REPORT UC-018 (10/04) PAGE I
ARIZONA DEPARTMENT OF ECONOMIC SECURITY
PO BOX 52027
PHOENIX, AZ 85072-2027
ARIZONA ACCOUNT NUMBER
Business Name and Address
CALENDAR QUARTER ENDING
TO AVOID PENALTY MAIL BY
FEDERAL ID NO.
USE BLACK INK ONLY
Telephone (602) 248-9354
UNEMPLOYMENT TAX AND WAGE REPORT
C. WAGE SUMMARY - Computation of payment due.
A. NUMBER OF EMPLOYEES - Report for each
( See instructions for assistance )
month, the number of full and part-time covered
workers who worked during or received pay
1.
TOTAL WAGES PAID IN QUARTER
subject to UI Taxes for the payroll period which
From Section B. Wage Listing
Includes the 12 of the month.
2.
SUBTRACT EXCESS WAGES
Cannot exceed Line 1 - see instructions
3.
TAXABLE WAGES PAID
Up to $7000 per Employee - Line 1 minus line 2
4.
TAX DUE
Line 3 X Tax Rate of
The decimal equivalent =
5.
ADD INTEREST DUE
1% of Tax Due for each month payment is late
6.
ADD PENALTY FOR LATE REPORT
0.10% of Line 1 ($35 min / $200 max)
7.
ADD JOB TRAINING TAX DUE
0.10% of Line 3 (Effective January 1, 2001 )
B. WAGES - List all employees in Social Security
8.
TOTAL PAYMENT DUE
Number order, or alphabetically by last name. Please
th
Effective 4
quarter of 2004:
use white paper in the same format for additional
If the sum of lines 4 & 7 is equal to or less than
employees. If you have ten or more employees,
$9.99, payment of the taxes due is not required.
consider reporting via magnetic media. Ask for
“Arizona Magnetic Media Reporting" (PAU-430).
9.
AMOUNT PAID
We support diskette and cartridge media.
Make check payable to DES-Unemployment Tax
LIEN MAY BE FILED WITHOUT FURTHER NOTICE ON DELINQUENT TAXES.
1. Employee Social Security Number
2. Employee Name (Last, First)
3. Total Wages Paid In Quarter
TOTAL WAGES PAID THIS PAGE
Signature:
TOTAL WAGES PAID ALL PAGES
Title:
Prepared By:
Date:
Telephone: (
)
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