950124
Form   941 for 2024:                 Employer’s QUARTERLY Federal Tax Return
(Rev. March 2024)                    Department of the Treasury — Internal Revenue Service                                                                                                   OMB No. 1545-0029

Employer identification number (EIN)     —                                                                                                                                Report for this Quarter of 2024 
                                                                                                                                                                          (Check one.)

Name (not your trade name)                                                                                                                                                1: January, February, March
                                                                                                                                                                          2: April, May, June
Trade name (if any)
                                                                                                                                                                          3: July, August, September
Address                                                                                                                                                                   4: October, November, December
        Number                                Street                                                                                          Suite or room number
                                                                                                                                                                         Go to www.irs.gov/Form941 for 
                                                                                                                                                                         instructions and the latest information.
        City                                                    State           ZIP code

        Foreign country name                       Foreign province/county    Foreign postal code

Read the separate instructions before you complete Form 941. Type or print within the boxes.
Part 1: Answer these questions for this quarter. Employers in American Samoa, Guam, the Commonwealth of the Northern 
        Mariana Islands, the U.S. Virgin Islands, and Puerto Rico can skip lines 2 and 3, unless you have employees who are 
        subject to U.S. income tax withholding.
1      Number of employees who received wages, tips, or other compensation for the pay period 
       including: Mar. 12 (Quarter 1), June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4)                                                                  1

2      Wages, tips, and other compensation       . .   .    . . .         . . . .          . . .                                                                  . . . . 2                               .
3      Federal 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                                                                                     Check here and go to line 6.
                                                    Column 1                                     Column 2
5a     Taxable social security wages   . .                      .           × 0.124 =                                                                                   .
5b     Taxable social security tips  . . .                      .           × 0.124 =                                                                                   .

5c     Taxable Medicare wages & tips   . .                      .           × 0.029 =                                                                                   .
5d     Taxable wages & tips subject to 
       Additional Medicare Tax withholding                      .           × 0.009 =                                                                                   .

5e     Total social security and Medicare taxes. Add Column 2 from lines 5a, 5b, 5c, and 5d  .                                                                      . . . 5e                              .

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      Current quarter’s adjustment for fractions of cents    . .         . . . .          . . .                                                                  . . . . 7                               .

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                              .
11     Qualified small business payroll tax credit for increasing research activities.Attach Form 8974                                                                    11                              .

12     Total taxes after adjustments and nonrefundable credits. Subtract line 11 from line 10 .                                                                         . 12                              .
13     Total deposits for this quarter, including overpayment applied from a prior quarter and 
       overpayments applied from Form 941-X, 941-X (PR), or 944-X filed in the current quarter                                                                            13                              .

14     Balance due. If line 12 is more than line 13, enter the difference and see instructions                                                                      . . . 14                              .
15     Overpayment. If line 13 is more than line 12, enter the difference                      .                                                                    Check one:      Apply to next return. Send a refund.

You MUST complete both pages of Form 941 and SIGN it.
For Privacy Act and Paperwork Reduction Act Notice, see separate instructions.                                                                                      Cat. No. 17001Z   Form 941 (Rev. 3-2024)

                                                                                                                                         950224
Name (not your trade name)                                                                   Employer identification number (EIN)
                                                                                                       –
Part 2: Tell us about your deposit schedule and tax liability for this quarter.
If you’re unsure about whether you’re a monthly schedule depositor or a semiweekly schedule depositor, see section 11 of Pub. 15.
16 Check one:              Line 12 on this return is less than $2,500 or line 12 on the return for the prior quarter was less than $2,500, 
                           and you didn’t incur a $100,000 next-day deposit obligation during the current quarter. If line 12 for the prior 
                           quarter was less than $2,500 but line 12 on this return is $100,000 or more, you must provide a record of your 
                           federal  tax  liability.  If  you’re  a  monthly  schedule  depositor,  complete  the  deposit  schedule  below;  if  you’re  a 
                           semiweekly schedule depositor, attach Schedule B (Form 941). Go to Part 3.
                           You were a monthly schedule depositor for the entire quarter.   Enter your tax liability for each month and total 
                           liability for the quarter, then go to Part 3.

                           Tax liability: Month 1                             .

                                          Month 2                             .

                                          Month 3                             .

                      Total liability for quarter                             .     Total must equal line 12.
                           You were a semiweekly schedule depositor for any part of this quarter.    Complete Schedule B (Form 941), 
                           Report of Tax Liability for Semiweekly Schedule Depositors, and attach it to Form 941. Go to Part 3.
Part 3: Tell us about your business. If a question does NOT apply to your business, leave it blank.
17     If your business has closed or you stopped paying wages          . . . . . .      . . . .     . . . .  .      Check here and

       enter the final date you paid wages        /       /                 ; also attach a statement to your return. See instructions.

18     If you’re a seasonal employer and you don’t 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 the instructions 
       for details.
        Yes. Designee’s name and phone number

             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.
                                                                               Print your 
Sign your                                                                      name here
name here                                                                      Print your 
                                                                               title here

        Date               /       /                                           Best daytime phone

Paid Preparer Use Only                                                                     Check if you’re self-employed               . . .

Preparer’s name                                                                                PTIN

Preparer’s signature                                                                           Date           /        /
Firm’s name (or yours 
if self-employed)                                                                              EIN

Address                                                                                        Phone

City                                                                      State                ZIP code

Page 2                                                                                                               Form 941 (Rev. 3-2024)

Form 941-V, 
Payment Voucher

Purpose of Form                                                              Specific Instructions
Complete Form 941-V if you’re making a payment with                          Box 1—Employer identification number (EIN). If you 
Form 941. We will use the completed voucher to credit                        don’t have an EIN, you may apply for one online by going 
your payment more promptly and accurately, and to                            to www.irs.gov/EIN. You may also apply for an EIN by 
improve our service to you.                                                  faxing or mailing Form SS-4 to the IRS. If you haven’t 
                                                                             received your EIN by the due date of Form 941, write 
Making Payments With Form 941                                                “Applied For” and the date you applied in this entry space.
To avoid a penalty, make your payment with Form 941                          Box 2—Amount paid. Enter the amount paid with 
only if:                                                                     Form 941.
• Your total taxes after adjustments and nonrefundable                       Box 3—Tax period. Darken the circle identifying the 
credits (Form 941, line 12) for either the current quarter or                quarter for which the payment is made. Darken only 
the preceding quarter are less than $2,500, you didn’t                       one circle.
incur a $100,000 next-day deposit obligation during the 
current quarter, and you’re paying in full with a timely filed               Box 4—Name and address. Enter your name and 
return; or                                                                   address as shown on Form 941.
• You’re a monthly schedule depositor making a                               • Enclose your check or money order made payable to 
payment in accordance with the Accuracy of Deposits                          “United States Treasury.” Be sure to enter your 
Rule. See section 11 of Pub. 15 for details. In this case,                   EIN, “Form 941,” and the tax period (“1st Quarter 2024,” 
the amount of your payment may be $2,500 or more.                            “2nd Quarter 2024,” “3rd Quarter 2024,” or “4th Quarter 
                                                                             2024”) on your check or money order. Don’t send cash. 
     Otherwise, you must make deposits by electronic funds                   Don’t staple Form 941-V or your payment to Form 941 (or 
transfer. See section 11 of Pub. 15 for deposit                              to each other).
instructions. Don’t use Form 941-V to make federal tax 
deposits.                                                                    • Detach Form 941-V and send it with your payment 
                                                                             and Form 941 to the address in the Instructions for 
        Use Form 941-V when making any payment with                          Form 941.
▲!      Form 941. However, if you pay an amount with 
CAUTION                                                                      Note: You must also complete the entity information 
        Form 941 that should’ve been deposited, you 
may be subject to a penalty. See Deposit Penalties in                        above Part 1 on Form 941.
section 11 of Pub. 15.

                               Detach Here and Mail With Your Payment and Form 941.

                                                                                                                                   OMB No. 1545-0029
Form                                                         Payment Voucher
Department941-Vof the Treasury                  Don’t staple this voucher or your payment to Form 941.                             2024
Internal Revenue Service       
1    Enter your employer identification         2                                                                          Dollars   Cents
     number (EIN).
                                                      Enter the amount of your payment.
             –                                        Make your check or money order payable to “United States Treasury.”  
3    Tax Period                                 4     Enter your business name (individual name if sole proprietor).
             1st                        3rd 
             Quarter                    Quarter       Enter your address.

             2nd                        4th           Enter your city, state, and ZIP code; or your city, foreign country name, foreign province/county, and foreign postal code.
             Quarter                    Quarter