Form Rt-7 - Employer'S Reemployment Tax - Annual Report For Employer'S Of Domestic Employees Only Page 4
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4RT-7
RT ACCOUNT NUMBER
CALENDAR YEAR ENDING
EMPLOYER’S NAME
/
/
F.E.I. NUMBER
10. EMPLOYEE’S SOCIAL SECURITY NUMBER
-
11. EMPLOYEE’S NAME
(Please print first twelve characters of last name, first
12a. EMPLOYEE’S GROSS WAGES PAID EACH QUARTER
12b. EMPLOYEE’S TAXABLE WAGES PAID EACH QUARTER
eight characters of first name and middle initial in boxes.)
GROSS WAGES PAID EACH QUARTER
SOCIAL SECURITY NUMBER
EMPLOYEE
FIRST QUARTER ENDING 3/31
SECOND QUARTER ENDING 6/30
THIRD QUARTER ENDING 9/30
FOURTH QUARTER ENDING 12/31
-
-
12a.
6
Last
Name
TAXABLE WAGES PAID EACH QUARTER
12b.
First
Middle
Name
Initial
GROSS WAGES PAID EACH QUARTER
SOCIAL SECURITY NUMBER
EMPLOYEE
FIRST QUARTER ENDING 3/31
SECOND QUARTER ENDING 6/30
THIRD QUARTER ENDING 9/30
FOURTH QUARTER ENDING 12/31
-
-
12a.
7
Last
TAXABLE WAGES PAID EACH QUARTER
Name
12b.
First
Middle
Name
Initial
GROSS WAGES PAID EACH QUARTER
SOCIAL SECURITY NUMBER
EMPLOYEE
FIRST QUARTER ENDING 3/31
SECOND QUARTER ENDING 6/30
THIRD QUARTER ENDING 9/30
FOURTH QUARTER ENDING 12/31
-
-
12a.
8
Last
TAXABLE WAGES PAID EACH QUARTER
Name
12b.
First
Middle
Name
Initial
GROSS WAGES PAID EACH QUARTER
SOCIAL SECURITY NUMBER
EMPLOYEE
FIRST QUARTER ENDING 3/31
SECOND QUARTER ENDING 6/30
THIRD QUARTER ENDING 9/30
FOURTH QUARTER ENDING 12/31
-
-
12a.
9
Last
TAXABLE WAGES PAID EACH QUARTER
12b.
Name
First
Middle
Name
Initial
GROSS WAGES PAID EACH QUARTER
SOCIAL SECURITY NUMBER
EMPLOYEE
FIRST QUARTER ENDING 3/31
SECOND QUARTER ENDING 6/30
THIRD QUARTER ENDING 9/30
FOURTH QUARTER ENDING 12/31
-
-
12a.
10
Last
TAXABLE WAGES PAID EACH QUARTER
Name
12b.
First
Middle
Name
Initial
Enter the total of all Line 12a. entries from
Enter the total of all Line 12a. entries from
Enter the total of all Line 12a. entries from
Enter the total of all Line 12a. entries from
above for First Quarter Ending 3/31
above for Second Quarter Ending 6/30
above for Third Quarter Ending 9/30
above for Fourth Quarter Ending 12/31
13a. TOTAL GROSS WAGES EACH QUARTER THIS PAGE
,
.
,
.
,
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,
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INCLUDE IN LINE 2 ON PAGE 1
Enter the total of all Line 12b. entries from
Enter the total of all Line12b. entries from
Enter the total of all Line 12b. entries from
Enter the total of all Line 12b. entries from
above for First Quarter Ending 3/31
above for Second Quarter Ending 6/30
above for Third Quarter Ending 9/30
above for Fourth Quarter Ending 12/31
13b. TOTAL TAXABLE WAGES EACH QUARTER THIS PAGE
,
.
,
.
,
.
,
.
INCLUDE IN LINE 4 ON PAGE 1
Social security numbers (SSNs) are used by the Florida Department of Revenue as unique identifiers for the administration of Florida’s taxes. SSNs obtained for tax administration purposes are
confidential under sections 213.053 and 119.071, Florida Statutes, and not subject to disclosure as public records. Collection of your SSN is authorized under state and federal law. Visit our Internet site
at and select “Privacy Notice” for more information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions.
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