Form 941p-Me - Pass-Through Entity Return Of Maine Income Tax Withheld From Members - 2014

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2014
MAINE REVENUE SERVICES
00
PASS-THROUGH ENTITY RETURN
FORM 941P-ME
OF MAINE INCOME TAX WITHHELD FROM MEMBERS
*13941P0*
04 30 2015
Due on or Before:
01 01 2014 - 12 31 2014
Period Covered:
Federal Identifi cation No:
A. Check this box and complete Schedule 3P if you are claiming the Compliant
Taxpayer or Composite Filing exemption from pass-through entity withholding
X
Amended return:
Check here if your address changed.
for any non-resident member. See Schedule 3P instructions ...........................
B . Total number of non-resident members (see instructions) __________
1.
Pass-through entity
withholding for this year
Name
$
(from Schedule 2P, line 12) ....
$
2.
Estimated Payments ..............
3a. Amount due with this return
Address
(line 1minus line 2, if line 1
$
is greater than line 2)..............
City
State
ZIPCode
3b. Overpayment to be refunded
(line 2 minus line 1, if line 2
$
is greater than line 1)..............
Tiered entities see instructions for lines 1 and 2.
Schedule 1P- Entity Apportionment
If tax year is a fiscal year, enter
_____/_____/_____ to _____/_____/_____
tax year begin and end dates :
MM
DD YYYY
MM
DD YYYY
4a. Maine
4b. Everywhere
999999999999
.00
999999999999
.00
Sales
Sales
4c. Maine
5. Total Entity
.
. 00
Apportionment
income or loss
Factor
Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements, and to the best of my knowledge and
belief, they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
Signature:
Date:
Print Name:
Telephone:
Contact Person Email:
For Paid Preparers Only
Paid Preparer’s Signature:
Date:
Telephone:
Firm’s Name (or yours, if self-employed):
Paid Preparer EIN:
Address:
See pages 3 and 4 for electronic fi ling and payment requirements and options
If enclosing a check, make check payable to:
If not enclosing a check,
Treasurer, State of Maine
MAIL RETURN TO:
and MAIL WITH RETURN TO:
MAINE REVENUE SERVICES
MAINE REVENUE SERVICES
P.O. BOX 1065
P.O. BOX 1064
AUGUSTA, ME 04332-1064
AUGUSTA, ME 04332-1065

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