Form 941/c1c-Me - Name And Address Change - 2007 printable pdf download

Form 941/c1c-Me - Name And Address Change - 2007

MAINE INCOME TAX WITHHOLDING

NAME AND ADDRESS CHANGE FORM

FORM 941/C1C-ME 2007

If there has been a change in your name, address or telephone number, complete this form and mail it to MAINE REVENUE SERVICES.

If there has been a change in your Federal Identiﬁ cation Number, call CENTRAL REGISTRATION at (207) 287-2338.

Note:

If your business is discontinued or the requirement to withhold permanently ceases,

complete the cancellation notice at the bottom of the quarterly return.

Mail to:

Present Withholding Account Number:

Maine Revenue Services

P.O. Box 9103

Present UC Employer Account Number:

Augusta, ME 04332-9103

Present Name and Address:

New Name and Address:

Old Phone Number: ____________________________________________________

New Phone Number (If Applicable): _______________________________________

Effective Date of Change: _______________________________________________

Remarks: __________________________________________________________________________________________________________________________________

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Date

Signature

Title

Telephone Number

Form 941/c1c-Me - Name And Address Change - 2007