Form K-Cns 100 - Quarterly Wage Report & Unemployment Tax Return - Kansas Department Of Labor
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2KANSAS DEPARTMENT OF LABOR
K-CNS 100 (Rev. 06-2010)
QUARTERLY WAGE REPORT & UNEMPLOYMENT TAX RETURN
For Internal Use Only
To avoid a penalty this return must be postmarked or electronically submitted by the last day of the month after the
quarter ending date. This report must be filed if you have an active account, even if you have No Wages or No Tax Due.
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D
D
Y
Y
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Y
Q
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Y
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Y
2.
Employer
3.
Quarter
1.
Business
Serial Number
Ending
Name:
4. Social Security Number
5. Employee Last Name
First Name
MI
6. Total Wages Paid This Quarter
7. Excess Wages
Dollars
Cents
Dollars
Cents
(PLEASE PRINT UPPER CASE CLEARLY)
8. Total Wages for THIS page
9.
Number of
(See Instructions)
continuation
11.
For each month, report the number of covered workers who worked during or
sheets attached
received pay for the payroll period which includes the 12th of the month.
Month 1
Month 2
Month 3
10. NAICS CODE:
(For Internal Use Only)
X
12. Total Wages from ALL pages If NO Wages were paid mark
Here
13.
Total Excess Wages from ALL Pages
22.
I certify that the information on this return is true, correct and complete, to the best of
my knowledge and belief.
14.
Compute Taxable Wages. (item 12 minus item 13)
Tax Rate =
15.
Unemployment Tax Due. Multiply
(Item 14 by Tax Rate)
Signature
Penalty Rate =
16.
SUTA Penalty Rate (See Instructions)
17.
Late Filing Penalty
(See Instructions)
Print
Name
18.
Interest on Late Payment (See Instructions)
19.
Prior amount due
Phone
Number
20.
Prior Overpayment
21. Total Due.
KANSAS EMPLOYMENT SECURITY FUND
If tax is $5 or more, pay to
Date
NOTICE: By submitting your payment by check, you are consenting to the department processing your check
by using your routing numbers to initiate an electronic funds transfer. If you do not want to electronically
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transfer funds from your bank account, you must pay by money order or credit card.
23. Check if this is your final wage report.
(Please refer to Instructions on back for assistance with completing each item)
FILE ONLINE AT: OR RETURN TO: Kansas Department of Labor P.O. Box 400, Topeka, KS 66601-0400
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