Transcription of 4977 Department of the Treasury- Internal …
1 Tax period ended Department of the treasury - Internal revenue ServiceSchedule of Tax LiabilityForm4977(Rev. February 2002)Section 1042, Withholding TaxPeriodTax liability for periodTax liability for periodTax liability for periodLineLineLinePeriodPeriodending(inc luding any taxes assumed(including any taxes assumed(including any taxes assumed Form(s) 1000)on Form(s) 1000)Form(s) 1000) totalMay totalSept. totalJune totalOct. total1535 July total55 Nov. total77 7151515 AprilAugustDec22222230313120 Apr. total40 Aug. total60 Dec. total6161 Total liability for year(add monthly total lines from above)Section 940, Unemployment TaxQuarterLiability for Quarter (Do not include state liability)FirstSecondThirdFourthTotalUnd er penalties of perjury, I declare that I have examined the above liability schedule,and to the best of my knowledge and belief, it is true, correct, and (Rev.)
2 02-2002)Catalog Number 42142 LNameEmployer Identification NumberNumber, street, and room or suite number (optional)City or town, state, and ZIP codeThis form supports adjustments to:Form 1042 Form 9401234212223246789262728291112131431323 3341617181936373839414243444647484951525 35456575859
