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SOUTHERN UTE INDIAN TRIBE TERO Division, P.O. Box (SOUTHERN UTE INDIAN TRIBE)

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SOUTHERN UTE INDIAN TRIBE
TERO Division, P.O. Box 737, Ignacio, CO 81137
Fax: 970-563-4824 Phone: 970-563-0117
Company Name:_____________________________________________
1. Quarterly work performed for who: ___________________________
_________________________________________________________
_________________________________________________________
2. Quarterly gross amount for work performed $_____________________
.
3. Quarterly payroll for work performed $__________________________
.
4. Quarterly TERO fee due _$_______________________
The TERO fee is calculated by multiplying the amount listed in question
#3 by 4%. Example: The quarterly payroll for work performed is
$100.00. The $100.00 is multiplied by 4% which will equal $4.00
($100.00 X 4% = $4.00).
Representative _______________________ Date: _________________
Indicate below what quarter you are submitting this report for:
___________ quarter ___________year
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SOUTHERN UTE INDIAN TRIBE TERO Division, P.O. Box (SOUTHERN UTE INDIAN TRIBE)

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Completed 20 July 2020

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