Form 941p-Me - Pass-Through Entity Return Of Income Tax Withheld From Owners - 2004 Page 2

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FORM 941P-ME
040625100
Name:
Withholding
Account No.:
This page contains (check one):
-
Period
Individuals with
Entities with Federal
Covered:
social security numbers
Employer ID numbers
-
-
-
-
-
Income Tax Withholding Listing for Pass-through Entities
7. Member Name (Last, First, MI)
8. Social Security Number (EIN if
9. Maine Income Tax
other than an individual)
Withheld in Quarter
$
a.
.
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-
,
b.
.
-
-
,
c.
.
-
-
,
d.
.
-
-
,
e.
.
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,
f .
.
-
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,
g.
.
-
-
,
h.
.
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,
i.
.
-
-
,
j.
.
-
-
,
k.
.
-
-
,
l.
.
-
-
,
m.
.
-
-
,
n.
.
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-
,
o.
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,
p.
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,
q.
.
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-
,
r.
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,
s.
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,
t.
.
-
-
,
u.
.
-
-
,
v.
.
-
-
,
w.
.
-
-
,
.
10. Total on this page .................................................................................................................................................................. 10.
,
,
.
11. Total for ALL pages (Enter here and on page 1, line 4, or line 1, if not completing Schedule 1) .......................................... 11.
,
,

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