Form Gr-501 - Employer'S Monthly Deposit Of Income Tax Withheld
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4GR-501
GRAND RAPIDS INCOME TAX DEPARTMENT
GR-501
EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD
2004
941
01M
DO NOT
4. WITHHOLDING TAX DEPOSIT
1. IDENTIFICATION NUMBER
2. DEPOSIT PERIOD
3. DUE ON OR BEFORE
WRITE IN
JANUARY 2004
3/01/2004
SPACE BELOW
MONTHLY DEPOSIT OF INCOME TAX
TAXPAYER
IS REQUIRED IF TAX WITHHELD IN FIRST
OR SECOND MONTH OF A QUARTER
EXCEEDS $100.
IMPORTANT
MONTH
YEAR
5.
IF DEPOSIT IS FOR A
PERIOD OTHER THAN
BOX 2, ENTER THE
CORRECT PERIOD.
MAKE REMITTANCE PAYABLE TO:
GRAND RAPIDS CITY TREASURER
MAIL THIS FORM AND PAYMENT TO:
SIGNATURE
TITLE
DATE
GRAND RAPIDS INCOME TAX DEPT.
P.O. BOX 347
PRINTED NAME OF SIGNER
GRAND RAPIDS, MI 49501-0347
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
CUT ON DOTTED LINE
GR-501
GRAND RAPIDS INCOME TAX DEPARTMENT
GR-501
EMPLOYER'S MONTHLY DEPOSIT OF INCOME TAX WITHHELD
2004
941
02M
DO NOT
4. WITHHOLDING TAX DEPOSIT
1.
IDENTIFICATION NUMBER
2. DEPOSIT PERIOD
3. DUE ON OR BEFORE
WRITE IN
FEBRUARY 2004
3/31/2004
SPACE BELOW
MONTHLY DEPOSIT OF INCOME TAX
TAXPAYER
IS REQUIRED IF TAX WITHHELD IN FIRST
OR SECOND MONTH OF A QUARTER
EXCEEDS $100.
IMPORTANT
MONTH
YEAR
5.
IF DEPOSIT IS FOR A
PERIOD OTHER THAN
BOX 2, ENTER THE
CORRECT PERIOD.
MAKE REMITTANCE PAYABLE TO:
GRAND RAPIDS CITY TREASURER
MAIL THIS FORM AND PAYMENT TO:
SIGNATURE
TITLE
DATE
GRAND RAPIDS INCOME TAX DEPT.
P.O. BOX 347
PRINTED NAME OF SIGNER
GRAND RAPIDS, MI 49501-0347
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
CUT ON DOTTED LINE
GR-941
GRAND RAPIDS INCOME TAX DEPARTMENT
GR-941
EMPLOYER'S QUARTERLY RETURN OF INCOME TAX WITHHELD
2004
941
01Q
DO NOT
4. TAX WITHHELD THIS QUARTER
1. IDENTIFICATION NUMBER
2. RETURN PERIOD
3. DUE ON OR BEFORE
WRITE IN
ST
4/30/2004
1
QUARTER 2004
SPACE BELOW
5. ADJUSTMENTS
TAXPAYER
6. ADJUSTED TAX WITHHELD
7a. TAX PAID FIRST
MONTH OF QUARTER
7b. TAX PAID SECOND
MONTH OF QUARTER
8. AMOUNT DUE
(Line 6 less lines 7a and 7b)
PAY THIS AMOUNT
SIGNATURE
TITLE
DATE
PAY TO:
GRAND RAPIDS CITY TREASURER
MAIL TO:
GRAND RAPIDS INCOME TAX DEPT.
If final return, check here and
P.O. BOX 347
GRAND RAPIDS, MI 49501-0347
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