Wage Detail specifications for forms JFS 20127 and JFS 22128 
 
Reproduction and use of JFS 20127, Contribution Wage Detail and Quarterly Summary 
and JFS 20128, Reimbursing Wage Detail requires that the format, location and spacing 
must be exact.  Employers having more than 15 employees, therefore requiring more 
than one Wage Detail form, should use the same format for all additional pages.  
 
All fields are right justified except fields 11, Employee’s Social Security Number and 12, 
Employee’s Last Name, which are left justified.  Machine printed characters do not need 
to be spaced so that a single character is in a box by itself and may run together without 
spaces so long as the first character is placed in the first box respective to left or right 
justified.  For example: SMITH, rather than S  M  I  T  H, is acceptable so long as the 
letter “S” is placed in the first box using left justify. 
 
Do not use commas or dollar signs ($), but do include a decimal point between dollars 
and cents.  All dollar amounts must contain cents, including .00.  Do not include 
hyphens in the social security numbers. 
 
Barcode 
   1.  Must be a 3 of 9 barcode.  
   2.  Sizing:  Width of 2.275 inches, Height of the bars .375 inches (this height does 
   not include the text shown below the barcode). 
   3.  Barcode must contain the following text for JFS 20127: F0034 and for JFS 
   20128: F0042.  The text below the barcodes will be FOR 0034 or FOR 0042, 
   respectively.  
   4.  A minimum of .25 inch of white space on either end of the barcode and ideally 
   around all sides of the barcode although the space on the top and bottom of the 
   barcode is much less critical.   
   
Alignment Points 
   1.  The font must be Arial, 12pt, Bold.    
   2.  Upper Left Corner – The “O” placement in “OHIO” is:   
   X: 0.25  
   Y: 0.25  
   3.  Lower Left Corner -  The “T” placement is: 
   X: 0.25  
   Y: 10.526 
 
   4.  Lower Right Corner – The “T” placement is: 
   X: 8.133  
   Y: 10.526 
   Note: X represents the Horizontal axis and Y represents the Vertical axis 
 
                                    Page  1of  4
 

Quarterly Summary specifications for form JFS 20127 
 
Scanline   
 
   1.  The scan line is 32 characters in length 
   2.  The font must be OCR-A size 10 print font and OCR quality print ribbon. 
   3.  The scanline must be positioned 5/16" from the bottom of the page. 
   4.  The rightmost scanline digit must be positioned 1" from to the right edge.   
   5.  The Quarterly Summary should be no larger or smaller than 4 ¼ inches tall and 8 
    1/2 inches wide. 
   6.  The scanline definitions are: 

           Quarterly Summary Remittance Stub coupon (left to right) 
Nbr Field Name  Start  Min  Max  Typ             #         Field Information 
                 pos    Len          Len e       Can’
                                         (N      t  
                                         or      Read
                                         A)      s 
 6  Type Code        40 2            2   N       0     Type Code is 17  
 5 Employer ID 30       10           10  N       0     Employer ID Number  
    Number  
 4  Quarter          28 2            2   N       0     Valid 01-04  
 3         Year      24 4            4   N       0     CCYY Year  
 2  Amount Due       11 13           13  N       0     Set to all 0’s 
 1 Scanline 10          1            1   N       0     Scanline Check Digit 
    Check Digit 

                 Scanline Check Digit Calculation Requirements 
 
                 Field Location          Field 1 (Scanline Check Digit) 
           Check Digit Location                  10 (Rightmost) 
                 Weights 2,1,2,1,2,1,2,1,2 
                 Method                          Sum of Digits 
                 Modulus 10 
           Subtract Remainder                          Yes 
 
An example of calculating the check digit is included. 
 
                                     Page  2of  4
 

Target Marks  
 
 1.  Left side target mark must be 3/16" from bottom edge and 3/16" from left edge. 
 2.  Right side target mark must be 3 3/4" from the bottom and 3/8" from the right 
 edge. 
 
Any form makers producing these forms must obtain approval from ODJFS that their 
forms meet these specifications prior to their use. Form makers must submit 20 test 
samples of both Forms JFS 20127 and JFS 20128.  The test samples will be validated 
for accuracy, and then a letter of approval or denial will be sent to the form maker.  
Quarterly Summary reports must be submitted on the correct size paper; therefore, 
reports printed on a full page of paper must be cut to the specifications mentioned 
above.  If the correct format is not followed, future reports will be returned and forfeiture 
and interest penalties may be assessed if the reports are not resubmitted correctly prior 
to the due date.   

                   Page  3of  4
 

   32                                                                                                                                                                                                               9                                                                                                                               
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   31                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                 1
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                      
   30

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   28

   27

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   25

   24

   23

   22

   21
                                                                                                                                                                                                                                                                                                                                                                                                                                                                             
   20 

   19                                                                                                                                                                                                                                                                                                                                                                                                                                                                       Steps:                                                  Divide the sum of the digits by 10………………………  6.1                                               Subtract the remainder from 10…………………………    9 

   18                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         
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   17                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                         of 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                             4
   16
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
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   15

   14                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                               

   13
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
   12                                                                                                                                                                                                                                                                                                                                              0 0 3 4 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 

   11                                                                                                                                                                                                                                                                                                                                              18
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
                                                                                                                                                                                                                                                                                                                                                   8 

                                                                                                                                                                                                                                                                                                                                                   14                                                                                                                                                                                                                                      Remainder……………………………………………….             
                                                                                                                                                                                                                                                                                                                                                   6 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                    
                                                                                                                                                                                                                                                                                                                                                   10 
                                                      E E E E E E E Q Q Y Y Y Y A A A A A A A A A A A A A C                                                     4 5 6 7 8 9 0 0 3 2 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0                                                     1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2 1 2                        4                                                      4 1 6 5 8 9 0 0 3 4 0 2 0 0 0 0 0 0 0 0 0 0 0 0 0 0 
                                                      E                                                                                                         3                                                                                                       2                                                                          6                                                      6                                                                                                                                                                          Number                                         

                                                      E                                                                                                         2                                                                                                       1                                                                          2                                                      2 
   3 4 5 6 7 8 9 10                                   E                                                                                                         1                                                                                                       2                                                                          2                                                      2                                                                                                                                                                          Account                                        
   2                                                  T                                                                                                         7                                                                                                       1                                                                          7                                                      7 
   1                                                  T                                                                                                         1                                                                                                       2                                                                          2                                                      2                                                                  
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     Employer 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                     = Type Code 17                                                                                 = Quarter                                    = Year                                                     = Amount Due (Set to all 0’s for Quarterly Reports)               = Check Digit 
                                                                                                                                                                                                                                                                                                                                                                                                                                                                             KEY                                                    T                                                E =                                           Q                                             Y                                                          A                                                                 C                    
                                                                                                                                                                                                                                                                                                                                                                                                   Sum of 
                                                                                                                                                                                                                           Weighting 
                                                                                                            Customer                                                                                                  Data                                                                                                  Factor         Product                                         factor)                                                            the Digits 
                                                                                                                                                                                                                                                                                                                                                   (multiply by