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Click ‘Get Form’ to open it in the editor.
Begin by entering the employer's name, address, and contact person's telephone number in the designated fields.
Input the employer account number assigned by the agency. If applicable, include both the consolidated and branch account numbers.
Specify the quarter and year for correction using the format Q-YYYY (e.g., 1-2001). Remember, a separate form is needed for each quarter.
Enter the applicable tax rate for the year being corrected.
(A) Fill in wages paid this quarter subject to law; (B) deduct any excess wages per worker; (C) calculate wages subject to tax in both 'as reported' and 'as corrected' columns.
Complete sections for tax due, additional tax due, interest due, and late payment penalties as necessary.
For individual employee corrections, enter their Social Security Number, name, previously reported wages, and correct amounts.
Provide a reason for adjustments and ensure you sign and date the form before submission.

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