Form 941SS-V OTC 941SS-V OTC Payment Voucher

MAILOUT

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I.R.S. SPECIFICATIONS
TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 941-SS, PAGE 3 of 4 (Mailout)
MARGINS: TOP 13 mm (1⁄ 2 ") CENTER SIDES.
PRINTS: HEAD TO HEAD
PAPER: WHITE, WRITING, SUB. 20
INK: BLACK
FLAT SIZE: 216 mm (81⁄ 2 ") x 279 mm (11")
PERFORATE: NONE
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Layer 1 prints black

Form 941-V(SS),
Payment Voucher

Layer 3 prints 185 red

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Complete Form 941-V(SS), Payment Voucher, if you
are making a payment with Form 941-SS, 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.
If you have your return prepared by a third party and
make a payment with that return, please provide this
payment voucher to the return preparer.

Making Payments With Form 941-SS

To avoid a penalty, make your payment with Form
941-SS only if:
● Your net taxes for the quarter (line 8 on Form
941-SS) are less than $2,500 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 8 of Pub. 80 (Circular SS), Federal
Tax Guide for Employers in the U.S. Virgin Islands,
Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands, for details. In this case,
the amount of your payment may be $2,500 or more.
Otherwise, you must deposit your taxes at an
authorized financial institution or by using the
Electronic Federal Tax Payment System (EFTPS). See
section 8 of Circular SS for deposit instructions. Do
not use Form 941-V(SS) to make federal tax deposits.

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Specific Instructions

● Enter on the voucher the amount paid with Form Delete
941-SS.
● Enclose your check or money order made payable to
the “United States Treasury.” Be sure also to enter
your EIN, “Form 941-SS,” and the tax period on your
check or money order. Do not send cash. Do not
staple Form 941-V(SS) or your payment to Form
941-SS (or to each other).
● Detach Form 941-V(SS) and send it with your
payment and Form 941-SS to the address in the
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Instructions for Form 941-SS. Do not send a
photocopy of Form 941-V(SS) because your payment
may be misapplied or delayed.
If any of the preprinted information is incorrect, make
changes on the top of Form 941-SS, not on the
payment voucher. If you change any of the preprinted
information on the voucher, your payment may be
misapplied or delayed.

payment

Detach Here and Mail With Your Payment and Form 941-SS. Ä

Department of the Treasury
Internal Revenue Service
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Caution. Use Form 941-V(SS) when making any
payment with Form 941-SS. However, if you pay an
amount with Form 941-SS that should have been
deposited, you may be subject to a penalty. See
Deposit Penalties in section 8 of Pub. 80 (Circular SS).

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Purpose of Form

OMB No. 1545-0029

2008

Form 941-V(SS), Payment Voucher

Do not staple this voucher or your payment to your return.

Enter the amount of
your payment

Form 941-SS.

Dollars
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Cents