Form P-941 - Employer'S Return Of Income Tax Withheld - City Of Pontiac Income Tax Division - 2004

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1 M
2004
P - 941 City of Pontiac - Income Tax Division
Employer’s Return of Income Tax Withheld
Tax withheld
Make remittance payable to:
Adjustments
Treasurer, City of Pontiac
If this is your first return, enter date this
Mail to:
business was started
City of Pontiac Payroll Tax
Net tax withheld
P O Box 430330
If this is final return, or employer status has changed,
Late payment penalty - 1%
see back of form for required information to be submitted.
Pontiac, MI 48343-0330
per month ($2.00 minimum)
I certify the tax withheld as shown on this return is correct.
Interest due
(contact city for daily rates)
Signature
Date
TOTAL DUE
Phone #
PAY THIS AMOUNT
FEDERAL EMPLOYER I D #
2004
TAX YEAR
JANUARY 1M
PAYROLL PERIOD
DUE DATE
February 28, 2004
DO NOT WRITE BELOW THIS LINE
2 M
2004
P - 941 City of Pontiac - Income Tax Division
Employer’s Return of Income Tax Withheld
Tax withheld
Make remittance payable to:
Adjustments
Treasurer, City of Pontiac
If this is your first return, enter date this
Mail to:
business was started
City of Pontiac Payroll Tax
Net tax withheld
P O Box 430330
If this is final return, or employer status has changed,
Late payment penalty - 1%
see back of form for required information to be submitted.
Pontiac, MI 48343-0330
per month ($2.00 minimum)
I certify the tax withheld as shown on this return is correct.
Interest due
(contact city for daily rates)
Signature
Date
TOTAL DUE
Phone #
PAY THIS AMOUNT
FEDERAL EMPLOYER I D #
2004
TAX YEAR
FEBRUARY 2M
PAYROLL PERIOD
DUE DATE
March 31, 2004
DO NOT WRITE BELOW THIS LINE
3 M
2004
P - 941 City of Pontiac - Income Tax Division
Employer’s Return of Income Tax Withheld
Tax withheld
Make remittance payable to:
Adjustments
Treasurer, City of Pontiac
If this is your first return, enter date this
Mail to:
business was started
City of Pontiac Payroll Tax
Net tax withheld
P O Box 430330
If this is final return, or employer status has changed,
Late payment penalty - 1%
see back of form for required information to be submitted.
Pontiac, MI 48343-0330
per month ($2.00 minimum)
I certify the tax withheld as shown on this return is correct.
Interest due
(contact city for daily rates)
Signature
Date
TOTAL DUE
Phone #
PAY THIS AMOUNT
FEDERAL EMPLOYER I D #
TAX YEAR
2004
PAYROLL PERIOD
MARCH 3M
DUE DATE
April 30, 2004
DO NOT WRITE BELOW THIS LINE

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