Department of
                            DWS-ARK-209BR Reimbursable Employer’s Quarterly Contribution And 
WORKFORCE     SERVICES                 Wage Report - General Information And Instructions
                                                          Retain For Future Reference

The Department of Workforce Services Law, Arkansas Code Annotated § 11-10-101 et seq. requires all employ-
ers whose employees perform service in this state to complete the Employer’s Quarterly Contribution and Wage 
Report (Form DWS-ARK-209BR).

  Arkansas employers now have the option of filing their Quarterly Contribution and Wage  
  Report and paying their contributions due by Electronic Funds Transfer via the Internet.  http://
  www.ar-tax.org/  If this option is chosen, please do not file a paper report.

PART A. 
ITEM 1.      Enter the number of employees who worked during the week which includes the 12th day of 
             each calendar month of the calendar quarter covered by this report.
ITEM 2.      Enter the total wages (before any deductions) paid to all employees, including part-time and 
             temporary, during this calendar quarter excluding 125 Cafeteria Plan wages.  Total wages should 
             agree with the total wages listed in PART B.  If the legal business is:
             (A)  A  corporation,  the  wages  paid  to  all  employees  who  performed  services  in  Arkansas  
              should be  reported.  Corporate officers are employees and their wages and/or draws are report- 
              able.
             (B)  A political subdivision, the wages paid to elected officials should not be reported.
 
             Special payments given in return for services performed, i.e., commissions, bonuses, fees,  
             prizes, and back pay awards are wages and reportable under Department of Workforce Services Law of 
             Arkansas.  These payments (or dollar value) should be reported by the employer in the calen- 
             dar quarter(s) in which they are given.
ITEM 3.      Penalties are determined as follows:  during the first 20 days of delinquency, a penalty of $10.00 
             is assessed.  Beginning with the 21st day of delinquency, the penalty increases to $20.00.  Ad-
             ditional penalties shall be imposed if it is necessary to estimate the report, subpoena records  
             and/or for failure to properly submit all information requested on the report.
ITEM 4.      Include only payment for penalties.

PART B.  Enter the social security number, first name, middle initial, last name and total wages paid to     
             each employee during the quarter.  The total of all wages listed should agree with Item 2.  If 
             additional space is needed, please copy continuation sheet. Adjustments to prior quarters  
             should be made on adjustment form DWS-ARK-223, which may be obtained by calling (501)  
             682-3798 or accessing our website at www.dws.arkansas.gov.

             SPECIAL INSTRUCTIONS FOR SEASONAL - REIMBURSABLE EMPLOYERS

The total wages in ITEM 2 should include all wages from both columns in PART B.  Wages entered in PART 
B should be divided between In-Season and Out-Season according to the date paid not earned.

A reimbursable employer is not entitled to the noncharge provision of the Department of Workforce Services 
Law regardless of the reason for separation.  All benefits paid to a claimant, whose claim is based on wages 
earned while employed by you, will be charged to your account on a pro rata basis.

DWS-ARK-209 BRI (Rev. 01-07)