Form 1065me/1120s-Me - Maine Information Return For Partnerships/s Corporations - 2010 Page 2
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1
2SCHEDULE PSI
INCOME OF PARTNERS/SHAREHOLDERS
00
*0400801*
Enclose with your Form 1065/1120S-ME. Page ____ of ____.
Check here if part
/
/
/
/
01/01/04
12/31/04
0 4
For tax period
to
or
to
of amended return
MM
DD
YY
MM
DD
YY
Federal Employer ID No.
Entity Name
(As it appears on Form 1065ME/1120S-ME)
1
-
-
If partner/shareholder is an individual, enter last name above
First name
MI
Social Security Number
.
%
If partner/shareholder is other than an individual, enter name above
Ownership %
Federal ID number
,
,
.
$
Address
Partner/shareholder Maine income
Office use only
Partner/Shareholder
R
Resident of Maine
Partner/Shareholder
N
City
State
ZIP code
Nonresident of Maine
2
-
-
If partner/shareholder is an individual, enter last name above
First name
MI
Social Security Number
.
%
If partner/shareholder is other than an individual, enter name above
Ownership %
Federal ID number
,
,
$
.
Address
Partner/shareholder Maine income
Office use only
Partner/Shareholder
R
Resident of Maine
Partner/Shareholder
N
City
State
ZIP code
Nonresident of Maine
3
-
-
If partner/shareholder is an individual, enter last name above
First name
MI
Social Security Number
.
%
If partner/shareholder is other than an individual, enter name above
Ownership %
Federal ID number
,
,
.
$
Address
Partner/shareholder Maine income
Office use only
Partner/Shareholder
R
Resident of Maine
Partner/Shareholder
N
City
State
ZIP code
Nonresident of Maine
4
-
-
If partner/shareholder is an individual, enter last name above
First name
MI
Social Security Number
.
%
If partner/shareholder is other than an individual, enter name above
Ownership %
Federal ID number
,
,
$
.
Address
Partner/shareholder Maine income
Office use only
Partner/Shareholder
R
Resident of Maine
Partner/Shareholder
N
City
State
ZIP code
Nonresident of Maine
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