Form Tq01c - Alaska Quarterly Contribution Report - 2013
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1Alaska Quarterly Contribution Report
THE 2013 TAXABLE WAGE BASE FOR EACH EMPLOYEE IS $36,900.
Quarter nding:
Due ate:
Employer ccount o :
If none enter "0"
FEIN:
1. For each month, report the number
st
nd
rd
1
2
3
of workers who worked during or
Month
Month
Month
received pay for the payroll period,
th
which includes the 12
of the month.
2. Total reportable wages paid this
quarter. (See Instructions, page 2)
$
3. Less excess wages over the taxable
($
)
wage base.
AGENCY USE ONLY
$
4. Taxable wages paid this quarter.
A report must be filed even if no wages are paid
Employer's rate
5. Employer's contribution
$
for the quarter.
%
Employee's
You may now file your quarterly contribution
Rate
$
6. Employee's contribution
report online. Please visit our web site located
.
68%
at
or call
Total Rate
888 448 3527. To amend your quarterly
7. Total contributions due
$
%
report, please submit a “Correction of Wage
Item,” Form TADJ also available online.
8. Amount remitted
$
N otice to em ployers: W age inform ation and other
confidential UC inform ation m ay be requested and
9. Wages reported to other states? See
Yes
utilized for other authorized governm ental purposes,
instructions explaining this on page 2.
including, but not lim ited to, verification of an
individual’s eligibility for other governm ent program s.
*see area map for geographic location codes
10. Employee's
11. Employee's ame - ype or rint
12. Reportable wages
13. Full
14.
Social Security
(Do not list employees more than once.)
paid this quarter.
Occupational
Geographic
(No negative wages)
Number
Last
First
MI
tle or ode
de *
S
T
N
A
O
P
L
S
E
T
U
C
B
H
S
E
C
P
K
L
S
E
A
H
S
E
E
R
Make checks payable to the
15. Total umber of ages
16. Total eportable
ages - ll ages
E
Alaska Department of Labor and Workforce Development
(Same otal as in Block 2 above.)
If you have any questions,
call toll free 888 448 3527
I hereby certify that the information on this report is true and correct.
Signed: ________________________________________________ Title: ________________________________ Date: ________________
Printed Name:
Contact telephone number: (
)
Alaska Department of Labor
Workforce Development, Employment Security Tax, P O Box 115506, Juneau, AK 99811-5506
TQ01C (11/1 )
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