Form Uct-8a - Correction To Employer'S Quarterly Or Annual Domestic Report - Florida Department Of Revenue
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1
2UCT-8A
R. 05/04
Florida Department of Revenue
Correction to Employer’s Quarterly or Annual Domestic Report
Do Not Use This Area
UT Account Number
Correction to Quarter/Year
Batch Number
FEI Number
Audited By
Employer's Name
Date
Street Address
Remarks
City
State
ZIP
Explain, in detail, the reason for correction
1.
2.
3.
4.
5.
6.
7.
Employee's
Employee's Name
Page
Unit
Correct
Unit
Gross
Social Security
No.
Code
Gross
Wages Per
Code
Number
Last
First Middle
Original Report
Wages
Initial Initial
8. If this information changes the figures on your
Totals
$
$
original report - Please Complete
This Page
Originally
To Be
Item
Difference Between Column 4 and 6
$
Reported
Corrected To
Difference
I certify that the information contained in this report is true and correct.
Gross Wages
Signature
Excess Wages
Title
Date
Taxable Wages
Tax Due
Make check payable to Florida U.C. Fund
$
See page 2 for complete instructions and coupon
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