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Instructions For Completing Quarterly Report Of Wages - Paid-Ament Form (Ldol-Es51/web)

1. Enter the state unemployment insurance tax account number.

2. Enter the federal identification number.

3. Enter the calendar and year and quarter being corrected.

4. Enter the employer's experience rate for the year being corrected.

5. Enter the employer's name, business name, and mailing address.

NOTE: (You will need a copy of the originally filed report on hand to continue.)

6. Enter the total, excess and taxable wages reported on the original report. Enter the

contributions originally paid.

7. Enter the amended total, excess and taxable wages. Enter the correct amount of

contributions that were actually due.

8. Enter the amount overpaid (subtract the original contributions paid from the

amended contributions due).

9. If contributions were underpaid, enter the additional contributions due.

10. The remittance amount should include the appropriate interest and penalty. In the

case of tax underpayments, checks are to be made payable to the Office of

Regulatory Services.

Example of interest and penalty calculations:

Assume the underpayment is 15 days past the due date for the 1

quarter of 2000

(due 4/30/00).

The underpayment equals $352.50. Interest is calculated at 1% per month or

portion thereof. In this case, interest equals $1.74. Penalty accrues at 5% per

month (not to exceed 25% ) on the 1

day.

The penalty calculation is 5% of the underpayment plus the interest due. In this

case, penalty equals $17.71. The total amount of the remittance would equal

$371.95.

11. Note a brief explanation for this amendment. (Ex: “excess wage calculation

error,” etc.)

12. If an overpayment has occurred, you may choose to have a refund issued, or the

credit can be used toward future quarters.

NOTE: An increase in the total wages as amended requires a detail of the

employees’ original wage amount and the amended wage amount. You must

complete the bottom of this form.

13. Enter the employee's social security number.

14. Enter the employee's first initial and last name.

15. Enter the original wages reported for the employee.

Instructions For Completing Quarterly Report Of Wages - Paid-Ament Form (Ldol-Es51/web)