Form RT-7A Fillable Application for Annual Filing for Employers of Domestic Employees R.01/13
(all forms fillable on Windows, Mac, Android tablets, and iPad using Adobe Reader XI)

Although I will be reporting on an annual basis the wages for each employee must be itemized by quarter on the annual Failure to timely provide wage information requested by the Department of Economic Opportunity Reemployment I am eligible for an earned tax rate (to be eligible for an earned tax rate means the employer has reported for the required I only employ employee(s) who perform domestic services as defined in section 443 1216(6) Florida Statutes (F S ) I will remain in annual reporting status until I request a change to quarterly filing or I no longer qualify for annual reporting If I am assigned a penalty rate due to indebtedness billed for more than one year my filing period will revert to quarterly filing If I cease employment and my account is inactivated I will immediately revert to quarterly filling for the completed quarters If I do not have an annual payroll as defined in s 443 131(3)(b)1 F S and become ineligible for an earned rate my filing If I employ individuals who perform services other than domestic services I no longer qualify for annual reporting and M M / D D / Y Y Y Y Signature Date This application must be postmarked no later than December 1 to be eligible for annual filing for the next calendar year Title Area Code Telephone number (Example: A sole proprietor has a business employee and an employee in the owner s home who performs domestic (Note: for the transition year an Employer s Quarterly Report (RT 6 formerly UCT 6) will be due on January 1 for the fourth * Formerly Unemployment Tax 800 352 3671 Account Management agree to immediately notify the Department of Revenue and understand my filing period will revert to quarterly filing Application for Annual Filing for Assistance Program or its designee shall result in the loss of privilege to file annually effective the calendar quarter City State ZIP Effective Date 11/14 Employers of Domestic Employees employment must be reported quarterly) Florida Administrative Code Florida Department of Revenue For assistance call: has a Power of Attorney (DR 835) on file with the Department of Revenue I am an employer liable for reemployment tax* reporting and certify to the following: I hereby make application to change from quarterly reporting to annual reporting effective January 1 I understand that: immediately following the calendar quarter in which such failure occurred Internet address: Mailing address Name or legal entity name number of calendar quarters and has been assigned a tax rate other than the initial rate) of the current calendar year period will revert to quarterly filing PO Box 6510 quarter of the preceding calendar year The first annual report will then be due the following year on January 1 R 01/13 Reemployment Tax Account Number reporting form The annual report is due January 1 and is delinquent if not postmarked by January 31 RT 7A Rule 73B 10 037 services Since the sole proprietor employs individuals who perform services other than domestic services all Submit the completed application to: Tallahassee FL 32314 6510 Telephone number (include area code) This form must be signed by the sole proprietor or owner if a sole proprietorship; by a partner if a partnership; or by an authorized agent who www myflorida com/dor