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This is a fillable form. Please click on the appropriate area to enter information. Tab between fields and PRINT when completed.
QUARTERLY CONTRIBUTION REPORT ITEM 8. Required - Monthly Employment Count
TO BE FILED WITH QUARTERLY WAGE REPORT 8. MONTHLY DATA SHOULD COUNT ALL FULL-TIME AND PART-TIME WORKERS
IN COVERED EMPLOYMENT WHO WORKED DURING OR RECEIVED PAY
INSTRUCTIONS ON REVERSE SIDE FOR THE PAYROLL PERIOD WHICH INCLUDES THE 12TH OF THE MONTH.
IF NONE, ENTER -0-
1. U.I. ACCOUNT NUMBER 2. QUARTER YEAR
1st Number of 2nd Number of 3rd Number of
Month Employees Month Employees Month Employees
1a. INTERNET ACCESS NUMBER
http://dwd.wisconsin.gov/uitax

DOLLARS CENTS
9. TOTAL COVERED WAGE
Must agree with total wages on
3. REPORT AND PAYMENT DUE 4. ACCOUNT NUMBER Wage Report

10. LESS EXCLUSIONS FOR WAGES
OVER $14,000
5. FEIN 6. EMPLOYER TELEPHONE NO./EMAIL (See instructions on back of form.)

11. DEFINED (TAXABLE) PAYROLL
Item 9 minus item 10
7. EMPLOYER NAME AND ADDRESS THIS LINE MUST BE COMPLETED
12. TAX RATE:
13. TAX DUE:
Multiply Item 11 by Item 12

14. INTEREST DUE: If filed after due date,
compute interest on item 13 above.
(See instructions on back of form.)
15. LATE FILING FEE: If Wage Report
(UC-7823) is filed after due date, add fee.
(See instructions on back of form.)

16. LESS ELECTRONIC FUND TRANSFER
PAYMENT

17. LESS CREDIT AVAILABLE as of

18. TOTAL AMOUNT ENCLOSED
WITH THIS REPORT
RETURN THIS FORM AND ANY PAYMENT DUE.
MAKE CHECK OR MONEY ORDER PAYABLE TO: DIVISION OF UNEMPLOYMENT
19. I CERTIFY THE TAX AND WAGE REPORTS ARE CORRECT. INSURANCE. FOR INFORMATION CALL (608) 261-6700.
SIGNATURE PRINT NAME TITLE PHONE NUMBER DATE SIGNED

GENERAL INFORMATION
This report is required from all employers covered under Wisconsin's Unemployment Insurance (UI) Law. A completed
Quarterly Wage Report must be submitted in addition to this report.
DO NOT submit paper copies of reports that have been filed electronically.
DO NOT use this report to make adjustments to a previously filed report.
Adjustment reports can be obtained by contacting Unemployment Insurance Employer Services by mail at P.O. Box 7942,
Madison, WI 53707, by phone at (608) 261-6700 or the link to our forms page on our website: http://dwd.wisconsin.gov/uitax/

Mail this form and any payment due to:
Department of Workforce Development
Division of Unemployment Insurance
P.O. Box 78960
Milwaukee, Wisconsin 53278
INSTRUCTIONS ON THE REVERSE SIDE.

UCT-101 -E ( R. 02/2 /2014)6

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INSTRUCTIONS FOR COMPLETION OF CONTRIBUTION REPORT
This report is required from all employers covered under Wisconsin's Unemployment Insurance (UI) Law. This is required in addition to your Quarterly Wage
Report. You can file this report on the Internet using the access number on line 1a, and creating a user ID and password. See http://dwd.wisconsin.gov/uitax.
Items 1-7 are preprinted. They show:
1. Ten-digit UI employer account number.
1a. Eight-digit Internet Access Number - Used for filing report on the Internet.
2. Time period this report covers.
3. Report and payment due date. In order to be considered timely, your report must be received by the department on or before the quarterly due date.
4. 14-digit account number.
5. 6. 7. Employer information. Includes Federal Employer Identification Number (FEIN), telephone number, name and address.
8. The monthly employment data reported on line 8 should be a count of all full-time and part-time workers in covered employment under
Wisconsin’s UI Law, who performed services during or received pay for the payroll period which includes the 12th of the month. If no
employment in the payroll period, enter zero (-0-).
9. Enter COVERED wages PAID within this quarter before deductions. Wages include: salaries; commissions; bonuses; tips; sick or disability;
termination; holiday and vacation pay; value of room, meals, and payments in kind to all full time, part time and temporary employees for
services “localized” in Wisconsin. Include agricultural and domestic service wages if you have been determined covered for either employment.
Do not include wages paid for employment excluded under s. 108.02(15)(k) unless such wages are subject to the Federal Unemployment Tax
Act. NOTE: ITEM 9 OF THIS REPORT SHOULD AGREE WITH TOTAL WAGES ON THE QUARTERLY WAGE REPORT.
10. Enter wages paid this quarter in excess of the $14,000 per employee wage base. To determine the exclusion amount follow the steps below:
Step 1 - Determine which of your employees has been paid more than $14,000 since the beginning of the year.
Step 2 - If any of the employees identified in step 1 have already been paid more than $14,000 for the year during a previous quarter, all of the
wages paid to them during this quarter are excluded. Add the wages paid during this quarter to each of these employees to arrive at a total.
Step 3 - If any of the employees which you identified in step 1 went over $14,000 for the year during the quarter, the amount paid in excess of
$14,000 for the year is excluded. Add the excess paid each employee this quarter to arrive at a total.
Step 4 - Add the totals derived in step 2 and step 3 and enter in item 10. This constitutes excluded wages paid during this quarter which are not
taxed. (The amount on line 10 can be equal to but should not be more than the amount shown on line 9.)
11. Subtract item 10 from item 9 to obtain your defined (taxable) payroll. Always indicate an amount in this item. If item 10 is zero, the amount in
item 9 should also appear in item 11. If the amount in item 10 is equal to item 9, place a zero in item 11.
Items 12 through 14 do not apply to employers on reimbursement financing.
12. Your tax rate is shown as a decimal fraction on this report.
13. Enter your tax liability for this quarter. Multiply Item 11 (taxable payroll) by Item 12 (tax rate) to determine tax due.
14. The interest rate can change annually. Please refer to the Interest Assessment guide at
http://dwd.wisconsin.gov/uitax/interestrate/ for additional information regarding interest rates and calculations.
Starting Month Assessed Interest Ending Month Assessed Interest Monthly Interest Rate
May 1982 July 2012 1.00%
August 2012 Current Month 0.75%
15. If filing the Wage Report (Form UC-7823) within 30 days after the due date, the late filing fee is $50. If filing the Wage Report (Form UC-7823)
more than 30 days after the due date, the late filing fee is the greater of $100 or $20 per reported employee.
In addition, an employer who has 25 or more employees and fails to file its tax and wage reports electronically may be
assessed a penalty of $20 for each employee reported on paper and a $25 penalty for filing the tax report on paper.

16. If you have paid your taxes for this quarter by Electronic Fund Transfer (EFT), enter that amount here.

17. If you have been notified of any available credit, enter here.

18. Add Items 13 through 15 and subtract Items 16 and 17 to determine amount to be paid. If the total on line 18 is zero,
enter zero on line 18.

19. Sign the report, print your name, enter your title, your phone number, and the date signed.
DO NOT STAPLE ATTACHMENTS TO THIS REPORT.
For information on formats, more detailed instructions or additional pages for wage detail, contact Wage Reporting,
Division of Unemployment Insurance, P.O. Box 7962, Madison, Wisconsin 53707, e-mail wagenet@dwd.wisconsin.gov, or ______
telephone (608)266-6877. See http://dwd.wisconsin.gov/uiben/wagehome.htm for formats and specifications.

UCT-101-E (R. 02/26/2014)

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