SCHEDULE 2/C1
(
) 2006
Loose
FORM 941/C1- ME Loose
00
Name:
UC Employer
Withholding
*0608522*
:
Account No.:
Account No
/
/
/
/
to
Period Covered:
MM
DD
YY
MM
DD
YY
Quarterly Income Tax Withholding and Unemployment Compensation Wages Listing
INCOME TAX
All employers designated SEASONAL by Department
WITHHOLDING
of Labor (See instructions).
Maine Income Tax
Payee Name (Last, First, MI)
Social Security Number
UC Gross Wages Paid
Withheld in the Quarter
14.
15.
16.
17.
$
,
.
$
,
.
-
-
a. __________________________________
-
-
$
,
.
$
,
.
b. __________________________________
-
-
$
,
.
$
,
.
c. __________________________________
$
,
.
$
,
.
-
-
d. __________________________________
-
-
$
,
.
$
,
.
e. __________________________________
$
,
.
$
,
.
-
-
f . __________________________________
$
-
-
,
.
$
,
.
g. __________________________________
$
,
.
$
-
-
,
.
h. __________________________________
$
,
.
$
,
.
-
-
i. __________________________________
$
,
.
$
,
.
-
-
j. __________________________________
$
,
.
$
-
-
,
.
k. __________________________________
-
-
$
,
.
$
,
.
l. __________________________________
$
,
.
$
,
.
-
-
m. _________________________________
$
-
-
,
.
$
,
.
n. __________________________________
-
-
$
,
.
$
,
.
o. __________________________________
$
,
.
$
,
.
-
-
p. __________________________________
$
,
.
$
,
.
-
-
q. __________________________________
$
,
.
$
,
.
-
-
r. __________________________________
-
-
$
,
.
$
,
.
s. __________________________________
$
,
.
$
,
.
-
-
t. __________________________________
-
-
$
,
.
$
,
.
u. __________________________________
$
,
.
$
,
.
-
-
v. __________________________________
-
-
$
,
.
$
,
.
w. __________________________________
$
$
,
,
.
,
,
.
18. Total on this page .......................................................... 18a.
18b.
$
$
19. Total for ALL pages ...................................................... 19a.
,
,
.
19b.
,
,
.