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Vermont Department of Labor 

P.O. Box 488 

Montpelier, VT  05601-0488 

LARGE EMPLOYER 

Specifications and Instructions 

for Quarterly C-101 

Wage & Contribution 

Report Online Application 

                            C-29A (12/17) 



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                                          Introduction 

We  are  pleased  to  provide  an  on-line  application  that  will  accommodate  electronic  filing  of  all  required 
elements of the Vermont Department of Labor’s (VDOL) Quarterly C-101 Wage and Contribution report. 

To  use  this  application,  you  first  must  complete  the Registration Form provided  in  this  packet.  After  you 
have registered and been provided your 4-digit “User ID” number, you will access the application on-line with 
your “User ID” number and the password you create the first time you access the application. 

Each time you use the application, you will be certifying you are in compliance with the Terms and Conditions 
associated with this application. A copy of the “Terms and Conditions” is included in this pamphlet.  It is 
critical you read, understand, and comply with the “Terms and Conditions”.  Failure to do so will likely 
cause revocation of your access to this application. 

Before the Quarterly C-101 report is actually filed, you will be required to upload a Pre-Edit file.  The format for 
the Pre-Edit file is also included in this pamphlet.  Only if the report passes the Pre-Edit can the file be used for 
the actual reporting.  Details of any report errors will be provided as part of the application. 

Once the Pre-Edit file contains no errors, you will be asked to identify which of the following File Formats you 
are using to report each employer’s wage records.  Specific details for each of the following file formats for the 
wage record reporting is included in this pamphlet. 

      WageRecordFormats: 

        Format 1 = ‘ASCII format’
        Format 2 = fixed length 80 BYTE record with 25 records to a block.
        SSA’ format
        ‘ICESA’ format

Regardless of the format used, the follow rules apply to the wage record file: 

        DO NOT include ‘S’ record if wages are zero or negative.
        Only one record for each employee per employer during the quarter is permitted.
        All numeric fields are right justified, with preceding zero’s to fill required “field picture”.

Following the wage record report, you must also include a Contribution Report.  Details and file format for the 
Contribution Report follows the wage record format information in this pamphlet. 

After the file containing the wage record and contribution report has been uploaded and accepted, you will  
be given the opportunity to review the report submitted.  The “Review Page” also provides an option for the 
user to view/print a PDF report of the record by clicking upload report file button. To complete the filing, the 
user must click the “Confirm” button and then click the “Continue” button. 

The “Confirmation Page” is proof the report has been filed.  It will also provide you with the Confirmation 
Code that will be required when you submit payment.  The payment must equal the “total due” amount 
indicated on the “Confirmation Page”.  TheAddendum Formatwill provide        you with the details needed 
when submitting payment. 

If you have any questions regarding the information contained within or the application, please contact 
us at 1-802-828-4344. 

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                                    Bulk Filing Registration Form 
                  3 rdParty         Wage & Contribution Report On-Line Application 
                            Quarterly 
                      Please provide the following information and mail or fax to: 

Vermont Department of Labor                                    Fax number:                 802-828-4248    
ATTENTION: Employer Services    
                                                               Telephone number:    802-828-4344 
PO Box 488
Montpelier, VT 05601-0488 

Please list up to 5 employer #’s & how many employees that you will be filing for:  

Employer #        ______________ ______________ ______________ ______________ ______________ 
# of Employees  ______________ ______________ ______________ ______________ ______________ 

                                           Organization Information: 

Name of Organization ___________________________________________________________________ 

Mailing Address          ___________________________________________________________________ 

                        ___________________________________________________________________ 
City, State, Zip           ___________________________________________________________________ 
Federal ID number      ___________________________________________________________________ 

Contact information for Person Responsible for Filing Reports: 

Name                           ___________________________________________________________________ 

Title                              ___________________________________________________________________ 

Telephone Number      ______________________________  Fax number __________________________ 

E-Mail address            ___________________________________________________________________ 

Authorized signature    ___________________________________________________________________ 

Completed and returned by VDOL Representative: 
3 rdParty On-Line Application “User ID” # assigned 

VDOL Deposit Account information for electronic payment for reports filed electronically: 

Account Number: 89000203                             Routing Number: 011600062 

Approved by  ______________________________________________    Date ________________________ 

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                             Terms and Conditions 

              Quarterly C-101 Wage & Contribution Report 
                                      On-LineApplication 

Each time the Quarterly C-101 Wage & Contribution Report On-Line Application is accessed, the individual 
who has provided the application with the “User ID” number and “Password” will certify compliance with 
the following “Terms and Conditions”. 

Reporter: 

A) has submitted and had approved a Registration Form for the Quarterly C-101 Wage & Contribution
   Report Online Application;

B) will submit a “Pre-Edit” file in advance of the report’s “due date” to facilitate any corrections that may
   be necessary before the report can be accepted;

C) will validate and use current experience rate for the account;

D) will provide all reporting data as required on the Quarterly C-101 Wage & Contribution Report, in
   VDOL approved format;

E) will apply any outstanding credit balance against the current quarter amount due VDOL;

F) will electronically transmit from their banking institution or submit one paper check in the total amount
   due, as calculated by the Quarterly C-101 Wage & Contribution Report On-Line Application, for all
   employers included in the electronic file submission for the reporting quarter;

G) agrees to include the “Confirmation Code”, provided by VDOL on the application’s “Confirmation Page”,
   in the Addendum format of the electronic payments, or on the supercheck memo line;

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                                  Pre-Edit File Format 

The Pre-Edit file provides up-to-date information regarding the status of the employer’s account, as 
well as any outstanding credits. 

File format of information being sent by reporter in pre-edit file: 

The pre-edit file needs to include a header line.  The format of the header line is; 
ERN,FEIN,POA,USERFIELD1,USERFIELD2 

  Field Description                                                      Field Format Field Picture 
  Employer VDOL Account Number                                           Numeric      7 
  Employer Federal Identification Number                                 Numeric      9 
  Assigned 3rd Party Reporting 3-digit POA Number                        Numeric      3 
  User Field1 Employer Name or                                          Alpha/Numeric 
  (i.e. account number 3rd Party Reporter has assigned) (must be quoted)              Up to 50 
  User Field2 Payroll Service Name or                                   Alpha/Numeric 
  (i.e. account number 3rd Party Reporter has assigned) (must be quoted)              Up to 50 

Example: 
ERN,FEIN,POA,USERFIELD1,USERFIELD2 
1234567,987654321,123,”USER FIELD 1”,”USER FIELD 2” 
APPLIED FOR,222222222,011,"MISCELLANEOUS EMPLOYER","PAYROLL SERVICE NAME", 
File format of information being sent back by VDOL to 3rd Party reporter: 

  Field Description                                                      Field Format Field Picture 
  Employer VDOL Account Number                                           Numeric      7 
  Employer Federal Identification Number                                 Numeric      9 
  Credit Balance (if applicable)                                         13           9(11) V99 
  Debit Balance * (if applicable)                                        13           9(11) V99 
  Employer Name of Business (from VDOL files)                           Alpha/Numeric 
                                                                         (quoted)     Up to 35 
  Assigned 3rd Party Reporting User ID Number                            Numeric      3 
  Current Tax Rate (**see example below)                                 Numeric      4 
  Employer Name of Business (from VDOL files)                           Alpha/Numeric 
                                                                         (quoted)     Up to 35 
  User Field1 Employer Name or                                          Alpha/Numeric 
  (i.e. account number 3rd Party Reporter has assigned)                  (quoted)     Up to 50 
  User Field2 Payroll Service Name or                                   Alpha/Numeric 
  (i.e. account number 3rd Party Reporter has assigned)                  (quoted)     Up to 50 

This example for “TESTBUSINESS” has a $12.34 credit and no outstanding debit balance. 
ERN,FEIN,CREDITBALANCE,DEBITBALANCE,EMPLOYERNAME,POACODERATE,USERFIELD1,USERFIELD2 
1234567,123456789,000000001234,0000000000000,”TESTBUSINESS”,123,0090,”USERFIELD1”,”USERFIELD2  ” 
All numeric fields are right justified, with preceding zero (0) to fill. 
* For information only.
**  1.0% tax rate will be displayed as 0100; 2.6% tax rate will be displayed as 0260. 

                                              - 4 - 



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                                       FORMAT 1 

The department will accept quarterly wage data in ASCII format only. 

Location    Field                      Field                      Field  
Columns     Description                Pictur                     Description Details 

1-9         Social Security Number     9(9)                       Self Explanatory 

10-34       Name, Last, First, MI      X(25)                      Last Name, First Name, MI 

35          Quarter                    9                          Report Quarter     (1, 2, 3, 4) 

36-37       Year                       99                         Last 2 Digits 

38-47       Total Gross Wages          9(7).99                    Total gross wages paid during report 
                                                                  quarter. * 

48          Filler                     9                          Space 

49-55       VT Employer Account Number 9(7)                       Account number assigned by 
                                                                  Vermont Dept. of Labor. ** 

56-56       Hourly/Salaried Flag       X(1)                       H = hourly employee 
                                                                  S = salaried employee 

57-57       Gender                     X(1)                       F = female         M = male 

58-61       Total hours worked ***     9(4)                       Total hours paid for hourly workers only. 

62-68       Hourly Wages               9(4).99                    Rate paid for most hours in 
                                                                  quarter for hourly workers only. * 

69-80       Filler                     X(12) 

*   Indicate dollars and cents (decimal point is required) with preceding zeros if less than required “field
    picture”
**  Enter preceding zeros if VT Employer Account number is less than 7 digits. 
***  At this time, element is not required.  Field may be zero filled or left blank. 

REMEMBER: 

Only one record for each employee per employer is permitted.

There must be a carriage return/line feed in column 81 of each record.

A “Contribution Report” record must follow the wage record file.
   Specs for contribution report form are provided on page 15.

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                                    FORMAT 2 

Location Field                      Field                          Field 
Columns  Description                Picture                        Description Details 

1-9      Social Security Number     9(9)                           Self Explanatory 

10-34    Name                       X(25)                          Last Name, First Name, MI 

35       Quarter                    9                              Report Quarter    (1, 2, 3, 4) 

36-37    Year                       99                             Last 2 Digits 

38-46    Total Gross Wages          9(7)V99                        Total gross wages paid during report 
                                                                   quarter. * (no decimal point) 

47-48    Filler                     9(2) 

49-55    VT Employer Account Number 9(7)                           Account number assigned by 
                                                                   Vermont Dept. of Labor. ** 

56-56    Hourly/Salaried Flag       X(1)                           H = hourly employee 
                                                                   S = salaried employee 

57-57    Gender                     X(1)                           F = female        M = male 

58-61    Total hours worked ***     9(4)                           Total hours paid for hourly workers only. 

62-67    Hourly wage                9(4)v99                        Rate paid for most hours in quarter for 
                                                                   hourly workers only. * (no decimal point) 

68-80    Filler                     X(13) 

*   Indicate dollars and cents (no decimal point) with preceeding zero’s if less than required
    “field picture”.
**   Enter preceding zeros if VT Emplyer Account number is less than 7 digits. 
***  At this time, element is not required.  Field may be zero filled or left blank. 

REMEMBER: 

 Only one record for each employee per employer is permitted.

 There must be a carriage return/line feed in column 81 of each record.

 A “Contribution Report” record must follow the wage record file.
   Specs for contribution report form are provided on page 15.

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                                 SSA FORMAT 

  SSA Format as described on the following pages uses the general format of the social security 
administration, although specific field content and structure must conform to Vermont’s specifications. 
  The order of the records on the file would be as follows: 

         Record-Id                 Description 
         E                   A code ‘E’ record for each employer on the file, followed by at least 
         S                   one code ‘S’ record followed by a code ‘F’ record            at the end of the 
         S                   tape.  There is only 1 ‘F’ record on the entire file.
         S
         E
         S
         S
         F

In all cases, only one record for each employee per employer is permitted.  There must always be a carriage 
return/line feed in column 276 of each record. 

Use the following key codes for each SSA Format “Field Description Details”: 

*   Indicate dollars and cents with no decimal point with preceeding zero’s if less than required
    field picture.
**  If VDOL account number is less than 7 digits, enter preceeding zero’s to fill required 7 digit 
    field picture.
***  At this time, element is not required.  Field may be zero filled or left blank. 

  CODE ‘E’ - Employer Record 

Location Field                                 Field        Field 
Columns  Description                           Picture      Description Details 

1        Record-Id                             X            Always ‘E’ - 1 record for each
                                                            employer account. 
2-3      Report Quarter                        99           Last month of the report quarter. 
                                                            (‘03’ ‘06’               ‘09’ ‘12’ ) 
4-5      Report Year                           99           Last 2 digits of report year. 
6-14     Federal Employer Id                   9(9)         Federal employer number. 
15-21    VT Employer Account Number            9(7)         Account number assigned by Vermont 
                                                            Dept. of Labor. ** 
22-23    Filler                                X(2) 
24-73    Employer Name                         X(50) 
74-113   Employer Address                      X(40) 
114-138  Employer City                         X(25) 
139-148  Employer State                        X(10) 
149-158  Filler                                X(10) 
159-275  Filler                                X(117) 

                                               - 7 - 



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                       SSA FORMAT - Continued 

 CODE ‘S’ -  Supplemental State Record 

Location Field                      Field                          Field 
Columns  Description                Picture                        Description Details 

1        Record-Id                  X                              Always ‘S’ - 1 Record for Each Employer. 

2-10     Social Security No.        9(9)                           Self Explanatory 

11-37    Employee Name              X(27)                          Last Name, First Name, MI 

38-131   Filler                     X(94) 

132-140  Total Gross Wages          9(7)V99                        Total gross wages paid during 
                                                                   report quarter. * (no decimal point) 

141-142  Filler                     9(2) 

143-149  VT Employer Account Number 9(7)                           Account number assigned by Vermont 
                                                                   Dept. of Labor. ** 

150-159  Filler                     X(10) 

160-160  Hourly/Salaried Flag       X(1)                           H = hourly employee 
                                                                   S = salaried employee 

161-161  Gender                     X(1)                           F = female         M = male 

162-165  Total hours worked ***     9(4)                           Total hours paid for hourly workers only. 

166-171  Hourly Wage                9(4)v99                        Rate paid for most hours in quarter for 
                                                                   hourly workers only. * (no decimal point) 

172-275  Filler                     X(104) 

 CODE ‘F’ - Final Record 

1        Record-Id                  X                              Always ‘F’ - 1 code F record for the tape. 

2-7      Filler                     X(6) 

8-18     Total Wages                9(9)V99                        Total wages for all employees reported. 

19-275   Filler                     X(257) 

REMEMBER: 

 • A “Contribution Report” record must follow the wage record file.
  Specs for contribution report form are provided on page 15.

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                                     ICESA FORMAT 

This is the uniform format for quarterly UI wage reporting. As developed by the interstate conference of 
Employment Security agencies and is commonly referred to as the ICESA Format. 

The layouts for the various record types are described on the following pages.  Only the fields required by 
Vermont are shown.  Specific field content and structure must conform to Vermont’s specifications. All records 
are 275 BYTES. 

There are six record types used by this format.  They are: 

Record Id Description 

  A       First record in file;  identifies transmitter. 

  B       Second record in file;  identifies type of equipment used to create the file. 
          identifies employer whose wage data is being reported. There should be one  ‘E’ record for 
  E 
          each employer on the file. 

  S       Used to report wage data for an employee.  ‘S’  records should follow the related  ‘E’ record. 

  T       Contains the totals for all  ‘S’  records for the related ‘E’ record. 

  F       Last record in file;  indicates the end of file. 

The order of the records on the file would be as follows: 

A B E S S S S S S T E S S S S S T E S S S S S S S S S T F 

Use the above key codes for ICESA format “Field Description Details”: 

* Indicate dollars and cents with no decimal point with preceeding zero’s if less than required
  field picture.
**  If VDOL account number is less than 7 digits, enter preceeding zero’s to fill required 7 digit 
  field picture.
***  At this time, element is not required.  Field may be zero filled or left blank. 

                                     - 9 - 



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                          ICESA FORMAT - Continued 

CODE ‘A’  -  Transmitter Record 

Location Field                  Field   Field 
Columns  Description            Picture Description Details 

1-1      Record Id              X(01)   Always ‘A’ 

2-5      Year                   9(04)   Year Of Data On File. 

6-14     Transmitter’s Fein     9(09) 

15-18    Taxing Entity Code     X(04)   Always ‘UTAX’ 

19-23    Filler                 X(05) 

24-73    Name Of Transmitter    X(50) 

74-113   Street Address         X(40) 

114-138  Transmitter City       X(25) 

139-140  Transmitter State      X(02) 

141-153  Filler                 X(13) 

154-158  Transmitter Zip        X(05) 

159-163  Zip Extension          X(05) 

164-193  Name Of Contact Person X(30) 

194-203  Contact Telephone No.  9(10) 

204-207  Telephone Extension    9(04) 

208-213  Authorization Code     9(06) 

214-242  Filler                 X(29) 

243-250  Tape Creation Date     9(08)   MMDDYYYY 

251-275  Filler                 X(25) 

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                          ICESA FORMAT - Continued 

CODE ‘B’ - Authorization Record 

Location  Field              Field         Field  
Columns   Description        Picture       Description Details 
_____________________________________________________________________________________________ 

1-1       Record Id          X(01)         Always ‘B’ 
2-5       Year               9(04)         Year Of Data On  File 
6-14      Transmitter’s Fein 9(09)

15-22     Computer           X(08)         Manufacturer’s Name
23-24     Internal Label     X(01)         May Be Left Blank Or Zero Filled 
25-25     Filler             X(01)

26-27     Density            9(02)         May Be Left Blank Or Zero Filled 
28-30     Character Set      X(03)         Always ‘EBC’
31-32     Number Of Tracks   9(02)         May Be Left Blank Or Zero Filled 

33-34     Blocking Factor    9(02)         Always (25) 
35-38     Taxing Entity Code X(04)         Always ‘UTAX’ 
39-146    Filler             X(108)

147-190   Organization Name  X(44)         Organization to Which File Should Be Returned 
191-225   Street Address     X(35)         Address to Which The File Should Be Returned 
226-245   City               X(20)

246-247   State              X(2)
248-252   Filler             X(05)
253-257   Zip Code           X(05)

258-262   Zip Extension      X(05)
263-275   Filler             X(13)

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                     ICESA FORMAT - Continued 

CODE ‘E’ - Employer Record 

Location Field                      Field   Field 
Columns  Description                Picture Description Details 

1-1      Record Id                  X(01)   Always ‘E’ 

2-5      Year                       9(04)   Year Of Data On File. 

6-14     Transmitter’s Fein         9(09) 

15-23    Filler                     X(09) 

24-73    Employer Name              X(50) 

74-166   Filler                     X(93) 

167-170  Taxing Entity Code         X(04)   Always ‘UTAX’ 

171-172  State Code                 9(02)   ‘50’ state to which wages are being sent. 

173-179  VT Employer Account Number 9(07)   Account number assigned by Vermont 
                                            Dept. of Labor. ** 

180-187  Filler                     X(08) 

188-189  Reporting Period           9(02)   Last month of report quarter. 
                                            (‘03’   ‘06’   ‘09’   ‘12’) 

190-275  Filler                     X(86) 

                                    - 12 -



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                        ICESA FORMAT - Continued 

   CODE ‘S’ - Employee Record 

Location Field                      Field             Field 
Columns  Description                Picture           Description Details 

1-1      Record Id                  X(01)             Always ‘S’ 
2-10     Social Security Number     9(09)             Valid SSN. 

11-30    Employee Last Name         X(20) 

31-42    Employee First Name        X(12) 

43-43    Middle Initial             X(01) 

44-45    State Code                 9(02)             ‘50’ State to which wages are being  sent. 

46-49    Report Quarter-Year        9(04)             Last Month and Year Of Report Quarter. 
                                                      ‘0605’ = Apr-June 2005 

50-63    Gross Wages For Qtr        9(12)v99          Total gross wages paid during report 
                                                      quarter. * (no decimal point) 

64-142   Filler                     X(79) 

143-146  Taxing Entity Code         X(04)             Always ‘UTAX’ 

147-154  Filler                     X(08) 

155-161  VT Employer Account Number 9(07)             Account number assigned by Vermont 
                                                      Dept. of Labor. ** 

162-232  Filler                     X(71) 

233-233  Hourly/Salaried Flag       X(1)              H = hourly employee 
                                                      S = salaried employee 

234-234  Gender                     X(1)              F = female         M = male 

235-238  Total hours worked ***     9(4)              Total hours paid for hourly workers only. 

239-244  Hourly wage                9(4)v99           Rate paid for most hours in quarter for 
                                                      hourly workers only. * (no decimal point) 

245-275  Filler                     X (31) 

*    Indicate dollars and cents (no decimal points)

**   Enter preceding zeros if VT Employer account number is less than 7 digits

***  At this time, element is not required. Field may be zero filled or left blank. 

Only one employer is allowed per employer per quarter.

                                    - 13 -



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                     ICESA FORMAT - Continued 

  CODE ‘T’ - Total Record 

Location Field                     Field                          Field 
Columns  Description               Picture                        Description Details 

1-1      Record Id                 X(01)                          Always “T” 

2-8      Total Number of Employees 9(07)                          Total Number of ‘S’ Records for Employer. 

9-12     Taxing Entity Code        X(04)                          Always ‘UTAX’ 

13-26    Total Gross Wages         9(14)                          Total Wages on ‘S’ Records For Employer. 
                                                                  (no decimal points) 

27-275   Filler 

  CODE ‘F’ - Final Record 

1-1      Record Id                 X(01)                          Always ‘F’ 

2-11     Total Number of Employees 9(10)                          Total Number of ‘S’ Records in Entire File 

12-21    Total Number of Employes  9(10)                          Total Number of ‘E’ Records in Entire File 

22-25    Taxing Entity Code        X(04)                          Always ‘UTAX’ 

26-40    Total Gross Wages in File 9(15)                          Total of Gross Wages on All ‘S’ Records.  
                                                                  (no decimal point)  * 

41-275   Filler                    X(235) 

REMEMBER: 

A “Contribution Report” record must follow the wage record file.
  Specs for contribution report form are provided on page 15.

                                   - 14 -



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                          Contribution Report Format 

Unlike filing by Magnetic Media, each wage record must be followed by and end with a 
contribution report for each employer’s record. 

Field Field                                                                         Field 
No.   Description                                                                   Picture 
1     Record Type Indicator                                                         X(1) ALWAYS ‘C’ 

2     Employer Number                                                               7 

3     Year                                                                          9(4) 
4     Quarter                                                                       9(1) 
5     Month 1 Employee Count                                                        9(5) 
6     Month 2 Employee Count                                                        9(5) 
7     Month 3 Employee Count                                                        9(5) 
8     Zero (0) Fill (Former 3 Month Female Employee Count)                          9(5) 

9     Total Wages *                                                                 9(13) 
10    Excess Wages *                                                                9(13) 

11    Taxable Wages *                                                               9(13) 
12    Unemployment Contribution Amount Due **                                       9(11) 
13    Zero (0) Fill (Former FTE Employee Count )                                    9(6) 

14    Zero (0) Fill (Former Health Care Amount Due ** )                             9(11) 
15    Total Amount Due VDOL for reporting quarter **                                9(11) 
16    Employer no longer has employees in VT                                        X (Y or N) 

17    Employer has discontinued operations in VT                                    X (Y or N) 

18    Business has had a change in ownership                                        X (Y or N) 
19    Business has had a change in mailing address                                  X (Y or N) 

All numeric fields are right justified, with preceding zero (0) to fill. 

Do not truncate or round.                                                Should be: 

* Example:  $22,111,255,488.93 = 2211125548893          ** $111,255,488.93 = 11125548893 

Field No.:  NOT PART OF FORMAT 

                                               - 15 -



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                      Contribution Report Form 

                  with Column by Column Breakdown 

Field      Field Description                           Columns Field Picture 
No. 
1     Record Type                                      1       X(1) ALWAYS “C” 
2     Employer Number                                  2-8       9(7) 
3     Year 10-13                                       9-12      9(4)
4     Quarter  14                                      13        9(1)
5     Month 1 Employee Count                           14-18     9(5) 
6     Month 2 Employee Count                           19-23     9(5) 
7     Month 3 Employee Count                           24-28     9(5) 
8     Month 3 Female Employee Count                    29-33     9(5) 

9     Total Wages *                                    34-46     9(13) 
10    Excess Wages *                                   47-59     9(13) 
11    Taxable Wages *                                  60-72     9(13) 
12    Unemployment Compensation Amount Due **          73-83     9(11) 

13    Zero (0) Fill (Former FTE Employee Count)        84-89     9(6) 
14    Zero (0) Fill (Former Health Care Amount Due **) 90-100    9(11) 
15    Total Amount Due VDOL for reporting Quarter **   101-111   9(11) 

16    Employer no longer has employees in VT           112     X (Y or N) 

17    Employer has discontinued operations in VT       113     X (Y or N) 

18    Business has had a change of ownership           114     X (Y or N) 

19    Business has had a change in mailing address     115     X (Y or N) 

                                - 16 -



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                               Addendum Format 
                             (For Electronic Payments ONLY) 
Payment amount must equal the total amount determined due on the filing date.  All fields are 
mandatory. 

Field #    Field Name                 Field Type Field Size          Contents 
           Segment ID                            3                      DOL 
           Separator                             1                      * 
DOL01      Service Bureau # (user ID) N          3                      ### 
           Separator                             1                      * 
DOL02      Taxpayer ID (Employer #)   N          7                   ####### 
           Separator                             1                      * 
DOL03      Tax Type Code              ID         5                   01111 
           Separator                             1                      * 
DOL04      Tax Period End Date        DT         6                   yymmdd 
           Separator                             1                      * 
DOL05      Amount Type                ID         1                      T 
           Separator                             1                      * 
DOL06      Amount                     N2         10                  $$$$$$$$cc 
           Separator                             1                      * 
DOL07      Confirmation Code          AN         16                  XXXXXXXXXXXXXXXX 
           Terminator                 M          1                      \ 

Example:  Service bureau 333 reporting for Department of Labor employer account number 
2990001 filing for 1st quarter 2008, paying tax of $2550.50 and receiving a confirmation code passed 
back from the application of 27f8b12d-15aO-42 would be displayed as: 

     DOL*333*2990001*01111*080331*T*0000255050* 27f8b12d-15aO-42*\ 

BANK NAME:           PEOPLES UNITED BANK 
ACCOUNT NUMBER: 
                                 Provided on Approved Registration Form 
ROUTING NUMBER: 

                                         - 17 -



- 19 -
 Addendum format definitions: 

AMOUNT:   The amount fields are used to carry the dollar amount owed and/or being paid.  Only one 
amount field (DOL05) is required.  Currently, the other amount fields are not being used. 

AMOUNT TYPE:    The amount type is used to identify the type of amount that follows.  Currently, the 
only acceptable value is “T” for tax. 

AN: The string type data element is symbolized by the representation AN.  Contents of string type 
data elements are a sequence of letters, digits, spaces, and/or special characters.  The contents 
shall be left-justified.  Trailing spaces should be suppressed unless they are necessary to satisfy a 
minimum length requirement. 
DT: The date type element is symbolized by the representation DT.  Format for the date type is 
YYMMDD.  YY is the last two digits of the year (00-99 with 00 = 2000), MM is the numeric value of the 
month (01-12) and DD is the numeric value of the day (01-31). 

DATA ELEMENT TYPE:    The data element type identifies the type of information contained in the 
data element field.  For instance, AN, ID, DT, N2. 

FIELD REQUIRMENT:    The field requirement of a field data element indicates whether the field is 
mandatory (M), optional (O), or conditional (C). 

ID: The identified type data element is symbolized by the representation ID.  An identifier data 
element shall always contain a value from a predefined list of values. 

N2: The numeric type of field or data element is represented by the two-position representation N2. 
N indicates the numeric and 2 indicates the decimal places to the right of a fixed, implied decimal 
point.  The decimal point is not transmitted.  It is intended that this number will always be positive for 
the DOL application.  In the DOL convention, the amount fields are defined as N2 type data elements. 
Thus, $1,200.00 would look as follows *0000120000*.  Note for zero dollar amounts:  this data 
element type may contain one character - 0. 

  Addendum Field Name Requirements: 

Segment Identifier:  DOL must be entered in this field.  This identifies the transaction as a tax 
payment. 

Separator: An asterisk ( * ) must be entered to separate data elements in the CCD+ record. 

Online Filing Code:  This is the three digit number “User ID” number assigned for use of the 
Quarterly C-101 Wage and Contribution On-Line Application assigned by the Vermont Department 
of Labor. 

Taxpayer Identifier: The 7-digit account employer number assigned by the Vermont Department of 
Labor must be in this field. 

Tax Type Code:  01111 must be entered in this field to identify payment is for Quarterly Tax and 
Wage Reporting. 

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Tax Period End Date: Quarter end date for the report being submitted.  The date is entered as 
YYMMDD. YY = year; MM = month;  DD = day. (Example:  080331 represent 1st quarter of 2008 
filing, which ended on March 31st, 2008). 

Amount Type: Enter Tfor tax. 

Amount: Enter the dollar amount being paid.  The amount field should always contains cents. 

Confirmation Code: Enter the 16-character Confirmation Code provided on the confirmation page 
of the 3rd Party C-101 Wage and Contribution Report On-Line application for which the electronic 
payment is associated to. 

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