Form Uct-8a - Correction To Employer'S Quarterly Or Annual Domestic Report Page 3
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3UCT-8A
Correction to Employer’s Quarterly or Annual Domestic Report Instructions
R. 07/07
Page 3
This form (Form UCT-8A) is provided for use in correcting errors
Coupon Completion Instructions
made on the original Employer’s Quarterly Report (Form UCT-6)
Write your seven digit account number and the check digit in
or Annual Report for Employers of Domestic Employees Only
the “Account No.” boxes provided.
(UCT-7). Annual filers will need to complete one UCT-8A for
each quarter being corrected.
Enter the federal employer’s identification number in the “F.E.I.
Number” boxes.
Items 1 and 2 are used to correct an employee’s name or
Enter the employer’s legal entity name and the mailing address
social security number.
in the space provided.
Caution: Be sure that the employee’s social security number
Enter the amount of payment in the “Amount Enclosed” boxes.
and name shown in Items 1 and 2 agree with your original
report, unless the social security number and name originally
Enter the 1 digit quarter and 2 digit year in the boxes labeled
reported were incorrect. In such a case, enter the number
“Payment for QTR/YR.” For the quarter box, enter the number
and name, as per the original report. Underneath, write
“1” for quarter ending March 31
, the number “2” for quarter
st
social security number change and/or name change; then list
ending June 30
, “3” for quarter ending September 30
and “4”
th
th
the correct social security number and/or name.
for quarter ending December 31
. In the year boxes, enter the
st
last two digits for the year. For example: enter “07” for 2007.
Item 3 should be completed if continuation sheets were filed
with the original report.
Mail the original completed form and coupon along with any
remittance due to:
Items 4 and 6 are used to correct gross wages.
Florida Department of Revenue
Items 5 and 7 should be omitted unless you have received prior
5050 W Tennessee Street
approval. Unit codes are special codes assigned employers
Tallahassee FL 32399-0180
to identify the mailing address for unemployment insurance
claims forms, if different from the primary employer address.
Need Assistance?
Complete Item 8 if individual wage corrections change gross
To speak with a Department of Revenue representative, call
wages, excess wages, or taxable wages originally shown on
Taxpayer Services, Monday through Friday, 8 a.m. to 7 p.m., ET,
the tax report.
at 800-482-8293.
Hearing or speech impaired persons may call the TDD line at
800-367-8331 or 850-922-1115.
IMPORTANT
Complete page 1 for corrections to the Employer’s Quarterly or Annual Domestic Report.
Complete page 3 only if payment is enclosed.
Return completed form and coupon, if applicable, to the Department.
DO NOT
DETACh
Correction to Employer’s Quarterly or Annual Domestic Report
UCT-8A
Payment Coupon
R. 07/07
COMPLETE and MAIL with your REPORT/PAYMENT.
Florida Department of Revenue
DOR USE ONLy
Please write ACCOUNT NUMBER on your check.
Be sure to SIGN YOUR CHECK.
Make check payable to: Florida U.C. Fund
POSTMARk OR hAND DELIvERy DATE
-
ACCOUNT NO.
US Dollars
Cents
,
,
F.E.I. NUMBER
AMOUNT ENCLOSED
-
PAyMENT FOR QTR/yR
UCT-8A
Name
Address
Check here if you transmitted funds
City/St/ZIP
electronically.
9100 0 99999999 0068054049 2 5009999999 0000 4
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