Form Ui-3s - Employer'S Quarterly Unemployment Wage And Tax Substitute Report

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UI-3S
COMMONWEALTH OF KENTUCKY
EMPLOYER’S QUARTERLY UNEMPLOYMENT WAGE AND TAX
(R. 09/98)
DIVISION OF UNEMPLOYMENT INSURANCE
SUBSTITUTE REPORT
P.O. BOX 948
FRANKFORT, KENTUCKY 40602-0948
1. KY. EMP. ID. NO.
FED. EMP. ID. NO.
THIS REPORT IS FOR THE
ACCOUNTING
502/564-2168
DELINQUENCY
502/564-6835
QUARTER
STATUS
502/564-2272
THIS REPORT MUST BE FILED BY
FOR OFFICIAL USE
DO NOT WRITE
IN THIS SPACE
TO AVOID PENALTY FOR LATE FILING
DATE
AMOUNT
FOR OFFICIAL USE
2.
2.
GROSS WAGES
3.
3.
EXCESS WAGES (OVER $8000)
4.
4.
13. CHECK ENCLOSED? YES
NO
TAXABLE WAGES
5.
TAX DUE
5.
LINE 4 X
%
6.
SCUF
6.
14. NUMBER OF EMPLOYEES
.075% OF LINE 4
7.
7.
1ST. MO.
SUBTOTAL
8.
LATE PAYMENT INTEREST
8.
2ND. MO.
LINE 7 X 1 1/2% PER MONTH
9.
LATE FILING PENALTY
9.
3RD. MO.
(SEE INSTRUCTION PAGE 2)
10.
10.
PRIOR AMOUNT DUE
11.
11.
15. NO. OF PAGES IN THIS REPORT
PRIOR OVERPAYMENT
12.
12.
TOTAL AMOUNT DUE
ADDITIONAL DUE
LINE 5 IS THE ONLY TAX REPORTABLE ON THE
OVERPAID
940 FEDERAL UNEMPLOYMENT TAX RETURN.
16.
SOCIAL SECURITY NO.
17.
NAME OF WORKER
18.
GROSS WAGES
TOTAL FOR THIS PAGE
MAKE REMITTANCE PAYABLE: TREASURER KENTUCKY UNEMPLOYMENT INSURANCE FUND
20.
TOTAL FOR ALL PAGES
SIGNATURE
PRINT NAME AND TITLE
PHONE (INCLUDE AREA CODE
DATE
19.

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