before 4:00 P.M. on or before the due date
of the obligation. Payments will not be accepted at other Department
locations.
Department of Revenue
Bureau of Business Trust Fund Taxes, EFT Unit
(at Strawberry Square, 9th Floor)
Fourth and Walnut Streets
Harrisburg, PA 17128-0908
B-12
REV-331A AS (5-08)
•n PennsylvaniaDEPARTMENT OF REVENUE .
BUREAU OF BUSINESS TRUST FUND TAXES
PO BOX 280908
HARRISBURG, PA 17128-0908
AUTHORIZATION AGREEMENT
FOR
ELECTRONIC TAX PAYMENTS
COMPLETE AND RETURN WITHIN
10 DAYS OF RECEIPT
Print in black ink or type
Action requested:
□ Establish EFT Change Contact Person Name,
Business Name or Address
□ Change Payment Method □ Change Bank Information
Federal EIN:Taxpayer Business Name:
Mailing Address for EFT purposes:
C/O and Street address or PO Box
CityState ZIP Code
Q Name
Last
R~E-mail
and Telephone of Individual in
First
Address of Contact Person:
your Organization
M.I
that Revenue may contact regarding EFT:
Area Code.Telephone Number and Extension
( )ext.
Payment Method (check one):
□ ACH DEBIT □ ACH CREDIT □ CERTIFIED/CASHIER'S CHECK
If you selected the ACH Debit option, complete Sections 8, 9 and 10.
If you selected the ACH Credit or Certified/Cashier's Check option, complete Sections 9 and 10.
Bank Information:
Enter the bank account information from which tax payments will be drawn using the ACH Debit method.
If you use separate bank accounts to make different tax type payments, a separate Authorization
Agreement must be completed for each account.
Account Number:
Bank Name
Transit Routing (ABA) Number:
City State ZIP Code
Account Type: □ Checking Savings
B-13
Check the appropriate block(s) to indicate the tax(es) you will be paying by EFT. Enter the account number for each tax type. If you
select the ACH Debit option, the tax typefc) checked should fall under the bank account listed in Section 8 from which the
payments') will be drawn.
1 r~\ Capital Stock/Franchise Tax File
Loans Tax (AH 3 taxes reported on RCT-101)
Corporate Net Income Tax
Box) Number
2.
3.
□ Utilities Gross Receipts Tax
Q Gross Receipts Telecommunication Taxes for
Intra-State, Inter-State, Mobile
File
File
Box) Number
—
Box) Number
—
File (Box) Number
4. □ Public Utility Realty Tax
5. □ Bank Shares TaxTitle Insurance & Trust Company Shares Tax
Bank Loans Tax
File (Box) Number
6. □ Mutual Thrift Institutions Tax
7. Q Insurance Premiums Tax
hie
File |
Box) Number
—
Box) Number
—
8. [] Marine Insurance Premiums Tax
File (Box) Number
EIN
9. n Liquid Fuels and Fuels Tax
Account Number
10. □ Motor Carriers Road Tax
Account Number
11. LJ IFTA - Motor Carriers
Account Number
12. □ Malt Beverage Tax
Account Number
13. C] Cigarette Stamp Agents
Account Number
14. □ Pari-Mutuel
Authorized Signature Information:
I certify the
information
Print Name
Signature
information provided on this form is
herein in direct conjunction with the
: Last First
true
EFT
and correct and
program.
M.I.
hereby authorize
Title
Telephone
the PA
Mumber
Department of Revenue to use the
Date
Make a copy of this completed Authorization Agreement for your records. You may fax your completed Authorization Agreement to
(717) 787-0145, or mail it to the PA DEPARTMENT OF REVENUE, PO BOX 280908, HARRISBURG, PA 17128-0908.
For additional information visit www.revenue.state.pa.us or call (717) 783-6277 (electronic filing calls only). Services for taxpayers with
special hearing and/or speaking needs: 1-800-447-3020 (TT only).
B-14
PA e-TIDES
e-TIDES is an Internet-based filing system available free of charge from the
Department of Revenue at www.etides.state.pa.us. e-TIDES currently allows for the
filing of returns and payments for Sales, Use, and Hotel Occupancy Tax, Employer
Withholding Tax, and Unemployment Tax.
The site and your data are secured.
Register online to activate your e-TIDES account.
Simultaneously file your return and payment.
Pay electronically using either ACH Debit. ACH Credit, or by Credit Card.
If you will be using e-TIDES to transmit your tax returns and payments together
electronically, the system will create your payment for you.
You can opt to have returns and payments filed separately.
Allow multiple filers within your business or outside your business (i.e.
accountant, etc.) to file returns and/or payments for your business.
• The Multi-Import feature allows you to submit multiple returns or payments by
uploading a single file.
• You control the level of access of your filers. You can dictate if a filer can file a
return, make payments, and/or view your Internet filing history.
• View your Internet filing history online. The system will keep a record of your
returns and any payments made electronically by ACH Debit. Your return and
payment will be assigned an ID number for future reference.
• Employers are now able to electronically file their required unemployment
compensation quarterly reports (Form UC-2A) and pay their unemployment
compensation contributions electronically, which will be mandatory by 2011.
• Links to Labor & Industry, PA Open for Business, Revenue Homepage &
Commonwealth Homepage.
"Important Note to e-TIDES Users":
PA Department of Revenue discontinued mailing sales and use tax coupon
booklets. During 2006, the Department also discontinued EmployerWithholding
Coupon Booklets. Filing via e-Tides or Telefile is now required.
Filer Registration Instructions
In order to use e-TIDES, you must complete 2 types of registrations: Filer Registration
and Enterprise Registration.
NOTE: In order to use e-TIDES electronic filing options you must first be registered with
the Department of Revenue to collect Sales, Use, Hotel Occupancy Tax, Employer
Withholding Tax, and/or Unemployment Tax. If you are a new business and need to
obtain a tax account number(s), use the PA100 Pennsylvania Enterprise Registration
form or register using the Online PA100 at www.pa100.state.pa.us.
B-15
PA e-TIDES - continued
Filer Registration Instructions - continued
Log into www.etides.state.pa.us - To obtain a complete overview of the e-TIDES
registration requirement, follow the Quick Step Setup.
Step 1. Electronic Signature/Filer Registration
Step 2. Enterprise Registration
Options in e-TIDES - The PA Department of Revenue announced the following
options:
• W-2 Transmittal/W-2 Wage Statements/1099-R - The ability to file the W-2
Transmittal/1099-R/Rev.-1667. Click on W-2 Transmittal/W-2 Wage
Statement/1099R for more information.
• Amended Returns - You may file amended returns for Sales Tax and
Employer Withholding Tax. You can access this in two ways. Click on
Amended Return for more information.
• Enterprise Maintenance - The ability to change/update Sales and Employer
Withholding Taxes electronically. Click on Enterprise Maintenance for more
information.
Credit Card Payments
PA Department of Revenue accepts American Express, Master Card, Visa,
and Discover for sales tax and employer taxes.
You can charge by phone or over the internet by using the credit card service
provider listed here:
Official Payments Corp.
Phone: 1-800-2PAYTAX (1-800-272-9829)
Internet: www.officialpavments.com
Official Payments Corp. charges a 2.49% convenience fee ($1 minimum charge)for processing the credit card transaction. The convenience fee and taxpayment will appear as two different charges on your credit card statement.
B-16
PA e-TIDES-continued
Credit Card Payments - continued
• Your payment will be effective on the date you charged it. When your payment is
approved, you will be given a confirmation number. Retain this confirmation number
as proof of payment. Authorized payments cannot be cancelled.
• If you want to confirm your transaction, or if you have any questions, please call:
Official Payments Corp.
Customer Service: 1 -877-754-4413
Note: Payments made through Official Payments Corp.'s credit card service are not
reflected in the e-TIDES View Internet Filing History.
MULTI-STATE REPORTING
Multi-State Income Tax Withholding
Rule of Thumb-Withhold income tax for the state in which services are performed. This
is the default rule for employees who live and work in the same state. When that's not the
case, you must consider three other factors: residency, reciprocity, and resident/
nonresident taxation policies.
Multi-State Unemployment Insurance
Every state sets its own unemployment insurance (Ul) tax rate and taxable wage base.
Fortunately, you only have to pay state unemployment taxes to one state for each
employee, even if the employee works in more than one state. The trick is making sure
that you pay the correct state. If you pay unemployment taxes to the wrong state, you're
still liable for paying them to the correct state, and you may have trouble getting a refund
from the incorrect state.
What to do - Gather the facts on where the employee in question is based, performs
work, and lives.
1) Localized: The employee works basically in one state with only temporary or
transitory work in another state. Pay the state where the employee normally
works.
2) Base of operations: The employee works in more than one state on more than
a temporary or transitory basis, but receives instructions, maintains business
records, picks up mail or supplies, or has an office in one of the states where he
or she works. You pay that state.
3) Place of control: The employee's work is not localized and the base of
operations can't be pin-pointed. You pay the state where the control over the
employee is localized, if the employee works there some of the time.
4) Residence: When all else fails, pay the state where the employee lives, if he or
she works there at least some of the time.
B-17
BONUSES/SUPPLEMENTAL WAGES
Taxability and Withholding of Bonuses
Bonuses paid to employees for the performance of services are taxable wages
subject to federal income, FICA, state, local, FUTA and SUTA payroll taxes. This
includes holiday bonuses, incentive bonuses, bonuses for production, severance
pay, awards and prizes, and gift certificates. Bonuses are considered supplemental
wages for federal income tax withholding purposes.
You have three methods available to you for withholding on supplemental wages:
1. If you pay supplemental wages with regular wages but do not specify the
amount of each, withhold income tax as if the total were a single payment for
a regular payroll period.
2. If you pay supplemental wages separately (or combine them in a single
payment and specify the amount of each), you can either:
a. Withhold a flat 25% or
b. Add the supplemental wages to regular wages for the most recent payroll
period. Then compute the withholding tax as if the total were a single
payment. Subtract the tax already withheld from the regular wages and
withhold the remaining tax from the supplemental wages
3. If you do not withhold income tax from the employee's regular wages (i.e.,
when the value of your employee's withholding allowances claimed on FormW-4 is more than his/her wages), use the method described in method 2babove.
Gross up the Bonus
In cases where you want the employee to receive a specific amount without thetaxes deducted, you may "gross up" the bonus. In order to do this, follow thesesteps:
1. Add the withholding tax rates: Federal withholding = 25.00%
FICA, M/C = 7.65%
PA state tax = 3.07%
Local tax = 1.00%
PA UC Tax = .06%
36.78%
2. Subtract the total of step 1 from 100%: 100.00%
- 36.78%
63.22%
B-18
BONUSES/SUPPLEMENTAL WAGES - continued
Gross up the Bonus - continued
3. Divide the net amount by the answer in
step 2 to arrive at the gross amount of
wages: $500/63.22% = $790.89 Gross amt.
4. Gross amount $ 790.89
(25.00%) Federal w/h (197.71)
( 7.65%) FICA/MC w/h (60.51)
( 3.07%) PA w/h (24.28)
( 1.00%) Local w/h (7.91)
( 0.06%) PA UC tax w/h (.48)
$ 500.00 Net bonus
How And When To Use Cumulative Withholding
Situations can occur where the nature of the work or the duration of employment
causes an employee's earnings to be distorted. For example, an employee earns a
great deal in one part of the year, and relatively little in the rest. The employee will be
over-withheld at his or her earnings peak, and for the entire year, unless you withhold
on a cumulative basis.
Sales Employees - Cumulative withholding can reduce the amount withheld when a
seller's commissions or bonuses are at a seasonal low. The difference is made up
when sales, and hence compensation, are higher. Cumulative withholding does not
cost an employer anything, but it can be of great benefit to employees.
How It Works - A seller's total earnings to date are divided by the payroll periods
to date. This gives a salesperson's average pay per payroll period (per week, per
month). You then calculate withholding on this average amount and multiply it by
the number of payroll periods to date. If during the year this average amount, or
more, has already been withheld, no income tax is withheld on the latest
commission payment. If less has been withheld, the difference is withheld on the
current payment. In any case, FICA tax is deducted as usual. The employee must
make a written request for cumulative withholding.
Summer Workers - Cumulative withholding can also reduce income tax withholding for
so-called part-year workers. It's especially helpful for summer workers, like students,
who may have no other earnings during the rest of the year.
B-19
Cumulative Withholding -continued
What to Do
Another option to prevent overwithholding is for employees to sign a request like the
one below. Keep it with the W-4.
"/ request that federal income tax be withheld from my earnings using the part-year
employment method. I am a calendar-year taxpayer. I have not been employed
previously during the current year. And I do not anticipate being employed more than
245 calendar days during the current year."
The part-year withholding method works on the same principle of averaging earnings
over earlier periods, as in the method described previously for sales employees. Since
part-year employees have no earnings in these previous periods, withholding on the
average earnings is cut drastically.
OTHER BENEFITS EXEMPT FROM TAXES
Listed below are a few suggestions of nontaxable benefits:
1. Free services; example - hotel chain can allow employees to stay free.
2. Employee discounts 0 up to 20% off the price of service offered to regular
customers.
3. Parking - parking benefits up to $230 per month for parking spaces near the
employers premises.
4. Transit pass up to $120 per month.
5. Meals & Lodging - an employer can provide free meals and living
accommodations to its employees if it's in the best interest of the employer to do
so. Example - hospitals can provide free meals on its premises to personnel so
they are available for emergencies. An example of the lodging would be a
caretaker's apartment on the premises.
6. Supper money for employees who occasionally work late.
7. Employer-sponsored cafeterias - a cafeteria must be open to the entire
workforce and they must charge enough to cover their direct operating
expenses.
8. Parties, picnics, and occasional tickets to entertainment events.
9. Professional dues - civic clubs, professional groups, trade associations, and
chambers of commerce are tax free. Country club dues are taxable.
10. Gyms and athletic facilities - provided they are on the company's premises and
are available to all employees. They cannot be available to the public.
11. Education - up to $5,250 per year provided it is for job-related education.
B-20
OTHER BENEFITS EXEMPT FROM TAXES - continued
12. Child care - if it is offered to all employees, the value of employer-provided child
care is tax-free up to $5,000 per year.
13. Uniforms, company logo items.
14. Non-cash holiday gifts that are relatively inexpensive and distributed to all
employees.
15. Recognition awards - Employer awards for retirement or exceptional
performance are federal income tax-free if they have a low fair market
value. Awards of tangible personal property are tax-free up to $400 per
year or $1,600 if the award is for length of service or safety achievement
and it is available to all employees. Remember cash and gift certificates
are taxable, unless nominal in value.
GROUP TERM LIFE INSURANCE
Employer-provided group-term life insurance with a value of $50,000 or less is a tax-
free benefit to the employee if it is non-discriminatory. The value in excess of $50,000,
less any employee after-tax payroll deduction, is to be treated as taxable income,
also subject to social security and Medicare taxes. The employer is not required to
withhold federal income tax from the employee, but the value is subject to federal
taxation and must be reported on the employee's Form W-2 as "other compensation."
This amount is also included in box 12, using Code C.
The value in excess of $50,000 is not taxable for FUTA, PA income tax, local wage tax
or state unemployment purposes.
If the employee pays for additional coverage with cafeteria plan salary-reduction
dollars, the entire amount of salary reduction premium is excluded from the employee's
taxable wages. Table I must be used to calculate the taxable coverage of life insurance
over $50,000, and is taxed as other compensation as stated above.
If an employer-provided GTL policy provides coverage in excess of $50,000, the value
of the insurance benefit to be included in the employee's income is calculated by use of
the IRS "Uniform Premium Table I."
B-21
GROUP TERM LIFE INSURANCE - continued
UNIFORM PREMIUM TABLE I
Cost per $1000 of protection for one month
5-vear age bracket
Under 25 $0.05
25 to 29 0.06
30 to 34 0.08
35 to 39 0.09
40 to 44 0.10
45 to 49 0.15
50 to 54 0.23
55 to 59 0.43
60 to 64 0.66
65 to 69 1.27
70 and above 2.06
The employee's age on the last day of the calendar year needs to be determined
before the following formula can be used to calculate the value of GTL in excess of
$50,000:
(GTL coverage - $50,000) x GTL cost factor x .001) - employee after-tax deduction
for policy equals taxable GTL monthly premium value
EXAMPLE:
Employee's age at 12/31/09
Employee's GTL benefit:
Employee's GTL after tax payroll deduction per month:
Taxable wages on the value in excess of $50,000
2008 amount to be included in income
(100,000 - 50,000) x .43 x .001 -10.50 = $11.00/month x 12 months:
59
$100,000
$10.50
$132.00
The following are three exceptions where the excess GTL coverage would not be
taxable to the employee:
• The beneficiary of the policy is the company.
• The beneficiary of the policy is a charitable organization.
• The employee terminates during the year due to permanent disability.
B-22
CAFETERIA PLANS
What is a cafeteria plan?
Cafeteria plans or flexible-benefit plans are employee benefit plans, authorized by IRS
Code Sec. 125, under which employees may choose from among two or more
benefits consisting of cash and qualified benefits offered by an employer. The
cafeteria plan must be in writing. All participants must be employees or full-time life
insurance salespersons (to the extent that they are otherwise permitted to exclude the
elected benefit from income). No special permission is required from the IRS to
implement a cafeteria plan.
Why offer cafeteria plans?
Cafeteria plans give employees greater responsibility for planning their choice of
benefits while saving benefit costs for the employer. There are also some immediate
tax benefits. All of the before-tax deductions of the employees are exempt from
federal income tax, social security, Medicare, and in some states, are exempt from
state and local withholding. Most states exclude contributions to before-tax plans from
income taxes. Before-tax plans provide many employees with their only opportunity to
take a tax deduction for medical expenses, since few employees meet the percentage
of income test required to deduct medical expenses on individual tax returns.
Employers can save on social security, Medicare, and FUTA by instituting a cafeteria
plan. Annual payroll tax savings may actually exceed the administration costs
involved in implementing and maintaining a plan.
What benefits may be offered in a cafeteria plan?
Qualified benefits that can be offered include accident and health insurance, disability
insurance, dependent care assistance, adoption assistance, group-term life insurance
up to $50,000 coverage, and medical and dental expenses not reimbursed by
insurance.
With the release of IRS Revenue Ruling 2003-102 the Treasury Department and IRS
announced that over-the-counter drugs can be paid for with pre-tax dollars through
health care flexible spending accounts. This includes allergy medication, pain
relievers, cough & cold medicines, but specifically disallows the cost of dietary
supplements and vitamins.
B-23
CAFETERIA PLANS - continued
What benefits cannot be included in a cafeteria plan?
A cafeteria plan cannot offer employees an option to defer compensation, except
through a qualified cash or deferred arrangement under a 401 (k) plan. Generally, a
plan that permits employees to carry over unused benefits or contributions from one
plan year to a subsequent plan year enables an employee to defer the receipt of
compensation.
Several other benefits cannot be included in a cafeteria plan because they are already
tax-exempt under other parts of the Code. These benefits include: educational
assistance plans, scholarships, fellowships, rides in commuter vans, de minimis fringe
benefits, no-additional-cost services, employee discounts, and working condition
fringe benefits.
The plan cannot discriminate in favor of highly-compensated employees.
FSA Grace Period
Effective 2005, under IRS Notice 2005-42 employers had the option of
amending their FSA (Flexible Spending Arrangement) to include a grace
period. This would extend the time for reimbursement of health and dependent
care benefits by 21/2 months after the plan year ends. Medical and/or
dependent care expense incurred by March 15th would be allowed to be usedagainst previous year excess contributions. This lessens the "use-it-or-lose-it"
rules for FSA's.
Pennsylvania State Law
Elective contributions made by an employer and employee pursuant to a cafeteria
plan (that qualifies under Federal Code Sec. 125) for a nondiscriminatory welfare
benefit plan covering hospitalization, sickness, disability or death is NOT
considered taxable compensation and therefore, is not subject to PA tax withholding.
Unless allowable as a working condition, no-additional-cost, qualified transportation or
de minimis fringe benefit, any of the following ARE TAXABLE as PA compensation
and subject to PA withholding:
- Amounts paid for dependent care
- Amounts paid for non job-related legal, accounting or other professional services
or educational assistance
Pennsylvania Localities follow PA state compensation rules and exclude
employee contributions to cafeteria plans.
B-24
PERSONAL USE OF COMPANY PROVIDED VEHICLE
Although the business use of an employer-provided vehicle is non-taxable, the personal
use is considered to be a taxable fringe benefit. Employers are required to ascertain
the value of this personal use and to include it in the employee's wages reported on
Form W-2. The personal use of a company-provided vehicle is not taxable for
Pennsylvania tax purposes. The employee must submit to the employer an
accounting for the business use of the car to alleviate the employer reporting the entire
value of both business and personal use of the car on the employee's Form W-2. The
Internal Revenue Service has provided several valuation methods for the employer to
select from which to determine the amount of income that will be subject to reporting
and taxing of the employee's wages. The employer may either use the "general
valuation method" or select one of the following "safe harbor" valuation methods.
• Commuting Valuation
• Cents Per Mile Valuation
• Annual Lease Value
When the employer chooses one of the three "safe harbor" valuation methods they are
required to notify their employees, in writing, by January 31 (or 30 days after the
employer provides the vehicle to the employee), as to which method will be applied to
their assigned vehicle. This written notice, which must be posted in a location where all
affected employees are reasonably expected to see it, must state:
• The special valuation rule that has been selected
• The substantiation requirements under IRC Section 274(d)
• The effect of failing to comply with the substantiation requirements
• Date notice was posted
• If the employer has elected NOT to withhold Federal income tax
An employer must adopt a valuation rule by the first day on which the vehicle is made
available to the employee. The employer must continue to use the same valuation
method for an employee until the vehicle is no longer used by the employee
unless the employee and employer can change to the commuting method.
Substantiation of Business Use
Employees and employers must maintain adequate records to calculate the
business use of an employer-provided vehicle. The employee should log the
business use of the vehicle including the date, purpose of the trip, and number of
miles traveled.
To eliminate the necessity of the substantiation requirements, an employer can
issue a written policy that either prohibits workers from making personal use of
company cars or restricts any personal use to commuting trips only.
B-25
PERSONAL USE OF COMPANY PROVIDED VEHICLE -continued
General Valuation Method
The worker's personal use of the employer-provided vehicle is determined by the fair
market value of the automobile (the cost an individual would have to pay to lease the
same or comparable vehicle on the same comparable terms in the same geographic
area).
Commuting Valuation Method
The commuting use of an employer-provided car is valued at $1.50 per one-way
commute ($3.00 per round trip) if the employee meets the following requirements:
1. The vehicle is owned or leased by the employer and is provided to one or more
employees for use in connection with the employer's trade or business.
2. The employer, for bona fide noncompensatory business reasons, requires the
employee to commute to or from work in the vehicle.
3. The employer has established a written policy under which the employee may
not use the vehicle for personal purposes other than for commuting or de
minimis personal use (such as, stop for a personal errand on the way between
a business delivery or the employee's home).
4. The employee, except for de minimis personal use, does not use the vehicle
for any personal purpose other than commuting.
5. The employee required to use the vehicle for commuting is not a control
employee of the employer.
Cents Per Mile Valuation Method
The value is determined by multiplying the number of miles driven for personal
use by the standard mileage rates established by the IRS (55# per mile for 2009,
and for 2010). The standard rate includes maintenance, insurance, and
fuel provided by the employer. If the employee provides fuel, the valuation is
reduced by 5.5C. To use this valuation method the following conditions are
necessary:
• Employer expects the employee to use the vehicle while conducting the
employer's business during the year
• Vehicle will be driven more than 10,000 miles
• Vehicle will be used primarily by employees
• Fair market value of the vehicle cannot exceed $15,000 for a passenger
automobile or $15,200 for a truck or van.
B-26
PERSONAL USE OF COMPANY PROVIDED VEHICLEcontinued
Cents Per Mile Valuation Method - continued
EXAMPLE: Vehicle Cents Per Mile
John Smith was issued a vehicle on January 2, 2009
Fair market value of vehicle on January 2, 2009 was $12,500
John has driven 15,500 miles during 2009
(4,500 personal miles and 11,000 business miles)
The vehicle cents per mile valuation method is used
(4,500 x 55C) = $2,475.00)
to be included in John's income (fuel provided)
$2,475.00 minus $247.50 (5.5tf x 4,500) = $2,227.50 (fuel not provided)
Fair Market Valuation Method (Annual Lease Value)
An employer determines the fair market value of the employer-provided vehicle on the
first day the vehicle was available to the employee and then consults the IRS's
"Annual Lease Value Table." The fair market value of the vehicle is that amount
which the employee would pay when acquiring the vehicle in an arms-length
transaction, including sales tax, registration fees, and title fees.
Once the fair market value is determined for the vehicle, that value is to be used for
the first four (4) calendar years the employer makes the vehicle available to the
employee. After four calendar years, the employer may determine a new fair market
value. If a vehicle is transferred to another employee, the employer may redetermine
its fair market value and calculate a new annual lease value, provided this is not done
for the purpose of reducing an employee's income taxes.
Example of Annual Lease Value
John Smith was issued a vehicle on January 2, 2009
FMV of the vehicle on January 2, 2009 was $20,400
John has driven 15,500 miles during 2009; 4,500 personal miles and 11,000 business
miles
Calculation:
Annual lease value $5,600.00
Personal use percentage (4,500/15,500) 29.03%
Personal use value included in John's W-2 $1.625.68
If fuel is provided, the employer must include an additional 5.5C per mile for personal
miles. In this example, John would have an additional $247.50 (4,500 X .055) in
taxable wages.
B-27
PERSONAL USE OF COMPANY PROVIDED VEHICLE -continued
Fair Market Valuation Method (Annual Lease Value) - Continued
Automobile Annual Lease Value
Fair Market Value (ALV)
$ 0-999 $ 600
1,000 -1,999 850
2,000 - 2,999 1,100
3,000 - 3,999 1,350
4,000-4,999 1,600
5,000-5,999 1,850
6,000 - 6,999 2,100
7,000 - 7,999 2,350
8,000 - 8,999 2,600
9,000 - 9,999 2,850
10,000 - 10,999 3,100
11,000 - 11,999 3,350
12,000 -12,999 3,600
13,000 -13,999 3,850
14,000 - 14,999 4,100
15,000 -15,999 4,350
16,000 - 16,999 4,600
17,000 - 17,999 4,850
18,000 - 18,999 5,100
19,000 - 19,999 5,350
20,000 - 20,999 5,600
21,000 - 21,999 5,850
22,000 - 22,999 6,100
23,000 - 23,999 6,350
24,000 - 24,999 6,600
25,000 - 25,999 6,850
26,000 - 27,999 7,250
28,000 - 29,999 7,750
30,000 - 31,999 8,250
32,000 - 33,999 8,750
34,000 - 35,999 9,250
36,000 - 37,999 9,750
38,000 - 39,999 10,250
40,000-41,999 10,750
42,000-43,999 11,250
44,000-45,999 11,750
46,000-47,999 12,250
48,000-49,999 12,750
50,000 - 51,999 13,250
52,000 - 53,999 13,750
54,000 - 55,999 14,250
56,000 - 57,999 14,750
58,000 - 59,999 15,250
For vehicles having a fair market value in excess of $59,999, the ALV is equal to: (.25
x automobile fair market value) + $500. The ALV is decreased for any periods during
which the car was unavailable and increased to cover other services provided for the
car. The final amount is then multiplied by the percentage that represents personal
use.
B-28
PERSONAL USE OF COMPANY PROVIDED VEHICLE -continued
Company Fleets
Company fleets comprised of twenty or more vehicles using the annual lease value
method may choose a fleet average valuation. When the employer reasonably
expects the vehicles to be used in the employer's trade or business and each unit of
the fleet has a fair market value of $19,900 or less (adjusted periodically by the IRS),
the average of the fair market value for all vehicles may be used.
If the fleet falls below 20 vehicles for more than 50% of the days in the year, the
employer will not be able to use the fleet valuation method in the next year.
Employers may identify more than one fleet within the vehicles owned by the
employer. If the fleet average method is used, the employer must recalculate the
valuations every two years.
When the fleet valuation method is used, and the employer continuously provides a
unit from the fleet to the employee, the employer is not required to provide the same
vehicle for the entire period. Employer-provided fuel for fleet automobiles can be
valued by using an average fuel cost of the entire fleet, or 5.5C per mile.
After you have determined the fair market value or fleet value, find this amount on the
"annual lease value table" and multiply the amount from the table by the employee's
personal use percentage for the vehicle (personal miles divided by total miles driven).
The employer must add an additional 5.5C for each personal mile driven if the
employer also provides fuel for the vehicle.
Part Year Valuation
The annual lease value was designed primarily for vehicles used the entire calendar
year. However, special valuation rules exist for vehicles used for shorter periods of
time. To determine the value for a period of continuous availability that lasts at least
30 days, but less than a full year, the employer must multiply the annual lease value
by the number of days the car is available to the employee and divide that figure by
365. The days the car is unavailable to the employee for bona-fide business reasons
may be excluded. The days that the car is available but not used by the employee
(such as during vacation), may not be excluded. The employer may prorate the
annual lease value even if the 30 continuous day period straddles two years. This
method may not be used when the reduction of taxable income is the primary reason
for the change.
B-29
PERSONAL USE OF COMPANY PROVIDED VEHICLEcontinued
Fixed and Variable Rate Mileage Allowance (FAVR)
In the past employers paid employees an automobile allowance which was taxable
to the employee. Revenue Procedure 90-34 added a new methodology (FAVR) in
which employers can reimburse employees using their personal car for company
business and exclude the payments from income.
A FAVR allowance is made up of two parts:
1. A flat rate payment to cover the employee's fixed costs for depreciation,
insurance, registration license fees and personal property tax for the vehicle,
and
2. A periodic cents-per-mile payment for the employee's operating costs for gas,
oil, tires and routine maintenance and repairs.
A FAVR can only be used when the employee meets the following requirements:
•The employee owns the car
•The employee substantiates 5,000 miles driven in the employer's business, or, if
greater, 80% of the annual business mileage is using a FAVR allowance
•At no time during the year may greater than 50% of the employees covered by the
FAVR be management
•At least 5 employees must be covered under the FAVR at all times during the
calendar year
• Employees covered by the FAVR for less than the full year may prorate the FAVR.
When a FAVR is used, the employee's reimbursement must be paid no less
frequently than once a quarter. The costs (standard automobile cost) used in
determining the FAVR must be based on 95% of the sum of the dealer's invoice plus
state and local sales taxes paid by consumers in the geographic area where the
employee lives. The standard automobile cost may not exceed $27,200 for 2009 and
the employer is permitted to have different FAVR rates for different employees based
on different standard automobiles.
B-30
SICK PAY (DISABILITY INCOME)
1. Employer pays employee sick pay:
•Treated as normal wages
• Payments are subject to all withholding requirements
2. Agent pays employee:
•Agent (third-party) is paid on a cost-plus-fee basis by the employer, therefore
bears no insurance risk
• Payments are subject to all withholding requirements
•Agent is not treated as employer
3. Third-party pays employee:
•Third-party is paid an insurance premium by employer, so therefore bears the
insurance risk
• Payments are subject to FICA/Medicare withholding requirements, but not income
tax withholding
•Third-party is treated as the employer
• Can be responsible for "employer portion" of FICA/Medicare taxes, or transfer
responsibility back to original employer
a. Third-party retains responsibility for taxes:
• Third-party:
• Withholds FICA and Medicare from "employees" (income taxes if
requested)
• Deposits withheld and matching portion of FICA/Medicare according to
deposit requirements
• Files Form 941 and W-2s as any other employer
• Original employer does not need to do anything
b. Third-party transfers responsibility for taxes back to original employer:
• In order for transfer to occur, third-party must:
• Withhold employee's share of FICA/Medicare
• Deposit such tax according to deposit requirements
• Notify the employer of the amount of wages and withholdings within time
required for employer's share of deposit to be deposited according to
deposit requirements.
• Employer pays employer's share of FICA & Medicare taxes only
• Employer files 941 and W2's
B-31
FORM 1099 - MISCELLANEOUS INCOME
Non-employee Compensation
Fees, commissions, prizes and awards for services performed, or other forms of
compensation paid to non-employees for services rendered, and expenses incurred
for the use of an entertainment facility treated as compensation paid to a non-
employee are reported on Form 1099-MISC in box 7.
The exemption from reporting payments made to corporations no longer applies to
payments made for legal services. Report any attorneys fees, including corporations
that provide legal services, in box 7. If you make a payment to an attorney in
connection with legal services but you cannot determine the portion that is the
attorney's fee, then report the total amount paid to the attorney (gross proceeds) in
box 14, using code "A".
Include fees, commissions, prizes and awards for services performed, or other forms
of compensation for services performed for your trade or business by an individual
who is not your employee. Include oil and gas payments for a working interest,
whether or not services are performed. Also include expenses incurred for the use of
an entertainment facility that you treat as compensation to a non-employee. Do not
report in box 7, nor elsewhere on Form 1099-MISC, PS 58 costs (reported on Form
1099-R); an employee's wages, travel or auto allowance, or bonuses (reported on
Form W-2); or the cost of group-term life insurance paid on behalf of a former
employee (reported on Form W-2).
Generally, amounts reportable in box 7 are subject to self-employment tax. If
payments are not subject to this tax and they are not reportable elsewhere on Form
1099-MISC, report the payments in box 3.
If the following four conditions are met, a payment generally is reportable as non-
employee compensation: 1) you made the payment to someone who is not your
employee; 2) you made the payment for services in the course of your trade or
business (including government agencies and nonprofit organizations); 3) you made
the payment to someone other than a corporation (with the exception of legal
services), e.g., an individual or a partnership; and 4) you made payments to the payee
of at least $600 during the year.
Examples of payments to be reported in box 7 are:
1. Attorneys' fees for professional services, payments of $600 or more for legal
services regardless of the company structure, e.g., a corporation, individual, or
partnership.
2. Fees paid by one professional to another, such as fee-splitting or referral fees.
B-32
FORM 1099 - MISCELLANEOUS INCOME - continued
Examples of payments to be reported in box 7 are: - continued
3. Payments by attorneys to witnesses or experts in legal adjudication.
4. Payment for services, including payment for parts or materials used to perform
the services as long as supplying the parts or materials was incidental to
providing the service. For example, report the total insurance company
payments to an auto repair shop under a repair contract showing an amount
for labor and another amount for parts, since furnishing parts was incidental torepairing the auto.
5. Commissions paid to nonemployee salespersons, subject to repayment but notrepaid during the calendar year.
6. A fee paid to a nonemployee and travel reimbursement for which the
nonemployee did not account to the payer if the fee and reimbursement total at
least $600.
7. Payments to nonemployee entertainers for services.
8. Exchanges of services between individuals in the course of their trades or
businesses. For example, an attorney represents a painter for nonpayment of
business debts in exchange for the painting of the attorney's law offices. The
amount reportable by each on Form 1099-MISC is the fair market value of his
orherown services performed. However, if the attorney represents the painterin a divorce proceeding, the attorney must report on Form 1099-MISC the
value of his or her services, but the painter need not report. The payment by
the painter is not made in the course of the painter's trade or business, even
though the painting services are of the type normally performed in the courseof the painter's trade or business.
9. Taxable fringe benefits for non-employees. For information on valuation offringe benefits, see Pub. 535, Business Expenses.
10. Gross oil and gas payments for a working interest.
11. Payments to current and former self-employed insurance salespersons and
agents for (a) amounts paid after retirement, but calculated as a percentage of
commissions received by the individual from the paying company before
retirement; (b) renewal commissions; and (c) deferred commissions paid after
retirement but for sales made before retirement.
B-33
FORM 1099-MISC
CORRECTED (if checked)
PAYER'S name, street address, city, state, ZIP code, and telephone no.
PAYER'S federal identification
number
RECIPIENT'S identification
number
1 Rents
2 Royalties
| OMB No. 1545-0115
I(Q)09
Form 1099-MISC
3 Other income
$5 Fishing boat proceeds
$
Miscellaneous
Income
4 Federal income lax withheld
£6 Medical and health care payments
$
Copy B
For Recipient
RECIPIENT'S name
Street address (including apt. no.)
City, state, and ZIP code
7 Nonemployee compensation
$
8 Substitute payments in lieu of
dividends or interest
$9 Payer made direct sales of
$5,000 or more of consumer
product to a biyer
(recip ent) for re ale ► [ ]
10 Crop insurance proceeds
$11
Account number (see instructions) 13 Exce golde i parachute
payments
14 Gro proceeds paid to
an attorney
$
This is important tax
information and is
being furnished to
the Internal Revenue
Service. If you are
required to file a
return, a negligence
penalty or other
sanction may be
imposed on you if
this income is
taxable and the IRS
determines that it
has not been
reported.
15a Section 409A deferrals
$
15b Section 409A income 16 State tax withheld 17 State/Payer's state no. 18 State income
$
Form 1099-MISC (keep for your records) Department of the Treasury - Internal Revenue Service
Form 1099-MISC is due to the recipient on February 1 and to the IRS on March 1.
When Forms 1099 are transmitted to the IRS, they must be summarized on Form 1096,
Annual Summary and Transmittal of U. S. Information Returns. A separate Form 1096
should be used for each type of information return submitted to the IRS. Boxes are
provided on the form to indicate the types of information return being submitted.
B-34
BUSINESS EXPENSE REIMBURSEMENTS
The IRS has divided employee expense reimbursement plans into two categories:
Accountable Plans, and Non-Accountable Plans.
Accountable Plans
Reimbursements or other expense allowances made under this type of plan are
generally tax-free to the employee and do not require the reporting of income on the
employee's Form W-2. An accountable plan must meet the following threerequirements:
1. Business Connection: Expenses must be business related to the extent the
employee could deduct them on his or her personal income tax return.
2. Substantiation: The employee must substantiate the expenses with a detailed
record of the expense including the time, business purpose, place, and amountof the expense.
3. Return of Unsubstantiated Amounts: The employee must return, within a
"reasonable time," any advances that exceed their substantiated expenses. If
the employee does not return or substantiate the expenses, income and
employment taxes must be withheld on the first pay period ending after the
expiration of the "reasonable time." The IRS has provided two "safe-harbor"
methods for meeting the "reasonable time" requirements:
Fixed Date Method
• Advance payments made no more than 30 days before an employee incursbusiness expenses
• Expenses that are substantiated within 60 days after they are incurred or paid
• Excess payments returned to employer within 120 days after beingincurred/paid
Periodic Statement Method
• Employer issues periodic statements to employees, at least quarterly,
identifying unsubstantiated expenses or unreturned excess payments
• Employees substantiate the expenses and refund any excess within 120 daysafter receiving the statement
Reimbursing an employee at the standard IRS mileage rate or less, will allow a
mileage reimbursement plan to be classified as an accountable plan. The
standard mileage rate is 550 per mile, increasing to £ per mile in 2010.
B-35
BUSINESS EXPENSE REIMBURSEMENTS-continued
Per Diems and Mileage Allowances
Meals and incidental expense per diems or mileage allowances paid to employees
which are less than or equal to the applicable rates set for federal employees are
"deemed satisfied" without the employee having to provide receipts. The employees
need only account for time, place and business purpose of their expenses.
The CONUS "Continental United States" Advantage
The IRS allows private-sector employers to use these rates to provide employees with
tax-free reimbursements for their business travel-related expenses. That's good news
for employees and employers, since using the federally approved CONUS per diems
can mean less paperwork.
Under the accountable plan rules, an employee who is reimbursed for a business
expense must substantiate the cost of the expense. Rather than deal with collecting,
verifying, and totaling all those receipts, you can reimburse employees at the federally
approved per diem amount for each day the employee travels on business. Then, all
the employee has to do is substantiate the time, place, and business purpose.
Note: You will not have to withhold or pay employment taxes on the amount
reimbursed, or report it as wages on the employee's W-2.
High - Low Method
In lieu of using the maximum per diem rate from the CONUS table, the high-low
method, which is a simplified method of determining a lodging plus M&IE per diem,
can be used to compute per diem allowances for travel within the continental United
States. This method divides all CONUS localities into two categories: low-cost or
high-cost localities.
Certain areas are treated as high-cost only during designated periods of the year
(e.g., a peak tourist season) and low-cost during other periods of time. Thus,
employers who use the high-low method must determine whether the employee
traveled in a high-cost area and if the area was classified as high-cost during the
actual period of travel.
If the high-low method is used for an employee, then the payor may not use the actual
federal maximum per diem rates for that employee during the calendar year for travel
within the continental United States.
B-36
BUSINESS EXPENSE REIMBURSEMENTS-continued
Rates Effective October 1, 2009 to September 30, 2010
Meals
and
Incidentals
46
52
65
59
Lodqinq
70
111
193
Based on
overnight
location
Total
116
163
258
Standard "CONUS" Rate
Low-Cost Locality
High-Cost Locality
Transportation Industry
(Trucking, Bus, Airline)
A complete listing of localities eligible for the high-low substantiation can be found in
the IRS publication 1542. This publication also lists the maximum federal per diem
rates for many locations within the continental United States. The publication can be
downloaded from www.irs.gov. Another helpful website for per diem charts is
www.policvworks.gov and www.qsa.gov/perdiem.
Use What Works for You
You do not have to make an all-encompassing decision as to whether you will use the
CONUS rates, high-low rates, or actual-expense reimbursement. You have some
flexibility-and a few restrictions:
• If you have been using the high-low rates so far this year, you cannot switch to
the CONUS rates during the transition, and vice versa.
• If you used the CONUS per diems the first time you reimbursed an employee's
travel expenses in 2009, you must use CONUS rates for that employee's
reimbursements for the remainder of the year.
• You can, however, use the high-low rates for some employees and the CONUS
rates for others if you feel the different rates are more accurate for the sites most
visited by the employees.
If employees submit receipts, you can reimburse them tax-free for actual
expenses under an accountable plan, even if you reimbursed them for previous
expenses using the high-low or CONUS rates.
B-37
BUSINESS EXPENSE REIMBURSEMENTS-continued
Non-accountable Plan
Any business expense reimbursement or advance which does not meet the three
qualifications of an accountable plan is considered a non-accountable plan. These
reimbursements are to be treated as taxable wages when paid, subject to federal
income, social security, Medicare, and unemployment taxes. Payment is defined as
when the employee fails to meet any of the three requirements required for an
accountable plan. They must also be reported on the employee's Form W-2.
Reimbursing an employee at a higher amount than the standard IRS mileage
rate, would result in the amount of the excess being classified as a non-
accountable plan.
Business Meals and Entertainment
The deduction for the cost of business meals and entertainment is 50%. (For
Pennsylvania purposes, the deduction continues to be 100% of the cost of business
meals and entertainment).
Travel Expenses for Dependents
Employers are not allowed a deduction for travel expenses with respect to a spouse,
dependent, or other individual accompanying an employee on business trips unless:
• The spouse, dependent, or other person is a bona fide employee of the
person paying or reimbursing the expenses,
• The travel of the spouse, dependent, or other person is for bona fide business
purposes, and
• The expenses of the spouse, dependent, or other person would otherwise be
deductible.
If all three criteria are not met, the travel expenses of the spouse, dependent, or other
person can only be deducted to the extent they are treated as compensation to the
employee.
B-38
BUSINESS EXPENSE REIMBURSEMENTS-continued
MOVING EXPENSES
Qualified moving expenses are limited to reimbursements for moving your household
goods and traveling to a new residence, including lodging. They are non-taxable
fringe benefits (provided the move qualifies as deductible, i.e. a 50 mile increase in
distance from work, etc.). These excludable reimbursements should be shown in
Box 12 of Form W-2, identified by using Code "P", and are not included in Box 1.
Non-qualified moving expenses are meals, pre-move house hunting trips, temporary
lodging and costs associated with selling the old residence and buying the new.
These expenses are not deductible as moving expenses, and therefore, are taxable
fringe benefits. Reimbursements for these expenses must be included in boxes 1,3,and 5 of Form W-2.
B-39
PARTC
Payroll Start-Up Guide
PART C - PAYROLL START UP GUIDE
NEW EMPLOYERS - NEW EMPLOYEES
Page
Employer Responsibilities C -1
New Employer Packets C - 2
• SS-4 Instructions (Application for EIN) C - 2
• PA-100 Instructions C - 3
State Unemployment Tax C - 4
PA UC Withholding Tax C - 4
Form W-5 - Earned Income Credit - C - 5
Advance Payment Certificate
New Hire Reporting Requirements C - 5
• Multi-State Chart C - 7
Local Tax Enabling Act C - 20
• Local Tax Rates C - 21
Local Services Tax C - 26
• LST Chart C - 27
Designing the Payroll System C - 28
Maintaining Payroll Records C - 29
Pennsylvania Income Tax C - 30
• General Information C - 30
• Reciprocal Agreements C - 31
• PA Employer Withholding C - 32
York Adams Earned Income Tax C - 32
EMPLOYER RESPONSIBILITIES
Employer Responsibilities:
The following list provides a brief summary of our basic responsibilities:
New Employees:
• Verify work eligibility - Form 1-9
• Record employees' names and SSNs
from social security cards
• Ask employees for Form W-4
• File New Hire Reporting Form
Each Payday:
• Withhold Federal income tax based on
each employee's Form W-4
• Withhold employee's share of social
security and Medicare taxes
• Withhold state and local income taxes
• Include advance earned income credit in
paycheck if employee requested it on
Form W-5
• Deposit in an authorized financial
Institution or by EFTPS:
• Withheld income tax, plus
• Withheld and employer social
security taxes, plus
• Withheld and employer Medicare
taxes, less
• Any advance earned income credit
NOTE: Due date of federal and state
deposits depend on your deposit schedule
Quarterly (By April 30, July 31,
October 31 and January 31):
• Calculate the amount of Federal
unemployment (FUTA) tax for each
employee
• Deposit FUTA tax in an authorized
financial institution if undeposited
accumlated amount is over $500
• File Form 941 (pay tax with return if
not required to deposit)
• File state and local withholding tax
reconciliation forms
• File state unemployment form
• File Local Services Tax if required in
your locality
Annually:
• Remind employees to submit a new
Form W-4 if they need to change their
withholding
• Ask for a new Form W-4 from
employees claiming exemption from
income tax withholding
• Reconcile Forms 941 with Forms W-2
and W-3
• Furnish each employee a Form W-2
• File copy A of Forms W-2 and the
transmittal Form W-3 with the SSA
• File copy of Forms W-2 with the
appropriate transmittal form to state and
local
• Furnish each recipient a Form 1099
(e.g., Forms 1099-R and 1099-MISC)
• File Forms 1099 and the transmittal
Form 1096
• File Form 940 or 940-EZ
• File Form 945 for any nonpayroll income
tax withholding
• File Form 944 (Employer's Annual
Federal Tax Return) only if yearly total
employer liability is under $1,000
C-1
NEW EMPLOYER PACKETS
New Employer Packets are available in Stambaugh Ness, PC offices. These packets
contain the following forms:
• Form SS-4 - Application for (EIN) Employer's Federal Identification Number
As a new employer, you are required to have an Employer Identification Number
(EIN). Use Form SS-4 to apply for an EIN. You can apply for an EIN either by
mail, fax, telephone, or on-line.
To apply by mail: Complete Form SS-4 and mail to:
Attn: EIN Operation
Holtsville, NY 11742
To apply by fax: Complete Form SS-4 and fax to:
1-631-447-8960.
To apply by telephone: Complete Form SS-4 and call the new business
and specialty tax line, 800-829-4933.
To apply on-line: Complete the new on-line EIN Internet application at
http://www.irs.gov. The IRS will issue an EIN immediately.
Third parties may request El N's via the internet on behalf of their clients. A
copy of the SS-4 form, signed by the customer, must be maintained in the
third party business files.
• W-4 - Employee's Withholding Allowance Certificate
• I-9 - Employment Eligibility Verification Requirement
• PA New Hire Reporting Form
• Employee's Earnings Record
• Payroll Tax Deposit Worksheet
• Payroll and Other Tax Data Rate Schedule
• Form PA-100 - PA Combined Registration Form
As a new employer in Pennsylvania, you are required to register an enterprise
with the PA Department of Revenue.
What is an Enterprise?
An Enterprise is any individual or organization which is subject to the laws of the
Commonwealth of Pennsylvania. An Enterprise may be a sole-proprietorship, or
a partnership, a corporation, a government agency, a business trust, an
association, etc.
C-2
NEW EMPLOYER PACKETS - continued
How to Complete the Registration Form:
• New registrants should complete every item in Sections 1 through 10. The
preparer will be contacted to supply the information if required sections are not
completed.
• Complete any additional sections needed. Based on the business activity and
form of organization, there will be additional sections required. Section 5 (Form
of Organization) of the PA-100 has indicators to direct the registrant to the
additional forms needed.
• Type or print legibly.
• Use black ink.
• You may file by mail or complete and file on-line.
How to Avoid Delays in Processing:
• Review the registration form and any accompanying sections to be sure that
every item is complete.
• Enclose payment for any license or registration fees.
• Submit a separate form to PA Unemployment Compensation Fund.
• Sign the registration form.
• Remove completed pages from the booklet, arrange in sequential order and
mail to the address below:
Commonwealth of PA
Department of Revenue
Bureau of Business Trust Fund Taxes
Dept. 280901
Harrisburg, PA 17128-0901
For registration assistance contact: (717) 787-1064, Hearing Impaired 1-800-447-3020.
PA-100 ON-LINE REGISTRATION:
Businesses may register and open tax accounts over the Internet. The on-line
registration system will allow business owners to apply for Sales & Use Tax
Licenses, register to withhold employer taxes, and open Unemployment
Compensation accounts administered by the PA Department of Labor & Industry. It
can be accessed through the Department of Revenue's home page at:
www.revenue.state.pa.us or directly at www.pa100.state.pa.us.
The on-line system will reduce mistakes before the registration is sent, eliminating
the need for follow-up inquiries. The Department estimates that on-line registration
will cut the time needed to process an account by weeks.
C-3
NEW EMPLOYER PACKETS - continued
PA-100 ON-LINE REGISTRATION - continued:
Notify the Commonwealth in writing within 30 days of any change to the information
provided on the registration form.
STATE UNEMPLOYMENT TAX
New employers start paying unemployment tax based on a "new employer's rate".
The rate for new PA employers in 2010 is:
Nonconstruction Employers 3.7030%
New Construction Employers 10.2626%
Based on various factors, an employer's "experience rating" may be increased or
decreased each year. State unemployment tax is paid each quarter up to maximum
amount of wages per year per employee. (PA maximum wages per employee is
$8,000/Maryland is $8,500).
PA UC WITHHOLDING TAX
During 2003 Pennsylvania employers were required to begin withholding
Pennsylvania Unemployment Tax from each employee's wages. PA UC Tax to
be withheld has been reduced to .06% (.0006) on all wages earned during 2010.
A surcharge on employer contributions has been factored into the employer's
contribution rate. Due to higher unemployment, the surcharge and employee tax went
into effect to protect the PA Unemployment Compensation Trust Fund balance.
C-4
FORM W-5 - EARNED INCOME CREDIT -
ADVANCE PAYMENT CERTIFICATE
The American Recovery and Reinvestment Act of 2009 increased the earned
income credit for joint filers and for taxpayers with 3 or more qualifying children. This
affects the 2009 Form W-5 and 2009 W-5 because it increases the amount of
adjusted gross income you can have and still receive the advance earned income
credit if you are married filing jointly.
If your employees qualify for the earned income credit, you should provide them with
Form W-5 - Earned Income Credit Advance Payment Certificate. This form will allow
them to receive advance payments of the earned income credit in their regular
paycheck during the year. Payments of the Advance Earned Income Credit are limited
to 60% of the Employee's Earned Income Credit.
Employees with a qualifying child who are eligible for the Earned Income Credit and
expect to earn less than $35,463 ($40,463 if filing jointly) may choose to receive an
advance payment. Your employees can get any additional credit due to them when
they file their income tax returns.
NEW HIRE REPORTING REQUIREMENTS
The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 required
employers to report certain information on their newly-hired employees to a designated
State agency. States match new hire reports against their child support records to
locate parents, as well as detect and prevent erroneous benefit payments from
Employment Security and Workers' Compensation. The state will transmit the New
Hire Reports to the National Directory of New Hires. This has increased national child
support collections, reduced welfare payments, and saved $$ in Medicaid, food stamp
and unemployment insurance fraud.
New Hire reports are sent to the State Directory of New Hires in the state where the
employee works. Each state should be sending employers instructions on where and
how to send the new hire information. Federal law mandates that new hires be
reported within 20 days of the date of hire. General information on new hire reporting isavailable by accessing
www.acf.hhs.gov/proqrams/cse/newhire or by calling 1-202-401-9373.
An Employee Is Considered A "New Hire" And Must Be Reported If:
1) Your company never employed this individual previously
2) The individual is a former employee who is:
a) Rehired following termination.
b) Rehired following separation.
c) Returning to work following a layoff, or
d) Returning to work following a requested leave of absence without paygreater than 30 days.
C-5
NEW HIRE REPORTING REQUIREMENTS- continued
A summary of the requirements for Pennsylvania and Maryland employers is listed
below:
PENNSYLVANIA EMPLOYERS:
- Phone: (888-724-4737) 888-PAHIRES
- Fax: 717-657-HIRE(4473)
E-mail: [email protected]
- Website: www.panewhires.com
PA New-Hire Reporting may be reported electronically via FTP (File Transfer
Protocol), e-mail, or the Internet. First time users must register by calling 1-
888-724-4737.
MARYLAND EMPLOYERS:
- Phone: 888-634-4737
- Fax: 888-657-3534
- E-mail: [email protected]
- Website: www.mdnewhire.com
IF A MULTI-STATE EMPLOYER:
- May choose to report all new hires to only one state.
- May choose to report new hires to each state involved.
- If reporting all new hires to one state, employer MUST report either electronically
or through magnetic media.
- If reporting to each individual state, may report by paper, electronically or
magnetic media.
The following state-by-state new hire reporting chart provides the latest information
from each state with regard to employer responsibilities for new-hire reporting. If your
company will be reporting new hires on behalf of its subsidiaries that operate under
different names and Federal EIN's, make sure you list the names, EIN's and state in
which you have employees working.
C-6
ContactInformation
Alabama
Phone:
(334)206-6021
Fax:(334)242-8956
WilmaFleming-generalnewhirecontact
Email:[email protected]
RamonaJordan-
InternetuploadSupport
Phone:
(334)206-6028
Website:www.dir.alabama.gov/nh/
Alaska
Phone:
(907)269-6089
Phone:
(877)269-6685
-Alaskaonly
Fax:(907)787-3197,3181
Fax:(907)269-6077
Website:
www.childsupport.alaska.gov/employers/employerjnformation.asp
Arizona
Phone:
(888)282-2064-New
Hire
Phone:
(602)340-0555-New
Hire
Phone
(602)252-4045-
ChildSupport
Fax:(888)282-0502
Fax:(602)340-0669
Email:[email protected]
Website:www
az-newhire.com
FTP:ftp.az-newhire.com
EFT:
(602)340-0703
Arkansas
Phone:
(800)259-2095
Phone:(501)376-2125
Fax:(800)259-3562
Fax:(501)376-2682
Email:[email protected]
Website:
www.ar-newhire.com
Reporting
Timeframe
(non-magnetic
mediaonly)
Within
7days
of
hiring
or
re-
employment.
Maybesubject
toadministrative
penaltyup
to$25
foreach
violation.
20days
20days
20days
DataElements
W-4elements:
firs
tday
of
work;new
hire
,recall
orjob
refusal
(ifemployeereceiveda
job
offer)indicators;
Employer'sFEIN,complete
businessname,
mailing
address,phonenumber,
fax
number:
Full
contactnameand
job
title
W-4
elements;
Optional:date
of
birth,
dateof
hire,employer'sStateEIN
W-4elements
W-4
elements;
Optional:
date
of
birth,
dateof
hire
,Stateofhire
MethodofTransmission
mail,
fax,
internetupload,
website
-go
toNew
Hire
link
(enterFEIN
plusthreezeros)
mail,fax
phone,
mail,
fax,magnetic
tape,cartridgetape,
diskette,
website,FTP,EFT
mail,
fax,magnetictape,
cartridgetape,diskette,
website
Reportingof
Independent
Contractors?
Yes
No
No
No
$ m z m 7)m 73m ■o
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Office
ofChildSupportEnforcement
EmployerServicesTeam
October2009
Page
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ContactInformation
California
Phone:(916)651-7446
Fax:(916)255-0951
Email:
Website:www.edd.ca.gov/payroll_taxes/new_hire_reporting.htm
Colorado
Phone:(800)696-1468
Phone:
(303)297-2849
Fax:(303)297-2595
Website:www.newhire.state.co.us
Connecticut
Phone:
(860)263-6310-New
Hire
Phone:(800)228-5437-ChildSupport
Fax:(800)816-1108
Email:
Website:www.ctnewhires.com
Delaware
Phone:
(302)395-6632
Fax:(302)395-6729
Email:
Website:http://www.dhss.delaware.gov/dhss/dcse/index.html
DistrictofColumbia
Phone:
(877)846-9523
Fax:(877)892-6388
Email:[email protected]
Website:www.dc-newhire.com
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
20days
20days
20days
DataElements
W-4
elements,dateofhire
W-4elements
W-4
elements,dateof
hire
;
Optional:CTunemployment
insurancenumber,
contact
name,andphone
W-4elements
W-4elements,occupation,
insurance
availability;
Optional:dateof
birth,
dateof
hire
,insurance
eligibilitydate,
and
salary.
MethodofTransmission
,fax,
diskette,website,
internet,cartridgestape,CD-
Rom
mail,
fax,
magnetictape,
cartridgetape,diskette,
website
mail,
fax,
website,FTP
mail,
fax,
email,cartridgetape,
diskette
phone,
fax,
mail,diskette,CD,
cartridgetape
(willnotbe
returnedtoemployer),secure
file
transferfromweb,website
andFTP
Reportingof
Independent
Contractors?
Yes,
ifpaid$600
ormoreperyear
No
AsofOcti,
2003,
reportICs
ifover
$5000/year
payment
is
anticipated
No
No
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Officeof
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EmployerServicesTeam
October2009
Page2of13
O o 5 CDQ.
ContactInformation
Florida
Phone:
(888)854-4791-New
Hire
Phone:
(850)656-3343-New
Hire
Phone:
(888)854-4791-CustomerService
Fax:(888)854-4762
Fax:(850)656-0528
Email:[email protected]
Website:
www.fl-newhire.com
EFT:
(850)656-2657
Georgia
Phone:
(888)541-0469
Phone:
(404)525-2985
Fax:(888)541-0521
Fax:(404)525-2983
-Local
Email:[email protected]
Website:www.ga-newhire.com
BBS
orFTP:
(404)523-5863
Guam
Phone:(671)475-3360
Fax:(671)477-6118
Email:[email protected]
Website:www.guamcse.net
Hawaii
Phone:
(808)692-7029
Fax:(808)692-7001
Website:www.state.hi.us/csea/newhire.html
Idaho
Phone:
(800)627-3880
Phone:
(208)332-8941
Fax:(208)332-7411
Email:[email protected]
Website:
https://labor.
idaho.gov/applications/newhire/
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
10days
20days
20days
20days
DataElements
W-4elements,dateof
hire
,
address
forincomewithholding
order;
Optional:date
of
birth,
FL
unemploymentcompensation
accountnumber,medical
insurance
availability
W-4
elements,date
ofbirth,
date
ofhi
re,employer'sphone
number,
Stateofhi
re;
Optional:medicalinsurance
availability
W-4
elements,date
ofbi
rth
W-4
elements,dateofhire
W-4
elements,dateof
hire
,
employer'sunemployment
insuranceaccountnumber
Method
ofTransmission
phone,
mail,
fax,magnetic
tape,cartridgetape,
diskette,
website,EFT,FTP,
Internet
upload
phone,
mail,
fax,magnetic
tape,cartridgetape,
diskette,
website,FTP
,fax
fax,
mail,magnetictape,
cartridgetape,diskette
mail,
fax,
diskette,website,
Reportingof
Independent
Contractors?
No
No
Yes
forGuam
government
contractees
No
No
3 m z m 73m 7)m ■o
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OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
Page
3of13
3 CDQ.
o I
ContactInformation
Illinois
ShedrickC.Woods,Manager
Phone:
(800)327-HIRE
[4473]
-CustomerService
Phone:
(312)793-0322
-New
Hire
Phone:
(312)793-6298
-MagneticMediaTechnicalSupport
Fax:(217)557-1947
Email:[email protected]
Website:wwwides.state.il.us/employer/new-hire.asp
Indiana
Phone:(866)879-0198
Phone:(317)612-3028
Phone:
(866)879-0198,
ext.111
-TechnicalSupport
Fax:(800)408-1388
Fax:(317)612-3036
Email:[email protected]
Website:www.in.gov
orwww.in-newhire.com
Iowa
Phone:
(877)274-2580
Fax:(800)759-5881
Email:[email protected]
Website:www.iowachildsupport.gov
Kansas
Phone:
(888)219-7801
Phone:(785)296-1716
Fax:(888)219-7798
Fax:(785)291-3423
Email:[email protected]
Website,www.dol.ks.gov
Kentucky
Phone:(800)817-2262
Fax:(800)817-0099
Email:[email protected]
Website:www.kynewhire.com
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
15days
20days
20days
DataElements
W-4
elements;
Optional:
dateof
hire
,address
forincomewithholdingorders
W-4
elements,date
ofhire;
Optional:dateof
birth,
Stateof
hire
;medicalinsurance
W-4
elements,date
ofbirth,
dateofhi
re,employer'sphone,
medicalinsurance
avai
labi
lity
,
date
ofmed
insurance
qualification,address
forincomewithholding
W-4
Elements,
date
of
hire
,FEINandaddress
forwithholdingorders
W-4
elements;
Optional:date
of
birt
h,Stateofhi
re,dateof
hire
,KYemployerIDnumber,
medicalinsurance
availability,
contactphone
Method
ofTransmission
mail,
fax,
magneticcartridge&
diskette,websiteandemail
mail,
fax,
magnetictape,
cartridgetape,diskette,
website,email,FTP,EFT
mail,
fax,
CD,
diskette,
cartridgetape,website
Fax,
mail,CD-Rom,
diskette,
website
US
,fax,
magnetictape,
diskette,website,
file
upload
viaInternet
Reportingof
Independent
Contractors?
No
No
Yes*
No
No
OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
3 m z m m 7)m "0
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Page4
of13
COQ.
o
ContactInformation
Louisiana
Phone:
(888)223-1461
Fax:(888)223-1462
Email:[email protected]
Website:www.la-newhire.com
Maine
Phone:
(800)442-6003
-ChildSupport
Phone:
(800)845-5808
Phone:
(207)624-7880
Fax:(800)437-9611
Fax:(207)287-6882
Email:[email protected]
Website:www
state.me.us/dhs/bfi/dser/new_hire.htm
Maryland
Phone:
(410)281-6000
-CustomerService
Fax:(888)657-3534
Fax:(410)281-6004
Email:
Website:
www.mdnewhire.com
Massachusetts
Phone:
(617)626-4154
-New
HireandTechnicalSupport
Fax:(617)376-3262
Email:[email protected]
New
HireInformationWebsite:
hrtps://wfb.dor.statema.us/webfile/business/Public/Webforms/Login/L
ogin.aspx
Reporting
Timeframe
(non-magnetic
media
only)
20days
7days
20days
14days
DataElements
W-4
elements.
Optional:
birt
h
date,
hiredate,insurance
avai
labi
lity
,salaryand
occupation,
MaritalStatusand
SalaryFrequency
(hourly,
weekly,monthlyetc
W-4
elements,date
of
birt
h,
dateofhire/rehire,employer's
Maine
Dept.
ofLabornumber
andphonenumber;
Optional:
availability
of
medicalinsurancecoverage,
income,income
frequency,
occupation,employee'sphone
number
W-4
elements,dateof
hire
,
MD
unemploymentaccount
number(SUIN);medical
insurance
availability,starting
wage/salary,payfrequency;
Optional:dateof
birth,
gender,
employercontact,phone,and
fax
W-4
elements,dateofhireor
reinstatement
Method
ofTransmission
phone,
mail,
fax,
disks,secure
file
transferfromwebsite,and
web
entr
y,(diskandCD's
will
notbereturned
tothe
employer)
phone,
mail,
fax,
magnetic
tape,
diskette,email,website
mail,
fax,
magnetictape,
cartridgetape,
diskette,
website,email
website,
fax,mail
to:DOR
POBox55141
Boston,MA02205-5141
Reportingof
Independent
Contractors?
No
Yes,
fortheState
when
actingasa
contracting
agencyandany
contractorwho
contractswiththe
State,or
subcontractor
thereof(perME
LD
629).
No
Yes,
ifpaid$600
ormore/year
C/) i m m 73m 73m "0
O 7)
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Office
ofChildSupportEnforcement
EmployerServicesTeam
October2009
Page5of13
O O 5 c CDQ.
o
ContactInformation
Michigan
Phone:
(800)524-9846
Fax:(877)318-1659-
5orfewerperweek
Email:[email protected]
Website:www.mi-newhire.com
Minnesota
Phone:
(800)672-4473
Phone:(651)227-4661
Fax:(651)227-4991
Fax:
(800)692^*473
Email:[email protected]
Website:www.mn-newhire.com
FTP:ftp.mn-newhire.com
EFT:
(651)222^539
EFT:
(888)305-7101
Mississippi
Phone:(800)241-1330
Fax:(800)937-8668
Email:[email protected]
Website:www.ms-newhire.com
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
15days
DataElements
W-4
elements;
Optional:
date
ofbirth,
date
of
hire
,driver's
licensenumber
W-4
elements;Optional:
date
of
birth,
dateofhi
re,State
of
hire
,employercontactand
phonenumber
W-4elements,date
of
hire
,
contactname,
StateEIN;
Optional:dateof
birth,
Stateof
hire
,gender
MethodofTransmission
,fax,
magnetictape,
cartridgetape,
diskette,phone,
website,FTP
phone,
mail,
fax,magnetic
tape,
cartridgetape,
diskette,
FTP,EFT,website
,fa
x,magnetictape,
cartridgetape,
diskette,
website,
email,CD
Reportingof
Independent
Contractors?
No
The
Stateand
all
poli
tica
l
subdivisionsof
theStateare
required
toreport
ICs;Optional
for
private
employers
Yes.
According
toMississippi
Statelaw43-
19-46and93-
11-101,
all
employers
(or
independent
contractors)
arerequired
to
reportbasic
information
aboutnewly-
hired
personnel
within15
days.
m z m 73m m ■o
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O 7)m O 55 m m z
OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
Page6of13
O O CDQ.
ContactInformation
Missouri
Phone:
(800)585-9234
-EmployerHotline
Phone:
(573)526-8699
-EmployerHotline
Phone:
(800)859-7999
-GeneralInformation
Fax:(573)526-8079
Email:[email protected]
Email:[email protected]
Website:www.dss.state.mo.us/cse/newhire.htm
Montana
Phone:
(888)866-0327
Phone:
(406)444-9290
Fax:(888)272-1990
Fax:(406)444-0745
Email:[email protected]
Website:
www.dphhs.mt.gov/csed/relatedtopics/employerinformation.shtml
InternetUpload:
Phone:
(406)444-6893
Email:[email protected]
Website:
https://vhsp.dphhs.state.mt.us/nhrs/
Nebraska
Phone:
(888)256-0293
-New
Hire
Phone:
(877)631-9973
-ChildSupport
Fax:
(866)808-2007
Website:
www.ne-newhire.com
Nevada
Phone:
(888)639-7241
Phone:
(775)684-6370
Fax:(775)684-6379
Email,[email protected]
Website.
http://www.welfare.state.nv.us/child/newhires.htm#newhire
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
20days
20days
DataElements
W-4
elements,dateofhire(or
dateW-4
signed)
W-4
elements,dateof
hire
,
employer'sphone,
fax;
Optional:date
of
birth,
State
of
hire
,employee'shomeand
workphones,medical
insurance
avai
labi
lity
,dateof
qualification
W-4
elements,dateof
hire
;
Optional:
Stateof
hire
,
employercontactandphone
number,dateof
birth,
medical
insurance
availability
W-4elements;
Optional:date
of
birth,
dateof
hire
,State
of
hire
,NV
EIN
Method
ofTransmission
mail,
fax,
magnetictape,
cartridgetape
phone,
mail,
fax,
diskette,
email,
Internetupload
mail,
fax,magnetictape,
cartridgetape,
diskette,
website,FTP
mail,
fax,
magnetic
tape,cartridgetape,
diskette,CD
Reportingof
Independent
Contractors?
No
No
Yes,
effective
1/1/2010
No
to $ m z m 7)m 73m ■o
O 7)
O 73m 0 c 7)m m to
OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
Page7of13
O o c CDQ.
o I
ContactInformation
NewHampshire
Phone:
(800)803-4485
-Employment
SecurityOffice
Phone:
(603)229-4371
-Employment
SecurityOffice
-New
Hire
Fax:
(888)783-3598
Fax:
(603)229-4324
Email:[email protected]
Website:www.nhes.state.nh.us
NewJersey
Phone:
(888)624-6339
Phone:
(877)NJHIRES
(654-4737)
Fax:
(800)304-4901
Email:[email protected]
Website:www.nj-newhire.com
NewMexico
Phone:
(800)288-7207
inNM
-ChildSupport
Phone:
(800)585-7631
outsideNM-ChildSupport
Phone:
(888)878-1607
Fax:(888)878-1614
Email:[email protected](Not
forNew
Hirereporting)
Website:www.nm-newhire.com
NewYork
Phone:(800)972-1233
Phone:
(518)452-9814,
ext.
3143
-includingmultistate&magnetic
information
Fax:(518)869-3318
Email:[email protected]
Website:www.nynewhire.com
NorthCarolina
Phone:
(888)514-4568
-New
Hire
Fax:(866)257-7005
Email:[email protected]
Website:www.ncnewhires.com
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
20days
20days
20days
DataElements
W-4
elements;NHES
employeraccountnumber,
employer'sphone;
Optional:dateofhi
re,contact,
work
State,typeofhire
(employee
orcontractor)
W-4
elements;
Optional:date
of
birth,
date
of
hire,gender
W-4
elements;
Optional:dateofbirth,
dateof
hire
,Stateofhi
re,employer's
payrolladdress,
contact,
phone,medicalinsurance
availability
W-4
elements;
Optional:date
ofhire
W-4
elements,StateEIN;
Optional:dateof
birth,
date
ofhi
re,employercontact,
phone
MethodofTransmission
,fax,
magnetictape,CD,
diskette
phone,
mail,
fax,
magnetic
tape,cartridgetape,
diskette,
website,email
phone,
,fax,
magnetic
tape,cartridgetape,
diskette,
website,FTP
mail,
fax,
magnetictape,
cartridgetape,diskette
mail,
fax,
magnetictape,
cartridgetape,
diskette,
website
Reportingof
Independent
Contractors?
Yes
Yes
No
No
No
m z m 73m 71m ■o
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CD
71m O c 71m m z C
OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
Page8of13
8 4
c (0Q.
o I O1
ContactInformation
NorthDakota
Phone:
(800)755-8530
Phone:
(701)328-3582
TTY
Service:(800)366-6889
Fax:(701)328-5497
Email:[email protected]
Website:www.childsupportnd.com
Ohio
Phone:
(888)872-1490
Phone:(614)221-5330
Fax:(888)872-1611
Fax:(614)221-7088
Email:
Website:www.oh-newhire.com
Oklahoma
Phone:(800)317-3785
Phone:(405)557-7133
Phone:
(405)557-7297-TechnicalInformation
Fax:(800)317-3786
Fax:(405)557-5350
Email:
Website:
https://www.ok.gov/oesc/index.php?c=8&sc=2
Oregon
Phone:
(503)378-2868
Phone.
(866)907-2857
Fax:(877)877-7415
Fax:(503)378-2863,2864
Email:
Website:www.dcs.state.or.us/employers.htm
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
20days
20days
DataElements
W-4
elements;
Optional:
dateof
birth,
dateofhi
re,
W-4
elements,date
of
birt
h,
dateof
hire
,Stateof
hire
;
Optional:gender,Earned
IncomeTax
Creditclaim,date
oftermination
W-4
elements,
Stateof
hire
,
date
ofhire
(fir
stday
ofwork);
Optional,
occupation,
salary,
dateof
birth,OKemployer
account#(assignedby
OESC),
avai
labi
lity
ofhealth
insurance
fordependents,
recall
(rehire)
date
W-4
elements;
Optional:employercontact
name,numberandaddress
for
withholdingorders,employer
StateEmployer
Iden
tifi
cati
on
Number,
Optional:date
of
birth,
dateof
hire
.
Method
ofTransmission
website,web
file
transfer,
mail,
fax,
diskette
mail,
fax,
magnetictape,
cartridgetape,
diskette,
website,
ftp,
internetsecure
file
transfer
,fax,
magnetictape,
cartridge
tape,
diskette,
website
mail,
fax,
cartridgetape,
diskette,CDandFTP
Reportingof
Independent
Contractors?
No
Yes,
ifpaidover
$2,500ormore
peryear.
Please
Includedates
payment
will
beginand
length
ofcontract
service.
No
No
m z m 73m 73m ■o
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o 73m 0 m m z
Office
ofChildSupportEnforcement
EmployerServicesTeam
October2009
Page
9of13
O o c Q.
ContactInformation
Pennsylvania
Phone:
(888)PAHIRES
[724-4737]
Fax:(717)657-HIRE
(4473)
Email:[email protected]
Website:
www.panewhires.com
ftp:24.104.35.55
PuertoRico
Administration
forChildSupportEnforcement
StateNew
HireRegistry
P.O.Box70376
San
Juan,PR009368376
Phone:(787)767-1500
Fax:(787)767-3882;765-1313
Rhode
Island
Phone:
(888)870-6461-New
Hire
Phone:
(401)222-2847-
ChildSupport
Phone:
(888)870-6461-
Reporting
Fax:(888)430-6907
Email:[email protected]
(infoonly)
Website:www.Rinewhire.com
FTP:FTP.Rlnewhire.com
SouthCarolina
Phone:
(888)454-5294-New
Hire
Phone:
(803)898-9235-New
Hire
Phone:
(800)768-5858
-ChildSupport
Fax:(803)898-9100
Website:www.scnewhire.com
SouthDakota
Phone:
(888)827-6078
Phone:
(605)626-2942
Fax:(888)835-8659
Fax:(605)626-2842
Website:www.sdjobs.org
Reporting
Timeframe
(non-magnetic
mediaonly)
20businessdays
20days
14days
20days
20days
DataElements
W-4
elements,date
of
hire
,
employercontactnameand
phone,
Optional:dateofbi
rth
W-4
elements,employer's
StateIDnumber,date
ofbirth,
date
of
hire
,State
ofhi
re,
salary
W-4
elements,medical
insurance
avai
labi
lity
,date
of
avai
labi
lity
;
Optional:date
of
birth,
dateof
hire
,Stateof
hire
,payroll
address
W-4
elements;
Optional:dateof
birth,
date
of
hire
,employer'sphonenumber
W-4
elements;
Optional:dateof
birth,
dateof
hire
,Stateofhire
MethodofTransmission
mail,
fax,
magnetictape,
diskette,website,
email,FTP
mail,fax
phone,
mail,
fax,
magnetic
tape,cartridgetape,
diskette,
website,
Internetupload,FTP
mail,
fax,
internetupload,
website,FTP
phone,
mail,
fax,
cartridge
tape,
diskette,website
Reportingof
Independent
Contractors?
No
No
No
No
No
CO 3 m z m 7)m m O o 7)m 0 73m m z CO
OfficeofChildSupportEnforcement
EmployerServicesTeam
October2009
Page10of13
§ C CDQ.
ContactInformation
Tennessee
Phone:(888)715-2280
Fax:(877)505-4761
Email:[email protected]
Website:www.tnnewhire.com
FTP:maxpost.maximus.com
Texas
Phone:
(800)850-6442
-EmployerLine
Phone:
(800)252-8014
-ChildSupport
Fax:(800)732-5015
Email:[email protected]
Website:www.employer.oag.state.tx.us
Utah
Phone:
(800)222-2857
Phone:(801)526-9235
Fax:(801)526-4391
Website:
http://jobs.utah.gov/newhire
Vermont
Phone:
(800)786-3214
-ChildSupport
Phone:(802)241-2915
Fax:(802)828^286
Email:[email protected]
Website:
www.labor.vermont.gov
VirginIslands
Phone:
(340)776-3700,
ext.
2038
Fax:(340)774-5908
Email:
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
Optional:5days
(recommended
to)helpdetect
fraud
inUland
WC
programs)
20days
20days
20days
20days
DataElements
W-4
elements,dateof
hire
;
Optional:dateofbi
rth,
Stateof
hire
,gender,medical
insurance
availability,Earned
IncomeTaxCredit
availability,
payrolladdress,whether
employeehasbeen
terminated;
storeorlocation
number,
ifavailable
W-4
elements;
Optional:date
of
birth,
dateof
hire
,Stateof
hire
,TX
EIN,
salary,salaryfrequency,
contactname,
payrolladdress
W-4
elements;
Optional:dateof
birth,
dateof
hire
W-4
elements,date
ofhire
W-4
elements,date
of
birth,
dateof
hire
,Stateofhi
re;
Optional:employer's
unemploymentinsuranceID
number
MethodofTransmission
phone(upto
2),
mail,
fax,
magnetictape,cartridgetape,
diskette,website,
internet
upload,FTP
phone,
mail,
fax,
website,FTP,
DTS
phone
(up
to
3),mail,
fax,
magnetictape,cartridgetape,
diskette,website
mail,
fax,magnetictape,
cartridgetape,
diskette,
website,EFT
mail,
fax,email,diskette
Reportingof
Independent
Contractors?
No
No
No
No
No
3 m I m 73m ■o
O 73
Q 73m 0 c 73m m O)
Office
ofChildSupportEnforcement
EmployerServicesTeam
October2009
Page
11
of13
§ c CDQ.
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ContactInformation
Virginia
Phone:(800)979-9014
Phone:
(804)771-9733
Fax:(800)688-2680
Fax:(804)771-9709
Email:[email protected]
Website:
www.va-newhire.com
FTP:www.va-newhirecom
Modem:
(804)771-9768
Washington
Phone:
(800)562-0479
-New
Hire
Phone:(800)591-2760
-EmployerOmbudsman
Fax:(800)782-0624
Website:www.childsupportonline.wa.gov
West
Virginia
Phone:
(877)625-4669
-New
Hire
Phone:(304)346-9513
Fax:(877)625-4675
Fax:(304)346-9518
Website:
www.wv-newhire.com
Wisconsin
Phone:
(888)300-4473
Fax:(800)277-8075
Email:[email protected]
Website:
http://dwd.wisconsin.gov/uinh/
Website:www.wi-newhire.com
Wyoming
Phone:
(800)970-9258
Fax:(800)921-9651
Website:www.wy-newhire.com
Reporting
Timeframe
(non-magnetic
mediaonly)
20days
20days
14days
20days
20days
DataElements
W-4
elements;
Optional:date
of
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October2009
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I § 5'
a>a.
LOCAL TAX ENABLING ACT
You are required to register with your local taxing bureau.
To apply in the York Adams Area, complete the York Area Earned Income Tax
Employer Questionnaire and mail to:
York Office
York Adams Tax Bureau
1405 N. Duke Street
P. O. Box 15627
York, PA 17405-0156
Phone:717-845-1584
Fax:717-854-6376
www.vatb.com
or
Gettysburg Office
York Adams Tax Bureau
900 Biglerville Road
P. O. Box 4374
Gettysburg, PA 17325
Phone:717-334-4000
Fax:717-337-2565
www.yatb.com
To apply in the Hanover Area, contact:
Hanover Area Earned Income Tax Bureau
11 Baltimore Street, Lower Level
Hanover, PA 17331
Phone:717-632-8288
Fax:717-632-0208
www.haeitb.com
To apply to the Lancaster Area, contact:
Lancaster County Tax Collection Bureau
1845 William Penn Way
Lancaster, PA 17601-6713
Phone:717-569-4521
Fax:717-569-1623
www.lctcb.org
To apply to the West Shore Area, contact:
West Shore Tax Bureau
3607 Rosemont Ave., P.O. Box 656
Camp Hill, PA 17001
Phone:717-761-4900
Fax:717-975-8955
www.westab.org
C-20
CHANGES IN SOME LOCAL TAX RATES
Some localities saw changes in the local withholding tax rate. Local withholding is 1 % unless
listed below on pages C -15 through C -18.
ACT 24 TAX RATES
YORK ADAMS TAX BUREAU
ADAMS COUNTY
Bermudian Springs School District 1.7%
(New rate effective 7/1/09)
Gettysburg Area School District 1.7%
Fairfield Area School District 1.5%
Upper Adams School District 1.6%
Conewago Valley School District 1.5%
Reading Township
Huntington Township
York Springs Borough
Latimore Township
East Berlin Borough
Hamilton Township
Cumberland Township
Fairfield Township
Franklin Township
Freedom Township
Gettysburg Borough
Highland Township
Mt. Joy Township
Straban Township
Carroll Valley Borough
Fairfield Borough
Hamiltonban Township
Liberty Township
Arendtsville Borough
Bendersville Borough
Biglerville Borough
Butler Township
Menallen Township
Tyrone Township
Abbottstown Borough
Berwick Township
Bonneauville Borough
Conewago Township
Hamilton Township
McSherrystown Borough
Mt. Pleasant Township
New Oxford Borough
Oxford Township
Straban Township
Tyrone Township
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
Adams County
C-21
C - 22
CHANGES IN SOME LOCAL TAX RATES
ACT 24 TAX RATES - continued YORK ADAMS TAX BUREAU - continued YORK COUNTY Dover Area School Dist. 1.4% Dover Borough York County Dover Township York County Washington Township York County Southern York County S.D. 1.3% Codorus Township York County Glen Rock Borough York County New Freedom Borough York County Railroad Borough York County Shrewsbury Borough York County Shrewsbury Township York County West Shore S.D. 1.45% Lewisberry Borough York County WEST SHORE TAX BUREAU Camp Hill S.D. 2.0% Camp Hill Borough Cumberland County Cumberland Valley 1.6% Hampden Township Cumberland County Middlesex Township Cumberland County Monroe Township Cumberland County Silver Spring Township Cumberland County East Pennsboro S.D. 1.6% East Pennsboro Township Cumberland County Mechanicsburg Area S.D. 1.7% Mechanicsburg Borough Cumberland County Shiremanstown Borough Cumberland County Upper Allen Township Cumberland County Northern York Co. S.D. 1.25% Carroll Township York County Dillsburg Borough York County Franklin Township York County Franklintown Borough York County Monaghan Township York County Warrington Township York County Wellsville Borough York County West Shore School District 1.45% Fairview Township York County Goldsboro Borough York County Lemoyne Borough Cumberland County Lewisberry Borough York County Lower Allen Township Cumberland County Newberry Township York County New Cumberland Borough Cumberland County Wormleysburg Borough Cumberland County
CHANGES IN SOME LOCAL TAX RATES
ACT 24 TAX RATES - continued
LANCASTER TAX BUREAU
Lancaster School District
Solanco School District
Warwick School District
Middletown Area
CAPITAL TAX COLLECTION BUREAU
Big Spring School District
1.10%
1.65%
1.15%
1.75%
1IPPAIUKCAI
1.65%
Lancaster City
Bart Township
Colerain Township
Drumore Township
East Drumore Township
Eden Township
Fulton Township
Little Britain Township
Providence Township
Quarryville Borough
Elizabeth Township
Lititz Borough
Warwick Township
Lower Swatara Township
Middletown Boro
Royalton Boro
■j
Cooke Township
Lower Frankford Township
Lower Mifflin Township
Newville Borough
North Newton Township
Penn Township
South Newton Township
Upper Frankford Township
Upper Mifflin Township
West Pennsboro Township
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Lancaster County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Cumberland County
C-23
CHANGES IN SOME LOCAL TAX RATES
ACT 24 TAX RATES - continued
CAPITAL TAX COLLECTION BUREAU - continued
Carlisle Area School District 1.6%
Central Dauphin S.D. 2.0%
Greenwood S.D. 1.75%
Newport S.D. 1.60%
Shippensburg Area S.D. 1.40%
Susquenita School District 1.80%
Carlisle Borough
Dickinson Township
Mt. Holly Springs Borough
North Middleton Township
Dauphin Borough
Lower Paxton Township
Middle Paxton Township
Paxtang Borough
Penbrook Borough
Swatara Township
West Hanover Township
Greenwood Township
Liverpool Borough
Liverpool Township
Millerstown Borough
Tuscarora Township
Buffalo Township
Howe Township
Juniata Township
Miller Township
Newport Borough
Oliver Township
Hopewell Township
Newburg Borough
Shippensburg Borough
Shippensburg Township
Southampton Township
Orrstown Borough
Southampton Township
Reed Township
Duncannon Borough
Marysville Borough
New Buffalo Borough
Penn Township
Rye Township
Watts Township
Wheatfield Township
Cumberland County
Cumberland County
Cumberland County
Cumberland County
Dauphin County
Dauphin County
Dauphin County
Dauphin County
Dauphin County
Dauphin County
Dauphin County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Cumberland County
Cumberland County
Cumberland County
& Franklin County
Cumberland County
Cumberland County
& Franklin County
Franklin County
Franklin County
Dauphin County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
C-24
CHANGES IN SOME LOCAL TAX RATES
ACT 24 TAX RATES - continued
CAPITAL TAX COLLECTION BUREAU - continued
West Perry School District 1.70%
CENTRAL TAX BUREAU
South Middleton School District 1.60%
MIDDLETOWN AREA TAX BUREAU
Middletown Area S.D. 1.75%
CHAMBERSBURG AREA WAGE TAX
Chambersburg School District 1.70%
Blain Borough
Bloomfield Borough
Carroll Township
Centre Township
Jackson Township
Landisburg Borough
Northeast Madison Twp.
Saville Township
Southwest Madison Twp.
Spring Township
Toboyne Township
Tyrone Township
South Middleton Township
Lower Swatara Township
Royalton Borough
Middletown Borough
OFFICE
Chambersburg Borough
Greene Township
Guilford Township
Hamilton Township
LetterKenny Township
Lurgan Township
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Perry County
Cumberland County
Dauphin County
Dauphin County
Dauphin County
Franklin County
Franklin County
Franklin County
Franklin County
Franklin County
Franklin County
The Pennsylvania Department of Community and Economic Development posts both
the local earned income tax and local services tax rates on their website
http://www.newpa.com.
C-25
Pennsylvania's Local Earned Income Tax Law saw reform and change when Act 166
was created December 9, 2002. This act amended the Local Tax Enabling Act by
changing the definitions of "Earned Income" and "Net Profits". Under Act 166, these
two items are redefined and follow the same definitions as those for Pennsylvania's
Personal Income Tax.
All local Pennsylvania taxing agencies (except Philadelphia) now follow the same rules
for what they do and do not tax as earned income and net profits. This should resolve
much of the dispute between various local taxing agencies.
LOCAL MERGER
Effective January 1, 2006, Adams County Earned Income Tax Collection Agency
merged with the York Area Tax Bureau, naming the bureau: YORK ADAMS TAXBUREAU.
LOCAL SERVICES TAX
Senate Bill 218 signed into law on June 21,2007, amends the Local Tax Enabling
Act to make changes to the Emergency and Municipal Service Tax (EMST)effective January 1, 2008.
The name of the tax will change to the LOCAL SERVICES TAX. The rate,
determined by the Pennsylvania municipality, ranges from $10 -$52. If the Local
Services Tax is over $10, there is an "Income Exemption" for employees earning
a total of less than $12,000 during the calendar year. Employers must make
upfront exemption forms readily available to employees at all times and provide
new employees with the forms at the time they are hired. A "Military Exemption"
is also available for disabled veterans and members of the Armed Forces
Reserves on active duty during the tax year. If the tax rate is over $10, employers
will be required to withhold pro-rated over the number of pay periods.
Refer to the chart on the following page for rates in excess of $10.
C-26
LIST OF AREA MUNICIPALITIES COLLECTING A LOCAL SERVICES TAX OVER $10
COUNTY NAME
ADAMS
LANCASTER
YORK
MUNICIPALITY NAME
ABBOTTSTOWN BORO
EAST BERLIN BORO
CONEWAGO TWP
CUMBERLAND TWP
GETTYSBURG BORO
LITTLESTOWN BORO
MCSHERRYSTOWN BORO
NEW OXFORD BORO
OXFORD TWP
COLUMBIA BORO
DENVER BORO
EARL TWP
EAST DONEGAL TWP
EAST HEMPFIELD
EAST LAMPETER TWP
ELIZABETHTOWN BORO
EPHRATA BORO
LANCASTER CITY
MANHEIM BORO
MANHEIM TWP
MILLERSVILLE BORO
MOUNT JOY BORO
MOUNTVILLE BORO
NEW HOLLAND BORO
RAPHO TWP
UPPER LEACOCK TWP
WARWICK TOWNSHIP
WEST DONEGAL TWP
WEST EARL TWP
WEST HEMPFIELD TWP
WEST LAMPETER TWP
CARROLL TWP
CONEWAGO TWP
DILLSBURG BORO
DOVER BORO
EAST MANCHESTER TWP
FAIRVIEW TWP
HANOVER BORO
HELLAM TWP
HOPEWELL TWP
JACKSON TWP
MANCHESTER BORO
MANCHESTER TWP
MT WOLF BORO
NEWBERRY TWP
NORTH YORK BORO
PEACH BOTTOM TWP
PENN TWP
RED LION BORO
SHREWSBURY TWP
SPRING GARDEN TWP
SPRING GROVE BORO
WELLSVILLE BORO
WEST MANCHESTER TWP
WEST YORK BORO
WINDSOR TWP
WRIGHTSVILLE BORO
YORK CITY
YORK TWP
SCHOOL DISTRICT NAME
CONEWAGO VALLEY S D
BERMUDIAN SPRINGS S D
CONEWAGO VALLEY S D
GETTYSBURG AREA S D
GETTYSBURG AREA S D
LITTLESTOWN AREA S D
CONEWAGO VALLEY S D
CONEWAGO VALLEY S D
CONEWAGO VALLEY S D
COLUMBIA BORO SD
COCALICO S D
EASTERN LANCASTER S D
DONEGAL S D
EASTERN LANCASTER S D
CONESTOGA VALLEY S D
ELIZABETHTOWN AREA S D
EPHRATA AREA S D
LANCASTER S D
MANHEIM CENTRAL S D
MANHEIM TWP S D
PENN MANOR S D
DONEGAL S D
HEMPFIELD S D
EASTERN LANCASTER S D
MANHEIM CENTRAL S D
CONESTOGA VALLEY S D
WARWICK S D
ELIZABETHTOWN AREA S D
CONESTOGA VALLEY S D
HEMPFIELD SD
LAMPETER-STRASBURG S D
NOTHERN YORK CO S D
NORTHEASTERN YORK CO S D
NORTHERN YORK S D
DOVER S D
NORTHEASTERN YORK CO S D
WEST SHORE S D
HANOVER SD
EASTERN YORK S D
SOUTHEASTERN S D
SPRING GROVE AREA S D
NORTHEASTERN YORK CO S D
CENTRAL YORK S D
NORTHEASTERN YORK CO S D
NORTHEASTERN YORK CO S D
CENTRAL YORK S D
SOUTHEASTERN S D
SOUTH WESTERN S D
RED LION AREA S D
SOUTHERN YORK S D
YORK SUBURBAN S D
SPRING GROVE AREA S D
NORTHERN S D
WEST YORK AREA S D
WEST YORK AREA S D
RED LION AREA S D
EASTERN YORK S D
YORK CITY S D
DALLASTOWN AREA S D
TOTAL LOCAL
SERVICE TAX
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
52
20
52
52
40
52
52
52
52
52
52
35
52
15
52
52
26
52
52
52
52
52
52
52
52
52
52
52
52
52
52
25
52
52
52
52
52
52
C-27
DESIGNING THE PAYROLL SYSTEM
What Information Should the System Provide?
One of the most important elements of a well-designed payroll system is that it
provides the information the employer needs. For many companies, the payroll
system does not have to be elaborate. It can be designed to provide only the basic
information necessary to:
• Calculate payrolls, including gross pay and withholdings for federal, state, and
local income taxes, Social Security and Medicare taxes, and other payroll
deductions.
• Compute and make timely payroll tax deposits.
• Record payroll liabilities and expenses on the general ledger.
• Prepare monthly and/or quarterly and annual payroll tax returns.
What Information Should Be Provided?
To accurately calculate payrolls, the following information, at a minimum, is neededabout each employee:
a. Name, address and Social Security number.
b. Salary or hourly rate.
c. Pay frequency (for example, weekly, biweekly, semi-monthly, or monthly).
d. Amount of federal income tax that should be withheld from each payroll check(that is, the number of withholding allowances claimed on IRS Form W-4 plusany additional withholding requested by the employee).
e. Amount of other payroll tax deductions (for example, for retirement plans,
savings plans, or insurance) and whether those deductions should be madebefore or after federal income taxes.
f. Amount of advance payments of the earned income credit if the employee hasfiled Form W-5 to receive such payments.
g. Number of normal and overtime hours worked (if paid on an hourly basis).
The information in a. through f., above, need only be provided once - before theinitial payroll is processed. Thereafter, the information should be provided only as
employees are added or as changes in the information about existing employees
occur. Generally, the information in a. through f. can be obtained by reviewing
employee files containing employment contracts or letters, completed Form W-4's
and W-5's, benefit enrollment forms, etc. To facilitate payroll processing, however,the information should be summarized in one place.
C-28
MAINTAINING PAYROLL RECORDS
The Internal Revenue Service requires employers to maintain the following payroll
records for at least four years after the later of (1) the due date of the related payroll tax
returns or (2) the date the payroll taxes were paid:
1. Employer identification number
2. Copies of payroll tax returns that have been filed
3. Dates and amounts of payroll tax deposits made and verification numbers for
electronic deposits
4. Each employee's name, address, and Social Security number
5. The total amount and date of each wage payment and the period of time the
payment covers
6. For each wage payment, the amount subject to income tax, Social Security tax,
and Medicare tax withhold ings
7. The amounts of withholding taxes collected on each payment and the date it
was collected
8. The reasons for any differences between the taxable amounts and the total
wage payment
9. The total amount paid to employees during the calendar year
10. The amount of compensation subject to federal unemployment tax
11. The amount paid into state unemployment funds
12. Any other information required to be shown on Form 940 (or Form 940-EZ)
13. The fair market value and date of each payment of noncash compensation
made to a retail commission salesperson, if no income tax was withheld
14. For accident or health plans, information about the amount of each payment
15. The dates in each calendar quarter on which any employee worked for the
employer, but not in the course of the employer's trade or business, and the
amount paid for that work
16. Copies of any statements furnished by employees relating to nonresident alien
status, residence in Puerto Rico or the Virgin Islands, or residence or physical
presence in a foreign country
17. Form W-4, Employee's Withholding Allowance Certificate, for each
employee
C-29
MAINTAINING PAYROLL RECORDS - Continued
18. Form I-9, Employment Eligibility Requirements, for each employee
19. Any agreement between the employer and employee for the voluntary
withholding of additional amounts of tax
20. Copies of statements given to the employer by employees reporting tipsreceived in their work
21. Requests by employees to have their withheld tax figured on the basis of theirindividual cumulative wages
22. Form W-5, Earned Income Credit Advance Payment Certificate, of
employees who are eligible for the earned income credit and wish to receive
their payment in advance, rather than when they file their income tax returns
PENNSYLVANIA INCOME TAX
GENERAL INFORMATION:
Introduction:
Pennsylvania law requires the withholding of Pennsylvania Personal Income Taxfrom compensation of resident employees for services performed either within oroutside Pennsylvania and from wages of nonresident employees for servicesperformed within Pennsylvania. Every employer paying compensation subject to
withholding must withhold Pennsylvania Personal Income Tax from each payment oftaxable compensation to his employees.
Questions may be directed to the PA Department of Revenue, Bureau of BusinessTrust Fund Taxes, telephone (717) 783-1488, TDD# (717) 772-2252 (Hearing
Impaired Only) or to any of the PA Department of Revenue District Offices.
Statutory Requirement:
The requirement of withholding Personal Income Tax is imposed on every employermaintaining an office or transacting business within this Commonwealth and making
payment of compensation to a resident individual or to a nonresident individualperforming services on behalf of the employer within this Commonwealth.
C-30
PENNSYLVANIA INCOME TAX - continued
Reciprocity:
Pennsylvania has reciprocal agreements with Indiana, Maryland, New Jersey, Ohio,
Virginia and West Virginia. These agreements provide that:
1. Employers in these states may withhold Pennsylvania income tax from their
employees who are Pennsylvania residents.
2. Pennsylvania employers are not required to withhold Pennsylvania income tax
from certain employees who are residents of these states; instead, these
employers withhold the appropriate tax of the employee's resident state. To
qualify for exemption from Pennsylvania income tax withholding, an employee
who is a resident of one of the states with which Pennsylvania has a reciprocal
agreement must file Form REV-420 (Employee's Statement ofNonresidence in
Pennsylvania) with his or her employer. If a Form REV-420 is not filed, the
employer should withhold Pennsylvania income tax as for a resident.
Definition of Employer:
An "employer" is any individual, partnership, association, corporation, government
body or other entity that employs one or more persons for compensation. Any person
required under the Internal Revenue Code to withhold Federal Tax from compensation
paid to an employee will be considered an employer.
Employer Identification:
An employer should use his Pennsylvania Account Number to report all Pennsylvania
withholding. An Employer is also required to provide its Federal Employer
Identification number (EIN). If an employer has multiple divisions using the same EIN
but remitting and reconciling withholding tax separately, the employer should request
a separate Pennsylvania (PM) identification number for each division. Direct
questions relating to identification numbers to the PA Department of Revenue, Bureau
of Business Trust Fund Taxes, telephone (717) 787-3653, TDD# (717) 772-2252.
C-31
PENNSYLVANIA INCOME TAX - continued
Pa Employer Withholding:
The PA Department of Revenue eliminated the coupon system for filing Employer
Withholding Tax returns in 2006. Employers must file and pay Employer
Withholding Taxes by using the Internet based e-TIDES system at
www.etides.state.pa.us, or by calling the Department's Business Tax TeleFile
system at 1-800-748-8299.
YORK ADAMS EARNED INCOME TAX
Employers Required to Withhold:
A. Every employer having an office, factory, workshop, branch, warehouse or other
place of business located within the Taxing District, and who employs one or more
persons (other than domestic servants in a private home) for a salary, wage,
commission, or other compensation, shall deduct the tax from residents of that
district and nonresident employee's wages at the time of payment thereof.
B. Fiduciary Status - Employers who withhold earned income tax from employees, and
the person responsible for the transmission of earned income tax withheld by a
corporate employer, shall be a fiduciary charged with all the responsibilities of a
fiduciary with respect to taxes withheld, and shall be subject to all duties imposed by
law on fiduciaries, including criminal penalties for breach of duties.
Registration of Employers:
A. Each employer withholding or required to withhold tax shall register with the York
Adams Tax Bureau within fifteen (15) days after becoming a withholding employer.
B. All employers who have a place of business located within the Taxing Districts shallmaintain complete records of all employees for a period of six (6) years in such form
as to enable the Bureau to determine the employers' liability to withhold for each
employee, the amount of taxable income for each employee, the actual amount
withheld, the actual amount transmitted to the Bureau and such other informationavailable to such employers as will enable the administrator to carry out his or her
responsibilities.
C-32
YORK ADAMS EARNED INCOME TAX - continued
Returns of Employers and Payment of Withheld Tax:
A. Every employer required to withhold the tax shall file a quarterly return on the proper
form setting forth the gross earnings and amount of tax withheld for each employee,
and shall remit the total sum thereof to the York Adams Tax Bureau.
B. Employers may utilize computer printouts or similar listings to transmit quarterly
and/or annual employee withholding data provided the required information is
furnished in a manner acceptable to the Administrator. By prior arrangement with
the Administrator employers with less than 250 employees may furnish quarterly
and/or annual employee withholding data Form W-2 via magnetic media. In such
cases, an Employer's Quarterly Return shall be completed and attached as a cover
sheet to transmit the data and withheld tax to the York Adams Earned Income Tax
Bureau quarterly. The annual employee withholding Form W-2 data shall be
reported to the Bureau during February of the ensuing calendar year and shall by
accompanied by the annual reconciliation Form 322.
C. Every employer who discontinues business prior to the completion of the tax year,
shall, within thirty (30) days after discontinuance of business, file and furnish the
returns required by this section covering periods between the last such returns and
date of discontinuing business and transmit to the Officer all tax remaining due.
Should you require assistance or have questions regarding this information contact the
office at 1415 N. Duke St., York, PA 17405 or call 717-845-1584.
ACH credit method for tax remittance to York Adams Earned Income Tax Bureau is
available.
Employers can now register to file York Adams Tax Returns online by filling out the York
Adams Tax Bureau Employer Online Filing Questionnaire.
C-33
York Adams Tax Bureau
Employer Online Filing Questionnaire
In order to have the ability to file your EIT (earned income tax) W-2 and/or LST (local services
tax) detail online, please complete the form below and email it to onlineaccounts@,vatb.com. or
fax it to Doug at (717) 854-6376. He will register your account and issue a temporary
password. Employers who process their own payroll, fill out Section 1. Payroll processing
services, please fill out Section 2. Please type or write legibly.
SECTION 1 (Individual Employers):
1. Business Name:
2. York Adams Tax Bureau Account Number:
3. Federal EIN: -
4. Amount of Last Quarterly EIT Payment (for verification purposes): $_
5. Contact Person:
6. Contact Person's Email address:
7. Contact Person's Direct Phone Number:
SECTION 2 (Payroll Processors):
1. Payroll Processor Name:
2. Payroll Processor EIN: --
3. Contact Person:
4. Contact Person's Email address:
5. Contact Person's Direct Phone Number:
In addition to the above information, Payroll Processors must e-mail an Excel spreadsheetcontaining the following details:
• Identify the attachment as W-2 data or LST Accounts
• YATB account number for each employer
• Federal EIN for each employer
• Name of each employer
C-34
PARTD
Payroll Reporting Forms
PART D - PAYROLL REPORTING
QUARTERLY REPORTS
Federal Income Tax Withholding and FICA
PA Unemployment Compensation
PA Unemployment Correction Reports
PA Personal Income Tax
Local Earned Income Tax
Form# Page
941
UC-2
UC-2A
UC-2X
UC-2AX
E-Tides
319
D-1
D-5
D-6
D-7
D-8
D-9
D-10
ANNUAL REPORTS
Employer's Annual Federal Tax Return
Wage and Tax Statement
Reference Guide for Box 12, Codes
W-2, Box 13 - Checkboxes
Transmittal of Wage and Tax Statements
Federal Unemployment Tax Return (FUTA)
PA W-2 Transmittal
Local Annual Reconciliation
Miscellaneous Income
Annual Summary and Transmittal of
U.S. Information Returns
944
W-2
W-3
940
REV 1667
322
1099 MISC
D-11
D-13
D-14
D-15
D-16
D-17
D-20
D-21
D-22
1096 D-23
OTHER
Employment Eligibility Verification
PA New Hire Reporting Form
Household Employment Taxes
Federal Tax Deposits
Employer Deposit Statement of
Withholding Tax
Statement of Corrected Income
and Tax Amounts
Transmittal of Corrected Income
and Tax Statements
Employee Withholding Allowance
Certificate
Voluntary Withholding Request
Request for Federal Income Tax
Withholding from Sick Pay
Earned Income Credit Advance
Payment Certificate
I-9
New Hire Reporting Form
Schedule H
8109-B
E-Tides
W-2c
W-3c
W-4
W-4V
W-4S
W-5
D-24
D-25
D-26
D-28
D-29
D-30
D-31
D-32
D-33
D-34
D-35
941 for 2009: Employer's QUARTERLY Federal Tax ReturnForm
(Rev. April 2009) Department of the Treasury — Internal Revenue Service
(EIN)
Employer identification number3 - 1
Name (not your trade name)
Trade name (if any)
XYZ COMPANY INC
Address124 W FINE STREET
Suilo or room number
ANYTOWN
City
PA 11234-5663
State
OMB No. 1545-0029
Report for this Quarter of 2009
I I 1: January, February, March
I I 2: April, May, June
I I 3: July, August, September
ixJ 4: October, November, December
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 periodincluding: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept, 12 (Quarter 3), Dec. 12 (Quarter 4) 1
2 Wages, tips, and other compensation 2
3 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
5 Taxable social security and Medicare wages and tips:
Column 1 Column 2
I I Check and go to line 6.
5a Taxable social security wages
5b Taxable social security tips
5c Taxable Medicare wages & tips
61093 . 41
63793 . 41
X
X
X
.124 =
.124 =
.029 =
7575.
■
1850.
58
01
5d Total social security and Medicare taxes (Column 2, lines 5a + 5b + 5c = line 5d) . . 5d
6 Total taxes before adjustments (lines 3 + 5d = line 6) 6
7 CURRENT QUARTER'S ADJUSTMENTS, for example, a fractions of cents adjustment.
See the instructions.
7a Current quarter's fractions of cents
7b Current quarter's sick pay
7c Current quarter's adjustments for tips and group-term life insurance
-13 . 38
7d TOTAL ADJUSTMENTS. Combine all amounts on lines 7a through 7c 7d
8 Total taxes after adjustments. Combine lines 6 and 7d 8
9 Advance earned income credit (EIC) payments made to employees 9
10 Total taxes after adjustment for advance EIC (line 8 - line 9 = line 10) 10
11 Total deposits for this quarter, including overpayment applied from a
prior quarter and overpayment applied from Form 941-X or
Form 944-X 16285 . 46
12a COBRA premium assistance payments (see instructions) .
12b Number of individuals provided COBRA premium
assistance reported on line 12a
390 . 00
13 Add lines 11 and 12a
14 Balance due. If line 10 is more than line 13, write the difference here
For information on how to pay, see the instructions.
15 Overpayment. If line 13 is more than line 10, write the difference here
^- You MUST complete both pages of Form 941 and SIGN it.
13
14
63793 . 41
6886 . 78
9425 . 59
16312 . 37
-13 .
16298 .
■
16298 .
38
99
99
16675 . 46
376 . 47
I I Apply to next return.Check onelj/j Send a refund.
For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Cat. No. 170012 Form 941 (Rev. 4-2009)
D-1
Name (not your trade name)
XYZ COMPANY INC
Part 2: Tell us about your deposit schedule and tax liability for this quarter.
Employer identification number (EIN)
23-1234567
If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see Pub. 15
(Circular E), section 11.
Write the state abbreviation for the state where you made your deposits OR write "MU" if you made your
16p A
deposits in multiple states.
17 Check one: d Line 10 is less than $2,500. Go to Part 3.
CD You were a monthly schedule depositor for the entire quarter. Enter your tax liabilityfor each month. Then go to Part 3.
Tax liability: Month 1
Month 2
Month 3
Total liability for quarter Total must equal line 10.
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.
Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank.
18 If your business has closed or you stopped paying wages I I Check here, and
enter the final date you paid wages
19 If you are a seasonal employer and you do not have to file a return for every quarter of the year . . I I Check here.
Part 4: May we speak with your 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.
Yes. Designee's name and phone numberSTAMBAUGH NESS ( 717 ) 757 - 6999
Select a 5-digit Personal Identification Number (PIN) to use when talking to the IRS.
No.
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
Date
Print your
name here
Print your
title here
Best daytime phone
Paid preparer's use only
Preparer's name JOHNNY PAYROLL
Preparer's signature
Firm's name (or yours
if self-employed)
Address
City
STAMBAUGH NESS
2600 EASTERN BLVD
YORK
Check if you are self-employed .... | |
State PA
Preparer's
SSN/PTIN
Date
EIN
Phone
ZIP code
P00123456
01 / 10 / 10
23-7654621
( 717 ) 757 - 6999
17402
Page 2 Form 941 (Rev. 4-2009)
D-2
Schedule B (Form 941):Report of Tax Liability for Semiweekly Schedule Depositors(Rev. February 2009) Department of the Treasury — Internal Revenue Service OMB No. 1545-0029
(EIN)
Employer identification number
Name {not your trade name)
Calendar year
2 3
XYZ COMPANY INC
2 0 0 9(Also check quarter)
Report for this Quarter
(Check one.)
I I 1: January, February, March
I I 2: April, May, June
I I 3: July, August, September
I'' I 4: October, November, December
Use this schedule to show your TAX LIABILITY for the quarter; DO NOT use it to show your deposits. When you file this form with Form 941
(or Form 941-SS), DO NOT change your tax liability by adjustments reported on any Forms 941-X. You must fill out this form and attach it to
Form 941 (or Form 941-SS) if you are 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 (Circular E), Employer's Tax Guide, for details.
■
■
■
1024.
B
B
19
Month 1
1
2
3
A
5
6
7
8
Month 2
1
2
3
4
5
6
7
8
Month 3
1
2
3
4
5
6
7
■
1045.
■
B
B
B
B
29
B
■
B
B
B
1022.
B
B
75
9
10
11
12
13
14
1ft
9
m
11
12
13
14
1S
16
„
m
n
12
13
14
15
16
■
■
■
1037.
a
a
a
966.
S
B
B
a
B
.
1001 .
a
a
B
a
1092.
B
a
a
40
52
14
40
17
1fl
19
?n
21
22
2.3
24
a
a
a
1011.
a
a
a
a
92
2S
26
27
28
29
30
31
a
a
1017.
B
B
a
a
33
Tax liability for Month 1
4090. 84
17
18
19
?n
?1
2?
23
24
■
■
■
■
■
■
845. 63
a
»
26
27
2fl
29
30
31
■
■
■
■
867.
B
85
Tax liability for Month 2
4726. 43
B
a
B
978.
B
B
B
a
12
17
18
19
20
21
22
23
24
Fill in your total liability tor the quarter (Month 1 + Month 2 + Month 3) = Total tax liability for the quarter ►
Total must equal line 10 on Form 941 (or line 8 on Form 941-SS).
25
26
27
?8
29
30
31
■
■
4388. 45
a
■
a
■
Tax liability for Month 3
7481 . 72
Total liability for the quarter
16298. 99
For Paperwork Reduction Act Notice, see separate instructions. Cat. No. 11967Q Schedule B (Form 941) Rev 2-2009
D-3
Form 941-V,
Payment Voucher
Purpose of Form
Complete Form 941-V, Payment Voucher, if you are
making a payment with Form 941, Employer's
QUARTERLY Federal Tax Return. We will use the
completed voucher to credit your payment more
promptly and accurately, and to improve our service to
you.
If you have your return prepared by a third party and
make a payment with that return, please provide this
payment voucher to the return preparer.
Making Payments With Form 941
To avoid a penalty, make your payment with Form 941
only if:
• Your net taxes for the quarter (line 10 on Form 941)
are less than $2,500 and you are paying in full with a
timely filed return or
• You are a monthly schedule depositor making a
payment in accordance with the Accuracy of Deposits
Rule. See section 11 of Pub. 15 (Circular E),
Employer's Tax Guide, for details. In this case, the
amount of your payment may be $2,500 or more.
Otherwise, you must deposit your payment at an
authorized financial institution or by using the
Electronic Federal Tax Payment System (EFTPS). See
section 11 of Pub. 15 (Circular E) for deposit
instructions. Do not use Form 941-V to make federal
tax deposits.
Caution. Use Form 941-V when making any payment
with Form 941. However, if you pay an amount with
Form 941 that should have been deposited, you may
be subject to a penalty. See Deposit Penalties in
section 11 of Pub. 15 (Circular E).
Specific Instructions
Box 1—Employer identification number (EIN). If you
do not have an EIN, apply for one on Form SS-4,
Application for Employer Identification Number, and
write "Applied For" and the date you applied in this
entry space.
Box 2—Amount paid. Enter the amount paid with
Form 941.
Box 3—Tax period. Darken the capsule identifying the
quarter for which the payment is made. Darken only
one capsule.
Box 4—Name and address. Enter your name and
address as shown on Form 941.
• Enclose your check or money order made payable to
the "United States Treasury." Be sure to enter your
EIN, "Form 941," and the tax period on your check or
money order. Do not send cash. Do not staple Form
941 -V or your payment to Form 941 (or to each other).
• Detach Form 941-V and send it with your payment
and Form 941 to the address in the Instructions for
Form 941.
Note. You must also complete the entity information
above Part 1 on Form 941.
Detach Here and Mail With Your Payment and Form 941.
1941-VDepartment of the Treasury
nternal Revenue Service
1 Enter your employer identification
number (EIN).
3 Tax period
>O 1st(S Quarter
/-, 2nd
<S Quarter
o
o
3rd
Quarter
4th
Quarter
Do
Payment Voucher
not staple this voucher or your payment to Form 941.
2
Enter the amount of your payment. ►
OMB No. 1545-0029
Dollars
9Cents
4 Enter your business name (individual name if sole proprietor).
Enter your address.
Enter your city, state, and ZIP code.
D-4
INSTRUCTIONS:
Pennsylvania Unemployment Compensation (PA UC) Quarterly Tax Forms
• Form UC-2, Employer's Report for Unemployment Compensation (below)
• Form UC-2A, Employer's Quarterly Report of Wages Paid to Each Employee
• Form UC-2B, Employer's Report of Employment and Business Changes
(reverse side)
This is an Adobe Acrobat fill-in form To use this form you must have
Adobe Acrobat Reader 6.0. To download Acrobat Reader 6.0, go to
www.adobe com.
Start by keying in the your Employer's Contribution Rate (the first red box
at the far left of this form) Tab through the form to go to the next required
field. The round yellow question mark symbols are help instructions. To
view these instructions, hold the mouse over the question mark symbol.
For more detailed information, refer to the UC-2 INS (UC-2/2A/2B
Instructions).
PRINTING INSTRUCTIONS: When the Print dialog box appears, set
Page Scaling as NONE, uncheck AUTO-ROTATE AND CENTER and
uncheck CHOOSE PAPER SOURCE BY PDF PAGE SIZE.
Sign and date your report and mail it with payment to:
Office of Unemployment Compensation Tax Services
Labor & Industry Building
P.O. Box 68568
HarrisburgPA 17106-8568
For assistance, contact the nearest
Field Accounting Service (FAS) office.Allentown
Altoona
Bristol
Carlisle
OR
Chambersburg
Chester
Clearfield
Erie
Greensburg
Harrisburg
Johnstown
Lancaster
Malvern
610-821-6559
814-946-6991
215-781-3217
717-249-8211
717-697-1203
717-264-7192
610-447-3290
814-765-0572
814-871-4381
724-858-3944
717-214-2991
814-533-2371
717-299-7606
610-647-3799
Mercer
Wilkes-Barre
724-662-4007
570-301-1527
Norristown 610-270-1316 OR 3450
Philadelphia 215-560-1828 OR 3136
Pittsburgh 412-565-2400
Reading 610-378-4395 OR 4511
Scranton
Shamokin
Tannersville
Uniontown
Washington
Williamsport
York
All Out of State
Employers Call
570-963^686
570-644-3415
570-620-2870
724-439-7230
724-223-4530
570-327-3525
717-767-7620
866-403-6163
PA Form UC-2. Employer's Report for Unemployment Compensation. This form is machine-readable. Information MUST be
typewritten or printed in BLACK ink. Do not use dashes or slashes in place of zeros or blanks.
If typed, disregard the vertical bars in the shaded areas, type a consecutive
string of characters, left justified, with decimal only. Do not use commas (,) or
dollar signs ($). Font size MUST be a minimum of 10 pt.
12345678.90
If hand printed, print legible numbers within the data entry boxes provided. DO I fl3i( 5"fe7 S ^ 0NOT close the 4 or cross the 0 and 7. DO NOT fill in commas or decimal points. b *u
Do not staple anything to this form. Photocopy this report for your records. Do not photocopy this form for use.
Detach beiow and return with your payment. To report any changes to your account, complete the reverse side.
PA Form UC-2 REV 3-06, Employer's Report for Unemployment Compensation
Read Instructions -Answer Each Item
QJR./YEAR
w EXAMINED BY:
DUE DATE
1ST MONTH
1 .TOTAL COVERFO EMPLOYES
IN PAY PERIOD INCl. 12TH Ol:
MONTH
M /EDOI
3RD MONTH
s
>OX
I
Signature certifies that the information contained
herein is true and correct to the best of the signer's
knowledge.
TITLE
11. FILED
10. SIGN HERE-DO NOT PRINT
DATE PHONE #
D PAPER UC-2A □ INTERNET UC-2A JP_MAGNETIC_ MEDIA UC-2A
12. FEDERAL IDENTIFICATION NUMBER.
EMPLOYER'S CONTRIBUTION RATE EMPLOYER'S ACCT. NO.
EMPLOYER'S f
CONTRIBUTION RATE I .03663 -5
H!: to
U a,
XYZ COMPANY INC
124 W FINE STREET
ANYTOWN PA 11234
b7 0 000u00D50T4D00fc>
FOR DEPT. USE
2.GROSS WAGES
3.FMPLOYFE CONTRI-BUDONS
.0006 (0.06%)
^.TAXABLE WAGESFOR EMPLOYER
CONTRIBUTIONS
S.EMPLOYER CONTRI
BUTIONS DUE(RATE X ITEM 4)
6.TOTAL CONTRIBUTIONS DUE
(ITF-MS 3 + 5)
a.TOTALREMITTANCE
(ITEMS 6 i 7 + 8)
31.El
171EE.5D
fc.T5.T3
735-EE
$ 735.ES
MAKE CHECKS PAYABLE TO: PA UC FUND
SUBJECTIVITY DATE REPORT DELINQUENT DATE
D-5
PA Form UC-2A, Employer's Quarterly Report of Wages Paid to Each Employee
See instructions on separate sheet. Information MUST be typewritten or printed in BLACK ink. Do NOT use commas ( ,) or dollar signs ( $ ).
If typed, disregard vertical bars and type a consecutive siring of characters If hand printed, print in CAPS and within the boxes as below:
TsyAp?dLE
Employer name
(make corrections on Form UC-2B)
Employer
PA UC account no.
Check Quarter and year
d'9it 9LLD'Y
SAMPLE
Filled-in:
Quarter ending
XYZ COMPANY INC I 67 — 00000 HE™
date
MM / D D / Y Y Y Y
4/2009 12/31/2009
1. Name and telephone number pf prepgrer
STAMBAUGH NESS PC
717-757-6999
2. Total number of 3. Total number of employees listed
pages in this report in item 8 on all pages of Form UC-2A
4. Plant number
(if approved)
5. Gross wages, MUST agree with item 2 on UC-2
and the sum of item 11 on all pages of Form UC-2A
65,473.96
6. Fill in this circle if you would like the
Department to preprint your employee's
names & SSNs on Form UC-2A next
quarter
7. Employee's
Social Security Number
8 Employee's name
Fl Ml LAST
9 Gross wages paid this qtr
Example: 123456.00
10. Credit
Weeks
SOLO
CALRISSIAN
35000.00
30473.96
13
13
■ ■■ ■ ■ «CLI ~"~'——
■ ■ ' M —
List any additional employees on continuation sheets in the required format (see instructions).
11. Total gross wages for this page:
A 12. Totai number of employees for this page65473.96
UC-2A REV 9-05 13. Page of
D-6
TRANSMITTAL #
Of
PENNSYLVANIA UNEMPLOYMENT COMPENSATION CORRECTION REPORT
1. EMPLOYER ACCOUNT NUMBER
(To Amend Quarterly UC-2/2ATax Reports) (A separate form must be submitted for each quarter)
3. QUARTER/YEAR
R or M CHECK DIGIT
2. Employer Name and Address:
1, 2,
3 or 4
4. Reason For Adjustment (Check all that apply):
Q Incorrect Gross Wages. 'Please explain. Q Exempt Wages Reported in Error.* Please explain:
I I Incorrect Employee Withholding Rate Used LJ Calculation Error. Please explain:
List Rate Used
I I Incorrect Taxable Wages. Please explain: I I Other Error, Please i
□ Incorrect Employer Contribution Rate Used *PR0VIDE 'DIVIDUAL EMPLOYEE CORRECTIONFORM (UC-2AX), IF NECESSARY.
List Rate Used
d Wages Reported to Wrong State • □ PLEASE CHECK IF EMPLOYEE WAGE DETAIL WASCORRECTED ON ELECTRONIC MEDIA.
5. Was the employee withholding correctly withheld? Q Yes Q No [J Not applicable (Please see instructions on reverse side.)
TAX RATE
7.
B '■-■' ' ■■■■.■•:"■ ■■-- ' ■•■ .w * ■--■ -..;■. ;-■■.■■: . ■; ■. ,■ ■{
9.
:.'.'■■■:-:' -Vv\ ■■- ' .-. ^■-":':-,
GROSS WAGES
EMPLOYEE WITHHOLDING
TAXABLE WAGES
EMPLOYER CONTRIBUTION
AMOUNT PREVIOUSLY
REPORTED CORRECT AMOUNT
10.TOTAL (REFUND/CREDIT) OR TAX DUE (ADD LINES 7 AND 9) IN THE DIFFERENCE COLUMN refunos/credits shouldBE IN PARENTHESES 1 )
DIFFERENCE (OVER) UNDER
11. Please check one: £~J Refund [~] Credit Q] Not Applicable (Please see instructions on reverse side.)
12. Employer Certification: I certify that the information on this form is true and correct to the best of my knowledge and belief. No part of the
amount of employer contributions reported on taxable wages was deducted or is to be deducted from the employees' wages.
SIGNATURE OF OWNER, OFFICER, PARTNER, RESPONSIBLE OFFICER OR AUTHORIZED AGENT PHONE NUMBER
department use only (do not write below this line) —■
correction report □ journal voucher
SY MO YR QTR YR BASIC
RATE(X)
Totals
COMMENTS
WAGES
_J
J
uu
u
CONTRIBUTION
DEBIT CREDIT
INTEREST
DEBIT CREDIT
PENALTY
DEBIT CREDIT
A
4
TOTAL REMITTANCE
Rate Verification Certification: Date Contribution Received Date Report Received
B.I. Audit Needed □ Yes □ No □ N/A Benefit Charges □ Yes □ No □ N/A FSD CERTIFICATION/DATE
TAX TECHNICIAN
Vear I ] No Change Rate Revised From
DATE OTHER REQUIRED SIGNATURE
Year Q No Change Rate Revised From
UC-2X REV 4-06 (Page 1) COMMONWEALTH OF PENNSYLVANIA DEPARTMENT OF LABOR & INDUSTRY OFFICE OF UC TAX SERVICES
D-7
CORRECTED PENNSYLVANIA GROSS WAGES PAID TO EMPLOYEES
of
1. EMPLOYER ACCOUNT NUMBER
R or M CHECK DIGIT
2. Employer Business Name and Address:
3. QUARTER/YEAR (A separate form must be submitted for each quarter)
1. 2,
3 or 4
4. Reason For Correction (Check all that apply):
Q Incorrect Employee Social Security Number_
Correct Employee Social Security Number
Employee Name
Incorrect Employee Name
Correct Employee Name
Employee Social Security Number
I I Exempt Wages. Reason:
Employee Wage Adjustment (attach UC-2X, if necessary)
Reason:
Q Incorrect Credit. Weeks
| I Other (Please explain):
5. I certify that the information on this form is true and correct to the best of my knowledge and belief. No part of the amount of employer
contributions reported on taxable wages was deducted or is to be deducted from the employees' wages.
SIGNATURE OF OWNER, OFFICER, PARTNER, RESPONSIBLE OFFICER OR AUTHORIZED AGENT PHONE NUMBER PLANT NUMBER
6' EMPLOYEE'S SOCIAL SECURITY NO.NAME OF EMPLOYEE
FIRST NAME INITIAL LAST NAME
GROSS WAGES
DOLLARS CENTS
CREDIT
WEEKS
UC-2AX REV 4-06 IPage 1) commonwealth OF Pennsylvania DEPARTMENT OF" LABOR & INDUSTRY OFFICE OF UNEMPLOYMENT COMPENSATION TAX SERVICES
D-8
Return Successfully Submitted
Business Name
XYZ COMPANY INC
Period Start Date
7/1/2009
Transaction Effective
Date
10/29/2009
Employer Withholding Tax
Account Number1234 5678
Period End Date
9/30/2009
Time Filed
10/29/2009 10:35:41
AM
Entity ID# (EIN)
23-1234567
Due Date
11/2/2009
Tax Period
Third Quarter 2009:
W-3
Record of PA withholding tax by
period
Period Ending
7/31/2009
18/31/2009
9/30/2009
Total Amount
Withheld for Quarter
Withholding tax
469.97
384.86
379.49
1,234.32
Employer quarterly return of withholding
tax
l
2
3
4
5
Total Compensation Subject to PA Tax
Total PA Withholding Tax
Total Deposits for Quarter
(Including verified overpayments.)
Overpayment
(If line 3 is greater than line 2)
Payment
32,643.00
1,234.32
1,234.32
0.00
0.00
Payment Method Return Only (without payment)
Filed ByCOMPANY CONTACT
Transaction ID
Not Assigned
Status
Complete
D-9
MPLOYERNAMEAND
ADDRESS
<YZCOMPANYINC
124W
FINESTREET
XNYTOWNPA11234
0000012345
BUREAUACCOUNT
NO.
23-1234567
FEDERAL
EIN
4
QTR
2009
TAXYEAR
FORM
319
EMPLOYER'SQUARTERLY
COMPENSATIONTAX
RETURN
D i
657.44
OR
TOTALTAX
WITHHELD
DURING
THISQUARTER
PRIOR
PERIOD
ADJUSTMENT
3ENALTY
-.005X
LINE
1FOREACHMONTHTAX
ISPAST
DUE.
2.
NTEREST
-.000164X
LINE
1FOREACHDAYTAX
ISPAST
DUE.
3.
TOTAL
REMITTANCE.
LINE
1+
LINE
2+
LINE
34-
CONTACT
PERS
ON'S
NAME
(PRI
NT)JAINASOLO
YORKADAMS
TAX
BUREAU
P.O.BOX
15627.
YORK.
PA.
17405
(717)812-0759
657.44
657.44
IFTHISTAX
ISBEING
REMITTED
BYTHEACH
CREDITMETHOD.
CHECK
THIS
BOX.
DATE.0F
ACH
PHONE
NO..
FAX
NO..
(717)567-1234
(717)123-4566
AUTHORIZED
OFFICER'SNAME
(PRINT),
AUTHORIZED
SIGNATURE
REQUIRED
944 for 2009: Employer's ANNUAL Federal Tax Return
r
Department of the Treasury — Internal Revenue Service (77) OMB No. 1545-2007
Who Must File Form 944
You must file annual
Form 944 instead of filing
quarterly Forms 941
only if the IRS notified
you in writing.
JRead the separate instructions before you complete Form 944. Type or print within the boxes.
Part 1: Answer these questions for 2009.
1 Wages, tips, and other compensation 1
2 Income tax withheld from wages, tips, and other compensation 2
3 If no wages, tips, and other compensation are subject to social security or Medicare tax 3 I I Check and go to line 5.
Column 2
4a Taxable social security wages
4b Taxable social security tips
4 Taxable social security and Medicare wages and tips:
Column 1
4c Taxable Medicare wages & tips
X .124 =
x .124 =
X .029 -
■
■
4d Total social security and Medicare taxes (Column 2, lines 4a + 4b + 4c = line 4d) . . 4d
5 Total taxes before adjustments (lines 2 + 4d = line 5) 5
6 Current year's adjustments (see instructions) 6
7 Total taxes after adjustments. Combine lines 5 and 6 7
8 Advance earned income credit (EIC) payments made to employees 8
9 Total taxes after adjustment for advance EIC (line 7 - line 8 = line 9) 9
10 Total deposits for this year, including overpayment applied from a prior year and
overpayment applied from Form 944-X or Form 941-X 10
11a COBRA premium assistance payments (see instructions) 11a
11b Number of individuals provided COBRA premium assistance
reported on line 11a 11b
12 Add lines 10 and 11a 12
13 Balance due. If line 9 is more than line 12, write the difference here. For information on how to
pay, see the instructions 13
14 Overpayment. If line 12 is more than line 9, write the difference here. . 14
► You MUST complete both pages of Form 944 and SIGN it.
Check one I I Apply to next return.
I I Send a refund.
For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Cat. No. 39316N Form 944 (2009)
D- 11
Name (not your trade name) Employer identification number (EIN)
Part 2: Tell us about your tax liability for 2009.
15 Check one: EH Line 9 is less than $2,500. Go to Part 3.
r~j Line 9 is $2,500 or more. Enter your tax liability for each month. If you are a semiweekly depositor or you accumulate
$100,000 or more of liability on any day during a deposit period, you must complete Form 945-A instead of the boxes below.
Jan. Apr. JuL Oct.
15a
15b
15c
■
Feb.
■
Mar.
■
15d
15e
15f
Mav
■
Jun.
■
15g
15h
15i
■
Auq.
■
Sep.
■
Nov.
15k
151
Dec.
16
Total liability for year. Add lines 15a through 151. Total must equal line 9. 15m
If you made deposits of taxes reported on this form* write the state abbreviation for the state where you
made your deposits OR write MU if you made your deposits in multiple states.
Part 3: Tell us about your business. If question 17 does NOT apply to your business, leave it blank.
17 If your business has closed or you stopped paying wages...
I I Check here and enter the final date you paid wages.
Part 4: May we speak with your 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.
I i Yes. Designee's name and phone number
Select a 5-digit Personal Identification Number (PIN) to use when talking to IRS. □No.
Part 5: Sign here. You MUST complete both pages of Form 944 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.
XSign your
name here
Date
Print your
name here
Print your
title here
Best daytime phone
Paid preparer's use only
Preparer's name
Check if you are self-employed . .
Preparer's signature
Firm's name (or yours
if self-employed)
Address
City State
Preparer's
SSN/PTIN
Date
EIN
Phone
ZIP code
Page 2 Form 944 (2009)
D-12
i void □a Employee's social security number
222-33-4444For Official Use Only n-
OMB No. 1545-0008
b Employer identification number (EIN)
23-1234567
c Employer's name, address, and ZIF code
XYZ COMPANY INC
124 W FINE STREET
ANYTOWN PA 112 34
1 Wapess. tips, other compensation
8 316 0.00
d Control number
3 Social security wages
92400.00
5 Medicare wages find tips
92400.00
7 Social security tips
9 Advance E1C payment
2 Federal income tax withheld
12574.00
4 Social security lax withheld
5728 .'80
6 Medicare tax withheld
1339.80
8 Allocated tips
10 Dependent care benefits
e Employee's first name and initial i Last nameJACEN C I SOLO
Sulf. 11 Nonqualified plans 12a See Instructions for box 12
C I 1350.00
111 ALDER STREET
ANYTOWN PA 112 3 4
f Employee's address and ZIP code
13 SUTotory RstiferiGn! ThlrJ-pai'lemployes, plan Sid: pay
12by
D_14 Other
D 9240.00
12c
12d
L16 State wages, tips. etc. I 17 State income tax | 18 Local wages, tips. etc.15 'MM Employer's state ID number
PA i 1234 5678 83850.00 2574.20 83850.00
19 Local income tax
838.50
20 Locality name
ANYTOWK
Wage and Tax
Form ii~& Statement
Copy A For Social Security Administration — Send this entire page with
Form W-3 to the Social Security Administration; photocopies are not acceptable.
Department of the Treasury—Internal Revenue Service
For Privacy Act and Paperwork Reduction
Act Notice, see back of Copy D.
Cat. No. 10134D
Do Not Cut, Fold, or Stapie Forms on This Page — Do Not Cut, Foid, or Staple Forms on This Page
W-2
GROSS WAGES
CAF PLAN
401 (K)
GR. TERM LIFE
AUTO
SICK PAY
$86,250.00
2,400.00
9,240.00
1,350.00
1,200.00
6,000.00
FEDERAL
WAGES
FICA
WAGES
MEDICARE
WAGES
STATE
WAGES
LOCAL
WAGES
D-13
REFERENCE GUIDE FOR BOX 12 CODES
A) Uncollected social security or RRTA tax on tips
B) Uncollected Medicare tax on tips
C) Cost of group-term life insurance over $50,000
D) Elective deferrals to a section 401 (k) cash or deferred arrangement (including a
SIMPLE 401 (k) arrangement)
E) Elective deferrals under a section 403(b) salary reduction agreement
F) Elective deferrals under a section 408(k)(6) salary reduction SEP
G) Elective deferrals and employer contributions (including nonelective deferrals) to a
section 457(b) deferred compensation plan (state and local government and tax-
exempt employers)
H) Elective deferrals to a section 501 (c)(18)(D) tax-exempt organization plan
J) Nontaxable sick pay
K) 20% excise tax on excess golden parachute payments
L) Substantiated employee business expense reimbursements (Federal rate)
M) Uncollected social security or RRTA tax on taxable cost of group-term life insurance
(for former employees)
N) Uncollected Medicare tax on cost of group-term life insurance over $50,000 (forformer employees)
P) Excludable moving expense reimbursements paid directly to employee
Q) Nontaxable combat pay
R) Employer contributions to an archer MSA
S) Employee salary reduction contributions under a section 408(p) SIMPLE
T) Adoption benefits
V) Income from the exercise of nonstatutory stock option(s)
W) Employer contributions to an employee's Health Savings Account (HSA)
Y) Deferrals under a section 409A nonqualified deferred compensation plan
Z) Income under section 409A on a nonqualified deferred compensation plan
AA) Designated Roth contributions to a section 401 (k) plan
BB) Designated Roth contributions under a section 403(b) salary reduction agreement
D-14
W-2, Box 13 - Checkboxes
Statutory employee. Check this box for statutory employees whose earnings are subject to social
security and Medicare taxes but not subject to Federal income tax withholding. Do not checkthis box for common-law employees. There are workers who are independent contactors under the
common-law rules but are treated by statute as employees. They are called statutory employees.
1. A driver who distributes beverages (other than milk), or meat, vegetable, fruit, or bakery
products; or who picks up and delivers laundry or dry cleaning if the driver is your agent oris paid on commission.
2. A full-time life insurance sales agent whose principal business activity is selling lifeinsurance or annuity contracts, or both, primarily for one life insurance company.
3. An individual who works at home on materials or goods that you supply and that must bereturned to you or to a person you name if you also furnish specifications for the work to bedone.
4. A full-time traveling or city salesperson who works on your behalf and turns in orders to you
from wholesalers, retailers, contractors, or operators of hotels, restaurants, or other similarestablishments. The goods sold must be merchandise for resale or supplies for use in thebuyer's business operation. The work performed for you must be the salesperson'sprincipal business activity.
Retirement plan. Check this box if the employee was an active participant (for any part of the year)in any of the following:
1. A qualified pension, profit-sharing, or stock-bonus plan described in section 401 (a)(including a 401 (k) plan).
2. An annuity plan described in section 403(a).
3. An annuity contract or custodial account described in section 403(b).
4. A simplified employee pension (SEP) plan described in section 408(k).
5. A SIMPLE retirement account described in section 408(p).
6. A trust described in section 501 (c)(18).
7. A plan for Federal, state, or local government employees or by an agency or instrumentalitythereof (other than a section 457 plan).
Generally, an employee is an active participant if covered by (a) a defined benefit plan for any taxyear that he or she is eligible to participate or (b) a defined contribution plan (for example, a section401 (k) plan) for any tax year that employer or employee contributions (or forfeitures) are added tohis or her account. For additional information on employees who are eligible to participate in a plan,contact your plan administrator.
Do not check this box for contributions made to a nonqualified or section 457(b) plan.
Third-party sick pay. Check this box only if you are a third-party sick pay payer filing a Form W-2for an insured's employee or are an employer reporting sick pay payments made by a third party.
D-15
DO MOT STAPLE
33333Control number For Official Use Only
OMB Mo. 1545-0808
Kind
of
Payer
I
c Total m
43
941 Militarv 943 94 «l i 1 Wages, tips, oilier compensation
I 220845.10I 2 Federal income tax withheld
I 25435.20
f CT-1
_D __r 01 Form;; Yi/-',>
Hshld. Medicare Third-party I ;emp. oovt. emp. sick pay i c' toCia' security wagesemp. flow. emp.
212 5 3 5.10
4 Social security lax withheld
' 13177.18
i P ii/n-'dicftrf: -v.=ioei;~ and tr
I 230085.10'dicare ta» withheld
3 3 3 6.23
t Employer identification number ;EINj
23-1234567t 7 Social rheumy Tips
f brnplover'a name
XYY COMPANY INC9 Advance EIC pavments
124 W FINE STREET
- ANYTOWN PA 112 34
g Employer's address and ZIP code
h Otlw EiN used tni& year
i 11 Nonqualifies plans
AllocaisrJ tips
10 Dependent care benefits
12 Deferred compensation
! 13 For third-party &ick pay use only
14 Income tax withheld by payer of third-party sick pay
15 Stave Employer's state ID number
PA | 1234 5678! 16 State wages. Tips, etc.
I 234980.27
i i8 Local vvagfcs. tips, etc.
234980.27
Contact person.
Email address
_ < ! _
j Telephone number
j ( ) ■fci>: number
State income tax
7213 .89
13 Local income- tax
2349.80
For Official Use Only
I (Under penalties of perjury7, i declare that I havo examined this rettirn and -accompanying documents. and: to the best of my knowlec'c/e and belief,
they are true, conect, and complete.
Title Date *■
Form W-3 Transmittai of Wage and Tax Statements E D D TSend this entire page with the entire Copy A page of Form(s) W-2 to the Social Security Administration.
Do not send any payment (cash, checks, money orders, etc.) with Forms W-2 and W-3.
Department of the Treasury
Internal RtWtMiut' Sftn.'k;*?
Reminder
Separate instructions. See the 2009 Instructions for Forms W-2
and W-3 for information on completing this form.
Purpose of Form
A Form W-3 Transmittai is completed only when paper Copy A of
Form(s) W-2, Wage and Tax Statement, are being filed. Do not file
Form W-3 alone. Do not file Form W-3 for Form(s) W-2 that were
submitted electronically to the Social Security Administration (see
below). All paper forms must comply with IRS standards and be
machine readable. Photocopies and hand-printed forms are not
acceptable. Use a Form W-3 even if only one paper Form W-2 is
being filed. Make sure both the Form W-3 and Form(s) W-2 show
the correct tax year and Employer Identification Number (EIN). Make
a copy of this form and keep it with Copy D (For Employer) of
Form(s) W-2 for your records.
Electronic Filing
The Social Security Administration strongly suggests employers
report Form W-3 and W-2 Copy A electronically instead of on
paper. SSA provides two e-file options:
• Free online, fill-in Forms W-2 for employers who file 20 or fewer
Form(s) W-2.
• Upload a file for employers who use payroll/tax software to print
Form(s) W-2, if the vendor software creates a file that can be
uploaded to SSA.
For more information, go to www.socialsecurity.gov/employer and
select "First Time Filers" or "Returning Filers" under "BEFORE YOU
FILE."
When To File
Mail any paper Forms W-2 under cover of this Form W-3
Transmittai by March 1, 2010. Electronic fill-in forms or uploads are
filed through SSA's Business Services Online (BSO) Internet site
and will be on time if submitted by March 31, 2010.
Where To File Paper Forms
Send this entire page with the entire Copy A page of Form(s) W-2
to:
Social Security Administration
Data Operations Center
Wilkes-Barre, PA 18769-0001
Note. If you use "Certified Mail" to file, change the ZIP code to
"18769-0002." If you use an IRS-approved private delivery service, add
"ATTN: W-2 Process, 1150 E. Mountain Dr." to the address and change
the ZIP code to "18702-7997." See Publication 15 (Circular E),
Employer's Tax Guide, for a list of IRS-approved private delivery services.
For Privacy Act and Paperwork Reduction Act Notice, see the back of Copy D of Form W-2.
Cat. No. 10159Y
D-16
Form 940 for 2009: Employer's Annual Federal Unemployment (FUTA) Tax ReturnDepartment of the Treasury — Internal Revenue Service OMB No. 1545-0028
(EIN)
Employer identification number
^ame (not your trade name) _
Trarte namp (ii any)
AddressNumber Street
. ■ ■..r;' ,■:; ■■ -T-.
... Suite or room number
City .•■■•State ZIP code
f Return
'" that apply.)
"I 4 a. Amended
I I b. SuccessOrtemployer
I I • ;c. Np.payments to employees
v^.:;- y:-..'i -.V,~
, d;.;EinaJ|:Business closed or
vfc ped paying wages
Read the separate instructions before youifjiKout this form. Please type or priqtjwittiiri tfie boMsyii'*
1 If you were required to pay your state unpfrtployrnent tax iti ..-."> .'•^ *"h v
1a One state only, write the state abbreviation . "■?."". 4.
- OR - ;C: %v %.1 b More than one state (You are a multi-statejsempjbyer)>l.-ti
1a1
2 If you paid wages in a state that is subject to CREDIT REDUCTION
1b CD Check here. Fill out Schedule A.
2 I I Check here. Fill out Schedule A(Form 940), Part 2.
Part 2: Determine your FUTA tax before adjustments for 2009. If any line does NOT apply, leave it blank.
3 Total payments to all employees
4 Payments exempt from FUTA tax 4
Check all that apply: 4a LJ Fringe benefits 4c I I Retirement/Pension 4e I I Other4b I ] Group-term life insurance 4d I I Dependent care
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) 7
8 FUTA tax before adjustments (line 7 x .008 = 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 X .054 = line 9). Then 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), fill out
the worksheet in the instructions. Enter the amount from line 7 of the worksheet 10
11 If credit reduction applies, enter the amount from line 3 of Schedule A (Form 940) . . 11
Part 4: Determine your FUTA tax and balance due or overpayment for 2009. 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 difference 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. For more information on how to pay, see
the separate instructions 14
15 Overpayment (If line 13 is more than line 12, enter the difference on line 15 and check a box
below.) . 15
► You MUST fill out both pages of this form and SIGN it.
Check one: Lj Apply to next return.I I Send a refund.
For Privacy Act and Paperwork Reduction Act Notice, see the back of Form 940-V, Payment Voucher. Cat. No. 11234O Form 940 (2009)
D-17
Name (not your trade name) Employer identification number (EIN)
Part 5: Report your FUTA tax liability by quarter only if line 12 is more than $500. If not
16 Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had no liability fora quarter, leave the line blank.
16a 1st quarter (January 1 - March 31) . .
16b 2nd quarter (April 1 - June 30) .
16c 3rd quarter (July 1 - September 30)
16d 4th quarter (October 1 - December 31)
17 Total tax liability for the year (lines 16a +-16b + 16c + 16d = line 17),.17
16a;
16b
16c
16d
Part 6: May we speak with your third-party desig
Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructionsfor details.
I—I Yes. Designee's name and phone number
D No.
Select a 5-digit Personal Identification Number (PIN) to use when talking to IRS
Part 7: Sign here. You MUST fill out both pages of this form and SIGN it.
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and tothe best of my knowledge and belief, it is true, correct, and complete, and that no part of any payment made to a state
unemployment fund claimed as a credit was, or is to be, deducted from the payments made to employees. Declaration ofpreparer (other than taxpayer) is based on all information of which preparer has any knowledge.
KSign your
name here
Date
Print your
name here
Print your
title here
Best daytime phone
Paid preparer's use only Check if you are self-employed I I
Preparer's name
Preparer's
signature
Firm's name (or yours
if self-employed)
Address
City State
Preparer's
SSN/PTIN
Date
EIN
Phone
ZIP code
( )
Page 2 Form 940 (2009)
D-18
Form 940-V,
Payment Voucher
What Is Form 940-V?
Form 940-V is a transmittal form for your check or
money order. Using Form 940-V allows us to process
your payment more accurately and efficiently. If you
have any balance due of $500 or less on your 2009
Form 940, fill out Form 940-V and send it with your
check or money order. jH
Note. If your balance is more than $500,, jsee Wfien ;{■Must You Deposit Your FUTA Tax? iff:ffei^for Form 940. ":■
How Do You Fill Out Form 940-V?
Type or print clearly.
Box 1. Enter your employer identification
Do not enter your social security number (SS|SI|f
Box 2. Enter the amount of your payment. Be sfte'to
put dollars and cents in the appropriate spaces.
Box 3. Enter your business name and complete
address exactly as they appear on your Form 940.
How Should You Prepare Your Payment?
• Make your chepk or money order payable to the
United §taies* treasury. Do not sencj>'eash.
■■*. On the memo line of yourdkeck'orirnQney order,% write:*'■?■"' s:':s. %.i -■■., '■■■^
->—your EIN, ^^. % %%,Jt
— Form
— 2;pi% % ,|^.-v'""Carefully detacrf'Form 940-V along the dotted line.
Qo not?staple your payment to the voucher.
.tyialf-'your 2009 Form 940, your payment, and Form
940-V in the envelope that came with your 2009
Form 940 instruction booklet. If you do not have
that envelope, use the table in the Instructions for
Form 940 to find the mailing address.
Detach Here and Mail With Your Payment and Form 940.
940-VDepartment of the Treasury
Internal Revenue Service
Payment Voucher
► Do not staple or attach this voucher to your payment.
OMB No. 1545-0028
1 Enter your employer identification number
(EIN).
Enter the amount of your payment. ►
Dollars Cents
3 Enter your business name (individual name if sole proprietor).
Enter your address.
Enter your city, state, and ZIP code.
D-19
D O
Pennsylvania
DEPARTMENTOFREVENUE
REV-1667RAS
(11-08)
Part
IW-2
RECONCILIATION
2009
12345
1a
1b
1c
1d 2 3
Number
ofW-2formsattached
Number
of1099formswithPAwithholdingtax
Number
ofW-2s
reportedonmagnetic
tape(s)
Number
ofW-2s
reportedoncompact
discs
or
Totalcompensation
subject
^
toPAwi
thho
ldin
gta
x*
PAINCOMETAXWITHHELD
$
Part
IIANNUAL
RECONCILIATION
1st
2nd
3rd
4th
Quarter
Quarter
Quarter
Quarter
TOTAL
3.5"floppydiscs
23
Wages
paidsubject
toPAwithholdingtax
61646:
64326^
43533
65473
234980
4619
66
96
27
PA
4 6 tax
43;
43;
980.
579.
withheld
17261
1801i
191$
1833!
27
48
10
13
9134
6579148
L
678
231234567
—|
W-2TRANSMITTAL
DUEDATE
JANUARY
31
Part
III
FORMEDIAREPORTING
NUMBEROFTAPES
NUMBEROFCD's
NUMBEROF
3.5"FLOPPYDISCS
BUSINESSNAMEANDADDRESS
XYZCOMPANYINC
LEGALNAME
TRADENAME
124W
FINESTREET
ADDRESS
ANYTOWNPA11234
CITY,
STATE.
ZIP
DONOTSENDPAYMENTWITHTHISFORM.
Attachaddingmachinetape(s)or
someacceptable
list
ingof
taxwithheld
as
reportedonaccompanyingW-2
form(s)
tosubstantiate
reportedPA
withholdingtax.Thistapeor
list
ingappliesonlyto
paperW-2s,notmedia
reporting.
DATE
DAYTIMETELEPHONE#
EXT.
TITLE
SIGNATURE
FORM 322 ANNUAL RECONCILIATION OF COMPENSATION TAX WITHHELD FROM WAGES FOR 2009
EMPLOYER NAME AND ADDRESS
XYZ COMPANY INC
124 W FINE STREET
ANYTOWN PA 11234
98761522ACCOUNT NO.
FEDERAL E.I.N.
A. THE NUMBER OF W-2. RECORDS REPOR"1""^ LOCAL
COMPENSATION TAX WITHHELD IS , 43
B. ENCLOSE VERIFICATION OF THE TOTAL COMPENSATION TAX
WITHHELD AS REPORTED ON THE W-2 RECORDS SUBMITTED TO
QUARTERLY PAYMENTS BREAKDOWN
TOTAL COMPENSATION TAX REMITTED - JAN 1-
DEC. 31 AS REPORTED ON LINE 1, OF FORM FORM 319
1. QTR. ENDED 3/31
« 616.462. QTR. ENDED 6/30
s 643.26
3. QTR. ENDED 9/30
$ 47T?fi4. QTR. ENDED 12/31
s 616,82
TOTAL TAX REMITTED
SHOULD = ENTRY ON LINE 6. 2349.80
TOTAL TAX WITHHELD AS
REPORTED ON FORMS W-2. 2349.80
THIS BUREAU
YORK ADAMS TAX BUREAU
1405 N. DUKE STREET, P.O. BOX 15627CALCULATOR TAPE OR COMPUTER REPORT. YORK, PA 17405-0156 . PHONE (717) 812-0759
IF OVERPAID CHECK ONE DREFUND.
C. CONTACT PERSON'S NAME (PRINT)
D. ENCLOSE THE FORMS W-2 INFORMATION WITH THIS FORM 322.
QAPPLY TO 2010.
PHONE NO.
FAX NO.
I DECLARE UNDER PENALTIES PROVIDED BV LAW THAT THIS RETURN HAS BEENEXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE IS A TRUE, CORRECT
AND COMPLETE RETURN.
AUTH0AI2E0 SIGNATURE REQUIRED
FORM 322 ANNUAL RECONCILIATION OF COMPENSATION TAX WITHHELD FROM WAGES FOR 2009
EMPLOYER NAME AND ADDRESS
ACCOUNT NO.
NUMBER
PACKAGES
FEDERAL E.I.N.
A. THE NUMBER OF W-2 RECORDS REPORTING LOCAL
COMPENSATION TAX WITHHELD IS
QUARTERLY PAYMENTS BREAKDOWN
TOTAL COMPENSATION TAX REMITTED JAN 1-
DEC. 31 AS REPORTED ON LINE 1, OF FORM FORM 319
1. QTR. ENDED 3/31
$
2. QTR. ENDED 6/30
$
3. QTR. ENDED 9/30
$
A. QTR. ENDED 12/31
$
5TOTAL TAX REMITTED sSHOULD = ENTRY ON LINE 6.
'total tax withheld as sREPORTED ON FORMS W-2. *
B. ENCLOSE VERIFICATION OF THE TOTAL COMPENSATION TAX
WITHHELD AS REPORTED ON THE W-2 RECORDS SUBMITTED TO
THIS BUREAU. EXAMPLE: CALCULATOR TAPE OR COMPUTER REPORT.
IF OVERPAID CHECK ONE nREFUND
C. CONTACT PERSON'S NAME (PRINT)
D. ENCLOSE THE FORMS W-2 INFORMATION WITH THIS FORM 322.
YORK ADAMS TAX BUREAU
1405 N. DUKE STREET, P.O. BOX 15627>A 17405-0156 . PHONE (717) 812-0759
. DAPPLY TO 2010
PHONE NO.
FAX NO.
I DECLARE UNDER PENALTIES PROVIDED BY LAW THAT THIS RETURN HAS BEENEXAMINED BY ME AND TO THE BEST OF MY KNOWLEDGE IS A TRUE, CORRECT
AND COMPLETE RETURN.
AUTHORIZED SIGNATURE REQUIRED
FORM 322 ANNUAL RECONCILIATION OF COMPENSATION TAX WITHHELD FROM WAGES FOR 2009
EMPLOYER NAME AND ADDRESS
ACCOUNT NO.
NUMBER
PACKAGES
FEDERAL E.I.N.
A. THE NUMBER OF W-2 RECORDS REPORTING LOCAL
COMPENSATION TAX WITHHELD IS
QUARTERLY PAYMENTS BREAKDOWN
TOTAL COMPENSATION TAX REMITTED JAN 1-
DEC. 31 AS REPORTED ON LINE 1, OF FORM FORM 319
1. QTR. ENDED 3/31
$
2. QTR. ENDED 6/30
5
3. QTR. ENDED 9/30
$
4. QTR. ENDED 12/31
$
5TOTAL TAX REMITTED sSHOULD = ENTRY ON LINE 6.
6TOTAL TAX WITHHELD AS sREPORTED ON FORMS W-2. *
B. ENCLOSE VERIFICATION OF THE TOTAL COMPENSATION TAX
WITHHELD AS REPORTED ON THE W-2 RECORDS SUBMITTED TO
THIS BUREAU. EXAMPLE: CALCULATOR TAPE OR COMPUTER REPORT.
IF OVERPAID CHECK ONE DREFUND
C. CONTACT PERSON'S NAME (PRINT)
york adams tax bureau
1405 n. duke street, p.o. box 15627
york, pa 17405-0156 . phone (717) 812-0759
Dapply to 2010
PHONE NO.
D. ENCLOSE THE FORMS W-2 INFORMATION WITH THIS FORM 322.
FAX NO._
I DECLARE UNDER PENALTIES PROVIDED 8Y LAW THAT THIS RETURN HAS BEENEXAMINED BY ME ANO TO THE BEST OF MY KNOWLEDGE IS A TRUE. CORRECT
i AND COMPLETE RETURN.AUTH0RI2E0 SICNATURE
D-21
□ VOID CORRECTED
PAYER'S name, street address, city, state, ZIP code, and telephone no.
XYZ COMPANY INC
124 W FINE STREET
ANYTOWN PA 11234
PAYER'S federal identification
number
23-1234567
RECIPIENT'S identification
number
111-22-3333
1 Rents
$2 Royalties
$3 Other income
J_5 Fishing boat proceeds
OMB No. 1545-0115
09
Form 1099-MISC
Miscellaneous
Income
4 Federal income iax withheld
$6 Medical and heaHh care payments
Copy A
For
Internal Revenue
Service Center
File with Form 1096.
RECIPIENT'S name
JACEN C SOLO
7 Nonemployee compensation
$ 4500.00
8 Substitute payments in lieu ol
dividends or interest
$Street address (including apt. no.)
111 ALDER STREET
9 Payer made direct sales of
$5,000 or more of consumer
products to a buyer
(recipient) for resale ► [_J
10 Crop insurance proceeds
City, state, and ZIP code
ANYTOWN PA 11234Account number (see instructions)
11
I* . ■* ■
2nd TIN not.
□
13 Excess golden parachute
payment;
$
14 Gross proceeds paid to
an attorney
$
For Privacy Act
and Paperwork
Reduction Act
Notice, see the
2009 General
Instructions for
Forms 1099,
1098, 3921,
3922, 5498, and
W-2G.
15a Section 409A deferrals
i_
15b Section 409A income 16 State tax withheld 17 State/Payer's state no. 18 State income
.$. .$.$ $
Form 1099-MISC Cat. No. 14425J
Do Not Cut or Separate Forms on This Page — Do Not Cut
Department of the Treasury - Internal Revenue Service
or Separate Forms on This Page
D-22
Do Not Staple
1096Department of the Treasury
(literrial Revenue Service
Annual Summary and Transmittal of
U.S. Information Returns
OMB No. 154S-0108
»©09["FILER'S name
XYZ COMPANY INC
Street address (including room or suite number)
124 W FINE STREET
Cily, state, and ZIP code
ANYTOWN PA 11234
Name of person to contact
JAINA SOLO
Email address
Telephone number
(717)123-4567Fax number
For Official Use Only
niiiiiiim1 Employer identification number
23-1234567
2 Social security number 3 Total number of
forms I
6 Enter an "X" in only one box below to indicate the type of form being filed.
4 Federal income tax withheld 5 Total amount reported with this Form 1096
$4500.00
7 If this is your final return, enter an "X" here . ► □
W-2G
32
□ □
1098-C
78
1098-E
84
□
10B8-T
03
□
1099-A
SO
1099-B
79
□
10SS-C
□
1099-CAP
73
□ □
1099-G
86
□
1099-INT
92
□
1099-LTC
93
□
1099-MISC
85
□
1099-PATR
97
□
1098-Q
□ □
1099-S
□
1099-SA
□
■5498
28
5498-ESA
72
5498-SA
27
□ D
Return this entire page to the Internal Revenue Service. Photocopies are not acceptable.
Under penalties of perjury, I declare that I have examined this return and accompanying documents, and, to the best of my knowledge and belief, they are true,
correct, and complete.
Signature ► Title ► Date ►
Instructions
Reminder. The only acceptable method of filing information returns
with Enterprise Computing Center—Martinsburg (ECC—MTB) is
electronically through the FIRE system. See Pub. 1220,
Specifications for Filing Forms 1098, 1099, 3921, 3922, 5498, and
W-2G Electronically.
Purpose of form. Use this form to transmit paper Forms 1099,
1098, 3921, 3922, 5498, and W-2G to the Internal Revenue Service.
Do not use Form 1096 to transmit electronically. For electronic
submissions, see Pub. 1220, Specifications for Filing Forms 1098,
1099, 3921, 3922, 5498, and W-2G Electronically.
Caution: If you are required to file 250 or more information returns of
any one type, you must file electronically. If you are required to file
electronically but fail to do so, and you do not have an approved
waiver, you may be subject to a penalty. For more information, see
part F in the 2009 General Instructions for Forms 1099, 1098, 3921,
3922, 5498, and W-2G.
Who must file. The name, address, and TIN of the filer on this form
must be the same as those you enter in the upper left area of Forms
1099, 1098, 3921, 3922, 5498, or W-2G. A filer is any person or
entity who files any of the forms shown in line 6 above.
Preaddressed Form 1096. If you received a preaddressed Form
1096 from the IRS with Package 1096, use it to transmit paper
Forms 1099, 1098, 3921, 3922, 5498, and W-2G to the Internal
Revenue Service. If any of the preprinted information is incorrect,
make corrections on the form.
If you are not using a preaddressed form, enter the filer's name,
address (including room, suite, or other unit number), and TIN in the
spaces provided on the form.
When to file. File Form 1096 as follows.
• With Forms 1099, 1098, 3921, 3922, or W-2G, file by
March 1, 2010.
• With Forms 5498, 5498-ESA, or 5498-SA, file by June 1, 2010.
Where To File
Send all information returns filed on paper with Form 1096 to the
following:
If your principal business,
office or agency, or legal
residence in the case of an
individual, is located in
Use the following
three-line address
Alabama, Arizona, Arkansas, Connecticut, Delaware,
Florida, Georgia, Kentucky, Louisiana, Maine,
Massachusetts, Mississippi, New Hampshire,
New Jersey, New Mexico, New York, North Carolina,
Ohio, Pennsylvania, Rhode Island, Texas, Vermont,
Virginia, West Virginia
Department of the Treasury
Internal Revenue Service Center
Austin, TX 73301
For more information and the Privacy Act and Paperwork Reduction Act Notice,
see the 2009 General Instructions for Forms 1099, 1098, 3921, 3922, 5498, and
W-2G.
Cat. No. 144000 Form 1096 (2009)
D-23
OMB No. 1615-0047; Expires 08/31/12
Form 1-9, Employment
Eligibility Verification
Read instructions carefully before completing this form. The instructions must be available during completion of this form.
Department of Homeland Security
U.S. Citizenship and Immigration Services
ANTI-DISCRIMINATION NOTICE: It is illegal to discriminate against work-authorized individuals. Employers CANNOTspecify which document(s) they will accept from an employee. The refusal to hire an individual because the documents have aluture expiration date may also constitute illegal discrimination.
Section 1. Employee Information and Verification (To be completed and signed by employee at the time employment begins.)Print Name: Last _ First Middle Initial I Maiden Name
Address (Street Name and Number) Apt. # Date of Birth (month/day/year)
City State Zip Code Social Security #
I am aware that federal law provides for
imprisonment and/or fines for false statements or
use of false documents in connection with the
completion of this form.
1 attest, under penalty of perjury, that I am (check one of the following):
I \ A citizen of the United States
I I A noncitizen national of the United States (see instructions)
I | A lawful permanent resident (Alien #)
An alien authorized to work (Alien # or Admission #)
until (expiration date, if applicable - monlh/day/year)
Employee's SignatureDate (month/day/year)
Preparer and/or Translator Certification (To be completed and signed ifSection 1 is prepared by a person other than the employee ) J attest underPewlty ofperjury, that I have assisted in the completion ofthisform and that to the best ofmy knowledge the information is true and correct.
Preparer's/Translator's Signature ~~~~ | Print Name
Address (Street Name andNumber, City, State, Zip Code) Date (month/day/year)
Section 2. Employer Review and Verification (To be completed and signed by employer. Examine one documentfrom List A ORexamine one documentfrom List B and onefrom List C, as listed on the reverse ofthis form, and record the title number andexpiration date, ifany, ofthe documents).)
List A OR ListB
Document title:
Issuing authority:
Document #:
Expiration Date (ifany):
Document #:
Expiration Date (ifany):
AND ListC
CERTIFICATION: I attest, under penalty of perjury, that I have examined the document(s) presented by the above-named employee, thatthe above-listed document(s) appear to be genuine and to relate to the employee named, that the employee began employment on
(month/day/year) and that to the best of my knowledge the employee is authorized to work in the United States. (Stateemployment agencies may omit the date the employee began employment.)
Signature of Employer or Authorized Representative Print Name
Business or Organization Name and Address (Street Name and Number, City, Stale, Zip Code)
Title
Date (month/day/year)
ection 3. Updating and Reverification (To be completed and signed by employer.. New Name (ifapplicable) B. Date of Rehire (month/day/year) (ifapplicable)
C. If employee's previous grant of work authorization has expired, provide the information below for the document that establishes current employment authorization.
Document Title: Document #: Expiration Date (ifany):
I attest, under penalty of perjury, that to the best of my knowledge, this employee is authorized to work in the United States, and if the employee presenteddocuments), the documents) I have examined appear to be genuine and to relate to the individual.
Signature ofEmployer or Authorized Representative Date (month/day/year)
Form 1-9 (Rev. 08/07/09) Y Page 4
D-24
217
Required Employer Information
FEIN:
Employer Name:
Address:
Contact Name:
Contact Phone #:
COMMONWEALTH OF PENNSYLVANIA
New Hire Reporting Form
Please mail or fax to:
Commonwealth of Pennsylvania
New Hire Reporting Program
P. O. Box 69400
Harrisburg, PA 17106-9400
Fax: 717-657-HIRE (717-657-4473)
Phone: 1-888-PAHIRES (1-888-724-4737)
(for questions only)
This form can be duplicated
Required Employee Information
Employee Social Security #
Name (first)
Address
City
(Please type or print legibly in black or blue ink.)
Date of Birth (mm/dd/yyyy) optional
(middle) (last)
State
Date of Hire (mm/dd/yyyy)
Zip
Employee Social Security #
Name (first)
Address
City
Date of Birth (mm/dd/yyyy) optional
(middle) (last)
State
Date of Hire (mm/dd/yyyy)
Zip
Employee Social Security #Date of Birth (mm/dd/yyyy) optional Date of Hire (mm/dd/yyyy)
Name (first) (middle) (last)
CityState Zip
Commonwealth of Pennsylvania
New Lending a Hand
Hire to Pennsylvania's
Reporting Children
Department of Labor and Industry Center for Workforce Information and Analysis
Pennsylvania New Hire Reporting Program - 5
D-25
SCHEDULE H
(Form 1040)
Department of the Treasury
Internal Revenue Service (99)
Household Employment Taxes(For Social Security, Medicare, Withheld Income, and Federal Unemployment (FUTA) Taxes)
► Attach to Form 1040,1040NR, 1040-SS, or 1041.
► See separate instructions.
OMB No. 1545-1971
Attachment
Sequence No. 44Name of employer Social security number
Employer identification number
A Did you pay any one household employee cash wages of ^
spouse, your child under age 21, your parent, or anyone undfir
answer this question.) V
in 20099 (If an«
the line A instrf
t
usehold employee was your
fflg on page H-4 before you
D Yes. Skip lines B and C and go to line 1
□ No. GC.NneB. , *
-— If <jB Did you withhold federal income ta*Sdu);#ig 2009 for any household
I□ Yes. Skip line C and go to|jne1
□ No. Go to line C.hi t"
ss t-.
4 . v'i „-»„ t* *■
C Did you pay total cash wages of $fi OOm^r mdje in any calendar quarter of 2008 or 2009 to all household employees?
(Do not count cash wages paid in 2Qbj8 o'B'OOSHo your spouse, your child under age 21, or your parent.)
□ No. Stop. Do not file this schedule
D Yes. Skip lines 1-9 and go to line 10 on the back. (Calendar year taxpayers having no household employees in2009 do not have to complete this form for 2009.)
|^SU Social Security, Medicare, and Federal Income Taxes
1 Total cash wages subject to social security taxes (see page H-4) . .
2 Social security taxes. Multiply line 1 by 12.4% (.124)
3 Total cash wages subject to Medicare taxes (see page H-4) ....
4 Medicare taxes. Multiply line 3 by 2.9% (.029)
5 Federal income tax withheld, if any
6 Total social security, Medicare, and federal income taxes. Add lines 2, 4, and 5
7 Advance earned income credit (EIC) payments, if any
8 Net taxes (subtract line 7 from line 6) 8
9 Did you pay total cash wages of $1,000 or more in any calendar quarter of 2008 or 2009 to all household employees?
(Do not count cash wages paid in 2008 or 2009 to your spouse, your child under age 21, or your parent.)
CD No. Stop. Include the amount from line 8 above on Form 1040, line 59, and check box b on that line. If you are notrequired to file Form 1040, see the line 9 instructions on page H-4.
□ Yes. Goto line 10 on the back.
For Privacy Act and Paperwork Reduction Act Notice, see page H-7 of the instructions. Cat. No. 12187K Schedule H (Form 1040) 2009
D-26
Schedule H (Form 1040) 2009 Page 2
Federal Unemployment (FUTA) Tax
10 Did you pay unemployment contributions to only one state? (If you paid contributions to XXXXX, check "No.")
11 Did you pay all state unemployment contributions for 2009 by April 15, 2010? Fiscal yeaffilers, see page H-4
12 Were all wages that are taxable for FUTA tax also taxable for your state's unemploymentt&x9 .
' 4
10
11
12
Yes No
Next: If you checked the "Yes" box on all the lines above, complete Section A %~ *. f
If you checked the "No" box on any of the lines above, skip Section A and compfate Section B.Section A
13 Name of the state where you paid unemployment contributions^*-^.. **
14 State reporting number as shown on state unempjoyment tax retu
15 Contributions paid to your state unemploymervMtmi (see page H-5)16 Total cash wages subject to FUTA tax (s,.eefpagi|jH-5)^ "
17 FUTA tax. Multiply line 16-^'odi^nfflthe rel'ult here ski
18 Complete all columns below t
State reporting number
as shown on state
unemployment tax
return
(c)Taxable wages (
defined in state
(0Multiply col. (c)
by .054
(g)Multiply col. (c)
by col. (e)
Subtract col. (g)
from col. (f). If
zero or less,
enter-0-.
Contributions
paid to state
unemployment
fund
19 Totals
20 Add columns (h) and (i) of line 19
21 Total cash wages subject to FUTA tax (see the line 16 instructions on page H-5)
22 Multiply line 21 by 6.2% (.062)
23 Multiply line 21 by 5.4% (.054) I 23
24 Enter the smaller of line 20 or line 23
(XXXX employers must use the worksheet in the separate instructions and check here) .
25 FUTA tax. Subtract line 24 from line 22. Enter the result here and go to line 26Total Household Employment Taxes
26 Enter the amount from line 8. If you checked the "Yes" box on line C of page 1, enter -0-
27 Add line 17 (or line 25) and line 26 (see page H-5)
28 Are you required to file Form 1040?
26
27
D Yes. Stop. Include the amount from line 27 above on Form 1040, line 59, and check box b on that line. Do not completePart IV below.
D No. You may have to complete Part IV. See page H-5 for details-
Address and Signature— Complete this part only if required. See the line 28 instructions on page H-5.Address (number and street) or P.O. box if mail is not delivered to street address Apt., room, or suite no
City, town or post office, state, and ZIP code
Under penalties of perjury, I declare that I have examined this schedule, including accompanying statements, and to the best of my knowledge and belief, it is true,correct, and complete. No part of any payment made to a state unemployment fund claimed as a credit was, or is to be, deducted from the payments to employees'Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
► Employer's signature Date
Paid
Preparer's
Use Only
Preparer's
signature
Firm's name (or
yours if self-employed),address, and Zip code
DateCheck if __
self-employed I I
Preparer's SSN or PTIN
EIN
Phone no.
Schedule H (Form 1040) 2009
D-27
AMOUNT OF DEPOSIT (Do NOT type, please print.)
MONTH TAX
YEAR ENDS
EMPLOYER IDENTIFICATION NUMBER
BANK NAME/
DATE STAMP
Federal Tax Deposit Coupon
Form 8109-B p*,. 12-2006)
SEPARATE ALONG THIS LINE AND SUBMIT TO DEPOSIT
What's new. The oval for Form 990-C has been deleted. Form 990-C
has been replaced by Form 1120-C, U.S. Income Tax Return for
Cooperative Associations. Filers of Form 1120-C must use the 1120 ovalwhen completing Form 8109-B.
The type of tax ovals for the 1120, 1042, and 944 have been moved
on the coupon. Read the type of tax to the right of the oval before youdarken the oval.
Note. Except for the name, address, and telephone number, entries must
be made in pencil. Use soft lead (for example, a #2 pencil) so that the
entries can be read more accurately by optical scanning equipment. The
name, address, and telephone number may be completed other than by
hand. You cannot use photocopies of the coupons to make your
deposits. Do not staple, tape, or fold the coupons.
The IRS encourages you to make federal tax deposits using the
Electronic Federal Tax Payment System (EFTPS). For more infoi
on EFTPS, go to www.eftps.gov or call 1 -800-555-4477.
Purpose of form. Use Form 8109-B to make a tax deposit
following two situations.
1. You have not yet received your resupply of preprinteeH^ftaositcoupons (Form 8109).
2. You are a new entity and have already been a:
identification number (EIN), but you have not
of preprinted deposit coupons (Form 8109). lf|
EIN, see Exceptions below.
Note. If you do not receive your resupply of d'
deposit is due or you do not receive your ii
of receipt of your EIN, call 1 -800-829-49;
How to complete the form. Enter,
or other IRS correspondence, adi
Do not make a name or address chanj_Change of Address). If you are required
990-PF (with net investment in
which your tax year ends in tt
example, if your tax year ends
December, enter 12. Mak
ENDS (if applicable) as
Exceptions. Ifflpu hlfc appl
a deposit mu
payment to t
or money o
your name (as
Identifcation Nu
you applied for an El
rn on your retu
the spaces^
form (see I
•a Form 1iafcli20-C'2438, (
lONTH TAX YEAR ENDS tluary, enter 01; if it ends in*
for EIN and MONTH TAX YEAR
iunt of deposit below,
for an EIN, have not received it, and
Form 8109-B. Instead, send your
iere you file your return. Make your checkto the United States Treasury and show on it
~orm SS-4, Application for Employer
Iress, kind of tax, period covered, and date
not use Form 8109-B to deposit delinquent
taxes assessed by the IRS. Pay those taxes directly to the IRS. See Pub.
15 (Circular E), Employer's Tax Guide, for information.
Amount of deposit. Enter the amount of the deposit in the space
provided. Enter the amount legibly, forming the characters as shownbelow:
OMB NO. 1545-0257
►without using dollar signs, commas, ajjng zeros. If the deposit is for whole dollars only,
' oxes. For example, a deposit of $7,635.22
III2I3I4I5[6I7I8HIOI
_ n. Darken onT^bgpace for TYPE OF TAX and only one spaceWAX PERIOD. Darken^space to the left of the applicable form and
wperiod. Darkening the mQg space or multiple spaces may delay
proper creditm^b your account. See below for an explanation of Typesof Tax and MXkthe Proper Tax Period.
Types °ijK^^^&Form 94flf EmMiyer's QUARTERLY Federal Tax Return (includes
■ 941-M, 941-PR, and 941-SS)
Boyer's Annual Tax Return for Agricultural EmployeesEmployer's ANNUAL Federal Tax Return (includes Forms
*"44-PR, 944(SP), and 944-SS)1.945 Annual Return of Withheld Federal Income Tax
Quarterly Federal Excise Tax Return
Employer's Annual Railroad Retirement Tax Return
Employer's Annual Federal Unemployment (FUTA) Tax
Return (includes Form 940-PR)
Form 1120 U.S. Corporation Income Tax Return (includes Form 1120
series of returns, such as new Form 1120-C, and
Form 2438)
Form 990-T Exempt Organization Business Income Tax Return
Form 990-PF Return of Private Foundation or Section 4947(a)(1) Nonexempt
Charitable Trust Treated as a Private Foundation
Form 1042 Annual Withholding Tax Return for U.S. Source Income of
Foreign Persons
Marking the Proper Tax Period
Payroll taxes and withholding. For Forms 941, 940, 943, 944, 945,
CT-1, and 1042, if your liability was incurred during:
• January 1 through March 31, darken the 1st quarter space;
• April 1 through June 30, darken the 2nd quarter space;
• July 1 through September 30, darken the 3rd quarter space; and
• October 1 through December 31, darken the 4th quarter space.
Note. If the liability was incurred during one quarter and deposited in
another quarter, darken the space for the quarter in which the tax liability
was incurred. For example, if the liability was incurred in March and
deposited in April, darken the 1st quarter space.
Excise taxes. For Form 720, follow the instructions above for Forms
941, 940, etc. For Form 990-PF, with net investment Income, follow the
instructions on page 2 for Form 1120, 990-T, and 2438.
Department of the Treasury
Internal Revenue Service
Form 8109-B (Rev. 12-2006)
Cat. No. 61042S
D-28
E-Tides Pennsylvania Business Tax System Page 1 of 1
Payment Successfully Submitted
Employer Deposit Statement Of Withholding Tax
Business Name
XYZ COMPANYINC
Period Start Date
9/1/2009
Transaction Effective
Date
10/7/2009
Employer Withholding
Tax
Account Number
1234 5678
Period End Date
9/30/2009
Time Filed
10/7/2009 10:52:04
AM
Entity ID# (EIN)
23-1234567
Due Date
10/15/2009
Tax Period
September 2009: PA-
501
Tax Rate: 3.07000%
1
2
3
Total Compensation Subject to PA Tax:
PA Withholding Tax:
Less Credits:
[10,066.25
309.04
0.00
Payment: $ 309.04
Payment Method ACH Debit (EFT) Payment Through E-Tides
Filed By
CO CONTACT
Transaction ID
Not Assigned
Status
Complete
https://www. eti des. state .pa.us/Default. aspx 10/7/2009
D-29
DO NOT CUT, FOLD, OR STAPLE THIS FORM
M "4 4 M M
a Employer's ne
XYZ
124
ANYT
For Official Use Only ►
OMB No, 1545-0008
me. address, and ZIP code
COMPANY INC
W FINE STREET
OWN PA 112 34
b Employer's Federal EIN
23-1234567
Note: Only complete money fields that are being corrected
(exception: for corrections involving MQGE, see the Instructionsfor Forms W-2c and W-3c, boxes 5 and 6).
Previously reported
1 Wages, tips, other compensation
92400.00
3 Social security wages
92400.00
5 Medicare wages and tips
92400. 00
7 Social security tips
9 Advance EIC payment
11 Nonqualified plans
13 Statutory Kellrpineiu Tlrint-partvprnploveii plan sitt. nav
□ □ n14 Other (see instructions)
Correct information
1 Wages, tips, other compensation
95000.00
3 Social security wages
95000.00
5 Medicare wages and tips
95000.00 _j
7 Social security tips
9 Advance EIC payment
11 Nonqualified plans
13 Statutory Retirement 1 hint-party
ampUiyee plan skk nay
□ n it14 Other (sse instructions)
c Tax year/r-orm corrected
2 0 0 9 / W-2
d Employees correct SSN
222-33-7777
e Corrected SSN and/oi name (Check this box and complete boxes f and/or
g if incorrect on form previously filed.) r~i
Complete boxes f and/or g only it incorrect on form previously filed ►
f Employee's previously reported SSN
g Employee's previously reported name
h Emplo
JA]
777
ANY
i Emplo
yee's first name and initial
:na
Last name
SOLO
Sufi
SKY LANE
TOWN PA 11234
yee's address and ZIP code
Previously reported
2 Federal income tax withheld
12574 .00
4 Social security tax withheld
5728.80
6 Medicare tax withheld
1339.80
8 Allocated tips
10 Dependent care benefits
12a See Io
d
12bc
3
12ct:
? ,., .
12d
istructions for box 12
Correct information
2 Federal income tax withheld
23750.00 .
4 Social security tax withheld
5890.00
6 Medicare tax withheld
1377.50
8 Allocated tips
10 Dependent care benefits
12a See instructions for box 12
12b
12c
12d
Stale Correction Information
Previously reported15 State
PA
Employer s state ID number
1234 5678
16 State wages, tips, etc.
92400.00
17 State income tax
2574.20
Correct information
15 State
PA
Employer's state ID number
1234 5678
16 State wages, tips. etc.
95000.00
17 State income tax
2916.50
. Previously reported
15 State
Employer's state ID number
16 State wages, tips, etc.
17 State income lax
Correct information
15 State
Employer's state ID number
16 State wages, tips. etc.
17 State income lax
Locality Correction information
Previously reported
18 Local wages, tips, etc.
92400.00
19 Local income tax
838.50
20 Locality name
ANYTOWN
Correct information
18 Local wages, tips, etc. ^ -
95000.00
19 Local income tax
950.00
20 Locality name
ANYTOWN
Previously reported
Vaf* to6aVwages, tips, etc.
19 Local income tax
20 Locality name
Correct information
18 Local wages, tips, etc.
19 Local income tax
20 Locality name
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Form W-2C (Rev. 2-2009) Corrected Wage and Tax Statement
Copy A—For Social Security Administration
Department of the Treasury
Cat. No. 61437D Internal Revenue Service
D-30
DO NOT CUT, FOLD, OR STAPLE
SSSS5Tax year/Form corrected
...20.09./W-.3...For Official Use Only
OMB No. 1545-0008
b Employer's name, address, and ZIP code
XYZ COMPANY INC
124 W FINE STREET
ANYTOWN PA 11234
d Number of Forms W-2c
1
Complete boxes h. i. or j only il
incorrect on last form filed.
e Employer's Federal EIN
23-1234567
h Employer's incorrect Federal EIN
Kind
of
Payer
941/941 -S3
CT-1
□f Establishment number
Military 943 944/944-SS
□ □ □Hshld. Medicare Third-party
emp. qovt. emp. sick pay
□ D Dg Employer's state ID number
i Incorrect: establishment number j Employers incorrect stats ID number
Total of amounts previously reported
as shown on enclosed Forms W-2c.
Total of corrected amounts as
shown on enclosed Forms W-2c.
Total of amounts previously reported
as shown on enclosed Forms W-2c.
Total of corrected amounts as
shown on enclosed Forms W-2c,
1 Wages, tips, other compensation
92400.00
1 Wages, tips, other compensation
95000.00
2 Federal income tax withheld
12574 .00
2 Federal income tax withheld
23750.00
3 Social security wages
92400.003 Social security wages
95000.00
4 Social security tax withheld
5728 .80
4 Social security tax withheld
5890.005 Medicare wages and lips
92400'. 005 Medicare wages and tips
95000.00
6 Medicare tax withheld
1339.80
6 Medicare tax withheld
1377.50
7 Social security tips 7 Social security tips 8 Allocated tips 8 Allocated tips
9 Advance EIC payments 9 Advance EIC payments 10 Dependent care benefits 10 Dependent care benefits
11 Nonqualified plans 11 Nonqualified plans 12a-d {Coded items) 12a-d (Coded items)
14 inc. iax vV/H by 3rd party siuk pay payer 14 Inc. tax VV/H by 3rd party sick pay payer
16 Stale wages, tips. etc.
92400.00
■\A^s<:-:"^v:**c^-**r'::,-c "-■y^-;
16 State wages, tips, etc.
95000.0017 State income tax
2574 .2017 State income tax
2574.20
18 Local wages, tips. etc.
92400.00
18 Local wages, tips, etc.
95000.0019 Local income tax
838.50
19 Local income tax
950.00
Explain decreases here:
Has an adjustment been made on an employment tax return filed with the Internal Revenue Service? D Yes D No
If "Yes," give date the return was filed
Under penalties of perjury, I declare that I have examined this return, including accompanying documents, and. to the best of my knowledge and belief, it is truecorrect, and complete.
Signature t* Title Date
Contact person
Email address
Telephone number
Fax number
For Official Use Only
Form W-3c (Rev. 2-2009) Transmittal of Corrected Wage and Tax StatementsDepartment of the Treasury
Internal Revenue Service
Purpose of Form
Use this form to transmit Copy A of Form(s) W-2c, Corrected Wageand Tax Statement (Rev. 2-2009). Make a copy of Form W-3c and
keep it with Copy D (For Employer) of Forms W-2c for your records.File Form W-3c even if only one Form W-2c is being filed or if thoseForms W-2c are being filed only to correct an employee's name andsocial security number (SSN), or the employer identification number
(EIN). See the separate Instructions for Forms W-2c and W-3c forinformation on completing this form.
When To File
File this form and Copy A of Form(s) W-2c with the Social Security
Administration as soon as possible after you discover an error on
Forms W-2, W-2AS, W-2GU, W-2CM, W-2VI, or W-2c. Provide Copies
B, C, and 2 of Form W-2c to your employees as soon as possible.
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.
Where To File
If you use the U.S. Postal Service, send Forms W-2c and W-3c to thefollowing address:
Social Security Administration
Data Operations Center
P.O. Box 3333
Wilkes-Barre, PA 18767-3333
If you use a carrier other than the U.S. Postal Service, send Forms
W-2c and W-3c to the following address:
Social Security Administration
Data Operations Center
Attn: W-2c Process
1150 E. Mountain Drive
Wilkes-Barre, PA 18702-7997
Cat. No. 10164R
D-31
Form W-4 (2009)
Purpose. Complete Form W-4 so that your
employer can withhold the correct federal incometax from your pay. Consider completing a new
Form W-4 each year and when your personal or
financial situation changes.
Exemption from withholding. If you are
exempt, complete only lines 1,2,3, 4, and 7
and sign the form to validate it. Your exemption
for 2009 expires February 16, 2010. See
Pub. 505, Tax Withholding and Estimated Tax.
Note. You cannot claim exemption from
withholding if (a) your income exceeds $950
and includes more than $300 of unearned
income (for example, interest and dividends)
and (b) another person can claim you as adependent on their tax return.
Basic instructions. If you are not exempt,
complete the Personal Allowances Worksheet
below. The worksheets on page 2 further adjust
your withholding allowances based on itemized
deductions, certain credits, adjustments to
income, or two-earner/multiple job situations.
Complete all worksheets that apply. However, you
may claim fewer (or zero) allowances. For regular
wages, withholding must be based on allowances
you claimed and may not be a flat amount or
percentage of wages.
Head of household. Generally, you may claim
head of household filing status on your tax
return only if you are unmarried and pay more
than 50% of the costs of keeping up a home
for yourself and your dependent(s) or other
qualifying individuals. See Pub. 501,
Exemptions, Standard Deduction, and Filing
Information, for information.
Tax credits. You can take projected tax
credits into account in figuring your allowable
number of withholding allowances. Credits for
child or dependent care expenses and the
child tax credit may be claimed using the
Personal Allowances Worksheet below. See
Pub. 919, How Do I Adjust My Tax
Withholding, for information on converting
your other credits into withholding allowances.
Nonwage income. If you have a large amount
of nonwage income, such as interest or
dividends, consider making estimated tax
payments using Form 1040-ES, Estimated Tax
for Individuals. Otherwise, you may owe
additional tax. If you have pension or annuity
income, see Pub. 919 to find out if you should
adjust your withholding on Form W-4 or W-4P.
Two earners or multiple jobs. If you have a
working spouse or more than one job, figure
the total number of allowances you are entitled
to claim on all jobs using worksheets from only
one Form W-4. Your withholding usually will
be most accurate when all allowances are
claimed on the Form W-4 for the highest
paying job and zero allowances are claimed on
the others. See Pub. 919 for details.
Nonresident alien. If you are a nonresident
alien, see the Instructions for Form 8233
before completing this Form W-4.
Check your withholding. After your Form W-4
takes effect, use Pub. 919 to see how the
amount you are having withheld compares to
your projected total tax for 2009. See Pub.
919, especially if your earnings exceed
$130,000 (Single) or $180,000 (Married).
Personal Allowances Worksheet (Keep for your records.)
A Enter "1" for yourself if no one else can claim you as a dependent A _
f • You are single and have only one job; or "I
B Enter "1" if: < • You are married, have only one job, and your spouse does not work; or I ■ ■ ^ —[ • Your wages from a second job or your spouse's wages (or the total of both) are $1,500 or less, j
C Enter "1" for your spouse. But, you may choose to enter "-0-" if you are married and have either a working spouse or
more than one job. (Entering "-0-" may help you avoid having too little tax withheld.) ■ . C _
D Enter number of dependents (other than your spouse or yourself) you will claim on your tax return D _
E Enter "1" if you will file as head of household on your tax return (see conditions under Head of household above) . E _
F Enter "1" if you have at least $1,800 of child or dependent care expenses for which you plan to claim a credit . . F _
(Note. Do not include child support payments. See Pub. 503, Child and Dependent Care Expenses, for details.)
G Child Tax Credit (including additional child tax credit). See Pub. 972, Child Tax Credit, for more information.
• If your total income will be less than $61,000 ($90,000 if married), enter "2" for each eligible child; then less "1" if you have three or more eligible children.
• If your total income will be between $61,000 and $84,000 ($90,000 and $119,000 if married), enter "1" for each eligible
child plus "1" additional if you have six or more eligible children. G _
H Add lines A through G and enter total here. (Note. This may be different from the number of exemptions you claim on your tax return.) ► H —
For accuracy,
complete all
worksheets
that apply.
• If you plan to itemize or claim adjustments to income and want to reduce your withholding, see the Deductions
and Adjustments Worksheet on page 2.
• If you have more than one job or are married and you and your spouse both work and the combined earnings from all jobs exceed
$40,000 ($25,000 if married), see the Two-Earners/Multiple Jobs Worksheet on page 2 to avoid having too little tax withheld.
> If neither of the above situations applies, stop here and enter the number from line H on line 5 of Form W-4 below.
W-4Form
Department of the Treasury
Internal Revenue Service
Cut here and give Form W-4 to your employer. Keep the top part for your records.
Employee's Withholding Allowance Certificate
► Whether you are entitled to claim a certain number of allowances or exemption from withholding is
subject to review by the IRS. Your employer may be required to send a copy of this form to the IRS.
OMB No. 1545-0074
1 Type or print your first name and middle initial. Last name 2 Your social security number
Home address (number and street or rural route) Cl Single CD Married CD Married, but withhold at higher Single rate.Note. If married, bul legally separated, or spouse is a nonresident alien, check the "Single" box.
City or town, state, and ZIP code 4 If your last name differs from that shown on your social security card,
check here. You must call 1-800-772-1213 for a replacement card. ► □
5 Total number of allowances you are claiming (from line H above or from the applicable worksheet on page 2)
6 Additional amount, if any, you want withheld from each paycheck
7 I claim exemption from withholding for 2009, and I certify that I meet both of the following conditions for exemption.
• Last year I had a right to a refund of all federal income tax withheld because I had no tax liability and
• This year I expect a refund of all federal income tax withheld because I expect to have no tax liability.
If you meet both conditions, write "Exempt" here ► |~Under penalties of perjury. I declare that I have examined this certificate and to the best of my knowledge and belief, it is true, correct, and complete.
Employee's signature
(Form is not valid unless you sign it.) ►• Date ►
8 Employer's name and address (Employer: Complete lines 8 and 10 only if sending to the IRS.) 9 Office code (optional) 10 Employer identification number (EIN)
For Privacy Act and Paperwork Reduction Act Notice, see page 2. Cat. No. 10220Q Form W-4 (2009)
D-32
11/10/2008 11:33:23 AM
W-4VForm
(Rev. August 2006)
Department of the Treasury
Internal Revenue Service
Voluntary Withholding Request
(For unemployment compensation and certain federal government payments.)
Instructions
Purpose of Form
If you receive any government payment shown below, you
may use Form W-4V to ask the payer to withhold federal
income tax.
• Unemployment compensation (including Railroad
Unemployment Insurance Act (RUIA) payments),
• Social security benefits,
• Social security equivalent Tier 1 railroad retirement
benefits,
• Commodity Credit Corporation loans, or
• Certain crop disaster payments under the Agricultural Act
of 1949 or under Title II of the Disaster Assistance Act
of 1988.
You are not required to have federal income tax withheld
from these payments. Your request is voluntary.
Note. Payers may develop their own form for you to request
federal income tax withholding. If a payer gives you its own
form instead of Form W-4V, use that form.
Why Should I Request Withholding?
You may find that having federal income tax withheld from
the listed payments is more convenient than making quarterly
estimated tax payments. However, if you have other income
that is not subject to withholding, consider making estimated
tax payments. For more details, see Form 1040-ES,
Estimated Tax for Individuals.
How Much Can I Have Withheld?
For unemployment compensation, the payer is permitted to
withhold 10% from each payment. No other percentage or
amount is allowed.
For any other government payment listed above, you may
choose to have the payer withhold federal income tax of 7%,
10%, 15%, or 25% from each payment, but no otherpercentage or amount.
Detach
What Do I Need To Do?
Complete lines 1—4; check one box on line 5, 6, or 7; sign
Form W-4V; and give it to the payer, not to the IRS.
Note. For withholding on social security benefits, give or
send the completed Form W-4V to your local Social Security
office.
Line 3. If your address is outside the United States or the
U.S. possessions, enter on line 3 the city, province or state,
and name of the country. Follow the country's practice for
entering the postal code. Do not abbreviate the country
name.
Line 5. If you want federal income tax withheld from your
unemployment compensation, check the box on line 5. The
payer will withhold 10% from each payment.
Line 6. If you receive any of the payments listed on line 6,
check the box to indicate the percentage (7%, 10%, 15%, or
25%) you want withheld from each payment.
Line 7. See How Do I Stop Withholding? below.
Sign this form. Form W-4V is not considered valid unless
you sign it.
When Will My Withholding Start?
Ask your payer exactly when income tax withholding will
begin. The federal income tax withholding you choose on this
form will remain in effect until you change it, stop it, or the
payments stop.
How Do I Change Withholding?
If you are getting a payment other than unemployment
compensation and want to change your withholding rate,
complete a new Form W-4V. Give the new form to the payer.
How Do I Stop Withholding?
If you want to stop withholding, complete a new Form W-4V.
After completing lines 1-4, check the box on line 7, and sign
and date the form; then give the new form to the payer.
here
Form W-4V(Rev. August 2006)
Department of the Treasury
Internal Revenue Service
Voluntary Withholding Request
(For unemployment compensation and certain federal government payments.)
► Give this form to your payer. Do not send it to the IRS.
OMB No. 1545-0074
1 Type or print your first name and middle initial. Last name 2 Your social security number
3 Home address (number and street or rural route) City or town State ZIP code
4 Claim or identification number (if any) you use with your payer (for social security benefits, enter nine-digit number followed by the letter)
5 Q I want federal income tax withheld from my unemployment compensation at a rate of 10% of each payment.
6 I want federal income tax withheld from my (a) social security benefits, (b) social security equivalent Tier 1 railroadretirement benefits, (c) Commodity Credit Corporation loans, or (d) certain crop disaster payments under the AgriculturalAct of 1949 or under Title II of the Disaster Assistance Act of 1988, at the rate of (check one):
7%Q 10% □ 15% □ 25% □
7 LJ I want you to stop withholding federal income tax from my payment(s).
Your signature ► Date ►
BKA For Privacy Act and Paperwork Reduction Act Notice, see page 2. Form W-4V (Rev. 8-2006)
WK4 P FDN1A4 -001 29
D-33
Form W-4SDepartment of the Treasury
Internal Revenue Service
Request for Federal Income Tax
Withholding From Sick Pay
►• Give this form to the third-party payer of your sick pay.
OMB No. 1545-0074
Type or print your first name and middle initial. Last name Your social security number
Home address (number and street or rural route)
City or town, state, and ZIP code
Claim or identification number (if any)
I request federal income tax withholding from my sick pay payments. I want the following amount to be withheld fromeach payment. (See Worksheet below.)
Employee's signature ►Date ►
Cut here and give the top part of this form to the payer. Keep the lower part for your records. -
Worksheet (Keep for your records. Do not send to the Internal Revenue Service.)
1 Enter amount of adjusted gross income that you expect in 2009
2 If you plan to itemize deductions on Schedule A (Form 1040), enter the estimated total of your deductions.
For 2009, you may have to reduce your itemized deductions if your income is over $166,800
($83,400 if married filing separately). See Pub. 919, How Do I Adjust My Tax Withholding, for details. Call
1-800-829-3676 or visit the IRS website at www.irs.gov to order forms and publications. If you do not plan
to itemize deductions, enter the standard deduction, including additional amounts for age and blindness, and
any additional standard deduction for real estate taxes or a disaster loss
3 Subtract line 2 from line 1
4 Exemptions. Multiply $3,650 by the number of personal exemptions. For 2009, your personal exemption(s)
amount is reduced if your income is over $166,800 if single, $250,200 if married filing jointly or qualifying
widow(er), $125,100 if married filing separately, or $208,500 if head of household. See Pub. 919 for details
5 Subtract line 4 from line 3
6 Tax. Figure your tax on line 5 by using the 2009 Tax Rate Schedule X, Y, or Z on page 2. Do not use the Tax
Table or Tax Rate Schedule X, Y, or Z in the 2008 Form 1040, 1040A, or 1040EZ instructions
7 Credits (child tax and higher education credits, credit for child and dependent care expenses, etc.) .
8 Subtract line 7 from line 6
9 Estimated federal income tax withheld and to be withheld from other sources (including amounts withheld
due to a prior Form W-4S) during 2009 or paid with Form 1040-ES
10 Subtract line 9 from line 8
11 Enter the number of sick pay payments you expect to receive this year to which this Form W-4S will apply.
12 Divide line 10 by line 11. Round to the nearest dollar. This is the amount that should be withheld from each
sick pay payment. Be sure it meets the requirements for the amount that should be withheld, as explained
under Amount to be withheld below. If it does, enter this amount on Form W-4S above
10
11
General InstructionsPurpose of form. Give this form to the third-party payer of your sick
pay, such as an insurance company, if you want federal Income tax
withheld from the payments. You are not required to have federalincome tax withheld from sick pay paid by a third party. However, if
you choose to request such withholding, Internal Revenue Code
sections 3402(o) and 6109 and their regulations require you to
provide the information requested on this form. Do not use this formif your employer (or its agent) makes the payments becauseemployers are already required to withhold federal income tax fromsick pay.
Note. If you receive sick pay under a collective bargaining
agreement, see your union representative or employer.
Definition. Sick pay is a payment that you receive:
• Under a plan to which your employer is a party and
• In place of wages for any period when you are temporarily
absent from work because of your sickness or injury.
Amount to be withheld. Enter on this form the amount that youwant withheld from each payment. The amount that you enter:
• Must be in whole dollars (for example, $35, not $34.50).
• Must be at least $4 per day, $20 per week, or $88 per monthbased on your payroll period.
• Must not reduce the net amount of each sick pay payment that
you receive to less than $10.
For payments larger or smaller than a regular full payment of sick
pay, the amount withheld will be in the same proportion as your
regular withholding from sick pay. For example, if your regular full
payment of $100 a week normally has $25 (25%) withheld, then $20(25%) will be withheld from a partial payment of $80.
Caution. You may be subject to a penalty if your tax payments
during the year are not at least 90% of the tax shown on your tax
return. For exceptions and details, see Pub. 505, Tax Withholding
and Estimated Tax. You may pay tax during the year through
withholding or estimated tax payments or both. To avoid a penalty,
make sure that you have enough tax withheld or make estimated tax
payments using Form 1040-ES, Estimated Tax for Individuals. You
may estimate your federal income tax liability by using the worksheetabove.
(continued on back)
For Paperwork Reduction Act Notice, see page 2. Cat. No. 10226E Form W-4S (2009)
D-34
©09 Form W-5Department of the Treasury
Internal Revenue Service
(Rev. January 2009)
Instructions
What's New
Definition of qualifying child revised
The following changes have been made to the definition of a
qualifying child.
• Your qualifying child must be younger than you.
• A child cannot be your qualifying child if he or she files a joint
return, unless the return was filed only as a claim for refund.
• If the parents of a child can claim the child as a qualifying child
but no parent so claims the child, no one else can claim the child
as a qualifying child unless that person's AGI is higher than the
highest AGI of any parent of the child.
Purpose of Form
Use Form W-5 if you are eligible to get part of the earned income
credit (EIC) in advance with your pay and choose to do so. See
Who Is Eligible To Get Advance EIC Payments? below. The
amount you can get in advance generally depends on your
wages. If you are married, the amount of your advance EIC
payments also depends on whether your spouse has filed a Form
W-5 with his or her employer. However, your employer cannot
give you more than $1,826 throughout 2009 with your pay. You
will get the rest of any EIC you are entitled to when you file your
tax return and claim the EIC.
If you do not choose to get advance payments, you can still
claim the EIC on your 2009 tax return.
What Is the EIC?
The EIC is a credit for certain workers. It reduces the tax you
owe. It may give you a refund even if you do not owe any tax.
Who Is Eligible To Get Advance EIC
Payments?
You are eligible to get advance EIC payments if all four of the
following apply.
1. You (and your spouse, if filing a joint return) have a valid
social security number (SSN) issued by the Social Security
Administration. For more information on valid SSNs, see Pub.
596, Earned Income Credit (EIC).
2. You expect to have at least one qualifying child and to be
able to claim the credit using that child. If you do not expect to
have a qualifying child, you may still be eligible for the EIC, but
you cannot receive advance EIC payments. See Who Is a
Qualifying Child? on page 3.
3. You expect that your 2009 earned income and adjusted
gross income (AGI) will each be less than $35,463 ($38,583 if you
expect to file a joint return for 2009). Include your spouse's
income if you plan to file a joint return. As used on this form,
earned income does not include amounts inmates in penal
institutions are paid for their work, amounts received as a pension
or annuity from a nonqualified deferred compensation plan or a
nongovernmental section 457 plan, or nontaxable earned income.
4. You expect to be able to claim the EIC for 2009. To find out if
you may be able to claim the EIC, answer the questions on page
2.
How To Get Advance EIC Payments
If you are eligible to get advance EIC payments, fill in the 2009
Form W-5 at the bottom of this page. Then, detach it and give it
to your employer. If you get advance payments, you must file a
2009 Form 1040 or 1040A income tax return.
You may have only one Form W-5 in effect at one time. If you
and your spouse are both employed, you should file separate
Forms W-5.
This Form W-5 expires on December 31, 2009. If you are
eligible to get advance EIC payments for 2010, you must file a
new Form W-5 next year.
f^l You may be able to get a larger credit when you file
k_J your 2009 return. For details, see Additional Credit onpage 3.
(continued on page 3)
Give the bottom part to your employer; keep the top part for your records.
Detach here
W-5Form
(Rev. January 2009)
Department of the Treasury
Internal Revenue Service
Earned Income Credit Advance Payment Certificate
► Use the current year's certificate only.
► Give this certificate to your employer.
► This certificate expires on December 31, 2009.
OMB No. 1545-0074
Print or type your full name Your social security number
Note. If you get advance payments of the earned income credit for 2009, you must file a 2009 federal income tax return. To get advancepayments, you must have a qualifying child and your filing status must be any status except married filing a separate return.
1 I expect to have a qualifying child and be able to claim the earned income credit for 2009 using that child. I do not have
another Form W-5 in effect with any other current employer, and I choose to get advance EIC payments .... D Yes D No
2 Check the box that shows your expected filing status for 2009:
D Single, head of household, or qualifying widow(er) D Married filing jointly
3 If you are married, does your spouse have a Form W-5 in effect for 2009 with any employer? D Yes □ No
Under penalties of perjury, I declare that the information I have furnished above is, to the best of my knowledge, true, correct, and complete.
Signature ► Date ►
Cat. No. 10227P
D-35