Form 941/c1-Me - Combined Filing For Income Tax Withholding And Unemployment Contributions - 2013 Page 2

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SCHEDULE 1/C1 (FORM 941/C1- ME) 2013
99
Name:
*1308501*
Withholding
Account No.:
UC Employer
Account No:
2013 -
2013
Period Covered:
MM
DD
YY YY
MM
DD
YYYY
Reconciliation of Semiweekly Payments of Income Tax Withholding
For employers or non-payroll fi lers required to remit withholding taxes on a semiweekly basis (see instructions).
Date Wages or Non-
Payment
Date Wages or Non-
Payment
Date Wages or Non-
Payment
wages Paid
Amount
wages Paid
Amount
wages Paid
Amount
Subtotal A
Subtotal B
Subtotal C
.
12. Total (Enter on Form 941/C1-ME, line 2) ................................................................................. $
For Field Advisor Use:

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