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T INSTRUCTIONS ON REVERSE SIDE 1. U.I. ACCOUNT NUMBER 2. QUARTER YEAR ITEM 8. Required - Monthly Employment Count 8. MONTHLY DATA SHOULD COUNT ALL FULL-TIME AND PART-TIME WORKERS IN COVERED EMPLOYMENT WHO WORKED DURING OR RECEIVED PAY FOR THE PAYROLL PERIOD WHICH INCLUDES THE 12TH OF THE MONTH. IF NONE, ENTER -0- 1st Month Number of Employees 2nd Month Number of Employees 3rd Month Number of Employees 1a. INTERNET ACCESS NUMBER http://dwd.wisconsin.gov/uitax DOLLARS 3. REPORT AND PAY.

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