for instructions and the latest information. OMB No. 1545-0029 Name (not your trade name) Employer identification number (EIN) Trade name (if any) Applicable calendar quarter (check one) (2) April, May, June (3) July, August, September (4) October, November, December
7200 Form (March 2020) Department of the Treasury Internal Revenue Service Name (not your trade name) Advance Payment of Employer Credits Due to COVID-19 Go to www.irs.gov/Form7200 for instructions and the latest information. OMB No. 1545-0029 Employer identification number (EIN) Trade name (if any) Number, street, and apt. or suite no. If a P.O. box, see instructions. City or town, state, and ZIP code. If a foreign address, also complete spaces below. (See instructions.) Applicable calendar quarter (check one) (2) April, May, June (3) July, August, September (4) October, November, December Foreign country name Foreign province/county Foreign postal code Does a third-party payer file your employment tax return? (See instructions.) If "Yes," enter its name. Third-party payer's EIN (if applicable) Tip: File Form 7200 if you can't reduce your employment tax deposits to fully account for these credits that you expect to claim on your employment tax return for the applicable quarter. Don't reduce your employment tax deposits and request advanced credits for the same expected credits. You will need to reconcile your advanced credits and reduced deposits on your employment tax return. You can't request an advance payment of the credit for sick and family leave for self-employed individuals. Part I Tell Us About Your Employment Tax Return A Check the box to indicate which employment tax return form you file (or will file for 2020): (1) 941, 941-PR, or 941-SS (2) 943 or 943-PR (3) 944 or 944(SP) (4) CT-1 B Is this a new business started on or after January 1, 2020? . . . . . . . . . . . . . . . Yes No If "Yes," skip line C unless you've already filed Form 941, Form 941-PR, or Form 941-SS for at least one quarter of 2020. C Amount reported on line 2 of your most recently filed Form 941 (or wages reported on Schedule R (Form 941), column (c), by your third-party payer (see instructions)). If you file a different employment tax return, see instructions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D Enter the total number of employees you have. See instructions . . . . . . . . . . . . . . Part II Enter Your Credits and Advance Requested 1 Total employee retention credit for the quarter. See instructions . . . . . . . . . . . . . 1 2 Total qualified sick leave wages eligible for the credit and paid this quarter. See instructions . . . 2 3 Total qualified family leave wages eligible for the credit and paid this quarter. See instructions . . . 3 4 Add lines 1, 2, and 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 Total amount by which you have already reduced your federal employment tax deposits for these credits for this quarter . . . . . . . . . . . . 5 6 Total advanced credits requested on previous filings of this form for this quarter 6 7 Add lines 5 and 6 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 8 Advance requested. Subtract line 7 from line 4. If zero or less, don't file this form . . . . . . . 8 ThirdParty Designee Do you want to allow an employee, a paid tax preparer, or another person to discuss this return with the IRS? See the instructions for details. Yes. Complete below. No Designee's name and phone number Select a 5-digit personal identification number (PIN) to use when talking to the IRS Sign Here Under penalties of perjury, I declare that I have examined this form, including any accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Your signature Date Printed title Paid Preparer Use Only How To File Printed name Print/Type preparer's name Preparer's signature Firm's name Firm's address Fax your completed form to 855-248-0552. For Privacy Act and Paperwork Reduction Act Notice, see the separate instructions. Best daytime phone Date PTIN Firm's EIN Phone no. Check if self-employed Cat. No. 56392D Form 7200 (3-2020)Adobe LiveCycle Designer ES 9.0