Report List Filters, Select State: | Rhode Island, USA |
Parameters, Annual Form Code: | (example: use standard form code‘HL$US-W2-2014’) |
Parameters, Period Type: | Year |
Parameters, Period End Date: | Year End Date (i.e. 31-Dec-2013) |
Parameters, Media Format: | State File Format |
Column | Description | Source |
---|---|---|
1-2 | Record Identifier | Constant "RA" |
3-11 | Submitter’s Employer ID Number (EIN) | Required. Derived from the ‘SUB-ER-EIN’ IDFDV Field Identifier (seq 1000). Numeric only. |
12-19 | User Identification (User ID) | Required. Enter the eight-character BSO User ID assigned to the employee who is attesting to the accuracy of this file. |
20-23 | Software Vendor Code | Enter the numeric four-digit Software Vendor Identification Code assigned by the National Association of Computerized Tax Processors (NACTP). If "99 (Off-the-Shelf Software)" is entered in the Software Code field (positions 36-37) enter the Software Vendor Code. Otherwise, fill with blanks. |
24-28 | Blank | Fill with blanks. Reserved for SSA use. |
29 | Resub Indicator | Enter "1" if this file is being resubmitted. Otherwise, enter "0" (zero). |
30-35 | Resub Wage File Identifier (WFID) | If "1" was entered in Resub Indicator field (position 29), enter the WFID displayed on the notice SSA sent. Otherwise, fill with blanks. |
36-37 | Software Code | Enter "99" to indicate 'Off-the-Shelf Software' |
38-94 | Company Name | Enter the Company Name. Left justify and fill with blanks. |
95-116 | Location Address | Enter the company's location address (Attention, Suite, Room Number, etc). Left justify and fill with blanks |
117-138 | Delivery Address | Enter the company's delivery address (Street or Post Office Box). Example: 123 Main Street. Left justify and fill with blanks |
139-160 | City | Enter the company's city. Left justify and fill with blanks |
161-162 | State Abbreviation | Enter the company's State or commonwealth/territory. Use a postal abbreviation. For a foreign address, fill with blanks |
163-167 | ZIP Code | Enter the company's ZIP code. For a foreign address, fill with blanks |
168-171 | ZIP Code Extension | Enter the company's four-digit extension of the ZIP code. If not applicable, fill with blanks |
172-176 | Blank | Fill with blanks. Reserved for SSA use. |
177-199 | Foreign State/Province | If applicable, enter the company's foreign State/Province. Left justify and fill with blanks. Otherwise, fill with blanks. |
200-214 | Foreign Postal Code | If applicable, enter the company's foreign postal code. Left justify and fill with blanks. Otherwise, fill with blanks. |
215-216 | Country Code | If one of the following applies, fill with blanks: * One of the 50 States of the U.S.A. * District of Columbia * Military Post Office (MPO) * American Samoa * Guam * Northern Mariana Islands * Puerto Rico * Virgin Islands Otherwise, enter the applicable Country Code. |
217-273 | Submitter Name | Required. Enter the name of the organization's submitter to receive error notification if this file cannot be processed. Left Justify and fill with blanks. Derived from the ‘SUB-SUBM-NAME’ IDFDV Field Identifier (seq 1150). |
274-295 | Submitter Location Address | Enter the submitter's location address (Attention, Suite, Room Number, etc.) Left justify and fill with blanks. Derived from the ‘SUB-SUBM-LOCN’ IDFDV Field Identifier (seq 1160). |
296-317 | Submitter Delivery Address | Required. Enter the submitter's delivery address (Street or Post Office Box). Left justify and fill with blanks. Derived from the ‘SUB-SUBM-DELIV’ IDFDV Field Identifier (seq 1170). |
318-339 | Submitter City | Required. Enter the submitter's city. Left justify and fill with blanks. Derived from the ‘SUB-SUBM-CITY’ IDFDV Field Identifier (seq 1180). |
340-341 | Submitter State Abbreviation | Required. Enter the submitter's State or commonwealth/territory. Use a postal abbreviation. For a foreign address, fill with blanks. Derived from the ‘SUB-SUBM-STATE’ IDFDV Field Identifier (seq 1190). |
342-346 | Submitter ZIP Code | Required. Enter the submitter's ZIP Code. For a foreign address, fill with blanks. Derived from the ‘SUB-SUBM-ZIP’ IDFDV Field Identifier (seq 1200). |
347-350 | Submitter ZIP Code extension | Enter the submitter's four-digit extension of the ZIP code. If not applicable, fill with blanks. Derived from the ‘SUB-SUBM-ZIP-EXT’ IDFDV Field Identifier (seq 1210). |
351-355 | Blank | Fill with blanks. Reserved for SSA use |
356-378 | Foreign State/Province | If applicable, enter the submitter's foreign State/Province. Left justify and fill with blanks. Otherwise, fill with blanks. |
379-393 | Foreign Postal Code | If applicable, enter the submitter's foreign Postal Code. Left justify and fill with blanks. Otherwise, fill with blanks. |
394-395 | Country Code | If one of the following applies, fill with blanks * One of the 50 States of the U.S.A. * District of Columbia * Military Post Office (MPO) * American Samoa * Guam * Northern Mariana Islands * Puerto Rico * Virgin Islands Otherwise, enter the applicable Country Code. |
396-422 | Contact Name | Required. Enter the name of the person to be contacted by SSA concerning processing problems. Left justify and fill with blanks. Derived from the ‘SUB-CONT-NAME’ IDFDV Field Identifier (seq 1250). |
423-437 | Contact Phone Number | Required. Enter the contact's phone number with numeric valies only (including area code). Do not use any special characters. Left justify and fill with blanks. NOTE: It is imperative that the contact's telephone number be entered in the appropriate positions. Failure to include correct and complete submitter contact information may, in some cases, delay the timely processing of your file. Derived from the ‘SUB-CONT-TEL’ IDFDV Field Identifier (seq 1260). |
438-442 | Contact Phone Extension | Enter the contact's telephone extension. Left justify and fill with blanks. Derived from the ‘SUB-CONT-TEL-EXT’ IDFDV Field Identifier (seq 1270). |
443-445 | Blank | Fill with blanks. Reserved for SSA use. |
446-485 | Contact E-mail/Internet | Enter the contact's e-mail/internet address. Derived from the ‘SUB-CONT-EMAIL’ IDFDV Field Identifier (seq 1280). |
486-488 | Blank | Fill with blanks. Reserved for SSA use. |
489-498 | Contact Fax | If applicable, enter the contact's fax number (including area code). Otherwise, fill with blanks. Derived from the ‘SUB-CONT-FAX’ IDFDV Field Identifier (seq 1290). |
499 | Blank | Fill with blanks. Reserved for SSA use. |
500 | Preparer Code | Enter one of the following codes to indicate who prepared this file: * A = Accounting Firm * L = Self Prepared * S = Service Bureau * P = Parent Company * O = Other If more than one code applies, use the code that best describes who prepared this file. |
501-512 | Blank | Fill with blanks. Reserved for SSA use. |
Column | Description | Source |
---|---|---|
1-2 | Record Identifier | Constant "RE" |
3-6 | Tax year | Required. Enter the tax year for this report (YYYY). Derived from the user defined FROM-TO period, converted to YYYY. |
7 | Agent Indicator Code | If applicable, enter one of the following codes: * 1 = 2678 Agent * 2 = Common Paymaster * 3 = 3504 Agent If more than one code applies, use the one that best describes your status as an agent. Otherwise, fill with a blank. |
8-16 | Employer/Agent EIN | Required. Derived from the applicable Federal reporting EIN, from IDGV or IDGR. |
17-25 | Agent for EIN | If "1" was entered in the Agent Indicator Code field (position 7), enter the client-employer's EIN for which you are an Agent. Otherwise, fill with blanks. |
26 | Terminating Business Indicator | If this is the last tax year that W-2s will be filed under this EIN, enter "1". Otherwise, enter 0 (zero). |
27-30 | Establishment Number | For multiple RE (Employer) Records with the same EIN, you can use this field to assign a unique identifier for each RE (Employer) Record. Otherwise, fill with blanks. |
31-39 | Other EIN | For this tax year, if you submitted tax payments to the IRS under Form 941, 943, 944, CT-1 or Schedule H or W2 data to SSA, and a different EIN was used from the EIN in positions 8-16, enter the other EIN. Otherwise, fill with blanks. |
40-96 | Employer Name | Required. Enter the name associated with the EIN entered in positions 8 - 16. Left justify and fill with blanks. Derived from the 'W2-ER-NAME' IDFDV Field Identifier (seq 2010). |
97-118 | Employer Location Address | Enter the employer's location address (Attention, Suite, Room Number, etc.) Left justify and fill with blanks. Derived from the 'W2-ER-LOCN-ADDR' IDFDV Field Identifier (seq 2020). |
119-140 | Employer Delivery Address | Enter the employer's delivery address (Street or Post Office Box). Left justify and fill with blanks. Derived from the 'W2-ER-DELIV-ADDR' IDFDV Field Identifier (seq 2030). |
141-162 | Employer City | Enter the employer's city. Left justify and fill with blanks. Derived from the 'W2-ER-CITY' IDFDV Field Identifier (seq 2040). |
163-164 | Employer State Abbreviation | Enter the employer's State or commonwealth/territory. Use a postal abbreviation. For a foreign address, fill with blanks. Derived from the 'W2-ER-STATE' IDFDV Field Identifier (seq 2050). |
165-169 | Employer ZIP Code | Enter the employer's ZIP Code. For a foreign address, fill with blanks. Derived from the 'W2-ER-ZIP' IDFDV Field Identifier (seq 2060). |
170-173 | Employer ZIP Code Extension | Enter the employer's four-digit extension of the ZIP code. If not applicable, fill with blanks. Derived from the 'W2-ER-ZIP-EXT' IDFDV Field Identifier (seq 2070). |
174 | Kind of Employer | Required. Enter the appropriate kind of employer: * F = Federal Government * State/local non-501c * T = 501c non-government * Y = State/local 501c * N = None apply NOTE: Leave blank if the tax jurisdiction Code in position 220 of the RE (Employer) Records is "P" (Puerto Rico). |
175-178 | Blank | Fill with blanks. Reserved for SSA use. |
179-201 | Foreign State/Province | If applicable, enter the employer's foreign State/Province. Left justify and fill with blanks. Otherwise, fill with blanks. |
202-216 | Foreign Postal Code | If applicable, enter the company's foreign postal code. Left justify and fill with blanks. Otherwise, fill with blanks. |
217-218 | Country Code | If one of the following applies, fill with blanks: * One of the 50 States of the U.S.A. * District of Columbia * Military Post Office (MPO) * American Samoa * Guam * Northern Mariana Islands * Puerto Rico * Virgin Islands Otherwise, enter the applicable Country Code. |
219 | Employment Code | Required. Enter the appropriate employment code: * A = Agriculture (Form 943) * H = Household (Schedule H) * M = Military (Form 941) * Q = Medicare Qualified Government Employment (Form 941) * X = Railroad (CT-1) * F = Regular (Form 944) * R = Regular (all others) (Form 941). NOTE: Railroad reporting is not applicable for Puerto Rico and territorial employers. |
220 | Tax Jurisdiction Code | Required. Enter the code that identifies the type of income tax withheld from the employee's earnings: * Blank (W-2) * V = Virgin Islands (W-2VI) * G = Guam (W-2GU) * S = American Samoa (W-2AS) * N = Northern Mariana Islands (W-2CM) * P = Puerto Rico (W-2PR/499R-2) |
221 | Third Party Sick Pay Indicator | Enter "1" for a sick pay indicator. Otherwise, enter "0" (zero). |
222-248 | Employer Contact Name | Enter the name of the employer's contact. Left justify and fill with blanks. |
249-263 | Employer Contact Phone Number | Enter the employer's contact telephone number with numeric values only (including area code). Do not use any special characters. Left justify and fill with blanks. |
264-268 | Employer Contact Phone Extension | Enter the employer's contact telephone extension with numeric values only. Do not use any special characters. Left justify and fill with blanks. |
269-278 | Employer Contact Fax Number | If applicable, enter the employer's contact fax number with numeric values only (including area code). Do not use any special characters. Otherwise, fill with blanks. For US and US Territories only |
279-318 | Employer Contact E-Mail/Internet | Enter the employer's contact e-mail/internet address. |
319-512 | Blank | Fill with blanks. Reserved for SSA use. |
Column | Description | Source |
---|---|---|
1-2 | Record Identifier | Constant "RS" |
3-4 | State code, appropriate FIPS postal numeric code | Derived from the State being reported, from IDFDV sequence 7000 Numeric code for Rhode Island is ‘44’ |
5-9 | Taxing Entity Code | If County, City or School district tax is reported, this field is derived from the IDGV 'W2 TAXING ENTITY' field for the County, City or School district tax being reported |
10-18 | Social Security Number | Derived from IDFDV Field Identifier: ‘W2-EE-SSN’ (seq 2500) If an invalid SSN is encountered, this field is entered with zeroes. |
19-33 | Employee First Name | Derived from IDFDV Field Identifier: ‘W2-EE-FIRST-NAME’ (seq 2510) |
34-48 | Employee Middle Name or Initial | Derived from IDFDV Field Identifier: ‘W2-EE-MIDDLE’ (seq 2520) |
49-68 | Employee Last Name | Derived from IDFDV Field Identifier: ‘W2-EE-LAST-NAME’ (seq 2530) |
69-72 | Employee Suffix | Derived from IDFDV Field Identifier: ‘W2-EE-SUFFIX’ (seq 2540) |
73-94 | Employee Location Address | Derived from IDFDV Field Identifier: ‘W2-EE-LOCN-ADDR’ (seq 2600) |
95-116 | Employee Delivery Address | Derived from IDFDV Field Identifier: ‘W2-EE-DELIV-ADDR’ (seq 2610) |
117-138 | Employee City | Derived from IDFDV Field Identifier: ‘W2-EE-CITY’ (seq 2620) |
139-140 | Employee State Abbreviation | Derived from IDFDV Field Identifier: ‘W2-EE-STATE’ (seq 2630) |
141-145 | Employee ZIP Code | Derived from IDFDV Field Identifier: ‘W2-EE-ZIP’ (seq 2640) |
146-149 | Employee ZIP Code Extension | Derived from IDFDV Field Identifier: ‘W2-EE-ZIP-EXT’ (seq 2650) |
150-154 | Blank | |
155-177 | Employee Foreign State/Province | Derived from IDFDV Field Identifier: ‘W2-EE-F-STATE’ (seq 2660) |
178-192 | Employee Foreign Postal Code | Derived from IDFDV Field Identifier: ‘W2-EE-F-POSTAL’ (seq 2670) |
193-194 | Employee Country Code | Derived from IDFDV Field Identifier: ‘W2-EE-COUNTRY’ (seq 2680) |
Column | Description | Source |
---|---|---|
195-196 | Optional Code State Specific Data If not used, enter blanks | |
197-202 | Reporting Period MMCCYY | From user specified Period End Date converted to MMCCYY for the quarter e.g. Period End Date = ‘31-Dec-2003’, then reporting period is ‘122003’ |
203-213 | State Quarterly Unemployment Insurance Total Wages | Derived from IDFDV Field Identifier: ‘W2-ST-WAGE-HOME’ and ‘W2-ST-WAGE-WORK’ Note that the IDFDV Identifier ‘W2-SUI-WAGE-ER’ is not used to report this field because the value of Identifier ‘W2-SUI-WAGE-ER’ may already been capped by Vertex during the US Tax calculation in UPCALC and therefore for employees who exceed the maximum wage base, this identifier will contain no SUI Insurance wages. RPYEU would then be using the State Taxable wages from Identifier ‘W2-ST-WAGE-HOME’ and ‘W2-ST-WAGE-WORK’ that are related to the employee Home GEO and Work GEO code to report SUI Total Wages. |
214-224 | State Quarterly Unemployment Insurance Taxable Wages | This amount is derived from State Quarterly Unemployment Insurance Total Wages and the SUI Maximum wage base as defined by the state government Please read document Tax Reporting - US General for detail for quarterly reporting |
225-226 | Number of Weeks Worked | From system derived number of Weeks Worked for the Reporting State The system reads all pay headers with pay category = ‘Regular Pay’, that are not reversed, and the Pay Issue Date that falls within the user specified Quarter begin and end date If the Pay Header’s Work State or Home State is the same as the reporting State, then the Pay Header Tax Weeks is accumulated |
227-234 | Date First Employed MMDDCCYY | From system derived latest Employment Hired Date |
235-242 | Date of Separation MMDDCCYY | From system derived latest Employment Termination Date that is greater than the Employment Hired Date |
243-247 | Blank | |
248-267 | State Employer Account Number | Derived from IDFDV Field Identifier: ‘W2-STATE-REGIST’ for the reporting State When RPYEU is run, if the Media Format = ‘State SUI File Format’, then this field contains the SUI Registration Number from IDGV for the SUI Registration of the state |
268-273 | Blank |
Column | Description | Source | |
---|---|---|---|
274-275 | State code, appropriate FIPS postal numeric code | Derived from the State being reported e.g. Rhode Island numeric code is "44" | |
276-286 | State Taxable Wages | Derived from IDFDV Field Identifier: ‘W2-ST-WAGE-HOME’(7020) and ‘W2-ST-WAGE-WORK’ (7030) | |
287-297 | State Income Tax Withheld | Derived from IDFDV Field Identifier: ‘W2-ST-TAX-HOME’ (7040) and ‘W2-ST-TAX-WORK’ (7050) | |
298-307 | Other State Data, to be defined by each state | ||
308 | Tax Type Code | This field is used to report County, City or School district tax If the County, City or School district requires to report taxes along with the State Tax information, then the following values are used for this field: C – City Income Tax D – County Income Tax E – School District Income Tax F – Other Income Tax IDGV must be set up for the Local or School Registration by County/City or School district for the following fields on the Variables Tab: 'W2 STATE MEDIA FILING' 'W2 TAX TYPE CODE' 'W2 TAXING ENTITY' 'W2 STATE MEDIA FILING' indicates whether the County/City or School should report taxes with the State or not 'W2 TAX TYPE CODE' must contain the valid Tax Type Code as defined above 'W2 TAXING ENTITY' contains the Taxing Entity code supplied by the County/City or School government booklet If County, City or School district tax is reported, this field is derived from IDGV 'W2 TAX TYPE CODE' field | |
309-319 | Local Taxable Wages | If School Tax is reported, this field is derived from Identifier ‘W2-SCHL-WAGE’ (seq 6500) | If County Tax is reported, this field is derived from Identifier: ‘W2-CN-WAGE-HOME’ and ‘W2-CN-WAGE-WORK’ If City Tax is reported, this field is derived from: ‘W2-CI-WAGE-HOME’ and ‘W2-CI-WAGE-WORK’ |
320-330 | Local Income Tax Withheld | If School Tax is reported, this field is derived from Identifier ‘W2-SCHL-TAX’ (seq 6510) | If County Tax is reported, this field is derived from Identifier: ‘W2-CN-TAX-HOME’ and ‘W2-CN-TAX-WORK’ If City Tax is reported, this field is derived from: ‘W2-CI-TAX-HOME’ and ‘W2-CI-TAX-WORK’ |
331-337 | State Control Number (Optional) | Blank | |
338-412 | Supplemental Data 1 | State Specific Data If not used, enter blanks | |
413-487 | Supplemental Data 2 | State Specific Data If not used, enter blanks | |
488-512 | Blank |
Column | Description | Source |
---|---|---|
1-2 | Record Identifier | Constant "RT" |
3-9 | Number of RW Records | Total number of code "RW" records reported since last code "RE" record |
10-24 | Wages, Tips and Other Compensation | Derived from IDFDV Field Identifier: ‘W2-FIT-WAGE’, total of all code "RW" records since last "RE" record |
25-39 | Federal Income Tax Withheld | Derived from IDFDV Field Identifier: ‘W2-FIT-TAX’, total of all code "RW" records since last "RE" record |
40-54 | Social Security Wages | Derived from IDFDV Field Identifier: ‘W2-SSN-WAGE’, total of all code "RW" records since last "RE" record |
55-69 | Social Security Tax Withheld | Derived from IDFDV Field Identifier: ‘W2-SSN-TAX’, total of all code "RW" records since last "RE" record |
70-84 | Medicare Wages and Tips | Derived from IDFDV Field Identifier: ‘W2-MEDI-WAGE’, total of all code "RW" records since last "RE" record |
85-99 | Medicare Tax Withheld | Derived from IDFDV Field Identifier: ‘W2-MEDI-TAX’, total of all code "RW" records since last "RE" record |
100-114 | Social Security Tips | Derived from IDFDV Field Identifier: ‘W2-SSN-TIP’, total of all code "RW" records since last "RE" record |
115-129 | Advanced Earned Income Credit | Derived from IDFDV Field Identifier: ‘W2-EIC’, total of all code "RW" records since last "RE" record |
130-144 | Dependent Care Benefits | Derived from IDFDV Field Identifier: ‘W2-DEP-CARE’, total of all code "RW" records since last "RE" record |
145-159 | Deferred Compensation Contributions to Section 401(k) | Derived from IDFDV Field Identifier: ‘W2-CODE-D’, total of all code "RW" records since last "RE" record |
160-174 | Deferred Compensation Contributions to Section 403(b) | Derived from IDFDV Field Identifier: ‘W2-CODE-E’, total of all code "RW" records since last "RE" record |
175-189 | Deferred Compensation Contributions to Section 408(k)(6) | Derived from IDFDV Field Identifier: ‘W2-CODE-F’, total of all code "RW" records since last "RE" record |
190-204 | Deferred Compensation Contributions to Section 457(b) | Derived from IDFDV Field Identifier: ‘W2-CODE-G’, total of all code "RW" records since last "RE" record |
205-219 | Deferred Compensation Contributions to Section 501(c)(18)(D) | Derived from IDFDV Field Identifier: ‘W2-CODE-H’, total of all code "RW" records since last "RE" record |
220-234 | Filler | |
235-249 | Non-Qualified Plan Section 457 | Derived from IDFDV Field Identifier: ‘W2-NQUAL-457’, total of all code "RW" records since last "RE" record |
250-264 | Employer Contribution to a Health Savings Account | Derived from IDFDV Field Identifier: ‘W2-CODE-W’, total of all code ‘RW’ records since last ‘RE’ record |
265-279 | Non-Qualified Plan Not Section 457 | Derived from IDFDV Field Identifier: ‘W2-NQUAL-N457’, total of all code "RW" records since last "RE" record |
280-309 | Blank | |
310-324 | Employer Cost of Premiums for Group Term Life Insurance over $50000 | Derived from IDFDV Field Identifier: ‘W2-CODE-C’, total of all code "RW" records since last "RE" record |
325-339 | Income Tax Withheld by Third-Party Payer | Derived from IDFDV Field Identifier: ‘SUB-3RD-PARTY-TAX’, total of all code "RW" records since last "RE" record |
340-354 | Income from Non-statutory Stock Options | Derived from IDFDV Field Identifier: ‘W2-CODE-V’, total of all code "RW" records since last "RE" record |
355-512 | Blank |
Column | Description | Source |
---|---|---|
1-2 | Record Identifier | Constant "RF" |
3-7 | Blank | |
8-16 | Number of RW Records | Total number of code "RW" records on file |
17-512 | Blank |
Period Type | Quarter |
Period End Date | Enter the quarter end date, i.e. 30-Jun-2012 |
Media File Type | State SUI File Format |
Column | Description | Source |
---|---|---|
1-1 | Record Identifier | Constant "T" |
2-13 | Quarterly Wages | Total Wages paid during quarter |
14-25 | Wage Record total | Sum of all wages on ‘W’ records |
26-34 | Magnetic Tape Reporter Code | Only the CD option is supported (for other options, please contact our support department) Constant ‘CDFILEWGR’ for CD filer’s use. |
35-43 | Blank | |
44-53 | Rhode Island Employer Number | Derived from IDFDV Field Identifier: ‘W2-STATE-REGIST’ for the reporting State |
54-75 | Blank | |
76-77 | Year being reported | Last two digits of year only |
78-78 | Quarter Being Reported | Either 1, 2, 3, or 4 (i.e January-March = ‘1’) |
79-89 | Employer Name | Legal Business Name |
90-276 | Blank |
Column | Description | Source |
---|---|---|
1-1 | Record Identifier | Constant "W" |
2-25 | Blank | |
26-34 | Microfilm Index number | Only the CD option is supported (for other options, please contact our support department) Constant ‘CDFILEWGR’ for CD filer’s use |
35-43 | Employee Social Security Number | Use zeros if not available |
44-53 | Rhode Island Employer Number | Derived from IDFDV Field Identifier: ‘W2-STATE-REGIST’ for the reporting State |
54-62 | Employee Last Name | |
63-63 | Employee First Initial | |
64-75 | Wages Reported for the Quarter | |
76-77 | Year Being Reported | Last two digits of year only |
78-78 | Quarter Being Reported | Either 1, 2, 3, or 4 (i.e January-March = ‘1’) |
79-89 | Employer Name | Legal Business Name |
90-91 | Number of Weeks Paid | Number of Weeks paid during the reporting period No decimal allowed |
92-95 | Number of Hours Paid | Hours worked during the reporting period No decimal allowed |
96-276 | Blank |
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