Form Rt-7 - Employer'S Reemployment Tax* Annual Report For Employers Of Domestic Employees Only Page 2
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2
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4Use black ink. Example A - Handwritten Example B - Typed
Florida Department of Revenue Employer’s Reemployment Tax Annual Report for
RT-7
Example A
Example B
R. 12/12
0 1 2 3 4 5 6 7 8 9
Employers of Domestic Employees Only
0123456789
Page 1
Employers are required to file annual tax/wage reports regardless of employment activity or whether any taxes are due.
CALENDAR YEAR ENDING
DUE DATE
PENALTY AFTER DATE
TAX RATE
RT ACCOUNT NUMBER
/
/
Do not make any chang-
F.E.I. NUMBER
-
es to the pre-printed
information on this form.
If changes are needed,
request and complete
FOR OFFICIAL USE ONLY POSTMARK DATE
an Employer Account
/
/
Change Form (RTS-3).
1. Enter the total number of full-time and part-time covered employees who performed services during, or received pay for,
the payroll period including the 12th of the month.
Name
,
,
,
,
First Qtr. Ending 3/31
Second Qtr. Ending 6/30
Third Qtr. Ending 9/30
Fourth Qtr. Ending 12/31
Address
First
City/St/ZIP
Month
,
,
,
,
Second
Month
,
,
,
,
Third
Month
First Quarter Ending 3/31
Second Quarter Ending 6/30
Third Quarter Ending 9/30
Fourth Quarter Ending 12/31
,
.
,
.
,
.
,
.
Gross wages paid each quarter
2.
(enter total from all pages) ......................
,
.
,
.
,
.
,
.
Excess wages paid each quarter
3.
(See instructions) ....................................
,
.
,
.
,
.
,
.
Taxable wages for each quarter
4.
A A A
A A A
A A
B B B
B B B
B B
C C C
C C C
C C
D D D
D D D
D D
+
+
+
(enter total from all pages) ......................
,
.
,
.
Taxable wages for calendar year
Tax due
5.
6.
(see instructions, multiply
=
Tax Rate
X
RT-7
(see Line 4: A plus B plus C plus D = 5) .
Line 5 by tax rate) ....................................
,
.
+
Penalty due
7.
(see instructions) ........
,
.
+
Interest due
Make check payable to:
8.
(see instructions) ........
Florida U.C. Fund
,
.
Total amount due
9.
=
(Line 6 plus Line 7 plus Line 8) .............
Date
Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (section 443.131(1) Florida Statutes).
Sign here
Title
Phone
(
)
Signature of employer
Preparer’s
Preparer check
Preparer’s SSN
signature
if self-employed
or PTIN
Paid
preparers
Date
FEIN
Firm’s name (or yours
only
if self-employed)
Preparer’s phone
and address
ZIP
(
)
number
DO NOT DETACH
Employer’s Reemployment Tax Annual Report for Employers of Domestic Employees Only Payment Coupon
RT-7
R. 12/12
Florida Department of Revenue
COMPLETE and MAIL with your REPORT/PAYMENT.
Please write your RT ACCOUNT NUMBER on check.
Be sure to SIGN YOUR CHECK.
DOR USE ONLY
Make check payable to: Florida U.C. Fund
POSTMARK OR HAND DELIVERY DATE
RT ACCOUNT NO.
-
F.E.I. NUMBER
US Dollars
Cents
,
AMOUNT ENCLOSED
Name
Address
PAYMENT FOR
City/St/ZIP
CALENDAR YEAR
RT-7
Check here if you transmitted
funds electronically.
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