Form 5208b - Quarterly Wage Detail Report - State Of Washington
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1Quarterly Wage Detail Report
(Form 5208B)
To file or pay electronically, go to
1) QTR ENDING DATE (MMDDYY)
Submit originals only.
3) ES REFERENCE NUMBER (9-DIGITS)
2) BUSINESS NAME
6) DUE DATE (MMDDYY)
4) FEDERAL ID NUMBER (9-DIGITS)
5) UBI NUMBER (12-DIGITS)
Do not report hours and wages for limited liability company (LLC) members, limited liability partners (LLP), general partners and sole proprietors or their spouses.
Corporate officers of for-profit corporations must be reported, unless they have been approved by the Employment Security Department to opt out of coverage.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
A)
13) IF ZERO, WHY
14) TOTAL WAGES PAID THIS QTR
10) FIRST NAME
11) MI
12) TOTAL HOURS
,
,
.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
B)
13) IF ZERO, WHY
14) TOTAL WAGES PAID THIS QTR
10) FIRST NAME
11) MI
12) TOTAL HOURS
,
,
.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
C)
13) IF ZERO, WHY
14) TOTAL WAGES PAID THIS QTR
10) FIRST NAME
11) MI
12) TOTAL HOURS
,
,
.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
D)
13) IF ZERO, WHY
14) TOTAL WAGES PAID THIS QTR
10) FIRST NAME
11) MI
12) TOTAL HOURS
,
,
.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
E)
13) IF ZERO, WHY
10) FIRST NAME
11) MI
14) TOTAL WAGES PAID THIS QTR
12) TOTAL HOURS
,
,
.
7) LAST NAME
8) SUFFIX (JR, SR, ETC)
9) SOCIAL SECURITY NO.
F)
13) IF ZERO, WHY
14) TOTAL WAGES PAID THIS QTR
10) FIRST NAME
11) MI
12) TOTAL HOURS
,
,
.
SUBTOTAL WAGES PAID THIS PAGE
EMS 5208 B (Rev. 3/11)
,
,
.
CC 7540-032-820
Out-of-state wages claimed for employee and from what state
A) $ _____________________ State ___________
B) $_____________________ State ___________ C) $____________________ State ___________
D) $ _____________________ State ___________
E) $_____________________ State ___________ F) $ ____________________ State ___________
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