Form 900me - Payment Voucher For Maine Income Tax Withheld - 2001 Page 2

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TAXPAYER WITHHOLDING PAYMENT RECORD
1st Quarter
3rd Quarter
Date Wages Paid
Amount Withheld
Check Amount
Date Wages Paid
Amount Withheld
Check Amount
1st QTR TOTALS
$
$
1st QTR TOTALS
$
$
2nd Quarter
4th Quarter
Date Wages Paid
Amount Withheld
Check Amount
Date Wages Paid
Amount Withheld
Check Amount
1st QTR TOTALS
$
$
1st QTR TOTALS
$
$

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