Form K-Cns 120 - Wage Detail For The Kansas Quarterly Wage Report And Contribution Return

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KANSAS DEPARTMENT OF HUMAN RESOURCES
MAGNETIC MEDIA TRANSMITTAL SHEET
WAGE DETAIL FOR THE KANSAS
QUARTERLY WAGE REPORT AND CONTRIBUTION RETURN
Complete all parts. The Quarterly Wage Report and Contribution Return must be submitted with wage totals.
The paper tax return should be submitted with the magnetic media. Call (785) + 296-5006 with non -technical
questions about quarterly reporting. Send completed transmittal sheet and labeled tape/diskette and a dump of
the first 20 records to:
Magnetic Media Coordinator
Alternate address for carriers (UPS, FedX)
Department of Human Resources
unable to deliver to post office boxes
PO Box 400
401 SW Topeka Blvd
Topeka, KS 66601-0400
Topeka, KS 66603-3182
PART I - TRANSMITTER / CONTACT INFORMATION
TRANSMITTING FIRM NAME AND ADDRESS
REPORTING PERIOD
•
•••
QUARTER
YEAR
NAME, ADDRESS TELEPHONE OF CONTACT FOR
•
TECHNICAL INFORMATION ABOUT THIS FILE
CHECK FOR CHANGE OF ADDRESS
••• - ••• - ••••
PART II - FIRM(S) REPORTED
ATTACH ADDITIONAL SHEETS IF REQUIRED. PRINTOUTS OF PART II DATA ARE ACCEPTABLE.
THE KS UNEMPLOYMENT TAX ACCOUNT (SERIAL) NUMBER IS SIX DIGITS PLUS A CHECK DIGIT.
THE CHECK DIGIT IS OPTIONAL.
EMPLOYER NAME (FIRM #1)
EMPLOYER NAME (FIRM #2)
KS UNEMPLOYMENT TAX
KS UNEMPLOYMENT TAX
ACCOUNT (SERIAL) NUMBER
ACCOUNT (SERIAL) NUMBER
•••••• •
•••••• •
FEDERAL EMPLOYER ID NUMBER – FEIN
FEDERAL EMPLOYER ID NUMBER – FEIN
•• - ••••••
•• - •••••••
PART III - MAGNETIC MEDIA FILE INFORMATION
• 9 TRACK TAPE
RECORD LENGTH
• 275
• 276
• 3480 TAPE CARTRIDGE
BLOCK SIZE
• 6875
• OTHER – SPECIFY: _____________________
• 3 ½ inch DISKETTE
LIST ANY EXTERNAL TAPE / CARTRIDGE / DISKETTE
NOT
MEDIA AND CONTAINERS ARE
FILE IDENTIFICATION NUMBERS
RETURNED
PART IV – DECLARATION
: I declare that this information is true and correct to the best of my knowledge and belief.
NAME AND TITLE (PLEASE PRINT)
VOICE TELEPHONE WITH AREA CODE + EXTENSION
SIGNATURE
FAX TELEPHONE
EMAIL
DATE
K-CNS 120 (8-98)

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