Form 2333c-04 - Withholding Tax And Unemployment Contributions Forms - Order Form - 2004

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MAINE REVENUE SERVICES
2004
P.O. Box 9100
AUGUSTA, ME 04332-9100
FORM 2333C-ME
WITHHOLDING TAX AND UNEMPLOYMENT
CONTRIBUTIONS FORMS
ORDER FORM
Business Name _______________________________ E-mail ________________________________
Address _____________________________________ City, State _________________ ZIP ________
Contact Person _______________________________ Telephone Number ( ) __________________
Use this form to request your Withholding tax and Unemployment contributions forms. Downloadable forms are
available at: All forms come in packages of 10 at $1.70 each package. Indicate the
number of packages you wish to purchase and multiply that number by $1.70 for the total.
Abbreviations: WH = Withholding UC = Unemployment Contributions
Loose Forms (To be completed by hand)
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Please submit your order (and make checks payable) to:
S
l a
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Goodwill Industries of Northern New England, Inc.
5
%
(
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) 5
243 Leighton Road
T
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$
Augusta, Maine
04330
Rev 10/03

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