1st Quarter 2023- Quarterly Payroll Information
Please fill out the below information for your 1st Quarter Payroll
BUSINESS NAME
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
Email
example@example.com
1ST QUARTER PAYROLL INFORMATION
PAYROLL INFORMATION - SPECIFY PAYROLL PER EMPLOYEE / PER MONTH
*
GROSS REVENUE - PLEASE INCLUDE APPROX YTD GROSS REVENUE
*
HEALTH INSURANCE
TOTAL AMOUNT OF HEALTH INSURANCE PREMIUMS BY COMPANY OR SELF FOR 2022
ARE YOU CURRENTLY COVERED BY YOUR SPOUSE?
YES
NO
ARE YOU CURRENTLY COVERED BY A SEPARATE EMPLOYER?
YES
NO
FEDERAL EFTPS PAYMENTS
DO YOU MAKE MONTHLY EFTPS PAYMENTS
YES
NO
IF YES, LIST THE AMOUNTS YOU PAY EACH MONTH
STATE PAYMENTS
DO YOU MAKE MONTHLY STATE PAYMENTS
YES
NO
IF YES, LIST THE AMOUNTS YOU PAY EACH MONTH
UNEMPLOYMENT
HAVE YOU COLLECTED UNEMPLOYMENT IN THE MONTHS OF OCTOBER , NOVEMBER, DECEMBER 2022
YES
NO
HAVE YOU COLLECTED UNEMPLOYMENT?
YES
NO
IF YES, PLEASE SPECIFY THE DATES YOU COLLECTED
HAVE YOU COMPLETED ALL THE INFORMATION NEEDED?
*
YES
Submit
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