Form Uct-6a - Employer'S Quarterly Report Continuation Sheet
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1Employer’ s Quarterly Report Continuation Sheet
Division of Unemployment Compensation
BUREAU OF TAX
107 E. Madison Street – Tallahassee, FL 32399-0212
RETURN ORIGINAL WITH EMPLOYER’ S QUARTERLY REPORT
READ INSTRUCTIONS ON REVERSE SIDE BEFORE COMPLETING THIS FORM
1.
Page Number (Ex. 2 of 4)
2. Date Quarter Ended
3.
Location Unit Code
4. Employer’ s Name
5. UC Account Number
CK Digit
6.
Employee’ s
7. Employee’ s Name
8. Employee’ s Gross Wages
Social Security Number
Last Name
First Name
Mdl Init
Paid This Quarter
9. TOTAL WAGES THIS PAGE
LES FORM UCT-6A (Rev. 8/12/98)
Internet Address:
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Parent category: Financial