STATE OF ALABAMA
DEPARTMENT OF INDUSTRIAL RELATIONS
UNEMPLOYMENT COMPENSATION AGENCY
MONTGOMERY, ALABAMA 36131
Quarterly Contribution Report UC-CR4
1 Total Wages Paid This Quarter Must Agree Quarter Date Due
to Item 17 on Page 2 . . . . . . . . . . . . . . . .
2 Wages in Excess of $ for
Calendar Year Paid to Individual Workers
THIS QUARTER . . . . . . . . . . . . . . . . . . . .
Employer Account Number FOR STATE USE ONLY
3 Net Taxable Wages (Must be 1st 10 Digits)
(Line 1 Minus Line 2) . . . . . . . . . . . .
4 Employer Tax @ .. %
Liability Dates
EMPLOYER EMPLOYEE
5 Employee Tax @ .. %
6 Employment
Security
Assessment @ .... % 12
Number of covered workers earning wages during the pay
period which includes the 12th of each month. (See Instructions)
7 Credit Amount ..................
1ST
MO. THIS REPORT MUST BE
8 Net Tax Due .................... COMPLETED AND
2ND RETURNED BY THE
MO. ABOVE DATE DUE TO
9 Interest @ 1% per Month AVOID LATE FILING
(Add Interest if Report is Late) ......... PENALTY EVEN IF NO
3RD WAGES WERE PAID
10 Penalty Due ' The greater of MO.
$25.00 or 10% of Net Tax Due .
11 Total Amount Paid ..... $