Form K-Cns 100 - Quarterly Wage Report & Unemployment Tax Return Page 2

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Schedule A – Employer’s Report of Wages Paid
Continuation Sheet for Employer’s Quarterly Wage Report and Unemployment Tax Return
Kansas Department of Labor
Employer
Six Digit KANSAS UI Account Number
Quarter Ending MM – DD – YYYY
Total Wages Paid
Excess Wages Paid
Social Security Number
Name
This Quarter
This Quarter
000
00
0000
Last, First, Middle Initial
Dollars
Cents
Dollars
Cents
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Page Totals
Quarterly Wage Report and Unemployment Tax Return, K-CNS 100, must accompany this continuation sheet.
K-CNS 101 (Rev. 9-04)

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