Skip to Content

Paper Reporting


  (615) 741-2486


A quarterly Premium (Form LB-0456) and Wage (Form LB-0851) Report is required from all employers covered under Tennessee’s Unemployment Insurance (UI) law. The Premium Report must be submitted with the appropriate payment by the date due, even if no wages were paid during the quarter.

It is important that an original agency-provided form is used (NO PHOTOCOPIES PLEASE) and that instructions are closely followed. The data you provide on the form will be imaged and read by scanning equipment, using Image and Intelligent Character Recognition (IICR) and Optical Character Recognition (OCR). Your data can be either hand-printed or machine-printed (using a typewriter or printer) in black ink only. Gray hand-print boxes and instructions indicate the items to be completed. If a typing error is made, use white-out or erase completely. Please Do Not Over-type. NOTE: Follow the instructions and examples shown above the areas on the report that you are completing. Use the example applicable to your use of hand-written or machine-printed.

If data is machine-printed, use one of the following 12-point fixed pitch fonts: OCR-A, OCR-B, COURIER NEW, LINE PRINTER or MS LINE DRAW.

If your federal employer identification number (FEIN) as printed on the report is incorrect, send a letter to correct the FEIN. Please Do Not Change FEIN on Form. Other business changes such as address, ownership, name, etc. should also be made by submitting a letter explaining the circumstances.


Note: The monthly employment data reported on the Premium Report should be a count of all full-time and part-time employees who worked during or received pay (subject to UI law) for the payroll period which included the 12th of the month. If none, enter zero.

Item 1: Enter gross wages paid to all employees, including part-time and temporary, in this calendar quarter. Wages should include employee contributions to 401K and cafeteria plans. Negative wage items cannot be included. See your Handbook for Employers or UI Law with Regulations for definitions of employment, wages and reportable workers.
Item 2: Enter the amount of wages paid during the quarter in excess of the taxable wage base. Effective January 1, 2009, the first $9,000 paid to each employee during the calendar year is subject to UI tax. For example, employee John Doe earns $4,000 per quarter. He is the only employee. His wages would be reported as shown below.


1st Qtr.
2nd Qtr.
3rd Qtr.
4th Qtr.
Item 1:
Item 2:
Item 3:


Item 3: Subtract Item 2 from Item 1. Enter the difference. This figure cannot be a negative amount.
Item 4: Multiply Item 3 by the combined premium rate shown. Enter the resulting figure.
Item 5: Enter the amount of interest due on any premium that is delinquent for this quarter. Compute interest at 1.5% per month times the amount of premium due this quarter for any portion of a month after the due date.
Item 6: No longer applicable.
Item 7: No longer applicable.
Item 8: Enter the amount of late filing penalty due for this quarter. Penalty is computed at $10.00 per month (minimum) for any portion of a month after the due date. The maximum late filing penalty is $50.00 per quarter. This penalty also applies to intentionally incomplete reports, i.e. missing Social Security numbers, names, etc.
Item 9: Enter any amount due or overpayment credit from a previous quarter and use in calculating the amount due on line 10.
Item 10: Enter the total of lines 4, 5, 8 and 9. Make check payable to Tennessee Department of Labor and Workforce Development.
Item 11: Sign, list your title, and date the premium report.  Please provide your phone and fax numbers.


  1. TOTAL WAGES: Enter the sum of individual wage items. (Figure should equal total wages in Item 1 on premium report.)
  2. Individual Wage Items:
    • Enter the social security number of every worker whose wages are included in total wages reported on the premium report.
    • Enter the first initial, middle initial and first six (6) letters of the last name of each worker.
    • TOTAL WAGES PAID THIS QTR: Enter the total gross wages and special payments made to each employee during the quarter. Enter the total paid each employee regardless of whether or not the employee exceeded the taxable wage base for the year. Do not reduce current quarter employee wages or report negative wages to adjust for over-reported employee wages in prior quarters. Please request adjustment forms for each quarter to be corrected. LB-0459 Claim for Adjustment or Refund.
  3. TOTAL WAGE ITEMS THIS REPORT: Enter the total number of wage items (individuals) included on this report.
  4. FILED ON CD/DISKETTE: Mark the box below this heading if wage items are filed on magnetic media.
  5. TOTAL WAGES THIS PAGE: Enter the sum of the wage item amounts shown on this page only. Each page must have a page total and the sum of the page totals must equal both TOTAL WAGES on the Wage Report and ITEM 1 on the Premium report.
  6. Sign, list your title and date the Wage Report in the space provided.
  7. The Wage Report (LB-0851) provides space to report 33 wage items. If you are reporting more than 33 employees, you can contact us at 615-741-3280 to request a supply of Form LB-0852 Wage Continuation Sheets or you can follow the instructions below for reporting wage information on plain paper attachments. In fact, these instructions can be used to report all your employees on a plain paper attachment, rather than attempting to list the individual employee wage information on the pre-printed wage report form itself.


Employee wage item information can be printed on plain paper and attached to the Wage Report. Please see the sample wage list on the agency website.

If you do not have Adobe Acrobat Reader, click here to get it.
Download Acrobat Reader

Please follow the instructions below and the sample wage list for printing lists of employee wages that can be read by this agency's scanning equipment.

  1. Employee information should be legibly printed on standard 8.5” X 11” white, 20-lb. (minimum), plain office paper.
  1. List information for each employee only once in five separate columns in the following order:  Social Security Number, First Name (left-justified), Middle Initial, Last Name (left-justified) and Total (Gross) Wages Paid this Quarter (right justified).
  2. Include the full First Name or First Initial and full Last Name or first six letters of Last Name. The Middle Initial is required.
  1. Omit titles such as Jr., Sr., M.D., R.N., etc.
  2. Employee information should be double-spaced, so a blank line is between each row.
  1. Each individual Employee’s data should be printed on only one line (row) across the page.
  2. Print on only one side of the paper.
  1. The data should be printed length-wise (portrait-style) on the page.
  2. Include no more than 24 employees per page.
  1. All information on the page needs to be printed from a laser printer, or its equivalent, in a 12-point, fixed-pitch font. Some Font recommendations, in order of preference, are OCR-A, OCR-B and Courier New. If using BOLD then all printed items need to be BOLD.
  2. Print all Letters in UPPER CASE.
  1. Do not use Impact or Dot-matrix Printers and/or Green Bar or Blue Bar Paper.
  2. Wage amounts need to be right justified and have a decimal (do not round off or omit cents).
  1. Do not include commas or dollar signs.
  2. Employees with zero or negative quarterly wage amounts are not to be listed on the report or included in the Total Wages of the Wage Report.
  1. The Employer Name (optional), Labor & Workforce Development Account Number and Quarter/Year need to be printed on the same row positioned ½” from the top of each page.
  2. A Page Total, in alignment with the Total (Gross) Wages column, needs to be printed ½” from the bottom of each page.
  1. Print the First Employee 1½” from the top of each page.  Print the Last Employee 1½” from the bottom of each page.  Print the Social Security Numbers at a Left 1" Margin.  Print the Wages at a Right 1" Margin.  Print all other columns a minimum of 1/4” apart.
  2. IMPORTANT:  The Wage Report Form (LB-0851) should be signed, dated and returned to us with the Total (Gross) Wages entered in the correct field with your wage list(s) attached.
  1. All documents need to be originals.  (NO PHOTOCOPIES or FAXES).
  2. Forms need to be Agency approved versions and printed accurately including, but not limited to: acceptable font, proper alignment, etc.  Note: Approved Substitute Forms need to have the Approval Code printed on each page.
  1. Omit items such as, but not limited to: Mailing Address, Federal Identification Number, Date Paid, Weekly Paycheck Amounts, Withholdings, Taxable Wages, Employee Identification Number, Hire or Termination Date, etc., from each page.

Please see the sample wage list on the agency website.

If you have any questions regarding wage reporting on paper, please call an agency representative at (615) 741-3280.

Completed Premium and Wage Reports and payments should be mailed to:

State of Tennessee
Department of Labor and Workforce Development
Employer Accounts Operations
P. O. Box 101
Nashville, Tennessee 37202-0101