rom 941 for 2014: Employer's QUARTERLY Federal Tax Return 950144
(Rev. January 2014) Department of the Treasury — Internal Revenue Service
OMB No. 1845-0029
[2]
Name (not your tade name) [Virginians for Alternatives to the Death Penalty, Inc,
Employer ider
ion number (EIN)
Trade name (if any) [vADP |
Address [P-0. Box 12222
%
jumber Srest ‘Suite or room number
Report for this Quarter of 2014
(Check one.
(5 1: January, February, March
2: April, May, June
C5 s: July, August, September
LJ 4: October, November, December
and prior year forms are
[Richmond [23241 |
oy WF ode
Far Sa a Fanign picalmny —— Foign povalcode
available at www.irs.gov/form941.
Read the separate instructions before you complete Form 941. Type or print within the boxes.
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
2 Wages, tips, and other compensation
3 Federal income tax withheld from wages, tips, and other compensation
4 Ifno wages, tips, and other compensation are subject to social security or Medicare tax
LC check and go te line 6.
Column 1 Column 2
Sa Taxable social security wages . «| 6737, 50] x 124 | 45]
Sb Taxable social security tips... | + | xt2a= | |
5c Taxable Medicare wages &tips. . [ 6737 50| x 029 = [ 195, 39|
5d Taxable wages & tips subject to
iti jicare Tax wit i [ . | x .009 = | @ ]
5e Add Column 2 from lines 5a, 5b, 5c, and 5d Be 1030, 84
Sf Section 3121(q) Notice and Demand=Tax due on unreported tips (see i Fe
6 Total taxes before adjustments. Add lines 3, 5e, and 5f 6 1030, 84}
7 Current quarter's adjustment for fractions of cents . |
8 Current quarter's adjustment for sick pay |
9 Current quarter’s adjustments for tips and group-term life insurance 9 ——
10 ‘Total taxes after adjustments. Combine lines 6 through 9
10 1030 ,
ah Total deposits for this quarter, including overpayment applied from a prior quarter and
overpayments applied from Form 941-X, 941-X Gal 944-X, 944-X x (PR), or 944-X CoN filed 03,
Dae "
in the current quarter
12 Balance due. If line 10 is more than line 11, enter the difference and see instructions
SS
43 Overpayment. iffine 11 ismore than line 10, enter the difference[___————» | Check one: [Tagnytonrteten, [1 snd a run
» You MUST complete both 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 9411 (Rev. 1-2014)
950214
Name (rot y je name) Employer identification number (EIN)
Tell us about your deposit schedule and tax liability for this quarter.
If you are unsure about whether you are a monthly schedule depositor or a i ‘schedule itor, see Pub. 15
(Circular E), section 11.
14 Check one: [_] Line 10 on this return is less than $2,500 or line 10 on the return for the prior quarter was less than $2,500, and you did not incur a
{$100,000 next-day deposit obligation during the current quarter. If ine 10 for the prior quarter was less than $2,500 but line 10 on this return
is $100,000 or more, you must provide a record of your federal tax liability. if you are a monthly schedule depositor, complete the deposit
schedule below; if you are a semiweekly schedule depositor, attach Schedule B (Form 941). Go to Part 3.
[x] 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 1 294, 52
Month 2 441, 78)
Month 3 294, 52
Total liability for quarter 1030. 82] Total must equal line 10.
[1 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.
Part Tell us about your business. If a question does NOT apply to your business, leave it blank.
15 Ifyour business has closed or you stopped paying wages. . . . . . . . . ~~... . [| Checkhere, and
enter the final date you paid wages [rar i].
16 Ifyou are a seasonal employer and you do not have to file a return for every quarter ofthe year . . [ ] Check here.
rt 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.
LJ Yes. Designee’s name and phone number ] [
it Personal Identification Number (PIN) to use when talking to theirs. [_| (| ][_] _]
Select a 5-
TF] No.
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, itis 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 {Michael E. Stone
Print your
name here file here, [Executive Director
Date Best daytime phone 434-960-7779
Paid Preparer Use Only Check if you are self-employed . . . [ ]
Preparers name | J oew CL
Preparer's signature [ | Date
Firm’s name (or yours
if self-employed) [ ] EIN
Adress | Phone [
oity | state [J] zpcode [
Page 2 Form 9411 (Rev. 1-2014)
