Les Form Uct-6 - Employer'S Quarterly Report
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1FLORIDA DIVISION OF UNEMPLOYMENT COMPENSATION
Employer's Quarterly Report
107 E. Madison Street, Tallahassee, FL 32399-0212
ALL INFORMATION MUST BE TYPED OR PRINTED CLEARLY IN BLACK INK
Quarter Ending
Due Date
Penalty After Date
UC Account Number
Employer's Name
Tax Rate
F.E.I. Number
Mailing Address
SIC Code
City/State/ZIP + 4
Bureau Use Only - Postmark Date
Do not staple or make changes on this form. Return original and make a copy for your records. See instructions
1.
Enter the total number of full-time and part-time covered
2. Gross Wages Paid this Quarter
workers who performed services during or received pay
(Must agree with Item 13)
th
for the payroll period including the 12
of the month.
3. Wages Paid this Quarter in excess of $7,000
per Employee this Year
4. Taxable Wages for this Quarter
st
1
Month
(Item 2 minus Item 3)
5. Tax Due
nd
2
Month
(Multiply Item 4 by Tax Rate)
6. Penalty Due
rd
3
Month
(See Instructions)
7. Interest Due
(See Instructions)
8. Total Amount Due for the Quarter Make check payable to Florida U,C.
Fund (If less than $1.00, no remittance is necessary.)
9.
Employee’ s
10. Employee’ s Name
First
Middle
11. Employee’ s Gross Wages
Social Security Number
Last Name
Initial
Initial
Paid This Quarter
12. Total Gross Wages This Page
13. Total Gross Wages All Pages (Must agree with item 2-Gross Wages)
14. Total Number of Employees Reported All Pages
I certify the information contained on this report is true and correct and no part of tax was, or is to be deducted from the employee's wages.
Signature:
Title:
Phone Number:
Date:
Preparer's Name:
Preparer's Phone:
LES FORM UCT-6 (Rev. 12/18/98)
Internet Address:
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