Form Ucb-7822 - Magnetic Media - Transmitter Report
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2STATE OF WISCONSIN - Unemployment Insurance Division
MAGNETIC MEDIA - TRANSMITTER REPORT
_________________For information call: (608) 267-4406
Please type or print. Complete the following information and return with tape(s) to:
Unemployment Insurance - DWD, Wage Reporting, P.O. Box 7962, Madison, WI 53707
1. NAME OF TRANSMITTER
2. QUARTER
3. YEAR
4. ADDRESS
CITY
STATE
ZIP
5.
RECORD LENGTH
6. BLOCK SIZE
7. TAPE DENSITY BPI (check one)
8. RECORDING CODE (check one)
9. INTERNAL TAPE LABEL
1600
6250
EBCDIC
ASCII
YES
NO
10. VOLUME SERIAL NUMBER(S)
11. TOTAL NUMBER
12. TOTAL NUMBER
OF EMPLOYERS
OF EMPLOYEES
REPORTED
REPORTED
EMPLOYER SUMMARY INFORMATION
13. STATE EMPLOYER ACCOUNT
14. NUMBER OF EMPLOYES
13. STATE EMPLOYER ACCOUNT
14. NUMBER OF EMPLOYES
NUMBER
REPORTED
NUMBER
REPORTED
(ATTACH ADDITIONAL SHEETS IF NECESSARY)
15.
I CERTIFY THAT ALL INFORMATION CONTAINED IN THIS REPORT AND ON THE ACCOMPANYING MAGNETIC TAPE(S) IS TRUE AND ACCURATE.
SIGNATURE
PHONE NUMBER
DATE
RETURN TAPE TO: (TRANSMITTER TO COMPLETE)
NAME
ADDRESS
CITY
STATE
ZIP CODE
STATE OF WISCONSIN - EXTERNAL TAPE LABEL
TRANSMITTER'S NAME
REEL
OF
VOLUME SERIAL NUMBER
QUARTER
YEAR
BPI
RECORDING CODE
1600
6250
EBCDIC
ASCII
BLOCK SIZE
RECORD LENGTH
TOTAL RECORDS
INTERNAL TAPE LABEL
YES
NO
UCB-7822 (R. 07/2002)
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