Form 132 - Amended Report Form
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Form 132 - AMENDED Report
Business Name:
Business
QTR/YR
_______________________
Identification Number: _______________ Changed: ___/___
Original Whole
Net
Correct
Social Security
First
Employee
Hours as
Change in
Amount of
Original Wages
Net Change
Correct Amount
Number
Initial
Last Name
Reported
Whole Hours
Whole Hours
As Reported
in Wages
of Wages
1
0
0.00
2
0
0.00
3
0
0.00
4
0
0.00
5
0
0.00
6
0
0.00
7
0
0.00
8
0
0.00
9
0
0.00
10
0
0.00
11
0
0.00
12
0
0.00
13
0
0.00
14
0
0.00
15
0
0.00
16
0
0.00
17
0
0.00
18
0
0.00
Page Totals
0.00
0
0
0
0.00
0.00
Page No. _____ of _____
I certify this report is true and correct and is filed under penalty of false swearing.
Prepared By
Date
Preparer Telephone Number
Signature
Required X__________________________
______________________
____________
_(_____)_________________
FAX TO: (503)947-1700
OR
MAIL TO: OREGON DEPARTMENT OF REVENUE, PO BOX 14800, SALEM OR 97309-0920
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Parent category: Financial