Wage Detail - Ohio Department Of Job And Family Services

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OHIO DEPARTMENT OF JOB AND FAMILY SERVICES
P.O. Box 182413
Columbus, Ohio 43218-2413
(614) 466-2319
FOR 0068
WAGE DETAIL
1. Employer Account Number
2. Federal Employer Identification Number
3. Quarter
4. Year
-
-
-
5. Employer Name
7. Total Number of Employees
6. Total Number of Wage Detail Pages
8. Total Wages From All Pages
From All Pages
.
9. Total Number of Covered Workers
10. MARK THE APPROPRIATE BOX: (IF APPLICABLE)
Month 1
Month 2
Month 3
Place an X here if you had no workers and paid no wages
this quarter or file by telephone by calling toll free
1-866-448-2829.
11. Certification: I certify that the information contained in this return is true and correct.
Signed
12. Page
of
Title
Date
First
Middle
13. Employee's Social Security Number
14. Employee's Last Name
16. Weeks
15. Total Wages Paid This Quarter
Initial
Initial
.
.
.
.
.
.
.
.
.
.
.
17. Total Number of Employees This Page Only
18. Total Wages This Page Only
Agency Use Only: Postmark Date
T
T

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