Form Uc-10-C - Statement To Correct Information Previously Reported Under The Alabama Unemployment Compensation Law

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Form UC-10-C
Account ______________________
(REV. 12-00)
STATEMENT TO CORRECT INFORMATION
PREVIOUSLY REPORTED UNDER THE ALABAMA UNEMPLOYMENT COMPENSATION LAW
Type or print the name, address and account number in this
STATE OF ALABAMA
DEPARTMENT OF INDUSTRIAL RELATIONS
space as it appears on your wage report
.
UNEMPLOYMENT COMPENSATION AGENCY
MONTGOMERY, ALABAMA 36131
Indicate the type wage report being corrected.
9
9
UC CR-4
UC-10-R
If the social security number, name or wage of one or more workers was
omitted from or erroneously reported on one or more returns, each such error
should be corrected on this form.
WORKERS SOCIAL
QTR 1,2,3 OR 4
NAME OF WORKER
Correct Total Wages
Total wages as
Correct Taxable
Taxable wages as
SECURITY NUMBER
(TYPE OR PRINT)
reported
Wages
reported
QTR
Yr.
Totals
0.00
0.00
0.00
0.00
Increase+/Decrease<>
0.00
0.00
REMARKS
Signature and Title
DATE
PLEASE DO NOT WRITE BELOW THIS LINE
AUDITOR
___________________________________________
DATE
______________________
KEYED BY
__________________________________
DATE
______________________
VERIFIED BY
__________________________________
DATE
______________________
TT
RCVD DATE
REMITTANCE
ACCOUNT NUMBER
WC
RATES
Q/YR
TOTAL WAGES
EXCESS WAGES
TAXABLE WAGES
PAYMENT
ER
ESA

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