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INSTRUCTIONS FOR COMPLETING QUARTERLY CONTRIBUTION, INVESTMENT FEE AND WAGE REPORT
Report and remittance are considered received on date shown on postmark of envelope in which they are received.
WAGE REPORT. Each page must show a total with a grand total on the LINE 14. CHANGES IN BUSINESS OR OWNERSHIP. GO TO ITEM 9 &
last page. 14 PAGE.
INTERNET REPORTING. Employers have the option to submit quarterly DISCONTINUANCE OF BUSINESS. Enter the date that wages were last
wage information online, by entering wage information or by uploading a paid.
file. Log-In at www.sdwagereport.com. Click on File a Quarterly
Report on left. BUSINESS SOLD, LEASED OR OTHERWISE TRANSFERRED.
COMPACT DISC OR DIGITAL VIDEO DISC. Rather than sending in Complete Item 14 (Form 55) portion in full, showing the name of the
quarterly wage information on paper, employers may submit this successor or successors and the effective date of the disposition. The
information on compact disc or digital video disc. Visit the SD Department Unemployment Insurance Law permits transfer of the employer’s payroll
of Labor and Regulation website (www.sdjobs.org) for more information. experience and experience rating account. Therefore, be specific as to
whether you authorize the transfer of your experience rating account to
ACCOUNT NUMBER, BUSINESS NAME, ADDRESS. Enter your UI the successor in the business.
account number, and your business name and address.
SIGNATURE. This report must be signed by (1) the individual, if the
QUARTER/YEAR. Enter the quarter and the two-digit year the report is employer is an individual; (2) the President, Treasurer or other principal
for. officer, if the employer is a corporation; or (3) a responsible duly-
authorized member or agent having knowledge of company affairs.
DUE DATE. Report due by last day of month, following end of quarter.
Q1 due by 4/30, Q2 due by 7/31, Q3 due by 10/31, and Q4 due by 1/31. LINE 15. EMPLOYEE'S SOCIAL SECURITY NUMBER. The employee’s
Social Security number is required. Those without Social Security
UI CONTRIBUTION RATE, SURCHARGE, AND INVESTMENT FEE. numbers must apply for one. Enter without hyphens.
Enter your current Unemployment Insurance tax rate on Line 6, the
applicable Surcharge rate on Line 6a, and Investment Fee rate on Line 7. LINE 16. EMPLOYEE'S NAME. Enter the full name of the employee in
this order: Last Name, First Name.
LINE 1. NUMBER OF WORKERS. The monthly employment data
reported on the Quarterly Contribution Report should be a count of all full- LINE 17. TOTAL GROSS WAGES PAID THIS QUARTER. Enter the
time and part-time workers who worked during or received pay (subject to gross wages paid this quarter subject to the Unemployment Insurance
Unemployment Insurance wages) for the payroll period that includes the Act. Wages paid include: money wages paid for employment,
12th of the month. commissions paid, and special cash payment (such as cash gifts, cash
prizes or cash bonuses), reasonable cash value of remuneration for
LINE 2. LOCATIONS. Mark "Yes" if your business has more than one services paid in a medium other than cash (such as lodging, meals, free
location. or paid rent, etc.), and special payments made in any medium (such as
LINE 3. TOTAL GROSS WAGES PAID THIS QUARTER. Enter the total gifts and prizes). Tips are also reportable in most instances. Employee
from Line 21. See Line 17 instructions for more information. contributions to tax-deferred retirement plan or cafeteria (Sec. 125) plan
are taxable. Employer contributions to retirement or pension plans,
LINE 4. WAGES PAID THIS QUARTER IN EXCESS OF ANNUAL established under USC 26: 401(k), 403(b), 408(k), 457 and 408(p) are not
WAGES BASE. Enter the total from Line 22. See Line 18 instructions for reportable wages.
more information.
LINE 18. EXCESS WAGES PAID THIS QUARTER. Enter the portion of
LINE 5. TAXABLE WAGES. Subtract Line 4 from Line 3 and enter. Line 17 paid to each individual during this quarter that exceeds the annual
taxable wage base for the calendar year. This will include only the wages
LINE 6. UI CONTRIBUTION. Multiply wages from Line 5 by rate listed. paid this quarter in excess of the annual taxable wage base for the
Enter tax here. This tax is reported on IRS Form 940. individual. The amount of this item can not exceed the amount reported
on Line 17 for any individual.
LINE 6A. SURCHARGE. Multiply wages from Line 5 by rate listed. Enter Taxable wage bases:
tax here. This tax is not included on IRS Form 940. Surcharge rate will be
announced prior to end of each quarter, if applicable. 2011=$11,000 2014=$14,000
2012=$12,000 2015 & after=$15,000
LINE 7. INVESTMENT FEE. Multiply wages from Line 5 by rate listed. 2013=$13,000
Enter tax here. This tax is not included on IRS Form 940.
LINE 19. GROSS WAGES THIS PAGE. Enter the sum of all wages in
LINE 8. TOTAL TAX DUE. Enter the total amount of tax due by adding Item 17 for this page.
Lines 6, 6a and 7.
LINE 20. TOTAL EXCESS WAGES THIS PAGE. Enter the sum of all
LINE 9. ADJUSTMENTS. Enter the amount of any debit or credit notices excess wages in Item 18 for this page. This total cannot exceed the
received from the Department or adjustments from prior quarters you may amount on Line 19.
have found. Include an explanation on Item 9 & 14 page or an attached
sheet. Remember to include this amount when completing Line 13. LINE 21. TOTAL GROSS WAGES ALL PAGES. Enter the sum of Line
19 from all pages of this report. Enter this figure on Line 3 also.
LINE 10. INTEREST. Enter the interest due if the report is late. Interest is
1.5% per month (or fraction of a month) from the due date of a report. LINE 22. TOTAL EXCESS WAGES ALL PAGES. Enter the sum of Line
Multiply the payment due from Line 8 by interest rate listed. 20 from all pages of this report. This total cannot exceed the amount on
Line 21. Enter this figure on Line 4 also.
LINE 11. PENALTY FOR LATE FILING. If the report is late, enter the
penalty amount. The penalty for filing a report late is $25 per month (or SIGNATURE. This report must be signed by the employer or on the
fraction of a month) from the due date. The maximum penalty is $150 per employer's behalf by someone having personal knowledge of the facts
quarterly report. herein stated and who has been authorized to sign such report.
LINE 12. PENALTY FOR LATE PAYMENT. If the payment is late, enter PREPARED BY. Enter the report preparer’s name and telephone
the penalty amount. The penalty for being late making full payment is $25 number.
per month (or fraction of a month) from the due date. The maximum
penalty is $150 per quarterly report.
LINE 13. TOTAL REMITTANCE. Enter the sum of Lines 8 through 12.
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