\fllllll For 20". State D's contribution rate for Lemonica Company. based on the experienteerating system of the state, was 2.8% of the rst $7,003 of each empioyee's earnings. The state tax returns are due one month after the end of each calendar quarter. During ZD--, the company paid $2,214.80 of contributions to State D's unemployment fund. The president of the company prepares and signs ail tax forms. The company uses Magnetic Media UC-ZA when completing the form. Employer's phone number: (613] 55570029. Empioyer's State D reporting number: 00596. Using the forms below, complete the foilowing for 20". Indicate on each form the date that the form should be electronically submitted and the amount of money that must be paid. a. What is the date and amount of the FUTA tax payment for the fourth quarter of 20-3 State D is not a credit reduction state. Enter date in mmjddfyvyy format. Tax Payment: Date 1,131,510" v Amount 5:] b. Employer's Report for Unempioyment Compensation. State D4th quarter only, Item 1 is the number of employees employed in the pay period that inciudes the 12th of each month in the quarter. For Lemonica Company, the number of employee; is eight in October, seven in November, and eight in December. Aii employees earned 13 credit weeks during the last quarter except for Rooks {8) and Tyier (9). If an input box does not require an entry, leave it blank. State D Form U672 REV [37721, Employer's enort for Unemnlnvment Comnensatiun OTRJYEAR .. frln State D Form UC-2 REV 07-21, Employer's Report for Unemployment Compensation QTR./YEAR 4/20-- Read Instructions-Answer Each Item DUE DATE 01/31/20-- 1ST MONTH 2ND MONTH 3RD MONTH W 1. TOTAL COVERED EMPLOYEES IN EXAMINED BY; DETACH HERE PAY PERIOD INCL. 12TH OF MONTH Signature certifies that the information contained herein is FOR DEPT. USE true and correct to the best of the signer's knowledge. 2. GROSS WAGES 98,100 10. SIGN HERE-DO NOT PRINT 3. EMPLOYEE XXXXXXX X X XXXXXX Bertram A. Gompers CONTRIBUTIONS TITLE President 4. TAXABLE WAGES FOR DATE 1/31/-- EMPLOYER CONTRIBUTIONS PHONE # (613) 555-0029 11. FILED O PAPER UC-2A O INTERNET UC-2A 5. EMPLOYER CONTRIBUTIONS DUE 12. FEDERAL IDENTIFICATION NUMBER (RATE X ITEM 4) EMPLOYER'S CHECK 6. TOTAL ACCT. NO DIGIT CONTRIBUTIONS DUE Employer name and address Make any corrections on Form UC-28 EMPLOYER'S 2.8% 00596 1 (ITEMS 3 + 5) CONTRIBUTION RATE 7. INTEREST DUE SEE INSTRUCTIONS LEMONICA COMPANY 8. PENALTY DUE 123 SWAMP ROAD SEE INSTRUCTIONS PIKESVILLE, D STATE 10777-2017 9. TOTAL REMITTANCE (ITEMS 6 + 7 + 8) MAKE CHECKS PAYABLE TO: PA UC FUND SUBJECTIVITY DATE REPORT DELINQUENT DATETell us about your return. If any line does NOT apply, leave it blank. See instructions before completing Part 1. 1a If you had to pay state unemployment tax in one state only, enter the state abbreviation . . . . . . . . . . 1a I D I C Ch k h . 1b If you had to pay state unemployment tax in more than one state, you are a multi-state employer . . . 1b at are Complete Schedule A (Form 940). C Ch k. h . 2 If you paid wages in a state that is subject to CREDIT REDUCI'IDN ........................... ac are Complete Schedule A (Form 940). Ian Determine your FUTA tax before adjustments. If any line does NOT apply, leave it blank. 3 Total payments to all employees ...................................................... 3 I 335,600 I ~/ 4 Payments exempt from FUTA tax ................................. 4| 0 y' Select: Blank Eno payments exempt from FUTA! v '4 5 Total of payments made to each employee in excess of $1000 .......... 5 I I 6 Subtotal (line 4 + line 5 = line 6) ....................................................... 6 3' Total taxable FUTA wages (line 3 line 6 = line 7]. See instructions ........................... 3' 8 FUTA tax before adjustments (line I" x 0.006 = line 3} ....................................... 8 m Determine your adjustments. If any line does NOT apply, leave it blank. 9 If ALL of the taxable FUTA wages you paid were excluded from state unemployment tax, multiply line 3' by 0.054 [line 7 x 0.054 = line 9]. Go to line 12 ........................................ 9 U I 10 If SOME of the taxable FUTA wages you paid were excluded from state unemployment tax, OR you paid ANY state unemployment tax late [after the due date for ling Form 940], complete the worksheet in 10 0 ~/ the instructions. Enter the amount from line I" of the worksheet ................................... 11 If credit reduction applies, enter the total from Schedule A (Form 940] ........................... 11 U U' m Determine your FUTA tax and balance due or overpayment. If any line does NOT apply, leave it blank. 12 Total FUTA tax after adjustments [lines 8 + 9 + 10 + 11 = line 12] ............................. 12 13 FUTA tax deposited for the year, including any overpayment applied from a prior year ........... l3 0 ti 14 Balance due. If line 12 is more than line 13, enter the excess on line 14. o If line 14 is more than $500, you must deposit your tax. 14 o If line 14 is 5500 or less, you may pay with this return. See instructions .......................... 15 Overpayment. If line 13 is more than line 12, enter the excess on line 15 and check a box below ......... 15 0 v