Question: Read the separate instructions before you complete Form 941. Type or print within the boxes.Part 1:Answer these questions for this quarter. Employers in American Samoa,

Read the separate instructions before you complete Form 941. Type or print within the boxes.Part 1:Answer these questions for this quarter. Employers in American Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the U.S. Virgin Islands, and Puerto Rico can skip lines 2 and 3, unless you have employees who are subject to U.S. income tax withholding.1 Number of employees who received wages, tips, or other compensation for the pay period including: Mar. 12(Quarter 1), June 12(Quarter 2), Sept. 12(Quarter 3), or Dec. 12(Quarter 4)2 Wages, tips, and other compensation3 Federal income tax withheld from wages, tips, and other compensation4 If no wages, tips, and other compensation are subject to social security or Medicare taxColumn 15a Taxable social security wages5b Taxable social security tipsSc Taxable Medicare wages

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