Working Together for Vermont
Vermont Department of Labor
5 Green Mountain Drive
P.O. Box 488
Telephone:
802-828-4000
Montpelier, VT 05601-0488
Fax:
802-828-4022
TDD:
802-828-4203
Wage Record Magnetic Media Transmittal Form
Type of Magnetic Media:
Magnetic Tape
Diskette or Compact Disc
Employer or Service Bureau Submitting Wages __________________________________
Quarter/Year of Wages __________
Date/Signature ______________________________________________
Direct Mail Deliver - Return To:
Vermont Department of Labor
Attn: Lucile Keene, Magnetic Media Specialist
5 Green Mountain Drive
Montpelier, VT 05602
Post Office Deliver-Return To:
Vermont Department of Labor
Attn: Lucile Keene, Magnetic Media Specialist
P.O. Box 488
Montpelier VT 05601-0488
PLEASE NOTE: When submitting live data for the first time, you must complete and return an
Application Form C-31 with your test cartridge diskette, or compact disc.
C-32 (9/05)
Equal Opportunity is the Law. Auxiliary aids and services are available upon request to individuals with disabilities.