$13$d Reserved for future use

$13$e Refundable portion of credit for qualified sick and family leave wages for leave taken after March $31,2021,$ and before October $1,2021.13e$

$13f$ Reserved for future use $...................................................................$

$13$h Reserved for future use $..........................................................................$

$14$ Balance due. If line $12$ is more than line $13g,$ enter the difference and see instructions $.....................14$

$15$ Overpayment. If line $13g$ is more than line $12,$ enter the difference Check one: $$ Apply to next return. $$ Send a refund.

Part $2$: Tell us about your deposit schedule and tax liability for this quarter.

If you're unsure about whether you're a monthly schedule depositor or a semiweekly schedule depositor, see section $11$ of Pub. $15.$

$16$ Check one: $b$

a$.$ Line $12$ on this return is less than $$2,500$ or line $12$ on the return for the prior quarter was less than $$2,500,$ and you didn't incur a $$100,000$ next$-$day deposit obligation during the current quarter. If line $12$ for the prior quarter was less than $$2,500$ but line $12$ on this return is $$100,000$ or more, you must provide a record of your federal tax liability. If you're a monthly schedule depositor, complete the deposit schedule below; if you're a semiweekly schedule depositor, attach Schedule B $($Form $941).$ Go to Part $3.$

b$.$ You were a monthly schedule depositor for the entire quarter. Enter your tax liability for each month and total liability for the quarter, then go to Part $3.$

Tax liability: Month $1$

Month $2$

Month $3$

Total liability for quarter

Total must equal line $12.$

c$.$ You were a semiweekly schedule depositor for any part of this quarter. Complete Schedule B $($Form $941),$

Report of Tax Liability for Semiweekly Schedule Depositors, and attach it to Form $941.$

You MUST complete all three pages of Form $941$ and SIGN it$.$

Page $2$

Form $941($Rev$.3-2023)$