KANSAS DEPARTMENT OF LABOR
Page 1 of 2
For Internal Use Only
QUARTERLY WAGE REPORT & UNEMPLOYMENT TAX RETURN
K-CNS 100 Web (Rev. 2-17)
FILE ONLINE:
OR
SEE INSTRUCTIONS ON PAGE 2. To avoid a penalty this return must be postmarked or electronically
MAIL TO: Kansas Department of Labor, P.O. Box 400, Topeka, KS 66601-0400
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.
M
M
D
D
Y
Y
Y
Y
Q
Y
Y
Y
Y
2. Employer
3. Quarter
1. Business
Name
Serial Number
Ending
4. Social Security Number
5. Employee Last Name
First Name
MI
6. Total Wages Paid This Quarter
7. Excess Wages Paid This Quarter
Dollars
Cents
Dollars
Cents
8. Total Wages for THIS page
9. Number of continuation sheets attached
(See Instructions)
11. For each month, report the number of covered workers who
10. NAICS CODE
Month 1
Month 2
Month 3
worked during or received pay for the payroll period which
(For Internal Use Only)
includes the 12th of the month.
Dollars
Cents
12. Total Wages from ALL pages. If NO Wages were paid, mark X here
22. I certify that the information on this return is true, correct and complete,
13. Total Excess Wages from ALL Pages
to the best of my knowledge and belief.
14. Compute Taxable Wages (Item 12 minus item 13)
Signature
15. Unemployment Tax Due (Multiply Item 14 by Tax Rate) Tax Rate =
+
16. SUTA Penalty Rate (See instructions)
Penalty Rate =
Printed
+
Name
17. Late Filing Penalty (See instructions)
+
18. Interest on Late Payment (See instructions)
Phone
+
19. Prior Amount Due
–
20. Prior Overpayment
Date
21. Total Due. If tax is $5 or more, pay to Kansas Employment
M
M
D
D
Y
Y
Y
Y
Security Fund.
NOTICE: By submitting your payment by check, you are consenting to the Department processing your check by using your routing numbers to initiate
23. Check if this is your final wage report.
an electronic funds transfer. If you do not want to electronically transfer funds from your bank account, you must pay by money order or credit card.