2021-044 - Laserfiche WebLink

Home Browse Search

III II IIIII I II III II II IIIII I II IIII II III II L _ Florida Department of Revenue Employer's Quarterly Report J R t'nplu�S arc required to lila uartarl � ax/ddaga r -_ports rearda_s of amooyman; actnrit or wherna( am taxes are due. R. of/15/15 v Black Ink to Complete This Form QUARTER ENDING EMPL`T;_R'S NAME RT ACCOUNT NUMBER I 14. rvPiO'iFE'::Ot.l.4,:.t(i_ ";I R[: II. PiFI :(Er Nitirtsr r a n i ct�.w:.r.,lt.v ane »i:',Ora ft.iFpiFF iFs( S C GAIDTHI QUARTER . :.31,a„u.:rh,.( ..a.:k•.b,..., -Im EMPLOYEE SltiedBLEWAGES PAUIHIS :.UARTER Onhi tin, fes 5;,�'6 paid l o each C-P�PIOvSe pe- crJarde wwis la'•'a1W DO NOT ----_- --- DETACH `-_-_----..__-_..__....____..-------------_.-_-__-------____-..__--d__-_-__-_----_--_-- Mail Reply To: Reemployment Tax Florida Department of Revenue 5050 W Tennessee St Bldg L Tallahassee FL 32399-01^00 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 la!d. visit our vdebsite at www.myflorida.com/dor and select "Privacy Notice' for more information regarding the state and federal laud governing the collection, use, or release of SSNs, including authorized exceptions. Please save your insiructions! Quarterly Report instructions (RT-GN/RTS-3) are only mailed with new accounts or when there are changes. If you misplace your instructions, you can download them from www.mytiorida.com/dor 12a. _ _ 12b, - , - 12a. ;. .. 12b. I 12b. t � , 9` ■ L : ,2b. I 12 a ; 12b : i i 12a. t I , 12b. I ■ 12a. ■ t i 12b. • � 12a " i ■i I I t ,2b. 3 i. Total Crass Wagi s (a (I l inr s I 2 only) Total Ihis p ago roily 1111,hdthiS and totals lion) a l itiOnal pagcts in Line 2 on p,qe 1 I 3b. Tut rl Taxabl e. bVages to dd I Inr 5 12b only). Total this page only L In dude this and totals from additional pages In Lin.. 4 ori page 1. i DO NOT ----_- --- DETACH `-_-_----..__-_..__....____..-------------_.-_-__-------____-..__--d__-_-__-_----_--_-- Mail Reply To: Reemployment Tax Florida Department of Revenue 5050 W Tennessee St Bldg L Tallahassee FL 32399-01^00 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 la!d. visit our vdebsite at www.myflorida.com/dor and select "Privacy Notice' for more information regarding the state and federal laud governing the collection, use, or release of SSNs, including authorized exceptions. Please save your insiructions! Quarterly Report instructions (RT-GN/RTS-3) are only mailed with new accounts or when there are changes. If you misplace your instructions, you can download them from www.mytiorida.com/dor