Figure 3.8 Form 941, Employer's QUARTERLY Federal Tax Return

Form 941 for 20--: (Rev. March 2023) Employer's QUARTERLY Federal Tax Return Department of the Treasury — Internal Revenue Service OMB No. 1545-0029 Employer identification number (EIN) 0 0 – 0 0 0 7 7 7 9 Name (not your trade name) JUSTIN GRANATELLI Trade name (if any) GRANATELLI Address 3709 FIFTH Number Street Suite or room number CHICAGO IL 60605 City State ZIP code Foreign country name   Foreign province/county Foreign postal code Report for this Quarter of 20-- (Check one.) ☑ 1: January, February, March ☐ 2: April, May, June ☐ 3: July, August, September ☐ 4: October, November, December Go to www.irs.gov/Form941 for instructions and the latest information. 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), or Dec. 12 (Quarter 4) . . . . . . . . . . . . 1 26   2 Wages, tips, and other compensation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 74895.92   3 Federal income tax withheld from wages, tips, and other compensation . . . . . . . . . . . . . . . . . . . . . . . . . 3 12372.13   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  5a Taxable social security wages* . . . . . . . . . . . 74895.92 x 0.124 = 9287.09 * Include taxable qualified sick and family leave wages paid in this quarter of 2023 for leave taken after March 31, 2021, and before October 1, 2021, on line 5a. Use lines 5a(i) and 5a(ii) only for taxable qualified sick and family leave wages paid in this quarter of 2023 for leave taken after March 31, 2020, and before April 1, 2021.  5a (i) Qualified sick leave wages* . . . . . . . . . . . . x 0.062 = .  5a (ii) Qualified family leave wages* . . . . . . . . . . x 0.062 = .  5b Taxable social security tips . . . . . . . . . . . . . . . x 0.124 = .  5c Taxable Medicare wages & tips . . . . . . . . . . 74895.92 x 0.029 = 2171.98  5d Taxable wages & tips subject to Additional Medicare Tax withholding . x 0.009 = .   5e Total social security and Medicare taxes. Add Column 2 from lines 5a, 5a(i), 5a(ii), 5b, 5c, and 5d . . . . 5e 11459.07   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 23831.20   7 Current quarter's adjustment for fractions of cents . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 -.15   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 23831.05  11a Qualified small business payroll tax credit for increasing research activities. Attach Form 8974 . . . . . 11a .  11b Nonrefundable portion of credit for qualified sick and family leave wages for leave taken before April 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11b .  11c Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11c . You MUST complete all three pages of Form 941 and SIGN it. For Privacy Act and Paperwork Reduction Act Notice, see the back of the Payment Voucher. Cat. No. 17001Z Form 941 (Rev. 3-2023) Name (not your trade name) Employer identification number (EIN) JUSTIN GRANATELLI 00-0007779 Part 1:   Answer these questions for this quarter. (continued)  11d Nonrefundable portion of credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11d .  11e Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11e .  11f Reserved for future use . . . . . . . . . . . . . . . . . . . . . .    11g Total nonrefundable credits. Add lines 11a, 11b, and 11d . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11g .  12 Total taxes after adjustments and nonrefundable credits. Subtract line 11g from line 10 . . . . . . . . . . . . . 12 23831.05  13a 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 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13a 23831.05  13b Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13b .  13c Refundable portion of credit for qualified sick and family leave wages for leave taken before April 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13c .  13d Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13d .  13e Refundable portion of credit for qualified sick and family leave wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13e .  13f Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13f .  13g Total deposits and refundable credits. Add lines 13a, 13c, and 13e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13g 23831.05  13h Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13h .  13i Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13i .  14 Balance due. If line 12 is more than line 13g, enter the difference and see instructions . . . . . . . . . . . . . . . . . 14 .  15 Overpayment. If line 13g is more than line 12, enter the difference   .   Check one: ☐ Apply to next return. ☐ Send a refund. 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.    You MUST complete all three pages of Form 941 and SIGN it. Page 2 Form 941 (Rev. 3-2023) Name (not your trade name) Employer identification number (EIN) JUSTIN GRANATELLI 00-0007779 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.   19 Qualified health plan expenses allocable to qualified sick leave wages for leave taken before April 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 19 .   20 Qualified health plan expenses allocable to qualified family leave wages for leave taken before April 1, 2021 . . . . . . . . . . . . . . . . . . . . . . . . . . 20 .   21 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21 .   22 Reserved for future use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22 .   23 Qualified sick leave wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . . . 23 .   24 Qualified health plan expenses allocable to qualified sick leave wages reported on line 23 . . . . . . . . . . . 24 .   25 Amounts under certain collectively bargained agreements allocable to qualified sick leave wages reported on line 23 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25 .   26 Qualified family leave wages for leave taken after March 31, 2021, and before October 1, 2021 . . . . . . 26 .   27 Qualified health plan expenses allocable to qualified family leave wages reported on line 26 . . . . . . . . . 27 .   28 Amounts under certain collectively bargained agreements allocable to qualified family leave wages reported on line 26 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28 . 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 all three 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. Sign your name here Justin Granatelli Print your name here JUSTIN GRANATELLI Print your title here OWNER Date   04/30/-- Best daytime phone 773-555-2119     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 3 Form 941 (Rev. 3-2023)

Source: Internal Revenue Service.