Withholding Tax Form 941

As you prepare to submit the Withholding Tax Form 941, refer to the corresponding tasks listed below (Hub / Curriculum):

FIN Task 18 - Prepare and Submit the 941 Payroll Tax Withholding Form
ACCT Task 10 - Establish Payroll Procedures

After completion of this form, the total remittance amount due should be paid to Account Number 630907102 (VE Payroll Tax). Please contact your regional lead with any questions.

Firm Name

Employer Identification Number (PF Code)

Find your PF Code by navigating to the Hub > Marketplace Tools > Firm Admin, on the top left.

Firm Contact Email

example@example.com

Facilitator Email

example@example.com

Employer Identification Number (PF Code)

Your firm's PF Code (Go to Hub / Marketplace Tools / Firm Admin on the top left)

School Name

VE Region

Street Address

City

State

ZIP

Bank Account #

Your firm's bank account #

Please choose one of the following

Tax Payroll Period

Number of Employees in the Pay Period (includes the 12th day of the month)

Total Wages

Enter the total gross salaries paid during this month (Taken from the Payroll Register)

Contributions to Qualified Retirement Plans

Enter the total 401K contributions made by employees during this month (Taken from the Payroll Register)

Wages Subject To Federal Tax Income

[Total Wages] - [Contributions to Qualified Retirement Plans]

Total Federal Income Tax Withheld

Enter the total FWT for this mont (Taken from the Payroll Register)

Social Security

[Total social security withheld from employees during this month] + [Total Wages x 0.062]

Medicare

[Total medicare withheld from employees during this month] + [Total Wages x 0.0145]

Total Federal Remittance Amount

[Total Federal Income Tax Withheld] + [Social Security] + [Medicare]

Amount of State Tax Withheld

Enter the total SWT for this month (Taken from the Payroll Register)

Total Remittance Amount (Due to VE Tax Account in your region)

[Total Federal Remittance Amount] + [Amount of State Tax Withheld]

Form Completed By:

First NameLast Name

Position Title:

Date:

MonthDayYear

Payroll Register 1

(Excel file)

Payroll Register 2

(Excel file)