Form  940 for 2022:               Employer’s Annual Federal Unemployment (FUTA) Tax Return                                                                                                         850113
                                  Department of the Treasury — Internal Revenue Service                                                                                                           OMB No. 1545-0028

Employer identification number               —                                                                                                                             Type of Return 
(EIN) 
                                                                                                                                                                           (Check all that apply.)
Name (not your trade name)                                                                                                                                                  a. Amended
Trade name (if any)                                                                                                                                                         b. Successor employer
                                                                                                                                                                            c. No payments to employees in 
Address                                                                                                                                                                        2022
        Number                           Street                                                                                               Suite or room number          d. Final: Business closed or 
                                                                                                                                                                               stopped paying wages
                                                                                                                                                                         Go to www.irs.gov/Form940 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 this form. Please type or print within the boxes.
Part 1: Tell us about your return. If any line does NOT apply, leave it blank. See instructions before completing Part 1.

1a  If you had to pay state unemployment tax in one state only, enter the state abbreviation .                                                                              1a 
1 b  If you had to pay state unemployment tax in more than one state, you are a multi-state                                                                                        Check here. 
      employer .    . .      .  . .   . .    . .    .    .   . .   .      . .  . . .    . .         .                                                              . . . .  1b     Complete Schedule A (Form 940).
2     If you paid wages in a state that is subject to CREDIT REDUCTION             .    . .         .                                                              . . . .  2      Check here. 
                                                                                                                                                                                   Complete Schedule A (Form 940).
Part 2: Determine your FUTA tax before adjustments. If any line does NOT apply, leave it blank. 

3     Total payments to all employees        . .    .    .   . .   .      . .  . . .    . .         .                                                              . . . .  3                            .
4     Payments exempt from FUTA tax          . .    .    .   . .   .        4                                                                                          .
      Check all that apply:  4a     Fringe benefits                         4c   Retirement/Pension                                                                      4e Other 
                             4b     Group-term life insurance               4d   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). See instructions .      .    . .         .                                                              . . . .  7                            .

8     FUTA tax before adjustments (line 7 x 0.006 = 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 0.054  (line 7   × 0.054 = line 9). 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), 
      complete the worksheet in the instructions. Enter the amount from line 7 of the worksheet .                                                                        .  10                           .

11    If credit reduction applies, enter the total from Schedule A (Form 940)           . .         .                                                              . . . .  11                           .
Part 4:  Determine your FUTA tax and balance due or overpayment. 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 excess 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. See instructions .    .         .                                                              . . . .  14                           .

15    Overpayment. If line 13 is more than line 12, enter the excess on line 15 and check a box below                                                                       15                           .
      You MUST complete both pages of this form and SIGN it.                            Check one:                                                                      Apply to next return.     Send a refund.

For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher.                                                                                   Cat. No. 11234O        Form 940 (2022)

                                                                                                                              850212
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, go to Part 6. 

16  Report the amount of your FUTA tax liability for each quarter; do NOT enter the amount you deposited. If you had no liability for
     a quarter, leave the line blank. 
     16a  1st quarter (January 1 – March 31)  . . . . . . . . .               16a                        .

     16b 2nd quarter (April 1 – June 30)  . .   . . . . . . . .              16b                         .

     16c  3rd quarter (July 1 – September 30)   . . . . . . . .              16c                         .

     16d 4th quarter (October 1 – December 31)    . . . . . . .              16d                         .

17  Total tax liability for the year (lines 16a + 16b + 16c + 16d = line 17) 17                          . Total must equal line 12.
Part 6:   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 7:   Sign here. You MUST complete 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 to the 
     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 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 

                                                                              Best daytime phone 
          Date             /        / 

     Paid Preparer Use Only                                                                             Check if you are 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 940 (2022)

Form 940-V, 
Payment Voucher 

Purpose of Form                                                            Specific Instructions
Complete Form 940-V if you’re making a payment with                        Box 1—Employer identification number (EIN). If you 
Form 940. We will use the completed voucher to credit                      don’t have an EIN, you may apply for one online by 
your payment more promptly and accurately, and to                          visiting the IRS website at www.irs.gov/EIN. You may also 
improve our service to you.                                                apply for an EIN by faxing or mailing Form SS-4 to the 
                                                                           IRS. If you haven’t received your EIN by the due date of 
Making Payments With Form 940                                              Form 940, write “Applied For” and the date you applied in 
To avoid a penalty, make your payment with your 2022                       this entry space.
Form 940 only if your FUTA tax for the fourth quarter                      Box 2—Amount paid. Enter the amount paid with 
(plus any undeposited amounts from earlier quarters) is                    Form 940. 
$500 or less. If your total FUTA tax after adjustments 
(Form 940, line 12) is more than $500, you must make                       Box 3—Name and address. Enter your name and 
deposits by electronic funds transfer. See When Must                       address as shown on Form 940.
You Deposit Your FUTA Tax? in the Instructions for Form                    •  Enclose your check or money order made payable to 
940. Also see sections 11 and 14 of Pub. 15 for more                       “United States Treasury.” Be sure to enter your EIN, 
information about deposits.                                                “Form 940,” and “2022” on your check or money order. 
                                                                           Don’t send cash. Don’t staple Form 940-V or your 
       Use Form 940-V when making any payment with                         payment to Form 940 (or to each other).
       Form 940. However, if you pay an amount with 
▲!     Form 940 that should’ve been deposited, you                         •  Detach Form 940-V and send it with your payment and 
CAUTION
       may be subject to a penalty. See Deposit                            Form 940 to the address provided in the Instructions for 
Penalties in section 11 of Pub. 15.                                        Form 940.
                                                                           Note: You must also complete the entity information 
                                                                           above Part 1 on Form 940.

                               Detach Here and Mail With Your Payment and Form 940.

                                                                                                                                  OMB No. 1545-0028
Form 940-V                                              Payment Voucher
Department of the Treasury                            Don’t staple or attach this voucher to your payment.                          22
Internal Revenue Service                                                                                                          20
1    Enter your employer identification number (EIN). 2                                                                   Dollars   Cents
                                                        Enter the amount of your payment. 
                                                        Make your check or money order payable to “United States Treasury”
          –
                                                      3 Enter your business name (individual name if sole proprietor).

                                                        Enter your address.

                                                        Enter your city, state, and ZIP code; or your city, foreign country name, foreign province/county, and foreign postal code.

Form 940 (2022) 

Privacy Act and Paperwork Reduction Act Notice.            your tax information to the Department of Justice for civil 
We ask for the information on this form to carry out the   and criminal litigation, and to cities, states, the District of 
Internal Revenue laws of the United States. We need it     Columbia, and U.S. commonwealths and possessions to 
to figure and collect the right amount of tax. Chapter     administer their tax laws. We may also disclose this 
23, Federal Unemployment Tax Act, of Subtitle C,           information to other countries under a tax treaty, to 
Employment Taxes, of the Internal Revenue Code             federal and state agencies to enforce federal nontax 
imposes a tax on employers with respect to employees.      criminal laws, or to federal law enforcement and 
This form is used to determine the amount of the tax that  intelligence agencies to combat terrorism. 
you owe. Section 6011 requires you to provide the          The time needed to complete and file this form will vary 
requested information if you are liable for FUTA tax under depending on individual circumstances. The estimated 
section 3301. Section 6109 requires you to provide your    average time is: 
identification number. If you fail to provide this 
information in a timely manner or provide a false or       Recordkeeping    . . . . . . . . . .       9 hr., 19 min.
fraudulent form, you may be subject to penalties.          Learning about the law or the form   . .   1 hr., 23 min.
You’re not required to provide the information             Preparing, copying, assembling, and                  
requested on a form that is subject to the Paperwork       sending the form to the IRS . . . . .      1 hr., 36 min.
Reduction Act unless the form displays a valid OMB  
                                                           If you have comments concerning the accuracy of 
control number. Books and records relating to a form or 
                                                           these time estimates or suggestions for making 
instructions must be retained as long as their contents 
                                                           Form 940 simpler, we would be happy to hear from 
may become material in the administration of any Internal 
                                                           you. You can send us comments from 
Revenue law. 
                                                           www.irs.gov/FormComments. Or you can send your 
Generally, tax returns and return information are          comments to Internal Revenue Service, Tax Forms and 
confidential, as required by section 6103. However,        Publications Division, 1111 Constitution Ave. NW, 
section 6103 allows or requires the IRS to disclose or     IR-6526, Washington, DC 20224. Don’t send Form 940 to 
give the information shown on your tax return to others    this address. Instead, see Where Do You File? in the 
as described in the Code. For example, we may disclose     Instructions for Form 940.