Form 1065me/1120s-Me - Maine Information Return Partnerships/llcs/s Corporations - 2005 Page 2

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SCHEDULE PSI
2005
2005
00
INCOME OF PARTNERS/SHAREHOLDERS
*0500801*
Enclose with your Form 1065/1120S-ME. Page ____ of ____.
0 5
/
/
to
/
/
01/01/05
12/31/05
Check here if part
For tax period
to
or
MM
DD
YY
MM
DD
YY
of amended return
-
Federal Employer ID No.
Entity Name
(As it appears on Form 1065ME/1120S-ME)
1
-
-
If partner/shareholder is an individual, enter last
First name
MI
Social Security Number
name above
-
If partner/shareholder is other than an individual, enter name above
Federal ID Number
$
,
,
.00
Address
Partner/shareholder Maine income
$
,
,
.00
City
State
ZIP code
Partner/shareholder Maine withholding
Partner/Shareholder
Partner/Shareholder
.
%
Office Use Only
Ownership %
Resident of Maine
Nonresident of Maine
2
If partner/shareholder is an individual, enter last
First name
MI
Social Security Number
name above
-
If partner/shareholder is other than an individual, enter name above
Federal ID Number
$
,
,
.00
Address
Partner/shareholder Maine income
$
,
,
.00
City
State
ZIP code
Partner/shareholder Maine withholding
Partner/Shareholder
Partner/Shareholder
.
%
Office Use Only
Ownership %
Resident of Maine
Nonresident of Maine
3
If partner/shareholder is an individual, enter last
First name
MI
Social Security Number
name above
-
If partner/shareholder is other than an individual, enter name above
Federal ID Number
$
,
,
.00
Address
Partner/shareholder Maine income
$
,
,
.00
City
State
ZIP code
Partner/shareholder Maine withholding
Partner/Shareholder
Partner/Shareholder
.
%
Office Use Only
Ownership %
Resident of Maine
Nonresident of Maine
4
If partner/shareholder is an individual, enter last
First name
MI
Social Security Number
name above
-
If partner/shareholder is other than an individual, enter name above
Federal ID Number
$
,
,
.00
Address
Partner/shareholder Maine income
$
,
,
.00
City
State
ZIP code
Partner/shareholder Maine withholding
Partner/Shareholder
Partner/Shareholder
.
%
Office Use Only
Ownership %
Resident of Maine
Nonresident of Maine

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