Form Rt-6 - Florida Department Of Revenue Employer'S Quarterly Report - 2015
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3Florida Department of Revenue Employer’s Quarterly Report
Use black ink. Example A - Handwritten Example B - Typed
Employers are required to file quarterly tax/wage reports regardless of employment activity or whether any taxes are due.
Example A
Example B
0123456789
0 1 2 3 4 5 6 7 8 9
RT-6
Use
Black Ink
to Complete This Form
R. 01/15
DUE DATE
PENALTY AFTER DATE
TAX RATE
QUARTER ENDING
RT ACCOUNT NUMBER
/
/
Do not make any changes
If you do not have an account number, you
to the pre-printed
are required to register (see instructions).
information on this form.
F.E.I. NUMBER
If changes are needed,
request and complete an
Employer Account
Change Form (RTS-3).
FOR OFFICIAL USE ONLY POSTMARK DATE
/
/
Reverse Side Must be Completed
Name
2.
Gross wages paid this quarter
Mailing
(Must total all pages)
Address
3. Excess wages paid this quarter
City/St/ZIP
(See instructions)
4. Taxable wages paid this quarter
(See instructions)
Location
Address
5. Tax due
(Multiply Line 4 by Tax Rate)
City/St/ZIP
6. Penalty due
,
(See instructions)
1. Enter the total number
of full-time and part-time
1st Month
7. Interest due
covered workers who
,
(See instructions)
performed services during
2nd Month
or received pay for the
8. Installment fee
,
payroll period including the
(See instructions)
12th of the month.
3rd Month
9a. Total amount due
(See instructions)
Check if final return:
9b. Amount Enclosed
Date operations ceased.
(See instructions)
Check if you had out-of-state wages. Attach Employer’s
RT-6
If you are filing as a sole proprietor, is this for
Quarterly Report for Out-of-State Taxable Wages (RT-6NF).
domestic (household) employment only?
Yes
No
Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (sections 443.171(5), Florida Statutes).
Title
Sign here
Phone
Fax
(
)
(
)
Signature of officer
Date
Preparer check
Preparer’s
Preparer’s
if self-employed
SSN or PTIN
signature
Paid
preparers
FEIN
Firm’s name (or yours
Date
only
if self-employed)
and address
Preparer’s
ZIP
(
)
phone number
DO NOT
DETACH
TC
Employer’s Quarterly Report Payment Coupon
RT-6
Rule 73B-10.037
R. 01/15
Florida Administrative Code
Effective Date 11/14
COMPLETE and MAIL with your REPORT/PAYMENT.
DOR USE ONLY
Florida Department of Revenue
Please write your RT ACCOUNT NUMBER on check.
Make check payable to: Florida U.C. Fund
POSTMARK OR HAND-DELIVERY DATE
RT-6
RT ACCOUNT NO.
Cents
U.S. Dollars
F.E.I. NUMBER
GROSS WAGES
(From Line 2 above.)
AMOUNT ENCLOSED
(From Line 9b above.)
-
PAYMENT FOR QUARTER
Name
ENDING MM/YY
Mailing
Address
Check here if you are electing to
Check here if you transmitted
pay tax due in installments.
funds electronically.
City/St/ZIP
9100 0 99999999 0068054031 7 5009999999 0000 4
9100 0 99999999 0068054031 7 5009999999 0000 4
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Parent category: Financial