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COMMONWEALTH of VIRGINIA Virginia Employment …

Employer s Quarterly Payroll Report (FC-21) COMMONWEALTH of VIRGINIA VIRGINIA Employment Commission T-FC-21 Web-07-05-2012 Tired of paperwork? We can help!File and pay your Unemployment Insurance tax online. It s fast, easy, accurate, and secure! Legibly Within The BoxesABC123 This Form Is Scanned. Do Not Attempt To Amend or Make Account Changes On This Form. Zip Code (Zip+4):Address 1: City:State:Address 2: EmployerName:_Account Number:Quarter Ending:Federal ID ,, ,, ,, ,, ,, ,,__FirstLastSocial Security NumberWages Paid in Quarter Employee s NamePayroll ContactPrint Preparer's Name and TitlePreparer s Phone Number / E-mail AddressTotal Wages Paid in Quarter (Add subtotal from all pages.)

COMMONWEALTH of VIRGINIA Virginia Employment Commission Web-07-05-2012 T-FC-21 Tired of paperwork? We can help! File and pay your Unemployment Insurance tax online. It’s fast, easy, accurate, and secure! www.vec.virginia.gov Write Legibly Within The Boxes A …

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