Form M-941A at a glance
What it is: The Massachusetts Department of Revenue Employer's Annual Return of Income Taxes Withheld, which you must file even though no tax may be due.
Who signs: The return is signed with a signature, title and date, under the penalties of perjury.
The blank Form M-941A: print it and complete it by hand

How to fill out Form M-941A, box by box
Federal identification number and period
Write the number of employees from whom taxes were withheld. The form also has boxes for the federal identification number and the year.
Be sure this return covers the correct period. If incorrect, see instructions. Do not alter.
If any information is incorrect, see instructions.
An entry must be made in each line. Enter "0," if applicable.
Lines 1 to 6: amounts
Line 1 is the amount withheld.
Line 2 is the adjustment for prior amount withheld. Explain any adjustment on reverse or it will be disallowed. Adjustment must be from immediate prior period.
Under line 2 adjustment information, state the reason for the adjustment request.
Check here if using the back of this form.
Line 3 is the amount due after adjustment (not less than "0").
Line 4 is penalties. Line 5 is interest.
Line 6 is the total amount due: add lines 3, 4 and 5.
EFT payment and final return
Check here if EFT payment.
Check if final return and you wish to close your withholding tax account.
Return due, mail to
Return is due with payment on or before the 31st day of January following the year indicated. Make check payable to Commonwealth of Mass. Mail to: Mass. Dept. of Revenue, PO Box 7042, Boston, MA 02204.
Signing under the penalties of perjury
Sign under this declaration: "I declare under the penalties of perjury that this return (including any accompanying schedules and statements) has been examined by me and to the best of my knowledge and belief is a true, correct and complete return."
Sources
[1] Massachusetts Form M-941A (4.5M 7/00), Employer's Annual Return of Income Taxes Withheld, served file (the Official source link on this page).
