Form 1065me/1120s-Me - Maine Information Return Partnerships/llcs/s Corporations - 2009 Page 2

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SCHEDULE PSI
INCOME OF NONRESIDENT
2009
99
PARTNERS/SHAREHOLDERS
*0900901*
Enclose with your Form 1065/1120S-ME. Page _____ of _____.
Check here if part
9
0
01/01/09
/
/
to
/
/
For tax period
of amended return
-
Entity Name (as it appears on Form 1065ME/1120S-ME)
Federal Employer ID No.
1.
-
-
If partner/shareholder is an individual, last name
First name
MI
Social Security Number
-
If partner/shareholder is other than an individual, enter name here
Federal ID Number
,
,
$
.00
Address
Partner/Shareholder Maine Income
,
,
$
.00
City
State
ZIP Code
Partner/Shareholder Maine Withholding
Distributive
Partner/Shareholder
Partner/Shareholder
.
%
Offi ce Use Only
Share %
Resident of Maine
Nonresident of Maine
2.
-
-
If partner/shareholder is an individual, last name
First name
MI
Social Security Number
-
If partner/shareholder is other than an individual, enter name here
Federal ID Number
,
,
$
.00
Address
Partner/Shareholder Maine Income
,
,
$
.00
City
State
ZIP Code
Partner/Shareholder Maine Withholding
Distributive
Partner/Shareholder
Partner/Shareholder
.
%
Share %
Offi ce Use Only
Resident of Maine
Nonresident of Maine
3.
-
-
If partner/shareholder is an individual, last name
First name
MI
Social Security Number
-
If partner/shareholder is other than an individual, enter name here
Federal ID Number
,
,
$
.00
Address
Partner/Shareholder Maine Income
,
,
$
.00
City
State
ZIP Code
Partner/Shareholder Maine Withholding
Distributive
Partner/Shareholder
Partner/Shareholder
.
%
Share %
Offi ce Use Only
Resident of Maine
Nonresident of Maine
4.
-
-
If partner/shareholder is an individual, last name
First name
MI
Social Security Number
-
If partner/shareholder is other than an individual, enter name here
Federal ID Number
,
,
$
.00
Address
Partner/Shareholder Maine Income
,
,
$
.00
City
State
ZIP Code
Partner/Shareholder Maine Withholding
Distributive
Partner/Shareholder
Partner/Shareholder
.
%
Share %
Offi ce Use Only
Resident of Maine
Nonresident of Maine
Rev. 10/09

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