Form Uc-2a - Employer'S Quarterly Report Of Wages Paid To Each Employee
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1PA Form UC-2A, Employer’s Quarterly
PA Form UC-2A,
Employer's Quarterly Report of Wages Paid to Each Employee
Report of Wages Paid to Each Employee
See instructions on separate sheet. Information MUST be typewritten or printed in BLACK ink. Do NOT use commas ( , ) or dollar signs ( $ ).
If typed, disregard vertical bars and type a consecutive string of characters. If hand printed, print in CAPS and within the boxes as below:
SAMPLE
SAMPLE
.
.
| 2 3 4 5 6
0 0
123456.00
SAMPLE
Typed:
Handwritten:
Filled-in:
Quarter and year
Employer
Quarter ending date
Employer name
Check
PA UC account no.
(make corrections on Form UC-2B)
digit
Q / Y Y Y Y
M M / D D / Y Y Y Y
1. Name and telephone number of preparer
2. Total number of
3. Total number of employees listed
4. Plant number
pages in this report
in item 8 on all pages of Form UC-2A
(if approved)
5. Gross wages, MUST agree with item 2 on UC-2
6. Fill in this circle if you would like the
and the sum of item 11 on all pages of Form UC-2A
Department to preprint your employee's
names & SSNs on Form UC-2A next
.
RESET FORM
PRINT FORM
quarter
7. Employee's
8. Employee's name
9. Gross wages paid this qtr
10. Credit
Social Security Number
FI
MI
LAST
Example: 123456.00
Weeks
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List any additional employees on continuation sheets in the required format (see instructions).
0.00
.
11. Total gross wages for this page:
12. Total number of employees for this page ______
RESET FORM
PRINT FORM
1
1
13. Page ____ of ____
UC-2A REV 4-05
UC-2A REV 07-12
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