Form Preview Example

FORM 941/C1-ME				MAINE REVENUE SERVICES
				MAINE DEPARTMENT OF LABOR
2010				COMBINED FILING FOR INCOME TAX WITHHOLDING
				AND UNEMPLOYMENT CONTRIBUTIONS
QUARTER #				Withholding Account No:

Name:				UC Employer Account No:

*1008520*

Period Covered:

File On or Before:

Part One - Income Tax Withholding

A. Number of payees subject to

Maine income tax withholding:

1.Maine income tax withheld this quarter (from Schedule 2/C1, line 19b)

(Semiweekly ﬁ lers complete Schedule 1/C1 on reverse side)	1.	$	,	,

2.Less any semiweekly payments (From Schedule 1/C1, line 13 on reverse side)

(See instructions for Schedule 1/C1 on page 7)	2.	$	,	,

		$	,	,
3. Income tax withholding due (line 1 minus line 2)	3.

Part Two - Unemployment Contributions Report

	Seasonal Code:		-			-	-
	Seasonal Code:	-			-
	Seasonal Period:	-			-				1st Month
4.	For each month, enter the total of all full-time and part-time workers who worked during,								1st Month
	or received pay reportable for unemployment insurance purposes for the payroll period
	which includes, the 12th of each month. If you had no employment in the payroll period,
	enter zero (0)							4.
	enter zero (0)							4.
5.	Number of female employees included on line 4.			If none, enter zero (0)				5.

6.Total Unemployment Compensation Gross Wages Paid this quarter (from Schedule 2/C1,line 19a)			... 6.	$	,

7.	DEDUCT EXCESS WAGES (SEE INSTRUCTIONS ON PAGE 6)		7.	$		,

	NOTE: THE TAXABLE WAGE BASE IS $12,000 FOR EACH EMPLOYEE.
8.	Taxable wages paid in this quarter (line 6 minus line 7)		8.	$		,

9a.	UC Contribution rate .	UC Contributions due (line 8 times line 9a)	9b.	$		,

				$		,
9c.	CSSF rate .0006	CSSF Assessment (line 8 times line 9c)	9d.

	Note: The CSSF Assessment does not apply to direct reimbursable employers. See instructions.
10.	Total Contributions and CSSF assessment due (line 9b plus line 9d)		10.	$		,

Part Three - Calculate the Total Amount Due

2nd Month

3rd Month

11. Amount due with this return (line 3 plus line 10)	11.	$		,
		$		,

See Page 8 for Electronic Filing and Payment Requirements and Options

Under penalties of perjury, I certify that the information contained on this return, report and attachment(s) is true and correct.

Signature:__________________________________________________________________________________ Date:_______________________________

Print Name: ___________________________________________ Telephone:_____________________ Contact person email:_______________________________

For Paid Preparers Only

Paid Preparer’s Signature:________________________________________________ Date:__________________ Telephone:__________________________________

Firm’s Name (or yours, if self-employed):_____________________________________

Address:_______________________________________________________________

Make check payable to: Treasurer, State of Maine

Mail return and check to: Maine Revenue Services P.O. Box 9103 Augusta, ME 04332-9103

Paid Preparer EIN:					-

Maine Payroll Processor License Number:

Ofﬁ ce use only

PWD

SCHEDULE 1/C1 (FORM 941/C1- ME) 2010

Name:

Withholding Account No.:

UC Employer Account No:

Period Covered:

- - -

*1008521*

Reconciliation of 900ME Voucher Payments or Electronic 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	Withholding	Payment	Date Wages	Withholding	Payment	Date Wages	Withholding	Payment
or Non-wages			or Non-wages			or Non-wages
	Amount	Amount		Amount	Amount		Amount	Amount
Paid			Paid			Paid

Subtotal A

12. Withholding Amount this Quarter













Subtotal B				Subtotal C

13. Payment Amount this Quarter

Subtotal A	$	,

Subtotal B	$	,

Subtotal C	$	,

Total (Enter on Form 941/C1-ME,		,
line 1)	$

Subtotal A	$	,
Subtotal B	$	,
Subtotal C	$	,
Total (Enter on Form 941/C1-ME,
line 2)	$	,

For the Third Quarter Only: all employers or non-payroll ﬁ lers, please check if applicable:

I ﬁ le my return electronically or my return is prepared by a tax preparer and I do not need Maine tax forms mailed to me next year.

For Field Advisor Use: ___________________________________________________

SCHEDULE 2/C1 (FORM 941/C1- ME) 2010

Name:

Withholding

UC Employer

Account No.:

Account No:

Period Covered:

*1008522*

Quarterly Income Tax Withholding and Unemployment Compensation Wages Listing

All employers designated SEASONAL by Department of Labor, see instructions for column 16 on page 7.

INCOME TAX

WITHHOLDING

Maine Income Tax

14. Payee Name (Last, First, MI)

15. Social Security Number

______________________________

18.Total of columns 16 and 17 on this page......................... 18a. $ ,

19.Total of columns 16 and 17 for ALL pages....................... 19a. $ ,

16. UC Gross Wages Paid

$ , .

, . 18b. $

, . 19b. $

17. Withheld in the Quarter

Question	Answer
Form Name	Form 941 C1 Me
Form Length	3 pages
Fillable?	No
Fillable fields	0
Avg. time to fill out	45 sec
Other names	941C1_10 form941c1 me

Form 941 C1 Me – Fill Out and Use This PDF

Form 941 C1 Me PDF Details

Form Preview Example

Form 941 C1 Me isn’t the one you’re looking for?

Form 941 C1 Me – Fill Out and Use This PDF

Form 941 C1 Me PDF Details

Form Preview Example

Form 941 C1 Me isn’t the one you’re looking for?

Related Documents