Form 941/c1-Me - Combined Filing For Income Tax Withholding And Unemployment Contributions - 2001 Page 2

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*010850100*
Form 941/C1-ME - Page 2
010850100
Reconciliation of 900ME Voucher Payments (See Instructions)
Schedule 1- For employers required to remit withholding taxes on a semi-weekly basis
Date Wages
Amount
Check
Date Wages
Amount
Check
Date Wages
Amount
Check
Paid
Withheld
Amount
Paid
Withheld
Amount
Paid
Withheld
Amount
12. Total withholding this quarter (enter here and on line 1)
13. Total semi-weekly payments this quarter (enter here and on line 2)
$
$
,
,
,
,
.
.
To reduce printing and postage costs, if you have your return done by a tax preparer and do not need Maine tax forms and instructions
mailed to you next year, check this box ........................................................................................................................................................ >
ALL EMPLOYERS, PLEASE CHECK THE ONE BOX THAT APPLIES:
I would like personalized wage listing pages next year.
I would like non-personalized (blank) wage listing pages next year.
I would like no wage listing pages next year (I have my wage listing pages printed by an approved alternate method).
For Field Advisor Use:

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