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EMPLOYER’S NAME A ND ADDRESS                             FS-131 (R-08-17)                                             NJ Taxpayer ID Number/FEIN
AS IT APPEARS ON UEZ CERTIFICATION                       State of New Jersey
                                                 Department of Labor and Workforce Development 
                                                         DIVISION OF EMPLOYER ACCOUNTS

                                                                                                                      To be Returned To:
                                                                                                                      Attn: Casandra McCray, UEZ Coordinator
                                                 ANNUAL CALCULATION OF                                                Division of Employer Accounts
                                                                                                                      Chief Auditor’s Office
                                           EMPLOYER UNEMPLOYMENT TAX REBATE                                           1 John Fitch Plaza, PO Box 942
                                                                                                                      Trenton, NJ 08625-0942 

Total of Taxable All Wages Paid Per NJ-927                                  Total Wages Paid to Eligible Employees*

                                   Date UI Taxes         Taxable                      Employer                        Rebate                 Refund*
Quarter Taxable Wages              Paid                  Wages                        UI Rate*                        %                     (C x D x E)

        A                          B                     C                                     D                      E                             F

TOTALS

Please enter the Urban Enterprise Zone(s)/City within which you employ qualified individuals  __________________________________________________________

Indicate the complete date this business was orginally certified as an Urban Enterprise Zone business  _____________________________________________________

Person responsible for completing this form: ____________________________________________Phone Number______________________________________________
                                           (please print)

*See reverse side for the definitions of an eligible employee and instructions for the completion of this application.
                                   I certify that the information provided is true and accurate.

        Signature                                                  Title                                                                Date



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Total Wages

4th Qtr Taxable Wages

NJ Taxpayer's ID Number/FEIN

3rd Qtr Taxable Wages

2nd Qtr Taxable Wages

)7
-18
1st Qtr Taxable Wages

FS-131A (R-0
State of New Jersey
Hire Date
Division of Employer Accounts
ATTACH TO FROM FS-131
EMPLOYEE CERTIIFICATION

Department of Labor and Workforce Development

The total quarterly taxable wages must agree with the total entered in column C on form, FS-131. Employee City of Residence

Indicate the requested information for each eligible employee from whom the unemployment rebate is claimed.

Eleigible Employee Name

TOTAL
Social Security No.
  Employer's Name and Address



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                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          31,

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        the date when a business was certified by the                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   or FAX (

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Instructions                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                              through                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         609) 292-2321
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        , 201
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          1                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                            6
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     can not be greater than 3.2825% for the period of January 1 through 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    6                                                                     July
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          of

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          period

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          the                                                                                                                                                                                                                                                                                                                                                                                                                                              employees on the form FS-131A attached, or attach facsimile 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          for                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  50% for employers entered into the program in 20 40% for employers entered into the program for years 200 30% for employers entered into the program for years 200  20% for employers entered into the program for years  199   10% for employers entered into the program for year 199                                                                                                                                                                                            Attn: Casandra McCray UEZ Coordinator Division of Employer Accounts Chief Auditor’s Office 1 John Fitch Plaza, PO Box 942                        Trenton, NJ 08625-0942 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             1.                                                 2.                                                       3.                                                       4.                                                         5.
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   Each employee total quarterly wages earned must be between $2,500 and $4,500.00. Each employee must be full-time (works at least 30 hrs. a week)                                    Each employee must have been hired             New Jersey Commerce and Economic Growth Commission. The employee must have been paid, and reported on the WR-30, in the quarter prior to the quarter for which the award is claimed. (The employee first quarter paid can not be claimed on the application).                                                                       and                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          qualified
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          ,
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         6
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   1.                                                                               2.                                                                                                 3.                                                                                                 4.                                                                                                                                                                                                                                                                                      %  An employer cannot claim a rebate if contribution liability is owed for the year in which the 
                                                                A resident of a New Jersey Urban Enterprise City/Town Zone or A New Jersey resident who has been unemployed or under a NJ public assistance program for at least 6 months prior to being hired or A New Jersey resident who has been an employee under the Jobs Training Partnership Act                   Public Law 97-300.
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                                                                1.                                                            2.                                                                                                                                  3.                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  Prepare form FS-131 as follows:                                                                                  Column A: total taxable wages from form NJ927 for all employees for each quarter Column B: the date UI taxes were paid Column C: Quarterly total taxable wages for employees for whom a rebate is claimed (form FS-131A) Column D: Employer UI rate (found on form NJ927) Column E: Rebate Percentage                                                                                                                                                                                                                                                                                           Column F: is the combination of Columns C x D x E
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          30,     2.6825                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                       . Indicate the total wages paid to eligible employees, by quarter under Column C of form FS-131. 

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                        NOTE: If you operate in multiple UEZ locations an application must be filled for each location.
             An eligible employee must be one of the following:                                                                                                                                                                                                                                                                                                                              In addition the eligible employees must meet all of the following for you to be able to claim a rebate for Unemployment Insurance (UI) contributions:                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                  An employer’s UI rate for the year 201                                June    than                                                                                             rebate is claimed or for any other year or if quarterly contribution reports are delinquent.                                                                                                              To determine the amount of rebate for which you qualify, first identify each employee who meets the criteria                 above. List the                                                                 quarter; the name, Social Security number,                                                                                                            hired                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                   *                                                                                               Return the completed application by May 2                                                                                                                                                                                      Questions regarding UEZ may be directed to (






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