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QUARTERLY WAGE REPORT                                                                                                   Wisconsin Department of Workforce Development
Required Under Chapter 108, Wis. Stats.                                                                                     Division of Unemployment Insurance
To be filed with Quarterly Contribution Report                                                                                        (608) 266-6877
1. U.I. ACCOUNT NUMBER                2. QUARTER                      3. YEAR

4. REPORT DUE DATE                     5. FEIN                               6. EMPLOYER NAME                                         7. ACCOUNT NUMBER
                                                                                                                                       
8. LINE 9.                          10. EMPLOYEE'S                            11. EMPLOYEE'S             12. EMPLOYEE'S                    13. EMPLOYEE'S
NUMBER  CHANGE                      SOCIAL SECURITY NUMBER                    LAST NAME                  FIRST NAME                        QUARTERLY WAGES
                                                                                                                                       DOLLARS           CENTS

  1.

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 23.
                                    14. TOTAL WAGES ALL PAGES                                            15. TOTAL WAGES THIS PAGE
                                           (Must agree with item 9 on
                                           Contribution Rpt. (UCT-101)

        UC-7823 -E( .R02/ /20126 4)                                                                                               16. PAGE ______ OF ______

GENERAL INFORMATION AND INSTRUCTIONS_________________________________________________________________________
All employers covered under Wisconsin's Unemployment Insurance Law must file the Quarterly Wage Report, which is submitted together with 
the Quarterly Contribution Report [Form UCT-101] and the appropriate tax payment. Both reports can be filed online by selecting the "File Tax 
and Wage Reports" option on our website, at http://dwd.wisconsin.gov/uitax/.
Type or Print the required information in black ink. Computer printed reports are also acceptable if prepared in portrait format on 8 1/2 x 11" white 
paper, if the data fields are positioned in the same locations as our standard form.
CAUTION:  Center typewritten or computer printed information in the white boxes.
ITEM NO.
 1. UI Employer Account Number.
 2. Calendar Quarter (1, 2, 3 or 4).
 3. Year.  2 digit year, example (01)
 4. Report Due Date.
 5. Federal Employer Identification Number.  (FEIN)
 6. Employer Name.
 7. Account Number (14-digits)
 8. 1-23 denote the line number.
 9. Employees’ social security numbers and names are preprinted on some wage reports.  Preprinted names are limited to the
       number of characters as shown.  If incorrect in items 9 through  11:
        a. Enter an “X” within the "Change" area (item 9);
        b. Draw a diagonal line through any incorrect character(s);
        c. Enter correct characters(s) above lined out information.

EXAMPLE:  CHANGE  SS NUMBER  LAST NAME  FIRST NAME
                     00      S          J
            X     123456789 //              CMITH     /   TOHN/

 ALIGN INFORMATION FOR ITEMS 10 THROUGH 13 UNDER THE PREPRINTED EXAMPLE PROVIDED.
10. Enter employee’s social security number if not preprinted.   If an employee has no social security number, enter the name and wages and have your 
      employee immediately take steps to secure a number.  Enter numbers without dashes or diagonal lines.  Acceptable methods of reporting the social security   
      number are:
              123 45 6789          123456789
11. Enter the employee’s last name if not preprinted.  Type or Print in all CAPITAL letters.  Do not use commas or periods.  Hyphens are acceptable.
12. Enter the employee’s first name if not preprinted.  Type or Print in all CAPITAL letters.  Do not report a middle initial.  Do not use commas or periods.  Hyphens
      are acceptable.
13. Enter total covered wages paid to the employee during the calendar quarter.  Always use a decimal point followed by cents.  Do not use commas or dollar 
      ($) signs.  Acceptable reporting methods are:
              1234.56              5603.00 (if even dollar amount paid)
      Leave blank if no wages were paid during this quarter.
14. Enter all wages listed on all pages of the report.  THIS AMOUNT MUST AGREE WITH THE AMOUNT ENTERED ON ITEM 9 OF FORM UCT-101, 
      CONTRIBUTION REPORT.  If submitting only one page, enter amount only on first page.
15. Enter total wages for all employees listed on this page.
16. Enter page number and total pages.
If you need additional pages for reporting wage detail or have questions about reporting, contact the Wage Reporting Unit, Division of Unemployment Insurance, PO 
Box 7962, Madison, WI, 53707,  or telephone (608) 266-6877.   You can also e-mail your request to wagenet@dwd.wisconsin.gov.
If you file this report electronically DO NOT submit a paper copy of this report.
Mail To: 
     Department of Workforce Development
     Division of Unemployment Insurance
     P.O. Box 78960
     Milwaukee, WI  53278
DO NOT STAPLE ATTACHMENTS
Send original report.  DO NOT submit copies of this form.
If your Quarterly Wage Report is not received by the UI Division on or before the Quarterly Due Date, a Late Filing Fee must be 
included in the payment due amount on the Quarterly Contribution Report (Form UCT-101). Also, if wages are reported for 25 
or more employees, both forms must be filed electronically. A penalty may be assessed of $20 per employee reported 
on paper and $25 for filing the tax report on paper. 
More information regarding these filing options is available on our website at http://dwd.wisconsin.gov/uiben/wagehome.htm
More information regarding filing fees and penalties can be found on our website at http://dwd.wisconsin.gov/ui201/w7201.htm

UC-7823-E (R. 02/26/2014)