Form 68-0061 - Employer'S Wage Adjustment Report
ADVERTISEMENT
1
2Iowa Workforce Development
Reason Codes for Adjustments
UI Account # :
Reporting Unit :
Employer's Wage Adjustment Report
1: Correct Reported Wages
Legal Business Name :
68-0061 (05-10)
2: Add Employee
Unemployment Insurance Tax Bureau
DBA :
3: Correct Social Security Number
1000 E Grand Ave
4:
Des Moines IA 50319-0209
Quarter And Year (QYYYY) :
Phone: (515) 281-5339
5:
Taxable Wage Base :
For correcting quarterly Employer's Contribution & Payroll Report 65-5300.
6:
A separate report must be prepared for each quarter and Reporting Unit.
Section A: Payroll Listing Corrections -
List only those workers whose wages are to be corrected.
Reason
Employee Name
Total Wages
Taxable Wages
Social Security Number
As Reported (A)
Should Be (B)
As Reported (A)
Should Be (B)
Code
(Last, First, MI)
Page Totals:
As Reported (A)
Should Be (B)
Section B: Correction of Payment Computation
1. Total Wages:
2. Taxable Wages:
Check here if your account status is Reimbursable
Enter the totals from all pages into lines 1 and 2.
Q
3. State Experience Rate @
%:
Enter your assigned rates in lines 3 - 5 and then multiply each rate
Q
4. Reserve Fund Rate
@
by the Taxable Wages in Line 2.
%:
Calculate lines 6 - 12.
Q
5. Surcharge Rate
%:
@
If additional wage adjustments are needed, click the button to the
Q
left of Page Totals in Section A.
6. State Experience Underpaid/(Overpaid)
[Line 3, B - A]:
7. Reserve Fund Underpaid/(Overpaid)
[Line 4, B - A]:
Authorized Signature:
8. Surcharge Underpaid/(Overpaid)
[Line 5, B - A]:
Print Preparer's Name:
9. Subtotal Additional Due or Total Credit
[Line 6 + 7 + 8]:
Preparer's Title:
10. Interest Due [Line 9 x # Days Late:
x 0.0003333]:
Phone:
11. Additional Penalty Due
[Only if penalty on original filing]:
Date Submitted:
12. Total Additional Due
[Line 9 + 10 + 11]:
Equal Opportunity Employer/Program
Auxiliary aids and services are available upon request to individuals with disabilities.
Page __of __
For deaf and hard of hearing, use Relay 711.
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Legal