EFTA01219718.pdf

Ca Along tut Dented Line Massachusetts Department of Revenue M-94 I • Employer's Return of Income Taxes Withheld. File this return online at mass.govimasstaxconneet. Account II>tomb« Number& employee. from Tan Ming petiod 1 An:0ga withheld whom wet Lute attack, 2 Previous payments made Buainem name S. Credit carry asand from previous period. Rumness san.. 4 Total may mems ad credits Add Imes 2 and 3. S. Total tax due. Bultram Line 4 :tom line I Cit,fro*n State Zip 6 Penalties Phone number Embed address 7 Interest S Total amount due. Add lines S through 7. ❑ Check if amended moan (see "Amended Return" in IMIIIKI10111) ❑ Choi k if final mum and you with In e Sae >mar withlwang um account 9 Antos* overpaid m be credited [oust period. See inemueons for Oie dales Mad an tdassachnuas BOR. PO Box 419255. Renton. MA 02241.9255. 10 Amount overpead to be refunded 1declare under the penalties of perjury that tes renan I includins an> am~puny ins uneduks and statements> has been esanameal by me ial to the best of my knowledge and belief ti a true. carom and con:Mete return. Agnarme Tide Date EFTA01219718