Cruz Company has gathered the information needed to complete its Form 941 for the quarter ended September 30, 2016. Using the information presented below, complete Part 1 of Form 941, reproduced on the next page (given below).
# of employees for pay period that included September 12-14 employees
Wages paid third quarter-$79,750.17
Federal income tax withheld in the third quarter-$9,570.00
Taxable social security and Medicare wages-$79,750.17
Total tax deposits for the quarter-$21,771.83

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Fom 941 for 20--: Employer's QUARTERLY Federal Tax Return Dapartmant of the Treasury-Intarmsal Ravanua Service anuary 201s OMB No. 1545-0020 Report for this Quarter of 20- CARLOS CRUZ 1:January, February, March □2: April, May, June □3:July, August, September Name hot your trade mag Trado namo fany) CRUZ COMPANY 901 KEYSTONE 4: October, November, December Instructions and prior year f 95916 Read the separate Instructions betore you complete Form 941. Type or print within the boxes. Part 1: Answer questions for 1 Numiber of employees who recelved wages, tips, or other compensation for the pay period Including: Mar. 12 (Quarter , 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 trom wages, tips, and other compensation 4 If no wages, tips, and other compensation are subject to soclal security or Medicare taxCheck and go to line 6. Column f Column 2 5a Taxable social security wages 5b Taxable social securtity tips . 5c Taxable Medicare wages & tips. 5d Taxable wages & tips subject to x.124 x.124 x .029 - Aoditional Medicare Tax wtthholding x .009 5e Add Column 2 from Iines 5a, 50, 5c, and 5d 5 Section 3121(4) Notice and Demand-Tax due on unreported tips (see Instructions) 6 Total taxes before adjustments. Add Ines 3, 5e, and St 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 fe Insurance 10 Total taxes after adjustments. Combine lines 6 through9 11 Total deposits for this quarter, Including overpayment applied from a prior quarter and 5e 51 10 overpayments applied from Form 941-X 941-x(PR), 944-X, 944-Х (PR). or 944-X (SP) nled In the current quarter 12 Balance due. If Ine 10 Is more than Ine 11, enter the dinerence and see Instructions 12 13 Overpayment. It ine 11 is more than Ine 10, enter the difference You MUST complete both pages of Form 941 and SIGN it. Next For Privacy Act and Paperwork Reduction Act Notice, soo the back of the Payment Voucher.C No. 170012 Form 941 (Rav. 1-2015)