SF-941                                 SPRINGFIELD INCOME TAX DEPARTMENT                                         941 01Q
                           EMPLOYER'S QUARTERLY DEPOSIT OF INCOME TAX WITHHELD
       FEIN                            DEPOSIT PERIOD               DUE ON OR BEFORE               WITHHOLDING TAX DEPOSIT
                           1ST QUARTER 2023                         APRIL 30, 2023
            CONTACT PERSON                            CONTACT PHONE                                CONTACT EMAIL

                                                                              MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD 
                                                                              DURING THE FIRSTMONTH OF QUARTER EXCEEDS $100
            WITHHOLDER NAME AND ADDRESS
                                                                    PAY TO: CITY OF SPRINGFIELD
                                                                    REMIT TO: CITY OF SPRINGFIELD INCOME TAX DEPT
                                                                              601 AVENUE A
                                                                              SPRINGFIELD, MI 49037

                           SIGNATURE                                                      DATE

                           PRINTED NAME OF SIGNER                                         TITLE

SF-941                                 SPRINGFIELD INCOME TAX DEPARTMENT                                         941 02Q
                           EMPLOYER'S QUARTERLY DEPOSIT OF INCOME TAX WITHHELD
       FEIN                            DEPOSIT PERIOD               DUE ON OR BEFORE               WITHHOLDING TAX DEPOSIT
                           2ND QUARTER                2023          JULY 31, 2023
            CONTACT PERSON                            CONTACT PHONE                                CONTACT EMAIL

                                                                              MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD 
                                                                              DURING THE FIRSTMONTH OF QUARTER EXCEEDS $100
            WITHHOLDER NAME AND ADDRESS
                                                                    PAY TO: CITY OF SPRINGFIELD
                                                                    REMIT TO: CITY OF SPRINGFIELD INCOME TAX DEPT
                                                                              601 AVENUE A
                                                                              SPRINGFIELD, MI 49037

                           SIGNATURE                                                      DATE

                           PRINTED NAME OF SIGNER                                         TITLE

SF-941                                 SPRINGFIELD INCOME TAX DEPARTMENT                                         941 03Q
                           EMPLOYER'S QUARTERLY DEPOSIT OF INCOME TAX WITHHELD
       FEIN                            DEPOSIT PERIOD               DUE ON OR BEFORE               WITHHOLDING TAX DEPOSIT
                           3RD QUARTER 2023                OCTOBER 31, 2023
            CONTACT PERSON                            CONTACT PHONE                                CONTACT EMAIL

                                                                              MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD 
                                                                              DURING THE FIRSTMONTH OF QUARTER EXCEEDS $100
            WITHHOLDER NAME AND ADDRESS
                                                                    PAY TO: CITY OF SPRINGFIELD
                                                                    REMIT TO: CITY OF SPRINGFIELD INCOME TAX DEPT
                                                                              601 AVENUE A
                                                                              SPRINGFIELD, MI 49037

                           SIGNATURE                                                      DATE

                           PRINTED NAME OF SIGNER                                         TITLE

SF-941                                 SPRINGFIELD INCOME TAX DEPARTMENT                                         941 04Q
                           EMPLOYER'S QUARTERLY DEPOSIT OF INCOME TAX WITHHELD
       FEIN                            DEPOSIT PERIOD               DUE ON OR BEFORE               WITHHOLDING TAX DEPOSIT
                           4TH QUARTER 2023                         JANUARY 31, 2024
            CONTACT PERSON                            CONTACT PHONE                                CONTACT EMAIL

                                                                              MONTHLY DEPOSIT REQUIRED IF TAX WITHHELD 
                                                                              DURING THE FIRSTMONTH OF QUARTER EXCEEDS $100
            WITHHOLDER NAME AND ADDRESS
                                                                    PAY TO: CITY OF SPRINGFIELD
                                                                    REMIT TO: CITY OF SPRINGFIELD INCOME TAX DEPT
                                                                              601 AVENUE A
                                                                              SPRINGFIELD, MI 49037

                           SIGNATURE                                                      DATE

                           PRINTED NAME OF SIGNER                                         TITLE