Form 941 Quarterly Summary, 2019–2020

Mason Street Bistro LLC · EIN 47-3829104

Originals on file with Hundredfold. Filing method: paper, prepared by Wexler & Associates CPA, signed by Daniel Reilly (member-manager).
941-X amendments filed for 2020 Q2 and 2020 Q3 in June 2021, claiming Employee Retention Credit under §2301 (CARES Act).

Quarterly Form 941 Line Items

Line	Q1 2019	Q2 2019	Q3 2019	Q4 2019	Q1 2020	Q2 2020	Q3 2020	Q4 2020
1. Employees who received wages	14	14	14	14	14	12	11	11
2. Wages, tips, comp (Box 1 of W-2 equiv)	$152,180	$158,900	$167,420	$149,640	$155,310	$92,440	$132,070	$141,100
3. Federal income tax withheld	$18,260	$19,070	$20,090	$17,100	$18,640	$11,090	$15,850	$15,860
5a. Soc Sec wages × 12.4%	$18,870	$19,704	$20,760	$18,556	$19,258	$11,463	$16,377	$17,496
5c. Medicare wages × 2.9%	$4,413	$4,608	$4,855	$4,340	$4,504	$2,681	$3,830	$4,092
6. Total taxes (lines 3+5a+5c)	$41,543	$43,382	$45,705	$39,996	$42,402	$25,234	$36,057	$37,448
11. Total deposits made	$41,543	$43,382	$45,705	$39,996	$42,402	$25,234	$36,057	$37,448
12. Balance due / (overpayment)	$0	$0	$0	$0	$0	$0	$0	$0

941-X Amendment History

Form	Filed	Quarter	Claim	IRS response
941-X (#1)	2021-06-12	Q2 2020	$46,220 ERC	Approved, refunded 2022-09
941-X (#2)	2021-06-12	Q3 2020	$66,035 ERC	Partial disallowance, IRS Letter 6577 dated 2024-02-11

Deposit Schedule

Monthly schedule depositor throughout 2019 and 2020. Deposits made via EFTPS, all timely (no failure-to-deposit penalties on record). Lookback period total tax: $170,626 (2019 annual total taxes per Form 941, sum of Q3 2017 through Q2 2018 fiscal year). Schedule confirmed monthly per Treas. Reg. §31.6302-1.

Qualifying Wages Reconciliation (for IRC §2301 ERC claim)

Quarter	Total wages	Owner exclusion	Health insurance allocable	Qualified wages base	ERC @ 50%
Q2 2020	$92,440	$0 (operator unpaid)	$0	$92,440	$46,220
Q3 2020	$132,070	$0	$0	$132,070	$66,035

Per CARES Act §2301: small employer (under 100 FTE 2019 avg), all wages paid to employees during the qualifying quarter count as qualified wages regardless of whether the employee was actively working. ERC = 50% of qualified wages, capped at $10,000 per employee per year.