×
tax forms found in
Tax Form Code
Tax Form Name

Maine Free Printable 19_CertVisualMediaPrdWgReimb_Form841.indd for 2020 Maine Media Production Wage Reimbursement Application

It appears you don't have a PDF plugin for this browser. Please use the link below to download 2019-maine-form-841me.pdf, and you can print it directly from your computer.

Media Production Wage Reimbursement Application
19_CertVisualMediaPrdWgReimb_Form841.indd

Clear Print Form 841ME Maine Revenue Services Certified Visual Media Production Wage Reimbursement Application ____________________________________________________________________________________ Certified Production Company Name ________________________ Federal Employer ID Number ____________________________________________________________________________________ Name of Production ____________________________________________________________________________________ Address ________________________ Production Start Date ______________________________________ City ________________________ Production End Date 1. 2. 3. 4. ____________ State ______________________ ZIP Code Certified production wages paid to Maine resident individuals (from Schedule 2, line 3 and Schedule 3, line 3).............................. 1. Reimbursement requested for Maine resident individuals (12% of line 1) .................................................................................. 2. Certified production wages paid to nonresident individuals (from Schedule 2, line 4 and Schedule 3, line 4).............................. 3. Reimbursement requested for nonresident individuals (10% of line 3) .................................................................................. 4. $_____________________________________ .00 $_____________________________________ .00 $_____________________________________ .00 $_____________________________________ .00 5. Total certified production wages (line 1 plus line 3) .......................... 5. $_____________________________________ .00 6. Total reimbursement requested (line 2 plus line 4)........................... 6. $_____________________________________ .00 NOTE: Complete and attach Schedule 2. Also complete and attach Schedule 3 if required. Reimbursement requests will not be processed until a properly completed Schedule 2 and/or Schedule 3 are received by Maine Revenue Services. Attach a copy of the certified visual media production report submitted to the Department of Economic and Community Development. Under penalties of perjury, I declare that I have examined this return and accompanying schedules and statements and to the best of my knowledge and belief they are true, correct and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge. Signature: ______________________________________________ Date: _________________________________________ Title: __________________________________________________ Telephone: _________________________________________ Paid Preparer’s EIN:______________________________________ Contact Person’s Name: __________________________________ Telephone: _________________________________________ Contact Person’s Email Address: ___________________________________________________ Mail To: Maine Revenue Services P.O. Box 1064 Augusta, ME 04332-1064 Rev. 10/19 SCHEDULE 2 (FORM 841ME) -- Certified Production Company Employees and Non-Employee Performing Artists Certified Production Company Name: _______________________________________________________________________ ___________________________ Federal Entity ID Number / / / ______ ______ ____________ Production Start Date / ______ ______ ____________ Production End Date List below information relating to amounts claimed on Form 841ME, lines 1 and 3. (See instructions) Column 1 Employee or Performing Artist Name Column 2 Social Security Number Column 3/4 Nonresident/ Non-employee Performing Artist 3 a. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ b. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ c. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ d. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ e. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ f. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ g. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ h. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ i. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ j. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ k. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ l. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ m. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ n. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ o. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ p. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ q. ________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ Column 5 # of Days Worked in Maine Column 6 Certified Production Wages 4 □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 _______ $ __________________ .00 1. Total resident certified production wages this page .................................................... 1. $ __________________________________ .00 2. Total nonresident certified production wages this page .............................................. 2. $ __________________________________ .00 3. Total resident certified production wages for all Schedule 2 pages (also enter on Form 841ME, line 1) ............................................................................ 3. $ __________________________________ .00 4. Total nonresident certified production wages, all Schedule 2 pages (also enter on Form 841ME, line 3) ............................................................................ 4. $ __________________________________ .00 SCHEDULE 3 (FORM 841ME) -- Temporary Employee-Leasing Company Employees Certified Production Company Name: _____________________________________________________________________________________________________ / ___________________________ Federal Entity ID Number / / ______ ______ ____________ Production Start Date / ______ ______ ____________ Production End Date _______________________________________________________ Employee Leasing Company Name ____________________________ EIN List below information relating to amounts claimed on Form 841ME, lines 1 and 3. (See instructions) Column 1 Employee Name Column 2 Social Security Number Column 3 Nonresident Column 4 # of Days Worked in Column 5 Certified Production Wages Maine a. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ b. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ c. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ d. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ e. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ f. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ g. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ h. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ i. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ j. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ k. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ l. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ m. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ n. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ o. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ p. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ q. _________________________ ___ ___ ___ - ___ ___ - ___ ___ ___ ___ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ □ _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 _______ $ ___________________ .00 1. Total resident certified production wages this page .................................................................... 1. $ _______________________________ .00 2. Total nonresident certified production wages this page .............................................................. 2. $ _______________________________ .00 3. Total resident certified production wages for all Schedule 3 pages (also enter on Form 841ME, line 1) ............................................................................................ 3. $ _______________________________ .00 4. Total nonresident certified production wages, all Schedule 3 pages (also enter on Form 841ME, line 3) ............................................................................................ 4. $ _______________________________ .00 GENERAL INSTRUCTIONS CERTIFIED VISUAL MEDIA PRODUCTION WAGE REIMBURSEMENT The visual media production tax incentive provides for a partial reimbursement of certified production wages paid to employees working on a visual media production in Maine. The first $50,000 paid to each individual performing personal services in Maine in connection with a certified visual media production is eligible for the wage reimbursement. The reimbursement rate is 12% for residents of Maine and 10% for nonresidents. Certified productions wages include: 1. Wages paid by the visual media production company to an employee for work performed in Maine in connection with a certified visual media production that will be reported as Maine wages on Form W-2; 2. An amount paid to a temporary employee-leasing company (e.g. loan-out company) for personal services rendered in Maine by a leased employee in connection wtih a certified visual media production; 3. An amount paid for the services of a performing artist for work performed in Maine in connection with a certified visual media production; 4. Other contractual payments for personal services performed in Maine in connection with a certified visual media production. The visual media production company is responsible for withholding Maine income taxes from its employees who work in Maine. A loan-out company is responsible for withholding Maine income taxes from employees of the loan-out company who are performing services for the production company in Maine. The process required to receive the reimbursement is outlined below. Required Certificates. The visual media production company must obtain certification from the Department of Economic and Community Development (“DECD”). The certificate is applied for prior to the start of the production. A visual media production certificate is issued to the visual media production company meeting all initial program requirements. Once the media production certificate is obtained, the business may begin the qualified production. Within four weeks after completion of the qualified production, the business must submit a certified visual media production report to DECD. Certified Visual Media Production Wage Reimbursement. To claim the wage reimbursement, the business must file a reimbursement application, Form 841ME, Schedule 2 and Schedule 3 (if required) with MRS within six weeks of filing the certified visual media production report with DECD. Eligible reimbursements will be paid within 90 days after the assessor received a complete application. Only certified production wages up to $50,000 for each individual may be used to calculate the wage reimbursement. You must attach a copy of the certified visual media production report submitted to DECD. SPECIFIC INSTRUCTIONS FORM 841ME Enter name, address, city, state, ZIP code, federal employer identification number (EIN), and production dates in the appropriate boxes. Line 1. Enter the amount from Schedules 2 and 3, line 3. Line 2. Enter the result of line 1 multiplied by 12% (0.12). Line 3. Enter the amount from Schedules 2 and 3, line 4. Line 4. Enter the result of line 3 multiplied by 10% (0.10). SCHEDULE 2 All filers requesting reimbursement must complete Schedule 2 for compensation paid directly to individuals for personal services performed in Maine during the production period (wages paid to employees and payments made to non-employee performing artists). Column 1. Enter the last name, first name and middle initial for each certified production employee and non-employee performing artist who earned wages or payments during the production period. Employees of temporary employee leasing and loan out companies must be reported separately on Schedule 3. CERTIFIED VISUAL MEDIA PRODUCTION WAGE REIMBURSEMENT SPECIFIC INSTRUCTIONS, cont. Column 2. Enter the social security number for each individual listed in column 1. Column 3. Enter an “X” in the box if the individual in column 1 is not a resident of Maine. If the individual is a Maine resident, the media production company must retain a copy of the individual’s residency affidavit on file for at least three years. This form is available on the MRS web site at maine.gov/ revenue/forms. Column 4. Enter an “X” in the box if the individual in column 1 is a non-employee performing artist. Column 6. Enter the certified production wages for each individual listed in column 1. Certified production wages are wages and other payments made during the certified visual media production period for personal services performed with respect to the production. The wages must have been subject to Maine income tax withholding to qualify. Certified production wages do not include payment in excess of $50,000 made to any single individual for personal services rendered in connection with a particular certified visual media production. 36 M.R.S. § 6901. Do not include payments for personal services provided by employees of an employee-leasing company or loan-out company; these employees should be listed on Schedule 3. Line 1. Enter the total certified production wages for Maine resident individuals listed on the page. Line 2. Enter the total certified production wages for nonresident individuals listed on the page. Line 3. Enter the sum of Maine resident certified production wages for all pages of Schedule 2 submitted. Also, enter this amount, combined with the amount from Schedule 3, line 3, on Form 841ME, line 1. Line 4. Enter the sum of nonresident certified production wages for all pages of Schedule 2 being submitted. Also, enter this amount, combined with the amount from Schedule 3, line 4, on Form 841ME, line 3. SCHEDULE 3 All filers requesting reimbursement must complete Schedule 3 for payments made to temporary employee leasing companies (including loan-out companies) for employees performing personal services directly related to the certified media production. For purposes of Form 841ME and Schedule 3, these payments are also known as certified production wages. Complete a separate Schedule 3 for each temporary employee leasing and loan out company to which payments were made. Only include the portion of payments for personal services. Column 1. Enter the last name, first name and middle initial for each temporary employee leasing company employee who earned wages during the production period. Column 2. Enter the social security number for each individual listed in column 1. Column 3. Enter an “X” in the box if the individual in column 1 is not a resident of Maine. If the individual is a Maine resident, the media production company must retain a copy of the individual’s residency affidavit on file for at least three years. This form is available on the MRS web site at maine.gov/ revenue/forms. Column 5. Enter the payments made to the temporary employee-leasing company or loan-out company with respect to each individual listed in column 1. The payments must be directly related to the certified visual media production. Do not enter amounts in excess of $50,000 paid for any single individual for personal services rendered in connection with a particular certified visual media production. 36 M.R.S. § 6901. Line 1. Enter total payments for Maine resident individuals listed on the page. Line 2. Enter total payments for nonresident individuals listed on the page. Line 3. Enter the sum of Maine resident payments for all pages of Schedule 3 submitted. Also, enter this amount, combined with the amount from Schedule 2, line 3, on Form 841ME, line 1. Line 4. Enter the sum of nonresident payments for all pages of Schedule 3 submitted. Also, enter this amount, combined with the amount from Schedule 2, line 4, on Form 841ME, line 3. Important: If all required lines and schedules are not completed, your reimbursement request cannot be processed.
Extracted from PDF file 2019-maine-form-841me.pdf, last modified November 2019

More about the Maine Form 841ME Other TY 2019

We last updated the Media Production Wage Reimbursement Application in February 2020, so this is the latest version of Form 841ME, fully updated for tax year 2019. You can download or print current or past-year PDFs of Form 841ME directly from TaxFormFinder. You can print other Maine tax forms here.


eFile your Maine tax return now

eFiling is easier, faster, and safer than filling out paper tax forms. File your Maine and Federal tax returns online with TurboTax in minutes. FREE for simple returns, with discounts available for TaxFormFinder users!

File Now with TurboTax

Other Maine Other Forms:

TaxFormFinder has an additional 61 Maine income tax forms that you may need, plus all federal income tax forms.

Form Code Form Name
Adult Dependent Care Credit Adult Dependent Care Credit Worksheet
Form CR Combined return for members of an affiliated group
Pine Tree Credit Worksheet (Worksheet PTE) Worksheet PTE -- Credit Ratio Worksheet for Individuals claiming the Pine Tree Development Zone Tax Credit
Seed Capital Credit Seed Capital Investment Tax Credit
Wellness Programs Credit Credit for Wellness Programs

Download all ME tax forms View all 62 Maine Income Tax Forms


Form Sources:

Maine usually releases forms for the current tax year between January and April. We last updated Maine Form 841ME from the Revenue Services in February 2020.

Show Sources >

Historical Past-Year Versions of Maine Form 841ME

We have a total of six past-year versions of Form 841ME in the TaxFormFinder archives, including for the previous tax year. Download past year versions of this tax form as PDFs here:


2019 Form 841ME

19_CertVisualMediaPrdWgReimb_Form841.indd

2017 Form 841ME

17_CertVisualMediaPrdWgReimb_Form841_rsd20170901.indd

2016 Form 841ME

16_CertVisualMediaPrdWgReimb_Form841.indd

Media Production Wage Reimbursement Application 2015 Form 841ME

15_CertVisualMediaPrdWgReimb_Form841.indd

2011 Form 841ME

11_Form 841CertVisualMediaPrdWgReimb.indd


TaxFormFinder Disclaimer:

While we do our best to keep our list of Maine Income Tax Forms up to date and complete, we cannot be held liable for errors or omissions. Is the form on this page out-of-date or not working? Please let us know and we will fix it ASAP.

** This Document Provided By TaxFormFinder.org **
Source: http://www.taxformfinder.org/maine/form-841me