Form Uct-6 - Florida Department Of Revenue Employer'S Quarterly Report
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3Florida Department of Revenue Employer’s Quarterly Report
UCT-6
R. 12/02
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
ACCOUNT NUMBER
TAX RATE
Do not make any
F.E.I. NUMBER
changes to the
pre-printed
information on this
form. If changes
are needed,
FOR OFFICIAL USE ONLY POSTMARK DATE
complete the
enclosed Employer
M M
D D
Y Y Y Y
Account Change
Form (UCS-3).
2. Gross Wages Paid This Quarter
1. Enter the total number of full-time and part-time covered workers who performed
$
,
,
.
(Must be same as item 13)
services during or received pay for the payroll period including the 12th of the month.
3. Wages Paid This Quarter in Excess of
,
$
,
,
.
1st Month
$7,000 Per Employee This Year
4. Taxable Wages For This Quarter
,
$
,
,
.
2nd Month
(Item 2 minus item 3)
5. Tax Due
,
$
,
,
.
3rd Month
(Multiply item 4 by Tax Rate)
6. Penalty Due
I certify the information contained on this report is true and correct and no part of the
$
,
,
.
(See instructions)
unemployment tax was, or is to be deducted from the employee’s wages.
7. Interest Due
$
,
,
.
Signature:
(See instructions)
8. Total Amount Due
$
,
,
.
Make check payable to: Florida U.C. Fund
Title:
(if less than $1.00 no remittance is necessary)
Phone:
Date:
Preparer’s Name:
Preparer’s Phone:
9. EMPLOYEE’S
10. EMPLOYEE’S NAME*
11. EMPLOYEE’S GROSS WAGES
SOCIAL SECURITY NUMBER
PAID THIS QUARTER
*please print first eleven characters of last name in boxes
First
Middle
Last Name
Initial
Initial
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
,
,
.
$
If Required Use Reverse Side
,
,
.
12. Total Gross Wages This Page
For Additional Employees.
13. Total Gross Wages All Pages
$
,
,
.
1234
(Must be same as item 2 - Gross Wages)
UCT-6
DO NOT DETACH
R. 12/02
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.
AMOUNT ENCLOSED
ENTER BUSINESS NAME:
Y
Y
Q
PAYMENT FOR QTR/YR
9999 99999999 315468 9999999997xxxxx
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Parent category: Financial