Form P-941 - Employer'S Return Of Income Tax Withheld - City Of Pontiac Income Tax Division - 2011 Page 2

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City of Pontiac
Income Tax Division
47450 Woodward Avenue
Pontiac, MI 48342
1. Last pay period on which Pontiac Taxes were
SUMM RY
withheld ___________________________
LIsT PAyMenTs MADe WITh P941
2. Check reason for “Final Return” and answer
eMPLoyer’s reTurns.
applicable questions
n
Business permanently discontinued
JAnuAry
n
Business temporarily discontinued
FebruAry
Operations will be resumed on
MArCh
__________________________
(Date)
1sT quArTer ToTAL $
n
Still operating – Ceased paying wages
APrIL
Wages will be paid starting
MAy
__________________________
(Date)
June
n
Business sold to
2nD quArTer ToTAL $
Name _________________________
JuLy
Street _________________________
AugusT
City ___________________________
sePTeMber
State __________________________
3rD quArTer ToTAL $
Zip Code _______________________
oCTober
n
Moved out of Pontiac
noveMber
3. Your current address
DeCeMber
Street _________________________
4Th quArTer ToTAL $
City ___________________________
yeArLy ToTAL $
State __________________________
Zip Code _______________________
n
4.
Other: _________________________
______________________________
______________________________

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