Form 941me - Employer'S Return Of Maine Income Tax Withheld - 2000

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*000620000*
MAINE REVENUE SERVICES
2000
INCOME/ESTATE TAX DIVISION
P.O. BOX 1061
AUGUSTA, ME 04332-1061
000620000
4
QUARTER #
EMPLOYER’S RETURN OF MAINE INCOME TAX WITHHELD
FORM 941ME
.
1. Maine Income Tax withheld for this quarter ... 1
Due on or Before:
Withholding Account Number:
01-31-01
01-234567890
2. Less Semi-weekly payments
.
(from Schedule 1, line 5 below) ..................... 2
Period Covered:
.
10-01-00 - 12-31-00
3. Amount due with this return ........................... 3
Name:
MADE UP NAME CORPORATION INC
JOHN DOE
MAKE CHECK PAYABLE TO TREASURER, STATE OF MAINE
Date _____________ Signature ________________________________ Title _____________________________________ Telephone _________________________
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
4. Total Withholding This Quarter (Enter here and on line 1 above)
5. Total Semi-weekly payments Remitted this quarter (Enter here and on line 2 above)
.
.
CANCELLATION NOTICE
6. Check this box and complete the following section if your business is discontinued or payment of wages permanently ceases.
FINAL
Reason for cancellation _________________________________________________________________________________________________________
Last Payroll Date:
Business Sold to: ___________________________________________________________
Mo.
Day
Year
(address): ________________________________________________________________
Date Sold: ____________________________________
Telephone: __________________________________________________
Office use only
Note: Use the Name and Address Change Form (Form 941/C1C-ME) on page 3 to change your business name or address.

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