DOMESTIC EMPLOYER’S ANNUAL REPORT CONTINUATION SHEET 1. ACCOUNT NUMBER 2. COUNTY CODE 3. TAX AREA 4. TAX RATE 5. NAICS CODE 6. FEDERAL I.D. NUMBER 7. YEAR % 8. EMPLOYER NAME 9. PAGE NO. OF DOM 22. TOTAL WAGES PAID DURING 20. SOCIAL SECURITY 1 2 ST ND 21. EMPLOYEE NAME ST QTR 2 NDQTR EACH QUARTER3 RDQTR 4 THQTR NUMBER INIT INIT LAST NAME 1 23. PAGE TOTAL TEXAS WORKFORCE COMMISSION AUSTIN, TEXAS 78714-9037 The sum of all page totals must equal item 13 on C-3DOM (512) 463-2222 C4DOM (12/07) |