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1501-21004344
TAXPAY® 14286
rom 941 for 2014: Employer’ 's QUARTERLY Federal Tax Return
(Rev. January 2014) Depariment of the Treasury - internal Revenue Service
(EIN)
Employer i
roneorl5.| Lal= La] [6] le lf} [2] fo JLo!
| VIRGINIANS FOR ALTERNATIVES TO
Name (not your trede nate) L
Trade
[PO BOX 4804 |
Address" Nambar sifeet ‘Suite or
CHARLOTTESVILLE Be | 22905
Gity ite ZIP code
Foreign postal code
Foreign province/county
Foreign country name
Read the seParate instructions before you complete Form 941. Type or Print within the boxes.
950114
OMB No. 1545-0020
Report for this Quarter of 201
(Check one.)
[7 4: January, February, March
[To aprit, May, June
EK] scduty, august, September
4:October, November, December
Instructions and prior-year forms are
ele. zh ectummisccwicme
HELIA Answer these for this quarter
1 Number of employees who received wages, tips, or other compensation for the pay period
including Mar. 12 (Quarter 1), J une 12 (Quarter 2), Sept. 12 (Quarter 3), Dec. 12 (Quarter4) 1
2 Wages, tips, andothercompensation . . « i e & & & a <
3 Federal income tax withheld trom wages, tips, and other compens:
4 5775 «00
3
C1 check and go to line 6.
4 If no wages, tips, and other i re je ial
Column 1 Column2
| [
5a Taxable social security wages | 5775 ,00 J x.124= | 716 20
5b Taxable social security tips | . | «124 = | . |
5c Taxable Medicare wages & tips | 5775 400 | x.029= | 167 48
5d Taxable wages & tips ‘subject to [
Medicare Tax it a. x 009 = .
Se Add Celumn 2 trom lines 5a,5b,5c,and5d . « 1 * ™ a “ . 5e 883 58
5f Section 3121(q) Notice and Demand - Tax due on tips (see Fr . 5f .
6 Total taxes betore adjustments. Addlines3,5e,and5—£ «2-0-7 eee 883.58
7 Current quarter’s adjustment for fractions ofcents F * % @ e = Ps vi Ld
8 Current quarter's adjustment forsick pay . . . soe ee . . . 8 |
9 Current quarter's for tips and group-t life it a e = Ps 9 Ly
10 Toiai taxes atier adjustments. Combine lines 6 through9 . 3 z = i 883 208
11 Total deposits for this quarter, including overpayment applied from a prior quarter and
overpayment applied from Fom| 941. % 941. 1X PR), sx 4x (PR), 0 or MAX (sP) Hila
inthe current quarter. . 883 58
12 Balance due. If line 10 is more than line 11, enter the dif and see it 12 a
13 Overpayment. If line 11 is more than line 10, enter di LI Check one: oO Apply tonext returr. im Send aretund.
> 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.
Next >
Form 941 (Rev. 1-2014)
1501-21004344 TAXPAY® 14286
Schedule B (Form 941): 0311
Report of Tax Liability for Semiweekly Schedule Depositors
(Rev Jaruary 214) Defientrertcfihe Treasury - Internal Reverue Service’ OMB No. 1545-00:
Quart
EM yerienncaionramter ? | L4]— 2] [6] € ][4)2] 2 [6] veer
Neane Got yourradanare) [VIRGINIANS FOR ALTERNATIVES TO | [7] +: January, February, Merch
Catonciar Year [2 | [0] (| [4] (Also check quarter) [7] 2: apr, ay, June
LX sau, August, September
Da ‘October, November, December
Use this schedule to show your TAX LIABILITY tor the quarter; DO NOT use it to show your deposits. When you file this form with Form
941 or Form 941-SS, DO NOT change your tax liability by adjustments reported on any Forms 941-X or 944-X. You must fill out this form and
attach it to Form 941 or Form 941-SS if you are a semiweekly schedule depositor or became one because your accumulated tax liabil
on any day was $100,000 or more. Write your daily tax liability on the numbered space that corresponds to the date wages were paid.
See Section 11 in Pub. 15 (Circular E), Employer’s Tax Guide, tor details.
jonth 1
‘Tax liability for Month 1
1 . Fy) . 1 . 5 | .
a 1 6 |
* * * * 294 52
2 14 . 1 . 27/ .
a__|; . . 8 .
LJ 131 = 1 a 20! LJ
a__|, s_| a |50) .
147_ 26 147 26
a_i, . = 134 .
a_i . .
Month 2
147_27]| Tax liability for Month 2
1 2 ol . 47 . .
ul a = 1 a 6 | LJ
294 453
mii . 1 = __|7/ 7
. | . . 8 .
= Il . 4 = Io .
| . = Io .
147, 26] «|e ele ‘i
sik . .
Month 3
47 28 ‘Tay liability for Month 3
1 . Fe) . 1 . 5 .
a__hid . 1 a__|26| .
294 1.53
147, 25},, ‘ F aor a
si . . 8 .
= |i . 4 = Io .
sia . = led, |
1 sis sl «lol |
si . .
Total for the quarter
Fill in your otal liability for the quarter (Month 1 + Nonth 2+ Month 3) >
Total must equal fine 1 cn Form 941 cr Form 9418S. 883 .58
For Pap Act Noti rate i IR ‘Schedule B (Form 941) (Rev. 1-2014)
