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ITEM 11 - Subtract Item 10 from Item 9. (Taxable wages for this quarter).

ITEM 12 - Multiply Item 11 by your tax rate shown. (Must not be deducted from workers' wages)

ITEM 13 - Any credit for a prior quarter will show here. This figure is subject to change as there may be charges or

credits to your account subsequent to the printing of this form.

ITEM 14 - Enter the amount due (Line 12 minus Line 13) and make check or money order payable to Vermont

Department of Employment & Training. If Line 13 is greater than Line 12, ENTER 0.

ITEM 15 - Check the appropriate box when a change in the business status, business name or ownership has taken

place, or if you no longer have employees and wish to inactivate your account.

ITEM 16 - Enter Date.

ITEM 17 - Enter Telephone Number.

ITEM 18 - Enter Signature & title. (Must be owner, principal officer or authorized representative)

REPORT PENALTIES - A penalty of $35.00 will be assessed 1) if this report is not correctly completed, or 2) if it is not

received postmarked on or before the due date, or 3) if the wage data on any employee (Item 1) is incomplete, illegible,

or in unacceptable format. Due dates that fall on a Sunday or legal Holiday will be accepted as timely if postmarked on or

before the next business day. Due dates that fall on a Saturday must be postmarked on or before Saturday to b

considered timely.

INTEREST FEES - Interest accrues at 18% annually on any unpaid tax from the quarterly due date to the date payment is

received.

GENERAL INFORMATION

Employees include ALL individuals who perform services for wages. (See below for definition of gross wages.)

INDIVIDUALS EXEMPT FROM COVERAGE AN NOT REPORTABLE: Sole proprietor or members of partnerships or

limited liability companies. Parents, spouses, civil union partners, and children under 18 years of age, of the sole

proprietor. Individuals who are entered in a full-time accredited educational program which combines academic

instruction with work experience. Elected officials of a government entity. Volunteer fire and emergency personnel.

GROSS WAGES PAID ARE DEFINED AS: Wages before deductions are made for such items as withholding and Social

Security/FICA taxes.

WAGES INCLUDE ALL REMUNERATION FOR SERVICES RENDERED SUCH AS: Wages, salaries, draws,

commissions, profit sharing draws, employees' shares of Social Security, or any other term, paid in money or something

other than money, on the basis of piece rates, hour rates, day rates or fixed weekly, monthly or annual stipends.

Payments into pension funds, union dues, insurance, etc. Meals and lodging provided by an employer to an employee

even when used to meet minimum wage requirement. Severance pay, wages in lieu of notice, vacation, advances to

employees for expenses (including travel) for which no accounting or reporting to the employer by the employee is

required. Tips which are reported pursuant to Section 6053 of the Internal Revenue Code. Sick pap payments made

under an employer's plan through the first six months. Otherwise the insurer is taxable. Employee contributions to a

401K deferred-compensation plan. Cash value of benefits provided under a Cafeteria Plan as described in Section 125

of the Internal Revenue Service.

WAGES DO NOT INCLUDE: Facilities or other privileges (entertainment, restaurant meals, medical services, "courtesy

discounts" on purchases) furnished or offered by an employer merely as a convenience to the work or as a means of

promoting the value or efficiency of work. Director's fees. Payments by the employer to or on behalf of an employee for

sickness or accidental disability after six months. Payments made by Workmen's Compensation.

Form C-101 - Employer'S Quarterly Wage & Contribution Report With Instructions - 2001 Page 2