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Get and Sign UCT 101 E , Quarterly Contribution Report to Be Filed with Quarterly Wage Report This Form is Used by Employers to Report Their 2012-2022
NONE, ENTER -0-
1st
Month
Number of
Employees
2nd
Month
Number of
Employees
3rd
Month
Number of
Employees
1a. INTERNET ACCESS NUMBER
http://dwd.wisconsin.gov/uitax
DOLLARS
3. REPORT AND PAYMENT DUE
5. FEIN
4. ACCOUNT NUMBER
6. EMPLOYER TELEPHONE NO./EMAIL
CENTS
9. TOTAL COVERED WAGE
Must agree with total wages on
Wage Report
10. LESS EXCLUSIONS FOR WAGES
OVER $13,000
(See instructions on back of form.)
11. DEFINED (TAXABLE) PAYROLL
Item 9 minus item 10
THIS LINE MUST BE...
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