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Get OK WOES-3 2010

DO NOT STAPLE OR SUBMIT COPIES WOES - 3 REV 03-10 OKLAHOMA EMPLOYMENT SECURITY COMMISSION Cartridge / Diskette Submitted EMPLOYERS QUARTERLY CONTRIBUTION REPORT 2. Last Name 1. Employee Social Security Number First Name 13. Monthly count of all full and part-time workers who worked or received pay subject to unemployment insurance for the payroll period that includes the 12th of the month. Month 3 3. Total Wages Paid PAGE TOTAL To obtain scannable Continuation Sheets visit website. Cashier P O Box 52004 Oklahoma City OK 73152-2004 4. Taxable Wages Paid Item 3 All Pages. 6. TAXABLE WAGES PAID Item 4 All Pages. 5. TOTAL WAGES PAID 7. Contribution Rate for This Calendar Quarter. Enter rate as a decimal Ex. 03. 003 14. Oklahoma Account Number 16. Qtr / Yr 15. Federal I. D. No* 17. Due Date Interest Due 1 per month after due date. 10. 10 Penalty Due 100. 00 Penalty Due. 11. Debit or Credit. 18. Taxable Amount For W003 OFFICIAL USE ONLY 12. PAY THIS AMOUNT. 2010 is 14 900. 00 2008 is 13 600. 00 ENTER AMOUNT OF CHECK. 19. Name / Address MAKE CHECK PAYABLE TO Oklahoma Employment Security Commission I certify this report is correct and that no contribution is paid by any employee. Signature RESET FORM Date Contact Phone Contact Name Auxiliary aids and services are available upon request to individuals with disabilities. Last Name 1. Employee Social Security Number First Name 13. Monthly count of all full and part-time workers who worked or received pay subject to unemployment insurance for the payroll period that includes the 12th of the month. Month 3 3. Total Wages Paid PAGE TOTAL To obtain scannable Continuation Sheets visit website. Cashier P O Box 52004 Oklahoma City OK 73152-2004 4. Month 3 3. Total Wages Paid PAGE TOTAL To obtain scannable Continuation Sheets visit website. Cashier P O Box 52004 Oklahoma City OK 73152-2004 4. Taxable Wages Paid Item 3 All Pages. 6. TAXABLE WAGES PAID Item 4 All Pages. 5. TOTAL WAGES PAID 7. Taxable Wages Paid Item 3 All Pages. 6. TAXABLE WAGES PAID Item 4 All Pages. 5. TOTAL WAGES PAID 7. Contribution Rate for This Calendar Quarter. Enter rate as a decimal Ex. 03. 003 14. Oklahoma Account Number 16. Contribution Rate for This Calendar Quarter. Enter rate as a decimal Ex. 03. 003 14. Oklahoma Account Number 16. Qtr / Yr 15. Federal I. D. No* 17. Due Date Interest Due 1 per month after due date. 10. 10 Penalty Due 100. Qtr / Yr 15. Federal I. D. No* 17. Due Date Interest Due 1 per month after due date. 10. 10 Penalty Due 100. 00 Penalty Due. 11. Debit or Credit. 18. Taxable Amount For W003 OFFICIAL USE ONLY 12. PAY THIS AMOUNT. 00 Penalty Due. 11. Debit or Credit. 18. Taxable Amount For W003 OFFICIAL USE ONLY 12. PAY THIS AMOUNT. 2010 is 14 900. 00 2008 is 13 600. 00 ENTER AMOUNT OF CHECK. 19. Name / Address MAKE CHECK PAYABLE TO Oklahoma Employment Security Commission I certify this report is correct and that no contribution is paid by any employee. 2010 is 14 900. 00 2008 is 13 600. 00 ENTER AMOUNT OF CHECK. 19. Name / Address MAKE CHECK PAYABLE TO Oklahoma Employment Security Commission I certify this report is correct and that no contribution is paid by any employee. Signature RESET FORM Date Contact Phone Contact Name Auxiliary aids and services are available upon request to individuals with disabilities. .

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