BIG RAPIDS INCOME TAX DEPARTMENT
BR-941
BR-941
EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD
2010
941
1M
1. IDENTIFICATION NUMBER
2. DEPOSIT PERIOD
3. DUE ON OR BEFORE
4. WITHHOLDING TAX DEPOSIT
DO NOT
WRITE IN
JANUARY 2010
2/28/2010
SPACE BELOW
TAXPAYER
MONTHLY DEPOSIT OF INCOME TAX IS
REQUIRED IF TAX WITHHELD IN FIRST
OR SECOND MONTH OF A QUARTER
EXCEEDS $100.
MAKE REMITTANCE PAYABLE TO:
___________________________________________
__________________________________________
_________________
BIG RAPIDS CITY TREASURER
SIGNATURE
TITLE
DATE
MAIL THIS FORM AND PAYMENT TO:
BIG RAPIDS TREASURER’S OFFICE
___________________________________________
__________________________________________
226 N. MICHIGAN AVENUE
PRINTED NAME OF SIGNER
TELEPHONE NUMBER
BIG RAPIDS, MI 49307
BIG RAPIDS INCOME TAX DEPARTMENT
BR-941
BR-941
EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD
2010
941
2M
1. IDENTIFICATION NUMBER
2. DEPOSIT PERIOD
3. DUE ON OR BEFORE
4. WITHHOLDING TAX DEPOSIT
DO NOT
WRITE IN
FEBRUARY 2010
3/31/2010
SPACE BELOW
TAXPAYER
MONTHLY DEPOSIT OF INCOME TAX IS
REQUIRED IF TAX WITHHELD IN FIRST
OR SECOND MONTH OF A QUARTER
EXCEEDS $100.
MAKE REMITTANCE PAYABLE TO:
___________________________________________
__________________________________________
_________________
BIG RAPIDS CITY TREASURER
SIGNATURE
TITLE
DATE
MAIL THIS FORM AND PAYMENT TO:
BIG RAPIDS TREASURER’S OFFICE
___________________________________________
__________________________________________
226 N. MICHIGAN AVENUE
PRINTED NAME OF SIGNER
TELEPHONE NUMBER
BIG RAPIDS, MI 49307
BIG RAPIDS INCOME TAX DEPARTMENT
BR-941
BR-941
EMPLOYER’S MONTHLY DEPOSIT OF INCOME TAX WITHHELD
2010
941
1Q
1. IDENTIFICATION NUMBER
2. DEPOSIT PERIOD
3. DUE ON OR BEFORE
DO NOT
MARCH
OR
WRITE IN
4/30/2010
TAX REMITTED
1
ST
QUARTER 2010
SPACE BELOW
TAXPAYER
January
February
March
Adjustments
_______________________________________
_______________________________________
___________________
SIGNATURE
TITLE
DATE
TOTAL
_______________________________________
PRINTED NAME OF SIGNER
PAY TO: BIG RAPIDS CITY TREASURER
MAIL TO: BIG RAPIDS TREASURER’S OFFICE
226 N. MICHIGAN AVENUE
_______________________________________
I I
If final return, check here and complete Notice
I I
TELEPHONE NUMBER
of Change or Discontinuance in return booklet.
BIG RAPIDS, MI 49307