Form Uct-6 - Florida Division Of Unemployment Compensation Employer'S Quarterly Report
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1
2
3Florida Division of Unemployment Compensation Employer's Quarterly Report
ALL INFORMATION MUST BE TYPED OR PRINTED CLEARLY IN BLACK INK
Employers are required to file quarterly tax/wage reports regardless of employment activity or whether any taxes are due.
Quarter Ending
Due Date
Penalty After Date
UC Account Number
Employer's Name
Tax Rate
F.E.I. Number
Mailing Address
Bureau Use Only - Postmark Date
City/State/ZIP + 4
SIC Code
DO NOT MAKE ANY CHANGES ON THIS FORM. IF CHANGES ARE NEEDED
COMPLETE THE ENCLOSED EMPLOYER ACCOUNT CHANGE FORM (UCS-3)
1.
Enter the total number of full-time and part-time covered workers
2. Gross Wages Paid This Quarter
$
who performed services during or received pay for the payroll period
(Must agree with Item 13)
th
including the 12
of the month.
3. Wages Paid This Quarter in Excess of
st
$
1
Month
$7,000 per Employee This Year
4. Taxable Wages for This Quarter
nd
$
2
Month
(Item 2 minus Item 3)
5. Tax Due
rd
$
3
Month
(Multiply Item 4 by Tax Rate)
I certify the information contained in this report is true and correct and
6. Penalty Due
$
no part of the U.C. tax was, or is to be deducted from the employee’ s
(See Instructions)
wages.
7. Interest Due
$
(See Instructions)
Signature
8. Total Amount Due
$
Make check payable to Florida U.C. Fund
Title
(If less than $1.00 no remittance is necessary)
Phone
Date:
CHECK HERE IF THIS IS AN ADDITIONAL REPORT FOR THIS QUARTER
Preparer's Name:
Preparer's Phone:
10. EMPLOYEE’ S NAME
11. EMPLOYEE’ S GROSS WAGES
9. EMPLOYEE’ S
First
Middle
SOCIAL SECURITY NUMBER
PAID THIS QUARTER
Last
Initial
Initial
$
$
$
$
$
$
$
$
$
$
$
If Required Use Reverse Side
12. Total Gross Wages This Page
$
(Page 2) for Additional Employees.
13. Total Gross Wages All Pages
$
(Must be same as item 2 - Gross Wages)
LES FORM UCT-6 (REV. 12/99)
Internet Address:
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