Form 941me - Employer'S Return Of Maine Income Tax Withholding - 2008

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FORM 941ME Loose
MAINE REVENUE SERVICES
2008
EMPLOYER’S RETURN
00
OF MAINE INCOME TAX WITHHOLDING
*0806220*
QUARTER #
Withholding Account Number:
-
A.
Number of payees subject to Maine income tax withholding ..........A.
,
Period Covered:
-
-
to
-
-
B.
Check here if MRS granted an exception to report non-wage
MM
DD
YY
MM
DD
YY
withholding detail annually on magnetic media. See instructions ..................................... B.
Name and Address:
1.
Maine income tax withheld for this
$
.
Quarter (from Schedule 2, line 11) .......1.
,
,
Name
2.
Less semiweekly payments (from
$
.
Schedule 1, line 6) ...............................2.
,
,
Address
3a. Amount due with this return (if line 1
$
.
,
,
is greater than line 2) .........................3a.
City
State
ZIP Code
3b. Overpayment to be refunded (if line 2
$
.
,
,
is greater than line 1) .........................3b.
Under penalties of perjury, I certify that the information contained on this return, report and attachment(s) is true and correct.
Date: ____________
Signature: _______________________________________
Title: __________________________________
Telephone: ________________
-
Contact person e-mail : _______________________________________________
Paid Preparer EIN:
Maine Payroll Processor License Number:
Make check payable to:
Treasurer, State of Maine
Mail return and check to:
Maine Revenue Services, P.O. Box 1061, Augusta, ME 04332-1061
For the Third Quarter Only: please check if applicable:
I fi le my return electronically or my return is prepared by a tax preparer and I do not need Maine tax forms mailed to me next year.
CANCELLATION NOTICE
4. Check this box and complete the following section if your business is discontinued or the requirement to withhold permanently ceases ...............................
Reason for Cancellation: _________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Business Sold to - Name: _____________________________________________________
Business Sold to - Address: _____________________________________________________
Last Payroll Date:
/
/
MM
DD
YY
_____________________________________________________
Date Sold:
/
/
MM
DD
YY
Telephone: _____________________________________________________
Note:
Use the Name and Address Change Form (Form 941/C1C-ME) to change your business name or
address. This form is available at (select “Forms, Publications & Applications”
link, then select “Employment Taxes”).
Offi ce use only
PWD

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