Form Uc-8a - Quarterly Payroll Report
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1STATE OF DELAWARE UNEMPLOYMENT INSURANCE
Reporting Period (Yr / Qtr)
Due Date
Account No.
Federal ID Number
IF YOU ARE AN APPROVED MAGNETIC MEDIA FILER, CHECK BOX AND RETURN THIS FORM. NO
FURTHER ENTRIES ARE REQUIRED.
Employee Social Security Number Employee Name (First Initial, Middle Initial and Last Name) Gross Covered Wages
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31 Total this Page
32 Total from additional pages
33 GRAND TOTAL
DO NOT USE THIS REPORT
Form UC-8A Doc. No. 60-06/00/08/05
QUARTERLY PAYROLL REPORT
TO FILE CORRECTIONS.
AGENCY COPY
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