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- Click ‘Get Form’ to open it in the editor.
- Review the business name, contact name, and mailing address in Section 2. Make any necessary corrections to ensure accuracy.
- In Section 3, verify the worksites listed. For each worksite, check the name, address, and description. If any details are missing or incorrect, update them accordingly.
- Enter the number of employees for each month of the quarter. This should include all full-time and part-time employees who worked during or received pay for the pay period that includes the 12th of the month.
- Input wages paid during the quarter that are subject to State Unemployment Insurance laws. Round these figures to the nearest dollar.
- Use the Comments section to explain any significant changes in employment or wages due to events like store closings or layoffs.
- If there are additional worksites not listed, provide their information as instructed, including business name and location details.
- Complete the Totals section at the end by summing up employees and wages across all worksites. Ensure these totals match your Quarterly Contributions Report.
- Return your completed form using the provided envelope to ensure timely submission.
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