Company ID Here 
                                                             Florida Department of Revenue                                                                 RT-6 
                                                                                                                                                       R. 07/23 
                                                              Employer’s Quarterly Report                                              Rule 73B-10.037, F.A.C. 
                                                             COMPLETE and MAIL your REPORT/PAYMENT to                                            Effective XX/XX
                                                  5050 W Tennessee Street, Bldg L, Tallahassee, FL 32399-0180 
            Employers are required to file quarterly tax/wage reports regardless of employment activity or whether any taxes are due. 
83XX0202333100680540319500123456700007 

      Quarter Ending           Due Date                 Penalty After Date       Tax Rate           RT Account Number               F.E.I. Number 
                                                                                                      1234567 
                                                                                                                                  For Official Use Only – Postmark Date
Employer’s Name      FDOR - Employer Test

Mailing Address      5050 W Tennessee Street 
City/State/ZIP       Tallahassee, FL 32399-0141 

                                                             1. Enter the total number of full-time and part-time        1stMonth           10 
                                                                covered workers who performed services during            2ndMonth           9 
                                                                or received pay for the payroll period including         rd                 8 
                                                                                                                         3 Month
                                                                the 12th of the month
                                                                2. Gross wages paid this quarter (Must total all pages) ......... 999999999.99
                                                                3. Excess wages paid this quarter (See instructions) ..........999999999.99
                                                                4. Taxable wages for this quarter (See instructions) ...........999999999.99
                                                                5. Tax Due (Multiply Line 4 by tax rate)  ..................999999999.99
                                                                6.   Penalty Due (See instructions).................... 999999999.99
                                                                7.   Interest Due (See instructions) ....................999999999.99
                                                                8.   Installment Fee (See instructions) ..........................9.99
                                                                9a. Total Amount Due (See instructions) .................. 999999999.99
                                                                9b. Amount Enclosed (See instructions) ................999999999.99

                                              All wage items must be reflected on the continuation sheet. 
E-Verify Certification
I attest, under penalty of perjury, that this employer uses the E-Verify system defined in section 448.095 (1)(c), Florida Statutes or the  Employment 
Eligibility Verification (Form USCIS I-9), if E-Verify is not available within three business days of a new hire, to verify the employment eligibility of 
newly hired employees.
                                                                      Signature       _________________________________________________
                                                                      Title                _________________________________________________
                                                                      Today’s Date  _________________________________________________

If you are filing as a sole proprietor, is this for domestic household employment only?         Yes     No 
      Check if you had out-of-state wages. Attach Employer’s         Check if final return Date 
      Quarterly Report for Out-of-State Wages (RT-6NF).              operations ceased. 
“Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (sections 443.171(5), Florida Statutes). 
                                                                       (do  not  detach) 
Signature                                                       Date                            Signature of Preparer 
Title                                                           Telephone No.                   Preparer’s Telephone No. 
                                                                (    ) 
FDOR - Employer Test                     t                                                                                          Company ID Here 
                                              Check here if you transmitted 
5050 W Tennessee Street                       funds electronically                                  DOR  USE  ONLY                                                      
                                                                                                                                                          RT-6
Tallahassee, FL 32399-0141 
                                                                                                                                                  R. 07/23              
                                    RT Account Number: 1234567                                  POSTMARK OR HAND DELIVERY DATE

1234567                             012345678                                 10                            9 
8                                   99999999999                               99999999999                   99999999999             
99999999999                         99999999999                               99999999999                   999 
99999999999                         99999999999                               0 
1                                   20180331                                  0 

99999999999                                                     83XX  0  20230331  0068054031  9  5001234567  0000  7