Form DWS-ARK-209BS "Employer's Quarterly Contribution and Wage Report (Seasonal)" - Arkansas

What Is Form DWS-ARK-209BS?

This is a legal form that was released by the Arkansas Department of Workforce Services - a government authority operating within Arkansas. Check the official instructions before completing and submitting the form.

Form Details:

  • Released on January 1, 2009;
  • The latest edition provided by the Arkansas Department of Workforce Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form DWS-ARK-209BS by clicking the link below or browse more documents and templates provided by the Arkansas Department of Workforce Services.

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Download Form DWS-ARK-209BS "Employer's Quarterly Contribution and Wage Report (Seasonal)" - Arkansas

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NAICS
AUD
CO
EMPLOYER’S QUARTERLY CONTRIBUTION AND WAGE REPORT
ARKANSAS DEPARTMENT OF WORKFORCE SERVICES
P.O. BOX 8007 LITTLE ROCK, ARKANSAS 72203-8007 (501) 682-3798
SEASONAL
DWS ID NUMBER
DATE QUARTER ENDED
FEDERAL ID NUMBER
SEASONAL CODE
SEASONAL DATES
Check box and return if no wages paid c
PART A.
1st  mo 
2nd  mo 
3rd  mo
1. Number of employees in the pay period including the 12th of:
of qtr _________  of qtr _________  of qtr _______
2. Total of all wages paid for personal services, including bonuses/commissions ............... $ _ ______________.____
3. Wages in excess of (see instructions) . .............................................................. $<_______________.____
4. Out of state wages if employee(s) are paid in multiple states (see instructions) ........... $<_______________.____
5. Taxable wages (subtract item 3 and 4 from item 2, enter results here) ........................... $_______________.____
6. Contribution rate for this reporting period . ......................................................................... ____________________
7. Contribution due for this quarter (multiply item 5 by ) .......................................... $_______________.____
8. Amount of debit or credit from previous quarters ............................................................. $________________.____
9. Interest (accrued on all unpaid contributions at the rate of 1.5% per month) ................ $________________.____
1 0. Penalty (see instructions) ..................................................................................................... $________________.____
1 1. Total amount due . ................................................................................................................ $________________.____
12. Amount of remittance (make payable to Arkansas Department of Workforce Services) ........ $________________.____
CASHIER’S STAMP
DO NOT ALTER THIS FORM
Initial
PART B.
Enter the SSN, first name, middle initial, last name and
total wages paid to each employee during the calendar
quarter in the space provided below (continuation sheet
Amt received
provided).
WAGES PAID
WAGES PAID
IN SEASON
OUT OF SEASON
SOCIAL SECURITY NO.
FIRST NAME, INITIAL & LAST NAME OF EMPLOYEE
1 )
.
.
$
2 )
.
.
$
3 )
$
.
.
4 )
.
.
$
5 )
.
.
$
6 )
.
.
$
7 )
.
.
$
8 )
.
.
$
.
.
$
TOTAL WAGES FOR THIS PAGE
PAGE ONE OF _______ PAGE(S)
TOTAL NO. OF EMPLOYEES
ON THIS REPORT __________
I HEREBY CERTIFY THIS REPORT IS TRUE AND CORRECT AND NO PARTS OF THE CONTRIBUTION HAVE OR WILL BE BORNE BY
ANY EMPLOYEE.
SIGNATURE ______________________________TITLE __________________________ DATE _______________ TELEPHONE __________________
DWS-ARK-209BS
(REV. 01-09)
MAINTAIN COPY FOR YOUR RECORDS
NAICS
AUD
CO
EMPLOYER’S QUARTERLY CONTRIBUTION AND WAGE REPORT
ARKANSAS DEPARTMENT OF WORKFORCE SERVICES
P.O. BOX 8007 LITTLE ROCK, ARKANSAS 72203-8007 (501) 682-3798
SEASONAL
DWS ID NUMBER
DATE QUARTER ENDED
FEDERAL ID NUMBER
SEASONAL CODE
SEASONAL DATES
Check box and return if no wages paid c
PART A.
1st  mo 
2nd  mo 
3rd  mo
1. Number of employees in the pay period including the 12th of:
of qtr _________  of qtr _________  of qtr _______
2. Total of all wages paid for personal services, including bonuses/commissions ............... $ _ ______________.____
3. Wages in excess of (see instructions) . .............................................................. $<_______________.____
4. Out of state wages if employee(s) are paid in multiple states (see instructions) ........... $<_______________.____
5. Taxable wages (subtract item 3 and 4 from item 2, enter results here) ........................... $_______________.____
6. Contribution rate for this reporting period . ......................................................................... ____________________
7. Contribution due for this quarter (multiply item 5 by ) .......................................... $_______________.____
8. Amount of debit or credit from previous quarters ............................................................. $________________.____
9. Interest (accrued on all unpaid contributions at the rate of 1.5% per month) ................ $________________.____
1 0. Penalty (see instructions) ..................................................................................................... $________________.____
1 1. Total amount due . ................................................................................................................ $________________.____
12. Amount of remittance (make payable to Arkansas Department of Workforce Services) ........ $________________.____
CASHIER’S STAMP
DO NOT ALTER THIS FORM
Initial
PART B.
Enter the SSN, first name, middle initial, last name and
total wages paid to each employee during the calendar
quarter in the space provided below (continuation sheet
Amt received
provided).
WAGES PAID
WAGES PAID
IN SEASON
OUT OF SEASON
SOCIAL SECURITY NO.
FIRST NAME, INITIAL & LAST NAME OF EMPLOYEE
1 )
.
.
$
2 )
.
.
$
3 )
$
.
.
4 )
.
.
$
5 )
.
.
$
6 )
.
.
$
7 )
.
.
$
8 )
.
.
$
.
.
$
TOTAL WAGES FOR THIS PAGE
PAGE ONE OF _______ PAGE(S)
TOTAL NO. OF EMPLOYEES
ON THIS REPORT __________
I HEREBY CERTIFY THIS REPORT IS TRUE AND CORRECT AND NO PARTS OF THE CONTRIBUTION HAVE OR WILL BE BORNE BY
ANY EMPLOYEE.
SIGNATURE ______________________________TITLE __________________________ DATE _______________ TELEPHONE __________________
DWS-ARK-209BS
(REV. 01-09)
MAINTAIN COPY FOR YOUR RECORDS
CONTINUATION SHEET FOR FORM 209BS
DWS ID Number ___________________________________
Quarter End Date _____________________
Employer ____________________________________________________________
Town
_________________________________________
Page ________ of ________
WAGES PAID
WAGES PAID
IN SEASON
OUT OF SEASON
SOCIAL  SECURITY  NO.
FIRST  NAME,  INITIAL  &  LAST  NAME  OF  EMPLOYEE
1 )
.
.
$
2 )
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.
$
3 )
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$
4 )
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$
5 )
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$
6 )
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$
7 )
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$
8 )
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$
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$
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$
11 )
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$
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$
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$
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$
15 )
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$
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$
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$
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$
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$
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$
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$
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$
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$
24 )
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$
25 )
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$
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$
TOTAL  WAGES  FOR  THIS  PAGE
DWS-ARK-209CS
(REV. 01-09)
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