Form Schedule A (Form 9 Schedule A (Form 9 Multi-State Employer and Credit Reduction Information

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I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 940), PAGE 1 of 2
MARGINS: TOP 13 mm (1⁄ 2 ") CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20
FLAT SIZE: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

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PRINTS: HEAD TO HEAD
INK: BLACK

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requested

860309

Schedule A (Form 940) for 2009:

OMB No. 1545-0028

Multi-State Employer and Credit Reduction Information
Department of the Treasury — Internal Revenue Service
—
Employer identification number (EIN)

Name (not your trade name)

About this schedule:
● You must fill out Schedule A (Form 940) if you were required to pay your state unemployment tax in more than one state or if you paid
wages in any state that is subject to credit reduction.
● File Schedule A (Form 940) as an attachment to your Form 940.
For more information, read the Instructions for Schedule A (Form 940) on the back.

Part 1: Fill out this part if you were required to pay state unemployment taxes in more than one state (including the
District of Columbia, Puerto Rico, and the U.S. Virgin Islands). If any states do NOT apply to you, leave them
blank.
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Check the box for every state in which you were required to pay state unemployment tax this year. For a list of state names and
their abbreviations, see the Instructions for Schedule A (Form 940).

AK

CO

GA

AL

CT

HI

AR

DC

IA

AZ

DE

ID

CA

FL

IL

IN

MD

MS

NH

OH

SC

VA

WY

KS

MI

MT

NJ

OK

SD

VT

PR

KY

MN

NC

NM

OR

TN

WA

VI

LA

MO

ND

NV

PA

TX

WI

MA

ME

NE

NY

RI

UT

WV

Part 2: Fill out this part to tell us about wages you paid in any state (including the District of Columbia, Puerto Rico,
and the U.S. Virgin Islands) that is subject to credit reduction. If any lines do NOT apply, leave them blank.
2

If you paid wages in any of these states...
2a–b
2c–d
2e–f
2g–h
2i–j

3

[Name of State] Total taxable
FUTA wages paid in [state]

2a

[Name of State] Total taxable
FUTA wages paid in [state]

2c

[Name of State] Total taxable
FUTA wages paid in [state]

2e

[Name of State] Total taxable
FUTA wages paid in [state]

2g

[Name of State] Total taxable
FUTA wages paid in [state]

2i

.
.
.
.

3 .00x = line 2b

2b

3 .00x = line 2d

2d

3 .00x = line 2f

2f

3 .00x = line 2h

2h

3 .00x = line 2j

2j

Total credit reduction (Lines 2b + 2d + 2f + 2h + 2j = line 3)

3

.
.
.
.
.
.

Enter the amount from line 3 onto line 11 of Form 940.
For Privacy Act and Paperwork Reduction Act Notice, see back of Form 940-V.

Cat. No. 16997C

Schedule A (Form 940) 2009

1
I.R.S. SPECIFICATIONS

TO BE REMOVED BEFORE PRINTING

INSTRUCTIONS TO PRINTERS
SCHEDULE A (FORM 940), PAGE 2 of 2
MARGINS: TOP 13 mm (1⁄ 2 ") CENTER SIDES.
PAPER: WHITE, WRITING, SUB. 20
FLAT SIZE: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE

PRINTS: HEAD TO HEAD
INK: BLACK

DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

860409

Instructions for Schedule A (Form 940) for 2009:
Multi-State Employer and Credit Reduction Information

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Specific Instructions: Completing Schedule A (Form 940)

Part 1: Fill out this part if you were required to pay
state unemployment taxes in more than one
state (including the District of Columbia,
Puerto Rico, and the U.S. Virgin Islands).

Part 2: Fill out this part to tell us about wages you
paid in any state (including the District of
Columbia, Puerto Rico, and the U.S. Virgin
Islands) that is subject to credit reduction.

1.

2.

Check the box for every state (including the District of
Columbia, Puerto Rico, and the U.S. Virgin Islands) in
which you were required to pay state unemployment
taxes this year.

You are subject to credit reduction if you paid wages
in any state listed.
If you paid wages in any states that are subject to credit
reduction, find the lines where the states are listed.

Note. Make sure that you have applied for a state
unemployment number for your business. If you do not
have an unemployment account number from a state in
which you paid wages, contact the state office to receive
one. For a listing of states and contact information, see
page 12 of the 2009 Instructions for Form 940.

In the first box, enter the total taxable FUTA wages that
you paid in that state. (Note that the FUTA wage base for
all states is $7,000.) Do not use your state
unemployment wages here.

For ease of reference, here is a list of the states and their
2-letter postal abbreviations.

Enter your answer in the box at the end of the line.

State

Postal
Abbreviation

State

Postal
Abbreviation

Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia

AL
AK
AZ
AR
CA
CO
CT
DE
DC

Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota

MT
NE
NV
NH
NJ
NM
NY
NC
ND

Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky

FL
GA
HI
ID
IL
IN
IA
KS
KY

Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee

OH
OK
OR
PA
PR
RI
SC
SD
TN

Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri

LA
ME
MD
MA
MI
MN
MS
MO

Texas
U.S. Virgin Islands
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

TX
VI
UT
VT
VA
WA
WV
WI
WY

Then multiply the total taxable FUTA wages by the
number shown.

3.

Total credit reduction

To calculate the total credit reduction,
line
line
line
line
line

+

2b
2d
2f
2h
2j

line 3
Then enter the amount from line 3 onto line 11 of
Form 940.
Example:
You paid wages to 3 employees in State A. State A is subject to
credit reduction at a rate of .003 (.3%). Because you paid wages
in a state that is subject to credit reduction, you must fill out
Part 2 of Schedule A (Form 940).
Since the FUTA wage base is $7,000 for each employee, the
total FUTA wage base for you is $21,000.00.
$7,000.00
3

3
$21,000.00

FUTA wage base for each employee
Number of employees you paid in State A
Total FUTA wage base

In Part 2, State A is listed on line 2a–b. In the box for 2a, write
$21,000.00. Do not use your state unemployment wages here.
$21,000.00
3

.003
$63.00

Total taxable FUTA wages you paid in State A
Credit reduction rate for State A shown on the form
Total credit reduction. You would report this amount
on line 2b.

In this case, you would write $63.00 on line 3 and then enter that
amount on line 11 of Form 940.

Attach Schedule A (Form 940) to Form 940 when you file
your return.

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