HomeMy WebLinkAbout2016 Q2 941aForm 941 for 2016: Employer's QUARTERLY Federal Tax Return 970114
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Employer identification number (EIN) 4 6- 2 7 3 717 8
Name (not your trade name) Mountain Auto Service, Inc .
Trade name (if any)
Address 11209 LA BARR MEADOWS RD
GRASS VALLEY
CA 95949
OMB No. 1545-0029
Report for this Quarter of 2016
(Check one.)
11 1: January, February, March
X— 2: April, May, June
3: July, August, September
❑ 4: October, November, December
Instructions and prior -year forms are
available at www.irs.gov/form941.
Read the separate instructions before you complete Form 941. Type or print within the boxes.
Part 1: Answer these questions for this quarter.
1 Number of employees who received wages, tips, or other compensation for the pay period
including: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), Dec. 12 (Quarter 4) ...... 1
2 Wages, tips, and other compensation........................................................ 2
3 Federal income tax withheld from wages, tips, and other compensation ........................ 3
QBMT2901 02/16/16 FW2
2
31,775.65
2,741.00
4 If no wages, tips, and other compensation are subject to social security or Medicare tax ................ ❑ Check and go to line 6.
Column 1 Column 2
5 a Taxable social security wages .......... 31 , 7 7 5. 65 x .124 = 3, 940.18
5 b Taxable social security tips .............
x .124 =
5 c Taxable Medicare wages & tips ......... 31, 7 7 5. 65 x .029 = 921.49
5 d Taxable wages & tips subject to
Additional Medicare Tax withholding ... x .009 =
5 e Add Column 2 from lines 5a, 5b, 5c, and 5d................................................... 5 e 4, 861. 67
5f Section 3121(q) Notice and Demand — Tax due on unreported tips (see instructions) ............ 5f
6 Total taxes before adjustments. Add lines 3, 5e, and 5f........................................ 6 7, 602.67
7 Current quarter's adjustment for fractions of cents ............................................ 7 - 0 . 01
8 Current quarter's adjustment for sick pay .................................................... 8
9 Current quarter's adjustments for tips and group -term life insurance ........................... 9
10 Total taxes after adjustments. Combine lines 6 through 9...................................... 10 7, 602.66
11 Total deposits for this quarter, including overpayment applied from a prior quarter and
overpayments applied from Form 941-X, 941-X (PR), 944-X, or 944-X (SP) filed in the
current quarter............................................................................. 11 7, 602.66
12 Balance due. If line 10 is more than line 11, enter difference and see instructions ................ 12
13 Overpayment. If line 11 is more than line 10, enter difference Check one: ❑ Apply to next return. ❑ send a refund.
► You MUST complete both pages of Form 941 and SIGN it. Next 0-
For Privacy Act and Paperwork Reduction Act Notice, see the Payment Voucher. BAA Form 941 (Rev. 1-2016)
Form 941 (Rev.1-2016) Page 2
Name (not your trade name) Employer identification number (EIN)
Mountain Auto Service, Inc. �46-2737178
Part 2: Tell us about your deposit schedule and tax liability for this quarter.
If you are unsure about whether you are a monthly schedule depositor or a semiweekly schedule depositor, see section 11
of Pub. 15.
14 Check one: ❑ Line 10 on this return is less than $2,500 or line 10 on the return for the prior quarter was less than $2,500, and you
did not incur a $100,000 next -day deposit obligation during the current quarter. If line 10 for the prior quarter was
less than $2,500 but line 10 on this return is $100,000 or more, you must provide a record of your federal tax liability.
If you are a monthly schedule depositor, complete the deposit schedule below; if you are semiweekly schedule
depositor, attach Schedule B (Form 941). Go to Part 3.
�X You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liability
for the quarter, then go to Part 3.
Tax liability: Month 1 3, 685.96
Month 2,454.50
Month 3 1,462.20
Total liability for quarter 7 , 6 0 2 . 6 6 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.
15 If your business has closed or you stopped paying wages .................................................. ❑ Check here, and
enter the final date you paid wages
16 If you area seasonal employer and you do not have to file a return for every quarter of the year .............. ❑ Check here.
Part 4: May we speak with 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 instructions for details.
Yes. Designee's name and phone number
QBMT2902 02/16/16 FW2
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.
1 Sign your
name here
Date
Paid Preparer Use Only
Preparer's name
Preparer's signature
Firm's name (or yours
if self-employed)
Address
Print your
name here
Print your
title here
Best daytime phone
Check if you are self-employed .......... ❑
PTIN
Date
EIN
Phone
City State ZIP code
Schedule B (Form 941): Report of Tax Liability for Semiweekly Schedule Depositors OMB No. 1545-0029 970311
Calendar Year 2 016 Department of the Treasury— Internal Revenue Service Report for this Quarter
Employer identification number 46-2737178 1: January, February, March
Name (not your trade name) Mountain Auto Service, Inc. RX 2: April, May, June
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 H 3: July, August, September
or Form 941-SS, DO NOT change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this form and
attach it to Form 941 or Form 941-SS if you are a semiweekly schedule depositor or became one because your accumulated tax liability on 4: October, November, December
any day was $100,000 or more. Enter 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.
Month 1
1 801.56 9 17 25 Tax liability for Month 1
2 10 18 26 1 3, 685.96
3 11 19 27
4 12 20 28
5 13 21 29 678.88
6 14 22 668.54 30
7 15 778. 98 23 31
8 758.0016 24
Tax liability for Month 2
1
9
17 25
2
10
18 26
2,454.50
3
11
19 27 415.28
4
12
20 434.16 28
5
13
782.40 21 29
6
822.6614
22 30
7
15
23 31
8
16
24
Month 3
1
9
17 434.16 25
Tax liability for Month 3
2
10
298.16 18 26
1,462.20
3
295.7211
19 27
4
12
20 28
5
13
21 29
6
14
22 30
7
15
23 31
8
16
24 434.16
Total liability for the quarter
Fill in your total liability for the quarter (Month 1 + Month 2 + Month 3)
Total must equal line 10 on Form 941 or Form 941-SS.
7, 602.66
BAA For Paperwork Reduction Act Notice, see separate instructions. QBMA3001 02/24/15 FW2 Schedule B (Form 941) (Rev. 1-2015)
Filing and Printing Instructions FEDERAL QUARTERLY FORM 941/SCHEDULE B
Name
Mountain Auto Service, Inc.
Address
11209 LA BARR MEADOWS RD
City, State, and ZIP Code
GRASS VALLEY, CA 95949
INSTRUCTIONS FOR FILING YOUR PAYROLL
TAX RETURN
Please file your federal 941 return by 08/01/2016. If filing by mail send your return
to the following address:
Department of the Treasury
Internal Revenue Service
Ogden, UT 84201-0005
Remember to sign and enter required
information in the signature line.
SPECIAL INSTRUCTIONS FOR EXEMPT ORGANIZATIONS OR NO LEGAL ADDRESS
If your business has no principal legal
residence or place of
business in any state, please mail your
return to:
Internal Revenue Service
P.O. Box 409101
Ogden, UT 84409
If you are filing this return for an
exempt organization or
government entity, please mail your
return to:
Department of the Treasury
Internal Revenue Service
Ogden, UT 84201-0005
Remember to sign and enter required
information in the signature line.
PRINTING AND FILING INSTRUCTIONS
The printed form may look different
from the form provided by the
U.S. government. However, the format
has been approved by the U.S.
government as long as you print the
form with black ink on white
bond 8-1/2-in x 11-in sized paper of
at least 20 lb weight.
Please staple multiple sheets in the
upper left corner when filing.
KEEP THIS PAGE FOR YOUR RECORDS -- DO NOT MAIL.
INWKS941