Form Uct-8a - Correction To Employer'S Quarterly Or Annual Domestic Report - Florida Department Of Revenue Page 2
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1
2UCT-8A
R. 05/04
Instruction
Page 2
Correction to Employer’s Quarterly or Annual Domestic
Complete Item 8 if individual wage corrections change gross
Report Instructions
wages, excess wages, or taxable wages originally shown on
the tax report.
This form (Form UCT-8A) is provided for use in correcting
errors made on the original Employer’s Quarterly Report
Coupon Completion Instructions
(Form UCT-6) or Annual Report for Employers of Domestic
Write your seven digit account number and the check digit in
Employees Only (UCT-7). Annual filers will need to complete
the boxes provided.
one UCT-8A for each quarter being corrected.
Enter the employer legal entity name in the field labeled “Enter
Under heading “ Correction to Quarter/Year”, insert the quarter
Business Name”.
and year of the original report being corrected. For example,
if the correction is to the 2
nd
quarter 2002, the Correction to
Enter the amount of payment in the “Amount Enclosed” field.
Quarter/Year field would be completed with “2/2002”.
Enter the 1 digit quarter and 2 digit year in the field labeled
Caution: Be sure that the employee’s social security number
“Payment for QTR/YR”. For the quarter field, enter the number
and name shown in Items 1 and 2 agree with your original
“1” for quarter ending March 31
st
, the number “2” for quarter
report, unless the social security number and name
ending June 30
th
, “3” for quarter ending September 30
th
and “4”
st
originally reported were incorrect. In such a case, enter the
for quarter ending December 31
. In the year field, enter the
number and name, as per original report. Underneath, write
last two digits for the year. For example: enter “01” for 2001.
social security number change and/or name change; then
Mail the original completed form and coupon along with
list the correct social security number and/or name.
any remittance due to the:
Item 3 should be completed if continuation sheets were filed
FLORIDA DEPARTMENT OF REVENUE
with original report.
5050 W TENNESSEE STREET
Items 4 and 6 are used to correct gross wages.
TALLAHASSEE FL 32399-0180
Items 5 and 7 should be omitted unless you have received
Need Assistance?
prior approval. Unit codes are special codes assigned
To speak with a Department of Revenue representative, call
employers to identify the mailing address for unemployment
Taxpayer Services, Monday through Friday, 8 a.m. to 7 p.m.,
insurance claims forms, if different from the primary
ET, at 1-800-482-8293.
employer address.
Hearing or speech impaired persons may call the TDD line at
1-800-367-8331 or 850-922-1115.
IMPORTANT
Complete page 1 for corrections to the Employer’s Quarterly or Annual Domestic Report.
Complete page 2 only if payment is enclosed.
Return completed form and coupon, if applicable, to the Department.
DO NOT
DETACH
Correction to Employer’s Quarterly or Annual Domestic Report
UCT-8A
Payment Coupon
R. 05/04
COMPLETE and MAIL with Your REPORT/PAYMENT.
Florida Department of Revenue
DOR USE ONLY
Please write ACCOUNT NUMBER on Your Check.
Be sure to SIGN YOUR CHECK.
Make check payable to: Florida U.C. Fund
POSTMARK OR HAND DELIVERY DATE
- - - - -
ACCOUNT NO.
US Dollars
Cents
,
,
F.E.I. NUMBER
AMOUNT ENCLOSED
- - - - -
Q
Y Y
PAYMENT FOR QTR/YR
Name
UCT-8A
Address
Check here if you transmitted funds
City/St/ZIP
electronically.
0100 0 99999999 006805404905050099999990000004
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