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.
Making Payments With Form 941
To avoid a penalty, make your payment with Form 941
• Your total taxes after adjustments for either the current
quarter or the preceding quarter (Form 941, line 10) are
less than $2,500, you did not incur a $100,000 next-day
deposit obligation during the current quarter, 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 make deposits by electronic funds
transfer. See section 11 of Pub. 15 (Circular E) for deposit
instructions. Do not use Form 941-V to make federal tax
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
Box 1—Employer identification number (EIN). If you do
not have an EIN, you may apply for one online. Go to
IRS.gov and type “EIN” in the search box. You may also
apply for an EIN by faxing or mailing Form SS-4,
Application for Employer Identification Number, to the
IRS. If you have not received your EIN by the due date of
Form 941, write “Applied For” and the date you applied in
this entry space.
Box 2—Amount paid. Enter the amount paid with
Box 3—Tax period. Darken the circle identifying the
quarter for which the payment is made. Darken only
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
Note. You must also complete the entity information
above Part 1 on Form 941.
Detach Here and Mail With Your Payment and Form 941.
Department of the Treasury
Internal Revenue Service
Do not staple this voucher or your payment to Form 941.
OMB No. 1545-0029
1 Enter your employer identification
Enter the amount of your payment.
Make your check or money order payable to “United States Treasury”
3 Tax Period
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.