SEARCH the Tax Division Online Files
26 U.S.C. § 7203
Sole Proprietorship or Partnership
Employer's Quarterly Return
Failure to File - Tabular Form Information
Venue in District of Service Center 1IN THE DISTRICT COURT OF THE UNITED STATES FOR THE ____________ DISTRICT OF ____________
UNITED STATES OF AMERICA
v.
_______________________
)
)
)
)
)No. __________________
26 U.S.C., § 7203The United States Attorney charges:
1. That during the period from [Date] to [Date], inclusive, [Defendant's Name], a resident of [City], [State], was an employer of labor2 and a person required under the provisions of the Internal Revenue Code to make a return of federal income taxes withheld from wages and Federal Insurance Contributions Act (F.I.C.A.) taxes; that during said period he [she] paid wages to his [her] employees which were subject to withholding of federal income taxes and Federal Insurance Contributions Act taxes; that by reason of such facts he [she] was required by law, after the close of each calendar quarter and on or before each due date, to make an Employer's Quarterly Federal Tax Return, Form 941, to the Director, Internal Revenue Service Center, at [City], [State], in the _____________ District of ____________, or to the District Director of the Internal Revenue Service for the Internal Revenue District of _____________, at _______________,1 or other proper officer of the United States; and that well-knowing and believing all of the foregoing, he [she] did willfully fail to make to said Director of the Internal Revenue Service Center, to said District Director of the Internal Revenue Service, or to any other proper officer of the United States, said Employer's Quarterly Federal Tax Return, Form 941, for each of the calendar quarters hereinafter set forth during the period from [Date] to [Date].
2. The allegations of paragraph "1." herein are repeated and realleged for Counts I through _____, inclusive, of this Information, as though fully set forth therein:
COUNT QUARTER ENDED DUE DATE TOTAL WAGES FICA TAXES (EMPLOYER'S & EMPLOYEE'S) INCOME TAXES WITHHELD TOTAL (FICA) AND INCOME) TAX LIABILITY I. ________ ______ _______ __________ __________ __________ II. ________ ______ _______ __________ __________ __________ III. ________ ______ _______ __________ __________ __________ In violation of Title 26, United States Code, Section 7203.
_________________________
United States Attorney
NOTES1. If employer is a corporation, refer to Forms - 25 as a guide in charging appropriate corporate officials with failure to file returns on behalf of corporation.
2. If venue is to be placed in the judicial district of the District Director, modify this form in accordance with language at Forms - 33.
Title Page || Table of Contents || Detailed Table of Contents
Table of Cases || Trial of a Criminal Tax Case
Model Jury Instructions || Indictment & Information Forms
Uploaded April 1998
