Form 941p-Me - Pass-Through Entity Return Of Maine Income Tax Withheld - 2003 Page 2

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*030627000*
Name:
Withholding
-
Account No.:
030627000
This page contains (check one):
Individuals with
Entities with
Period
01 - 01 - 03 – 12 - 31 - 03
Covered:
social security numbers
Federal ID numbers
FORM 941P-ME
Pass-through Entity Withholding Listing
4. Partner/Shareholder Name (Last, First, MI)
5. Social Security Number (EIN if other
6. Maine Income Tax Withheld on
than an individual)
income for the year
$
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a.
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7. Total on this page .................................................................................................................................................................... 7.
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8. Total for ALL pages (Enter here and on page 1, line 1) ........................................................................................................ 8.

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