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III II VIII (() III II II VIII I II IIII II III II Florida Department of Revenue Employer's Quarterly Report RT -6 Employers are required to file quarterly taxAvage reports regardless of employment activity or whether any taxes are due. J R. 01/15 Use Black Ink to Complete This Farm QUARTER ENDING EMPLOYER'S NAME RT ACCOUNT NUMBER D EMPLOYEES SOCIAL SECURITY NUMBER 11. EMPLOYEE'S NAME (please port rsttwelve cheractemoflestrrameand first! 12a EMPLOYEE'S GROSS WAGES PAID THIS QUARTER eight characters of first name in boxes)12b EMPLOYEE'S TAXABLE WAGES PAID THIS QUARTER Onlythe first $7.000 paid to each employee per calendar year wtaxable. ❑❑❑1111❑❑0❑CII Li -❑ 11 ddl2 Name ❑❑❑❑IIII❑0 lnbal L 12b. IIII _ ■ _ ❑ IIII❑—IIII—IIII❑❑ Nam IIII❑❑❑❑❑❑CC 12a. �❑❑711[] 1_ _'. _❑ Flame ❑❑II❑❑❑❑❑ r'bal 12b. — ❑❑,�_I 0'. ��❑ IIII—❑❑—IIII❑❑ dame IIII❑❑❑❑❑❑❑❑C 12a. LICE,❑❑❑,❑CliE.l '❑ First M;ndle IIII❑❑❑❑❑C ❑ ❑LI,C! L.0 Narne rnCal 12b. IJ V ❑❑—❑❑—[1000 Mme ❑❑❑❑❑❑❑❑❑❑C 12a. 1100,❑❑�,ECE.0 ❑❑11011❑❑C ti'lae C 12b. ❑,EE�i. ❑❑ ❑C—C❑—❑❑1111 N e 000❑❑❑E❑011❑C 12a. ❑❑E,❑❑101 E❑ first Middle F Name ❑❑❑❑11❑❑C nba [ 12b. ]Ell Lo F. C❑ ❑❑C—IIII—❑II[1❑ Name ❑0000❑❑❑❑❑E 12a. ❑❑E,❑❑�—a,__ —I.L❑ Name IIII❑❑❑❑0C 11�IrnC� �� ,�. ❑[—I' EE. Ell ❑!0C-0❑— ❑❑❑ uaSTe ❑❑❑❑❑❑0E❑❑ 72a ❑EC,❑E,LICL-.CC Firs; ❑❑❑❑❑❑❑❑ In alhrl ldla Ci ❑ ,❑_EF 1 E❑_ 0C❑—�i0 1:10 0111 N ,r ❑❑❑❑❑❑❑❑❑❑11C� 1 ' C!❑C' ❑❑E ❑D . Lel Name ❑❑❑❑❑❑❑❑ �i11A 12b. : 11 1:1,1L . E Include this and totals from additional pages in Line 2 on page 1. — ',E ❑ _'❑ 7 13a. Total Gross Wages (add Lines 12a only) Total this page only. 7 E ■ — I— L ,3b. Total Taxable Wages (add Lines 12b only). Total this page only. � I Include this and totals trom additional pages in Line 4 on page 1. J i _F7` J DO NOT ----------------`DETACH------------------------ .---------------------------------------------------------------- Mail Reply To. Social security numbers (SSNs) are used by the Florida Department of Revenue as unique Reemployment Tax identifiers for the administration of Florida's taxes. SSNs obtained for tax administration Florida Department of Revenue purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not 5050 W Tennessee St Bldg L subject to disclosure as public records. Collection of your SSN is authorized under state Tallahassee FL 32399-0180 and federal law. Visit our website at www.myflorida.com/dor and select "Privacy Notice" for more information regarding the state and federal law governing the collection, use, or release of SSNs, including authorized exceptions. Please save your instructions! Quarterly Report instructions (RT-6N/RTS-3) are only mailed with new accounts or when there are changes. If you misplace your instructions, you can download them from www.myflorida.com/dor