Enter the Social Security Number, last name, first name, and total covered wages paid in each quarter separately.
Part I: enter your DOL account number, the report year, employer name, mailing address, and email address.
New employer: if you are a new employer and have not yet been assigned a DOL account number, enter "Applied For" in the account number field.
Wages: all wages paid to an employee must be reported by the employer for the quarter in which payment was actually made.
Line 11: enter penalty if the report is filed after January 31.
Interest: interest is computed on the tax due (Line 9) from the due date (January 31) at the rate of 1.5% per month or fraction of a month.
| Question | Answer |
|---|---|
| Form Name | Form DOL-4A |
| Form Length | 3 pages |
| Fillable? | Yes |
| Fillable fields | 106 |
| Avg. time to fill out | 18 min |
| Edition | R-11/22 |
| Filing deadline | No later than January 31 |
| Matches the agency's file | Yes, checked October 4, 2026 |
| Other names | DOL-4A, DOL4A, Form 4A, DOL 4A, Annual Tax and Wage Report for Domestic Employment |
| Official source | Form DOL-4A (Rev 11/22), Georgia Department of Labor |
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