Florida Employer's Quarterly Report with Payment Coupon

Employer's Quarterly Report with Payment Coupon
Form RT-6
Florida Department of Revenue Employer’s Quarterly Report

QUARTER ENDING

/

DUE DATE

/

Employers are required to file quarterly tax/wage reports regardless
of employment activity or whether any taxes are due.
Use Black Ink to Complete This Form
PENALTY AFTER DATE

TAX RATE

0 1	 2	 3 4	 5 6 7 8 9

Rule 73B-10.037, F.A.C.
Effective XX/XX
Page 1 of 2

Provisional

RT ACCOUNT NUMBER

Do not make changes
If you do not have an account number, you
to the pre-printed
are required to register (see instructions).
information on this form. If F.E.I. NUMBER
changes are needed, visit
floridarevenue.com/taxes/
updateaccount to update
your information.
FOR OFFICIAL USE ONLY POSTMARK DATE

Use black ink. Example A - Handwritten Example B - Typed
Example A

RT-6
R. 07/23

Example B

0123456789

/	

Reverse Side Must be Completed

Name

/

2.	 Gross wages paid this quarter
(Must total all pages)

Mailing
Address

3.	 Excess wages paid this quarter
(See instructions)

City/St/ZIP

4.	 Taxable wages paid this quarter
(See instructions)

Location
Address

5.	 Tax due
(Multiply Line 4 by Tax Rate)

City/St/ZIP
1.	 Enter the total number
of full-time and part-time
1st Month
covered workers who
performed services during or
2nd Month
received pay for the payroll
period including the 12th of
the month.
3rd Month

6.	 Penalty due
(See instructions)

,
,
,

7.

Interest due
(See instructions)

8.

Installment fee
(See instructions)

9a.	 Total amount due
(See instructions)

Check if final return:
Date operations ceased.

9b.	 Amount Enclosed
(See instructions)

Check if you had out-of-state wages. Attach Employer’s
Quarterly Report for Out-of-State Taxable Wages (RT-6NF).

RT-6

If you are filing as a sole proprietor, is this for
domestic (household) employment only?

Yes

No

Under penalties of perjury, I declare that I have read this return and the facts stated in it are true (section 443.171(5), Florida Statutes).

Signature
Preparer’s
signature
Paid
preparers
only

Title

Date

Phone

Date

Firm’s name
(or yours if
self-employed)
Address

(

)

Preparer check
if self-employed

Name

Fax

RT ACCOUNT NO.
F.E.I. NUMBER

)

FEIN

Address

Preparer’s
phone number

City/St/ZIP

)
RT-6
R. 07/23

DOR USE ONLY

COMPLETE and MAIL with your REPORT/PAYMENT.
Please write your RT ACCOUNT NUMBER on check.
Make check payable to: Florida U.C. Fund

RT-6

(

DO NOT
DETACH

Employer’s Quarterly Report Payment Coupon
Florida Department of Revenue

(

Preparer’s
SSN or PTIN

POSTMARK OR HAND-DELIVERY DATE

U.S. Dollars

GROSS WAGES
(From Line 2 above.)

Cents

AMOUNT ENCLOSED
(From Line 9b above.)

Name
Mailing
Address
City/St/ZIP

PAYMENT FOR QUARTER
ENDING MM/YY
Check here if you are electing to
pay tax due in installments.

Check here if you transmitted
funds electronically.

9100 0 99999999 0068054031 7 5009999999 0000 4

Florida Department of Revenue Employer’s Quarterly Report

QUARTER ENDING

/

/

10.	 EMPLOYEE’S SOCIAL SECURITY NUMBER

EMPLOYER’S NAME

Employers are required to file quarterly tax/wage reports regardless
of employment activity or whether any taxes are due.
Use Black Ink to Complete This Form

RT ACCOUNT NUMBER

11.	 EMPLOYEE’S NAME (please print first twelve characters of last name and first

12a.	 EMPLOYEE’S GROSS WAGES PAID THIS QUARTER
12b.	EMPLOYEE’S TAXABLE WAGES PAID THIS QUARTER

eight characters of first name in boxes)

	

-

-

RT-6
R. 07/23
Page 2 of 2

Last
Name

Only the first $7,000 paid to each employee per calendar year is taxable.

12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

Last
Name

12b.
12a.

First
Name

Middle
Initial

12b.

13a.	 Total Gross Wages (add Lines 12a only). Total this page only.
Include this and totals from additional pages in Line 2 on page 1.
13b.	 Total Taxable Wages (add Lines 12b only). Total this page only.
Include this and totals from additional pages in Line 4 on page 1.

DO NOT DETACH

E-Verify Certification
I attest, under penalty of perjury, that this employer uses the E-Verify system defined in section 448.095(1)(c), Florida Statutes
or the Employment Eligibility Verification (Form USCIS I-9), if E-Verify is not available within three business days of a new hire,
to verify the employment eligibility of newly hired employees.
Signature
_________________________________________________
Title
_________________________________________________
Today’s Date _________________________________________________

Mail Reply To:
Reemployment Tax
Florida Department of Revenue
5050 W Tennessee St
Tallahassee FL 32399-0180

Social security numbers (SSNs) are used by the Florida Department of Revenue as unique
identifiers for the administration of Florida’s taxes. SSNs obtained for tax administration
purposes are confidential under sections 213.053 and 119.071, Florida Statutes, and not
subject to disclosure as public records. Collection of your SSN is authorized under state
and federal law. Visit floridarevenue.com/Privacy for more information regarding the state
and federal law governing the collection, use, or release of SSNs, including authorized
exceptions.