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2025-010
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Last modified
2/3/2025 2:56:13 PM
Creation date
2/3/2025 2:56:11 PM
Metadata
Fields
Template:
Official Documents
Official Document Type
Grant
Approved Date
01/14/2025
Control Number
2025-010
Agenda Item Number
13.I, 1.
Entity Name
Treasure Coast Diagnostic Laboratory, Inc
Subject
Local Jobs Grant Agreement
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111 1110111111111111111111111111111 11 Florida Department of Revenue Employer's Quarterly Report <br /> Ernployers are required to file quarterly tax/wage reports regardless of employment activity or whether any taxes are due j RT-6 <br /> R.01/15 <br /> Black Ink to Complet, ;As Form <br /> QUARTER ENDING EMPLOYERS NAME RT ACCOUNT NUMBER <br /> / <br /> 10 EMPLOYEES SOCIAL SECURITY NUMBER 11 EMPLOYEES NAME(geese prig first twelve characters of lag name and first 12a EMPLOYEE'S GROSS WAGES PAID THIS QUARTER <br /> eight characters of first name in boxes) 1 2b EMPLOYEES TAXABLE WAGES PAD THIS QUARTER <br /> Only the first$7,000 paid t o each employee pa calendar year is taxable <br /> T'it 1 i i 1 : r i r i <br /> I43me L-I II II L I 1 L___ - <br /> vi 1 I i <br /> 12a. I I [ <br /> I. t___„..., <br /> --i <br /> II Middl ,- <br /> ' <br /> e , <br /> 1ln 1 I , , <br /> initia i___ 12b. ____i• ___ ,____.. <br /> [ ,___Ii 1 II !I 1 II i , <br /> — 1 _ i i I ][ I LI <br /> :ime 12a. ________._7._ __ _ I.... _ .__.1• ' <br /> — <br /> rilSi 1-i <br /> 1 .I MIddii• I I I I. <br /> 12b, I_ I I. <br /> ! <br /> .dt1! 1 1 I — 1- 1 <br /> L I I <br /> [ <br /> "r Li 1 1 i 12.. 1 ___1• <br /> I Irst —I I M 1 <br /> ile <br /> _____L IL I initid I I 12b. __r..,, 1) ,__I• <br /> 12.. Li I .1[ r ill <br /> ._ - <br /> ,_., 1_, L.__5_ ___. • .=_._ <br /> 12b. <br /> -, <br /> 12a. _I <br /> 1r <br /> , _ ; —J___• <br /> 12b, <br /> i--- <br /> IH12a. 1 1—, <br /> 7 -- <br /> 12b. —. <br /> i i 1 • <br /> - -- ,)--- — - <br /> r_1 — F--------: <br /> 1 1 <br /> 128. .____1._L___IL__ y____ I s <br /> 1 <br /> 12b. I• , <br /> 1 ._ ) f <br /> 1 , <br /> 1 H ' -1 li :-.1 H _il IL 12a. 1. 1 <br /> -7 — !---I 1. [ i__r _ <br /> I 1 <br /> 12b. 1 L __. <br /> 13a. Total Gross Wages(add Lines 12a only). Total this page only. -1' ' 1 <br /> ) [ <br /> Include this and totals from additional pages in Line 2 on page 1. i I) l• <br /> L ,13b. Total Taxable Wages(add Lines 12b only). Total this page only. ' <br /> i Include this and totals from additional pages in Line 4 on page 1. .11 1 1• <br /> I• <br /> DO NOT <br /> DETACH <br /> Mail Reply To: Social security numbers(SSNs)are used by the Florida Department of Revenue as unique <br /> Reemployment Tax identifiers for the administration of Florida's taxes. SSNs obtained for tax administration <br /> Florida Department of Revenue purposes are confidential under sections 213.053 and 119.071,Florida Statutes,and not <br /> 5050 W Tennessee St Bldg L subject to disclosure as public records. Collection of your SSN is authorized under state <br /> Tallahassee FL 32399-0180 and federal law. Visit our website at www.myflorida.com/dor and select"Privacy Notice" <br /> for more information regarding the state and federal law governing the collection,use,or <br /> release of SSNs,including authorized exceptions. <br /> Please save your instructions! <br /> Quarterly Report instructions(RT-6N/RTS-3)are only mailed <br /> with new accounts or when there are changes.If you misplace <br /> your instructions,you can download them from <br /> www.myflorida.com/dor <br />
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