From                                       To Year
PH-941                                                                                  City of Port Huron Income Tax
Tax Withheld          Period                                                      Employer's Return of Income Tax Withheld
                      Covered
Adjustments           Due By:

Total Paid
                      Signature                                                   Title                        Date
                             Enter your F.E.I.N. (if not preprinted)
YOUR FEDERAL EMPLOYER 
IDENTIFICATION NUMBER                                                            Make checks payable to: Treasurer, City of Port Huron
Type or print business name and address in this box (if not preprinted)    
                                                                                  Mail to: Income Tax Division 
                                                                                           100 McMorran Blvd. 
                                                                                           Port Huron, MI 48060

                                                                                        If this is a final return, check this box and provide an 
                                                                                        explanation on the back of this form or on an attached 
                                                                                        statement.  Follow the additional instructions as  
                                                                                        explained in the instructions for form PH-941. 
Show corrections to preprinted information as necessary.

                                   City of Port Huron Income Tax
                                INSTRUCTIONS FOR FORM PH-941
                        EMPLOYER'S RETURN OF INCOME TAX WITHHELD

REGULAR RETURNS                                      INITIAL RETURNS

1. Port Huron tax withheld must be remitted          1. Type or print your Federal Employer
   quarterly with Form PH-941.  The returns are         Identification Number, business name,
   due on the last day of the month, following the      address and the period covered on the form.
   end of the quarter.                                  The City of Port Huron DOES NOT issue
                                                        separate identification numbers.  Use your
   Make checks payable to:                              Federal Employer Identification Number. If
                                                        you have applied for, but not received a
               Treasurer, City of Port Huron
                                                        Federal Employer Identification Number, write
   Mail to:    Income Tax Division                      "Pending" in the space for the employer
               100 McMorran Boulevard                   identification number.
               Port Huron, MI  48060
                                                     FINAL RETURNS
   If you have any questions, or if you need
                                                     1. If you do not expect to withhold the tax in the
   forms, call (810) 984-9741.  Our normal office
                                                        future, check the box showing a final return.
   hours are Monday through Friday 8:00 a.m. to
                                                        Provide an explanation on the back of the
   4:30 p.m.
                                                        form.  If you go out of business or
2. If you withhold more than $50.00 per month           permanently stop being an employer, you
   you may, AT YOUR ELECTION, pay monthly.              must file a final Form PH-941 within 15 days
   If you elect to pay monthly, you must do so          after you discontinue business.  
   until you file a written notice electing to return
                                                     2. If you will no longer be withholding the tax or
   to a quarterly basis.  Monthly returns are due
                                                        the business was sold or transferred, file form
   on the last day of the following month.
                                                        PH-5, “Notice of Change or Discontinuance.”
3. If you did not withhold any taxes for the
                                                     3. If a business is sold or transferred during a
   period, state the reason on the back of Form
                                                        quarter, both the old and new employers must
   PH-941. 
                                                        file returns.  Each business is to report only on
4. If you have temporarily stopped paying wages         amounts paid by their entity.
   (such as the seasonal nature of a business),
                                                     4. If your business has been stopped, give the
   continue to file returns.  On the back of Form
                                                        name and address of the person who will
   PH-941 provide a brief explanation including
                                                        have custody of the books and records of the
   the last date you paid wages and the
                                                        business on the back of Form PH-941.
   estimated date you expect to resume paying
   wages.                                                       Record payments here
5. Please use the preprinted forms mailed to             RETAIN WITH YOUR RECORDS

   you.  Check the name, address, and                QTR        DATE PAID     AMOUNT PAID
   identification number to ensure they are
   correct.  Mark corrections and changes               1
   directly on the form.
                                                        2
6. The return provides a space for withholding
   adjustments to correct mistakes made on prior        3
   returns in the same calendar year.  Every
                                                        4
   return that shows an adjustment must include
   a statement explaining the adjustment.  DO            TOTAL PAID 
   NOT take credit for a prior year adjustment.
   You must file a claim requesting a refund for
   any prior year overpayment.