Form 941/c1- Me Loose - Combined Filing For Income Tax Withholding And Unemployment Contributions - 2005 Page 2
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1
2
3SCHEDULE 1/C1
(
) 2005
Loose
FORM 941/C1- ME Loose
00
Name:
Withholding
*0508521*
Account No.:
UC Employer
Account No:
to
Period Covered:
MM
DD
YY
MM
DD
YY
Reconciliation of 900ME Voucher Payments or EFT Payments of Income Tax Withholding
For employers required to remit withholding taxes on a semi-weekly basis (see instructions).
Date Wages or
Withholding
Payment
Date Wages or
Withholding
Payment
Date Wages or
Withholding
Payment
Distribution Paid
Amount
Amount
Distribution Paid
Amount
Amount
Distribution Paid
Amount
Amount
Subtotal A
Subtotal B
Subtotal C
$
,
,
.
$
,
,
.
12. Withholding Amount this Quarter
13. Payment Amount this Quarter
Subtotal A .....................................
Subtotal A .......................................
$
,
,
.
$
,
,
.
Subtotal B .....................................
Subtotal B .......................................
$
,
,
.
$
,
,
.
Subtotal C ....................................
Subtotal C ......................................
$
,
,
.
$
,
,
.
Total (Should equal line 1) .............
Total (Enter here and on line 2) .......
For the Third Quarter Only: all employers, please check any boxes that apply:
My return is prepared by a tax preparer and I do not need Maine tax forms and instructions mailed next year.
I would like personalized Schedule 2/C1 – Quarterly Income Tax Withholding and Unemployment Compensation Wages Listing pages next year.
I would like non-personalized (blank) Schedule 2/C1 – Quarterly Income Tax Withholding and Unemployment Compensation Wages Listing pages
next year.
I would like no Schedule 2/C1 – Quarterly Income Tax Withholding and Unemployment Compensation Wages Listing pages next year because
I will submit Schedule 2/C1 data by an approved alternate method.
For Field Advisor Use:
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