Form 941p-Me - Pass-Through Entity Return Of Maine Income Tax Withheld From Members - 2015 Page 2

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SCHEDULE 2P (FORM 941P- ME) 2015
00
XXXXXXXXXXXXXXXXXXXXXXX
Name:
*13941P2*
Federal
Identifi cation
99 9999999
No.:
01 01 2015 - 12 31 2015
Period Covered:
Pass-through Entity Withholding Listing - File with Form 941P- ME
Do not include lower-tier entity withholdng or real estate withholding
6. Name of Member
7. Social Security Number/EIN
8. Check Here
9. Distributive
10. Maine Income Tax
(Last, First, MI if individual)
if EIN
Share %
Withheld during the Year
X
.
.
%
a.
X
.
.
%
b.
X
.
.
%
c.
X
.
.
%
d.
X
.
.
%
e.
X
.
.
%
f.
X
.
.
%
g.
X
.
.
%
h.
X
.
.
%
i.
X
.
.
%
j.
X
.
.
%
k.
X
.
.
%
l.
X
.
.
%
m.
X
.
.
%
n.
X
.
.
%
o.
X
.
.
%
p.
.
11. Total of column 10 on this page. ...................................................................................................... 11.
.
12. Total of line 11 for ALL pages (Enter here and on Form 941P-ME, Line 1) .....................................12.

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