Maine Business Change Notification

Business Change Notification
941BN-ME
FORM 941BN-ME

Maine Income Tax Withholding
Business Change Notification

Address changes and account closures may be reported electronically on the Maine
Tax Portal (MTP) at revenue.maine.gov. Otherwise, complete this form to report a
change to your withholding account. Incomplete forms will not be processed.
Mail to:	Maine Revenue Services, Taxpayer Assistance	 	
	
P.O. Box 1057, Augusta, ME 04332-1057		

Fax: 207-287-6975
Email: [email protected]

Step 1
Identify your
business as
currently on
file with Maine
Revenue
Services.

Current Legal Name:___________________________	DBA:__________________________________________

Step 2

New Legal Name:___________________________ 	 New DBA:______________________________________

List your new
contact
information;
enter only if
different from
current
information.

New ATTN Line:_____________________________________________________________________________

Current Address:_____________________________________________________________________________ 	
Current Phone Number:_______________________________________________________________________
Withholding Account Number:___________________

New Address:______________________________________________________________________________
New Email Address:_________________________________________________________________________
(PRINT CLEARLY)

/
/
New Phone Number: ___________________________Effective Date of Change__________________________
NOTE: Do not enter a payroll processor’s address or other contact information here.
Reason for Cancellation. Check the appropriate box:

Step 3
Request to
cancel
account.
(Do not
report
cancellation
for a seasonal
shutdown
period.)

Business Closed (Do not include a seasonal or temporary business closure.)
Business Sold to: 	

Name:___________________________ 	FEIN:________________________

	Address:_______________________________________ 	Phone:_______________________
	

______________________________________________

/
Date Business Sold: _________________________________
/
Other ____________________________________________________________
Date the business no
/
longer had employees. ______________________________________
Date of last payroll
/

Step 4
Sign and
mail your
report.

/

/

________________________________

Under penalties of perjury, I certify that the information contained on this form is true and correct.
Print Name:_________________________________________________________________________________
Signature:_________________________________ Title:_________________________________________

/
/
Date: ____________________________________
Daytime Phone: ____________________________________
For Paid Preparers Only

/
/
Paid Preparer’s Signature:____________________________________________________ Date:_____________________________
Firm’s Name (or yours if self-employed):_________________________________________

Phone: ___________________________

Address:____________________________________________________________________________________________________
FEIN/SSN: _______________________________Maine Payroll Processor License Number: _________________________________
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Clear

Revised: December 2025

Print

Form 941BN-ME
Maine Income Tax Withholding
Business Change Notification
Specific Instructions
Step 1. 	Enter the current legal name, DBA name (if applicable), address, phone number, and withholding account number
of the business.
Step 2.	 Complete this step only if you are updating the legal business name, DBA name, or contact information on file for
the withholding account. Enter the updated information and the effective date of the change, as applicable. If no
changes are necessary, leave blank. Verification from the Internal Revenue Service or Secretary of State is required
to support a legal name change.
		

Note: Do not include the name or contact information of a third party (e.g., a payroll processor) in this section.

Step 3.	 Complete this step to cancel the withholding account. Select the appropriate cancellation reason by checking the
corresponding box and complete the related fields. Do not report a seasonal or temporary business closure as a
cancellation. Completing this section will only close the withholding account and will not result in the closure of the
business.
Step 4.	 A wet signature of the owner, corporate officer, or designated business contact is required for processing. Typed or
digital signatures will not be accepted. A valid Form 2848-ME Power of Attorney must be on file with Maine Revenue
Services to authorize a paid preparer to sign on behalf of the business. If a valid Power of Attorney is not maintained
on file for the paid preparer signing the form, Form 941BN-ME will be deemed invalid and will not be processed.

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