1. |
Enter in the space next to each month designated, the number of full-time covered workers (subject to R.I. Employment Securiry Act) who performed services during or received pay for the payroll which includes the twelfth of the month. If no employment in the payroll period, enter zero.
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2. |
Enter all wages paid in this calendar quarter whether in money or in kind, such as meals and lodging. (This total must agree with the amount in Item 18. DO NOT include wages paid to employees who performed services which are exempt under the Rhode Island Employment Security law. For example, an individual owner of business should not report wages to his/her spouse or his/her children under 18 years of age. Refer to Employer Handbook for other specific exemptions.
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3. |
Follow the instructions in Item 2, but exclude wages paid by you in excess of the E.S. wage base ($14,000.00 FOR 2004) to any worker during the year.
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4. |
This is your Employment Security contribution rate.
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5. |
Compute and enter the dollar amount of Employment Security taxes due by multiplying the dollar amount in Item 3 by the percentage figure in Item 4.
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6. |
Follow the instructions in Item 2, but exclude wages paid by you in excess of the J.D.F. wage base ($14,000.00 for 2004) to any worker during the year.
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7. |
This is your Job Development Fund rate.
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8. |
Compute and enter the dollar amount of Job Development taxes due by multiplying the dollar amount in Item 6 by the percentage figure in Item 7.
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9. |
Follow the instructions in Item 2, but exclude wages paid by you in excess of the T.D.I. wage base ($46,800.00 for 2004) to any worker during the year.
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10. |
This is your Temporary Disability Insurance rate.
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11. |
Compute and enter the dollar amount of Temporary Disability taxes due by multiplying the dollar amount in Item 9 by the percentage figure in Item 10, or enter the amount withheld, whichever is greater.
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12. |
Enter the sum of Items 5, 8, and 11. Make ONE check payable to RIET.
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13. |
If answer is "yes", please attach an explanation.
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14. |
Enter the last date wages were paid within the quarter covered by the report. If no wages were paid during the quarter, write "None."
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15. |
Enter the social security number of every employee to whom you have paid wages during the quarter.
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16. |
Enter the last name, and the first initial of every employee to whom you have paid wages during the quarter.
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17. |
Enter the total amount of wages paid to each employee during the quarter, whether or not the wages paid to an employee exceed the wage base in effect for the year.
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18. |
Enter the sum of all wages listed on this page plus any additional pages. If this amount is not equal to the amount in Item 2, please explain the difference.
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