Form 5208 B - Quarterly Wage Detail Report
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Quarterly Wage Detail Report
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Form 5208 B
Washington State Employment Security Department
USE BLACK INK AND ALL CAPS - DO NOT STAPLE ANYTHING TO THIS FORM, YOU MAY USE PAPER CLIPS
1) DUE DATE
2) QTR ENDING DATE
3) ES REFERENCE NUMBER
4) BUSINESS NAME
MACHINE PRINT
5) EMPLOYEE’S SOCIAL
6) LAST NAME, FIRST NAME, MIDDLE INITIAL
7) TOTAL HOURS
8) TOTAL GROSS WAGES
SECURITY NUMBER
PAID THIS QUARTER
(14 CHARACTER MAXIMUM)
(SEE INSTRUCTIONS)
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TOTAL GROSS WAGES PAID MUST EQUAL LINE 12 ON QUARTERLY TAX REPORT
PAGE
OF
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EMS 5208 B (Rev. 5/99)
CC 7540-032-820
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