Form 0039 - Wage Detail
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1
2OHIO DEPARTMENT OF JOB AND FAMILY SERVICES
P.O. Box 182413
Columbus, Ohio 43218-2413
FOR 0039
(614) 466-2319
WAGE DETAIL
1. Employer Account Number
2. Federal Employer Identification Number
3. Quarter
4. Year
-
-
-
5. Employer Name
6. Total Number of Wage Detail Pages
7. Total Number of Employees From
8. Total Wages From All Pages
All Pages
.
9. Total Number of Covered Workers
10. MARK THE APPROPRIATE BOX: (IF APPLICABLE)
Place an X here if you had no workers and paid no wages
Month 1
Month 2
Month 3
this quarter or file by telephone by calling toll free
1-866-448-2829.
Place an X here if you've paid and reported taxable wages to
another state.
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
15. Total Wages Paid this Quarter
16. Weeks
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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Parent category: Legal