Form Wc-1 - New Mexico Workers Compensation Fee - 1999

ADVERTISEMENT

NEW MEXICO WORKERS' COMPENSATION FEE
FORM WC-1
EAN
A. EAN
TRD Use Only
0
0
0
B. CRS I.D.
1. Report for Quarter Ending
,
C. FEIN
2. Number of Employees
,
.
3. Assessment
$
For Department Use Only
Fee
,
.
CHECK HERE IF NEW ADDRESS
$
4. Penalty
,
.
$
5. Interest
,
.
$
6. TOTAL
Signature _________________________________________ Date _________________
Mail To: Taxation & Revenue Department, P.O. Box 2527, Santa Fe, NM 87504-2527
RPD-41054
REV. 07/99
t RETAIN THIS PORTION FOR YOUR RECORDS t
WORKERS’ COMPENSATION
WC-1
RPD-41054
REV. 07/99
WHO MUST FILE:
WHEN TO FILE:
WHERE TO FILE:
Please print your numbers like this:
8 7 6 5
3 2
0
NAME
SEE EXAMPLE ON BACK OF INSTRUCTIONS
RECORD VERIFICATION FILE
1. Report for Quarter Ending
Your Employer Account Number (EAN) is:
,
2. Number of Employees
,
.
Your CRS I.D. Number is:
3. Assessment
Fee
,
.
4. Penalty
Your Federal Employer I. D. Number (FEIN) is:
,
.
5. Interest
,
.
If these numbers are correct, no action is required.
6. TOTAL
If incorrect, please enter the correct numbers in A,
B or C above on Form WC-1.

ADVERTISEMENT

00 votes

Related Articles

Related forms

Related Categories

Parent category: Legal
Go