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Get and Sign Note Electronic Copies of Payee Statements Due February 28, 2018-2022 Form
Statements....... $
.
2. Total Maine income tax reported
on quarterly reports for the year . $
.
Name:
3. Third-party payers of sick pay
(see instructions below). All
others may skip this line ............. $
4. Employers (see instructions
below). All others may skip this
line .............................................. $
Third-party payer name
.
.
Third-party payer ID Number:
Under penalties of perjury, I certify that the information contained on this return, report and...
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