Form C-7 - Texas Workforce Commission
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1
2TEXAS WORKFORCE COMMISSION
Austin, Texas 78778
Page No.
Of
Wages List Adjustment Schedule
(To Correct Total Wages Previously Filed on Form C-4)
Account Number:
Qtr./Yr.
Employer’s Name and Address:
See Reverse Side For Instructions
If the Social Security number, name or wages of one
or more employees were omitted from or erroneously
reported on a Wages List, each such error should be
corrected on this form. List only the data for which
corrections are required.
For TWC Use Only
Reason For Adjustment
Audited by
AE Number
Important (If this adjustment affects total or taxable wages reported on Form C-3, Employer’s Quarterly Report, you
must complete Form C-5, Adjustment Report.)
C-5 Attached
(2)
(3)
(4)
(1)
Employee’s Name
Total Wages
Employee’s
1st
2nd
Social Security
As Reported
Corrected
Init.
Init.
Last
Account Number
Totals
I certify all information contained in this adjustment is true and correct.
Signed
Title
Date
19
(Signature and Title-Owner, Partner, President, Etc.)
C-7 (0996) Inv. No. 518950
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