P941
CITY OF PORTLAND -INCOME TAX DIVISION
EMPLOYER'S RETURN OF INCOME TAX WITHHELD
TAX WITHHELD
MAKE REMITTANCE PAYABLE TO:
BUSINESS DISCONTINUED DATE__________
TREASURER, CITY OF PORTLAND
NO EMPLOYEES SINCE ____________
MAIL CHECK WITH RETURN TO:
ADJUSTMENTS
BUSINESS CHANGED TO:
INCOME TAX DIVISION
DATE OF CHANGE: _____________
TOTAL TAX
CITY HALL
INDIVIDUAL
0.00
259 KENT STREET
PARTNERSHIP
PORTLAND MI 48875
CORPORATION
TYPE OF PRINT BUSINESS NAME, ADDRESS, AND EMPLOYER IDENTIFICATION NO.,
IF NAME, ADDRESS OR EMPLOYER NUMBER IS NOT CORRECT, PLEASE CORRECT
IF THIS IS YOUR FIRST RETURN ENTER DATE BUSINESS WAS STARTED
DUE:
APRIL 30TH
EMPLOYER NUMBER
EMPLOYER NAME
PERIOD COVERED: JANUARY 1- MARCH 31
I CERTIFY THE TAX WITHHELD AS SHOWN ON THIS RETURN IS CORRECT
SIGNATURE
P941
CITY OF PORTLAND -INCOME TAX DIVISION
EMPLOYER'S RETURN OF INCOME TAX WITHHELD
TAX WITHHELD
MAKE REMITTANCE PAYABLE TO:
BUSINESS DISCONTINUED DATE__________
TREASURER, CITY OF PORTLAND
NO EMPLOYEES SINCE ____________
ADJUSTMENTS
MAIL CHECK WITH RETURN TO:
BUSINESS CHANGED TO:
INCOME TAX DIVISION
DATE OF CHANGE: _____________
TOTAL TAX
CITY HALL
INDIVIDUAL
0.00
259 KENT STREET
PARTNERSHIP
PORTLAND MI 48875
CORPORATION
TYPE OF PRINT BUSINESS NAME, ADDRESS, AND EMPLOYER IDENTIFICATION NO.,
IF NAME, ADDRESS OR EMPLOYER NUMBER IS NOT CORRECT, PLEASE CORRECT
IF THIS IS YOUR FIRST RETURN ENTER DATE BUSINESS WAS STARTED
DUE:
JULY 31ST
EMPLOYER NUMBER
EMPLOYER NAME
PERIOD COVERED: APRIL 1 - JUNE 30
I CERTIFY THE TAX WITHHELD AS SHOWN ON THIS RETURN IS CORRECT
SIGNATURE
P941
CITY OF PORTLAND -INCOME TAX DIVISION
EMPLOYER'S RETURN OF INCOME TAX WITHHELD
TAX WITHHELD
MAKE REMITTANCE PAYABLE TO:
BUSINESS DISCONTINUED DATE__________
TREASURER, CITY OF PORTLAND
NO EMPLOYEES SINCE ____________
ADJUSTMENTS
MAIL CHECK WITH RETURN TO:
BUSINESS CHANGED TO:
INCOME TAX DIVISION
DATE OF CHANGE: _____________
TOTAL TAX
CITY HALL
INDIVIDUAL
0.00
259 KENT STREET
PARTNERSHIP
PORTLAND MI 48875
CORPORATION
TYPE OF PRINT BUSINESS NAME, ADDRESS, AND EMPLOYER IDENTIFICATION NO.,
IF NAME, ADDRESS OR EMPLOYER NUMBER IS NOT CORRECT, PLEASE CORRECT
IF THIS IS YOUR FIRST RETURN ENTER DATE BUSINESS WAS STARTED
DUE:
OCTOBER 31ST
EMPLOYER NUMBER
EMPLOYER NAME
PERIOD COVERED: JULY 1 - SEPTEMBER 30
I CERTIFY THE TAX WITHHELD AS SHOWN ON THIS RETURN IS CORRECT
SIGNATURE
P941
CITY OF PORTLAND -INCOME TAX DIVISION
EMPLOYER'S RETURN OF INCOME TAX WITHHELD
TAX WITHHELD
MAKE REMITTANCE PAYABLE TO:
BUSINESS DISCONTINUED DATE__________
TREASURER, CITY OF PORTLAND
NO EMPLOYEES SINCE ____________
ADJUSTMENTS
MAIL CHECK WITH RETURN TO:
BUSINESS CHANGED TO:
INCOME TAX DIVISION
DATE OF CHANGE: _____________
TOTAL TAX
CITY HALL
INDIVIDUAL
0.00
259 KENT STREET
PARTNERSHIP
PORTLAND MI 48875
CORPORATION
TYPE OF PRINT BUSINESS NAME, ADDRESS, AND EMPLOYER IDENTIFICATION NO.,
IF NAME, ADDRESS OR EMPLOYER NUMBER IS NOT CORRECT, PLEASE CORRECT
IF THIS IS YOUR FIRST RETURN ENTER DATE BUSINESS WAS STARTED
DUE:
JANUARY 31ST
EMPLOYER NUMBER
EMPLOYER NAME
PERIOD COVERED: OCTOBER 1- DECEMBER 31
I CERTIFY THE TAX WITHHELD AS SHOWN ON THIS RETURN IS CORRECT
SIGNATURE