Form 21d - Employer'S Annual Contribution, Investment Fee And Wage Report
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1Form 21D (rev. 3/08)
Page 1
Employer's Annual Contribution, Investment Fee and Wage Report
South Dakota Department of Labor, Unemployment Insurance Division
P.O. Box 4730 • Aberdeen, South Dakota 57402-4730 • Phone 605-626-2312 • Fax 605-626-3347 • Web site
Employer Name
Account Number
Address
Year
1st Quarter
2nd Quarter
3rd Quarter
4th Quarter
Totals
Computation of Payment Due
3/31
6/30
9/30
12/31
1. Total Gross Wages Paid during this Quarter
2. Wages in Excess of Annual Wage Base
3. Taxable Wages
4. UI Contribution Rate
% x line 3
5. Investment Fee
% x line 3
6. Total Tax Due
7. Adjustments from prior quarter(s)
%
%
%
%
8. Interest
9. Penalty for Late Filing
10. Penalty for Late Payment
11. Total Remittance
1. Enter here the total of all gross wages paid this quarter.
Explanation:
Annual Taxable Wage Base
2. Wages paid this quarter in excess of annual taxable wage base per individual. The annual taxable
2006 & prior = $7000
wage base for 2006 and prior = $7000, 2007 = $8500, 2008 = $9000, 2009 = $9500, 2010 = $10,00
2007 = $8500
3. Subtract line 2 from line 1 and enter here.
2008 = $9000
4. Multiple your UI tax rate by the taxable wages on line 3. Enter tax due.
5. Multiple your IF tax rate by the taxable wages on line 3. Enter tax due.
2009 = $9500
6. Add lines 4 and 5 and enter the total here. This is total quarterly tax due.
2010 = $10,000
7. Enter any amounts due or refunds due to you from prior quarters.
8. Enter the interest due if report is late for the corresponding calendar quarter. The interest amount is
computed by multiplying the tax (Line 6) by 1.5% per month or fractional part of a month the report is
delinquent.
9. This penalty is imposed if the employer is late in filing a report. The penalty is $5 per month or
Signature
fractional part of a month from the due date of a report. Maximum penalty is $30 per quarter.
10. This penalty is imposed if the employer is late in making full payment.
This penalty is $5 per month
Date
Phone
or fractional part of a month. Maximum penalty is $30 per quarter.
11. This is the sum of lines 6,7,8,9, and 10. Payable to "South Dakota Unemployment Insurance
Division."
More information regarding Unemployment Insurance can be found at .
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