WAGE REPORT &
This report can be filed online at:
UNEMPLOYMENT TAX RETURN
NOTICE: By submitting your payment by check, you are consenting to the department processing your check by using your routing numbers to initiate an electronic
funds transfer. If you do not want to electronically transfer funds from your bank account you must submit a money order or use a credit card for payment.
1. Employer's Name and Address
Number ____ ____ ____ ____ ____ ____
3. Quarter Ending
4. To avoid a penalty this return must be postmarked by
the last day of the month after the quarter ending date.
5. Number of continuation sheets attached
This report MUST BE FILED if you have an active account, even IF you have NO WAGES or NO TAX due.
6. Social Security Number
7. Employee Name
8. Total Wages
9. Excess Wages
Paid This Quarter
10. Total Wages for THIS page
11. For each month, report the number of covered workers who worked or
received pay during the payroll period, this includes the 12th of the month.
12. Total Wages from ALL pages
If NO WAGES were paid, enter ZEROS here and in items 13 & 14. Sign & Return.
13. Total Excess Wages from ALL Pages
14. Compute Taxable Wages
Total Wages (item 12) minus Excess Wages (item 13)
15. Unemployment Tax Due
Multiply Taxable Wages (item 14) by your Tax Rate
16. SUTA Penalty Rate
FOR KDOL USE
Multiply Taxable Wages (item 14) by your Penalty Rate
17. Maximum $200 late filing penalty
Minimum $25 penalty. See instructions
18. Interest on late payment
1% FOR EACH PART OR WHOLE MONTH
19. Prior Overpayment
Attach K-CNS 111 Adjustment OR K-CNS 2101 Credit Memo
20. Prior amount due
21. Total Due. If tax is $5 or more, pay to
KANSAS EMPLOYMENT SECURITY FUND
PO Box 400, Topeka, KS 66601-0400
22. I certify that the information on this return is true, correct and complete, to the best of my knowledge and belief.
Area Code &
K-CNS 100 (Rev. 10-08)