Form L941 - City Of Lapeer Income Tax Withheld - 2009 Page 2
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2L941 1ST QTR
L941 2ND QTR
L941 3RD QTR
L941 4TH QTR
PAYMENT SUMMARY
PAYMENT SUMMARY
PAYMENT SUMMARY
PAYMENT SUMMARY
Janaury
$
April
$
July
$
October
$
February
$
May
$
August
$
November
$
March
$
June
$
September
$
December
$
Total
$
Total
$
Total
$
Total
$
EFFECTIVE DATE AND
EFFECTIVE DATE AND
EFFECTIVE DATE AND
EFFECTIVE DATE AND
REASON FOR FINAL PAYMENT
REASON FOR FINAL PAYMENT
REASON FOR FINAL PAYMENT
REASON FOR FINAL PAYMENT
EFFECTIVE DATE __________________
EFFECTIVE DATE __________________
EFFECTIVE DATE __________________
EFFECTIVE DATE __________________
□
□
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□
Business permanently discontinued
Business permanently discontinued
Business permanently discontinued
Business permanently discontinued
□
□
□
□
Business temporarily discontinued
Business temporarily discontinued
Business temporarily discontinued
Business temporarily discontinued
□
□
□
□
Still operating - ceased paying wages
Still operating - ceased paying wages
Still operating - ceased paying wages
Still operating - ceased paying wages
□
Business sold to:
□
Business sold to:
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Business sold to:
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Business sold to:
Name:
Name:
Name:
Name:
Street:
Street:
Street:
Street:
City:
City:
City:
City:
□
□
□
□
Moved out of Lapeer
Moved out of Lapeer
Moved out of Lapeer
Moved out of Lapeer
Changed business type
Changed business type
Changed business type
Changed business type
□
□
□
□
New Business Type:
New Business Type:
New Business Type:
New Business Type:
Changed business FEIN
Changed business FEIN
Changed business FEIN
Changed business FEIN
□
□
□
□
New FEIN:
New FEIN:
New FEIN:
New FEIN:
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