FILED 6 TOTAL 588 X PAPER UC 2A MAGNETIC MEDIA UC 2A BUTIONS DUE

Filed 6 total 588 x paper uc 2a magnetic media uc 2a

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FILED 6. TOTAL CONTRI- 58 80 58.8 X PAPER UC-2A MAGNETIC MEDIA UC-2A BUTIONS DUE (ITEMS 3 + 5) EMPLOYER'S 2.8% CONTRIBUTION EMPLOYER'S CHECK 7. INTEREST DUE RATE ACCT. NO. DIGIT SEE INSTRUCTIONS 00596 1 8. PENALTY DUE SEE INSTRUCTIONS 9. TOTAL REMITTANCE 58 80 (ITEMS 6 + 7 + 8) LEMONICA COMPANY MAKE CHECKS PAYABLE TO: PA UC FUND 123 SWAMP ROAD PIKESVILLE, D STATE 1077-2017 DATE PAYMENT RECEIVED SUBJECTIVITY REPORT REPORT DELINQUENT DATE 1 st MONTH 2 nd MONTH 3 rd MONTH TOTAL COVERED EMPLOYEES IN PAY PERIOD INCL. 12th OF MONTH Signature certifies that the information contained herein is true and correct to the best of the signer’s knowledge EMPLOYEE CONTRIBUTIONS
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Employer name Employer PA UC Check Quarter and year Quarter ended date (Make corrections on Form UC-2B) account no. digit LEMONICA COMPANY 00596 1 4/2017 12/31/2017 1. Name and telephone number 2. Total number of pages in this 3. Total Number of employees 4. Plant number (if approved) of preparer report listed in item 8 on all pages of Form C-2A BERTRAM A. GOMBERS (613) 555-0029 5. Gross wages, MUST agree with item 2 on UC-2 6. Fill in this area of you would like the Department to preprint your and the sum of item 11 on all pages of Form UC-2A employees’ names & SSNs on Form UC-2A next quarter X 9 8 1 0 0 . 0 0 7. Employee's social security number 8. Employee's name 9. Gross wages paid MI LAST NAME this qtr. (Example: Credit FIRST NAME 123456.00) Week 000 00 0001 Robert G. Cramer 5200 00 13 000 00 0003 Daniel M. Enigish 13400 00 13 000 00 1998 Ruth A. Small 2400 00 13 000 00 7413 Harry B. Klaus 11700 00 13 000 00 6523 Kenneth N. George 15000 00 13 000 00 1014 Bertram A. Gompers 26300 00 13 000 00 7277 Arthur S. Rooks 1700 00 8 000 00 8111 Mary R. Bastiian 8200 00 13 000 00 2623 Klaus C. Werner 2500 00 13 000 00 3534 Kathy T. Tyler 11700 00 9 LIST ANY ADDITIONAL EMPLOYEES ON CONTINUATION SHEETS IN THE REQUIRED FORMAT (SEE INSTRUCTIONS) 98100 00 11. Total gross wages for this page: 12. Page 1 of 1 31-Jan-18 $ 58.80 Report must be filed by Amount due with report 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:
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5–17A. out of 6 possible Form 940 for 20--: Employer’s Annual Federal Unemployment (FUTA) Tax Return Department of the Treasury — Internal Revenue Service Employer identification number 0 0 - 0 0 0 6 4 2 1 Name (not your trade name) BERTRAM A. GOMPERS Trade name (if any) LEMONICA COMPANY Address 123 SWAMP ROAD PIKEVILLE D 10777-2017 Read the separate instructions before you fill out this form. Please type or print within the boxes. Part 1: Tell us about your return. If any line does NOT apply, leave it blank. 1 If you were required to pay your state unemployment tax in … 1a D - OR - 1 2 If you paid wages in a state that is subject to CREDIT REDUCTION . . . . . . . . . 2 Part 2: Determine your FUTA tax before adjustments for 20--. If any line does NOT apply, leave it blank 3 4 4 Check all that apply: 4a 4c 4e 4b 4d 5 Total of payments made to each employee in excess of $7,000 . . . .
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