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Form 1125-E Texas: What You Should Know
November 2016) Form 1125E — compensation of officers—for purposes of section 2601. (e) Date (f) Purpose (g) Amount (h) Name (i) Officer name of officer filing form (j) Officer's SSN (k) Officer's employer (1) IRS name, address, or TIN (2) Internal Revenue Service location (3) IRS return filing date or month (4) IRS tax year (5) Internal revenue service tax period (6) Employer tax year-end date (7) Return filing type (8) Reason(s) for filing (1) Number of persons (2) Gross income (3) Adjusted gross income from business, business activities, and foreign source income (4) Net income (5) Total gross wages and salaries from work for a person or entity (6) Name and contact information (7) Employer's SSN for any employee, partner, executive officer, or director of the employer (8) Federal Tax Identification Number or taxpayer ID number for any applicant for a federal tax exemption or tax deduction which is based upon the employer's exemption or tax deduction from gross income (9) Total wages, salaries, or other compensation paid to an individual by the individual or an entity to an individual (10) Type of business enterprise (11) Type of property or other assets of the business (12) Name of bank or trust A Form 1099-G should be given to the person or persons responsible for making the payments. 2. Print the information and insert the required amount into line 7 “Amount for Form 1095.” 3. Print line 7 “Form, number if given, of Form 1095, Statement of Payment of Compensation for Business, Business Activities, and Foreign Source Income.” 4. Print line 7 “Amount for Form 1095.” 5. Complete line 7 “Amount for Form 1095.” Enter the amount. 6. Print line 7 “Form, number if given, of Form 1095, Statement of Payment of Compensation for Business, Business Activities, and Foreign Source (rev. April 1, 2015).” 7. Print the information and insert the required amount into line 7 “Amount for Form 1095.” 8. Print line 7 “Amount for Form 1095.” 9. Complete line 7 “Amount for Form 1095.” Enter the amount. 10. Print line 7 “Form 1095.
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