Stan Barker opened Quik-Stop Market on January 1, 2013. The business is subject to FICA taxes. At the end of the first quarter of 2013, Barker, as president of the company, must file Form 941, Employer's Quarterly Federal Tax Return. Using Form 941 (Parts 1 through 5), reproduced on pages 3-58 and 3-59, prepare, sign, and date the return on the basis of the information shown below.

Employer’s address: ..... 234 Oak, Austin, TX 78711-0234

Employer’s ID number: ... 00-0005874

Phone number: ....... (512) 555–1111

Each employee is paid semimonthly on the 15th and last day of each month. Shown below is the payroll information for the first quarter of 2013. All pay periods were the same.

Employees’ FICA Tax—OASDI..... $130.41
Employer’s FICA Tax—OASDI..... 192.51
Employees’ FICA Tax—HI....... 45.03
Employer’s FICA Tax—HI....... 45.02
Employees’ FIT Tax............ 426.00
Total..... $ 838.97 * 6 deposits ¼ $5,033.82 for the quarter

None of the employees reported tips during thequarter.

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Fom 941 for 20-: Employer's QUARTERLY Federal Tax Return Flaw.Janiry 2012 Dopartmat of tho Treasury- Indarrl lewanua Servica OMB No. 1545-0020 Employer Idontification number0 Report for this Quarter of 20- Chook one Name poot your trado nama) STAN BARKER 1:January, February, March namo pr any) QUI-STOP MARKET 2: Apri, May, June 3 July, August, September Addross 234 OAK 4: October, November, December Prior-year forms are avallable at www.irs.gov om941 AUSTIN TX 78711 separ T 941. Type or pr Part 1: 1 Number of employees who received wages, tips, or other compensation for the pay period 1 2 3 4 including: Mar. 12 (Quarter , June 12 (Quarter 2), Sept. 12 (Quarter 3), or Dec. 12 (Quarter 4) Wages, tips, and other compensation Income tax withheld from wages, tips, and other compensation 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 5b Taxable social security tips . 5c Taxable Medicare wages & tips. 5d Add Column 2 line 5a, Column 2 line 5b, and Column 2 line 5 5e Section 3121(q) Notice and Demand-Tax due on unreported tips (see instructions) 6 Total taxes before adjustments (add lines 3, 5d, and 5e 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 10 Total taxes after adjustments. Combine lines 6 through 9 11 Total deposits for this quarter, including overpayment applied from a prior quarter and x.104 x.104 x.029 5d 5e 10 overpayment applied from Form 941-X or Form 944-X 12a COBRA premium assistance payments (see instructions) 12b Number of individuals provided COBRA premium assistance 13 Add lines 11 and 12a 14 Balance due. If line 10 is more than line 13, enter the difference and see instructions 15 Overpayment. If line 13 is more than line 10, enter the diffierenca 13 14 Check one:Apply to nae t.m Sand a raund 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. 170012 Form 941 Raw. 1-2012)