Form Wb101 - Mtq - Montana Employer'S Quarterly Tax Report - Unemployment Insurance/withholding - 2003
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1
2Rev. 3-03
Quarter End
Due Date
MTQ – Montana Employer’s Quarterly
Tax Report – Unemployment Insurance/Withholding (WB101)
Customer Id
Federal Id (FEIN)
UI Contribution Rate
%
UI Administrative Fund Tax Rate
%
UI Total Tax Rate
%
UI Annual Taxable Wage Base $
(Each Employee)
A report must be filed to avoid penalties. Please refer to MTQ instructions for information on completing this form.
Step 1. Check box(es), if applicable, and provide information requested.
No wages paid for the quarter covering this report
Sold business - name and address of new owner:
Ceased employing - last payroll date ____/_____/____
Change in name, address, telephone number and/or identification number (list corrections here):
Amended report
Step 2. Unemployment Insurance Employee Wage Listing
You are required to fill in all Employees’ Names, Social Security
Numbers and Wages on the enclosed UI-5A or equivalent format.
Step 3. Calculate Tax
State Unemployment
State Income Tax
Insurance (UI)
Withholding (WH)
1.
Total wages paid this quarter ………………………………..
1a
1b
UI excess wages (except governmentals and
2a
2.
reimbursables)………………………………………………….
Withholding Wages
3a
3.
UI taxable wages (box 1a minus box 2a) …………………
Withholding Liability
0.00%
4.
UI total tax rate..…………………………..……………………
4a
5.
Total tax (Box 3a times Box 4a)(Box 5b is WH liability)…..
5a
5b
6.
Credits (minus overpayment from prior quarters)………….
6a
6b
7.
WH taxes paid this quarter (monthly or accelerated payer)
7b
8.
Adjustments to prior quarters (attach explanation)………..
8a
8b
9.
Balance due……………………………………………………
9a
9b
10
Penalty and interest, if you file late ……………………..….
10a
10b
11
Subtotal (boxes 9a + 10a and 9b + 10b)……………………
11a
11b
12
Total payment enclosed. Payment should equal
the amounts from boxes 11a and 11b. ……………………..
12
Step 4. Number of Employees
th
Number of covered workers who worked during or received pay for the payroll which includes the 12
day of the month.
st
nd
rd
1
Month____________________ 2
Month_____________________ 3
Month____________________
Step 5.
Summary of WH Tax Liability for Monthly Withholding Payers Only. Total WH Liability should be equal to line 5b.
st
nd
rd
1
Month
2
Month
3
Month
Total WH Liability
$
+ $
+ $
= $
Step 6. Payment Coupon.
Complete the coupon by entering the amounts from 11a, 11b and 12 from Step 3 above onto
the coupon below. Return payment and coupon with form MTQ and UI-5A, and Schedule B if applicable. Do not fold or staple
the coupon. Mail your MTQ and payment to the Department of Revenue by the due date above, even if no tax is due.
Question? Call (406) 444-6900
Step 7. Sign and make
I certify the information on this report and
Date:
a copy of this form for
attachments are true and correct.
your records. Mail to:
Department of Revenue
Authorized Signature/Title
Telephone
Name/Title of Contact Person
Telephone No.
PO Box 6339
No.
Helena, MT 59604-
6339
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