Process Unemployment Step 3

	Sunday, March 14, 2010

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UI Quarterly Report

Process Unemployment Step 3

Process Unemployment Step 3

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FedIDNumber:

Quarter / Year

Jan/Feb/Mar 2010

FedID:

Total Wages paid this quarter (Do not use commas):

Contribution Rate:

Penalities and interest due:

Adjustments (explain below in comments section):

Pay via ACH (must have submitted authorization form prior to report):

Your total comes to: $0.00

Number of covered workers:

Total number of employees listed --->

1st Month:

2nd Month:

3rd Month:

Total:

Employment wage data tabs delimited spreadsheet file:

Cellular Phone:

Contact Name:

Contact Title:

Contact Email:

Date:

Comments:

I certify that the information on this report and attachments is true and correct.?

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