NYS-45-X (12/13) (back)
Withholding identification number
UI Employer registration number
Part C - Amended employee wage and withholding information
Annual wage and withholding totals
Amended quarterly employee/payee wage reporting information
(Do not use negative
If this return is for the 4th quarter or the last return you will be filing
numbers. See instructions on filing amended wage and withholding information.)
for the calendar year, complete columns d and e.
Gross federal wages or
Total NYS, NYC, and
Social security number
Last name, first name, middle initial
Total UI remuneration
a
b
c
d
e
paid this quarter
Yonkers tax withheld
distribution
(see instructions)
Part D - Form NYS-1 corrections/additions
Use Part D only for corrections/additions to the quarter being reported in Part B of this return. All corrections to withholding information originally reported
on Web- or paper-filed Form(s) NYS-1 for the quarter must be reported here by completing columns a, b, c, and d. All additional withholding information not
previously reported on Form(s) NYS-1 must be reported here by completing only columns c and d. Lines 8 through 11, Correct amounts column, on the front
of this return, must reflect these corrections/additions. See Form NYS-45-X-I, Instructions for Form NYS‑45‑X.
a
b
c
d
Original
Original
Correct
Correct
total withheld
total withheld
last payroll date
last payroll date reported
(mmdd)
on Form NYS-1, line A (mmdd)
reported on Form NYS-1, line 4
Note: Complete Form DTF-95, Business Tax Account Update, to report changes in federal identification
number/withholding ID number, ownership, business name, business activity, telephone number,
owner/officer/partner/responsible person information, or changes that affect any other tax administered by
the Tax Department. For questions regarding additional changes to your unemployment insurance account,
51339425
call the Department of Labor at (518) 485-8589 or 1 888 899-8810.
If you are using a paid preparer or a payroll service, the section below must be completed:
Mark
Preparer’s signature
Date
Preparer’s NYTPRIN
Preparer’s SSN or PTIN
Paid
an X if
self-employed
preparer’s
use
Preparer’s firm name
Address
Firm’s EIN
Telephone number
(or yours, if self‑employed)
(
)
Payroll service’s name
Payroll
service’s
EIN
•
Checklist for mailing:
File original return and keep a copy for your records.
•
Complete lines 7 and 19 to ensure proper credit of
your payment.
Mail to:
•
Enter your Withholding ID number on your remittance.
•
Make remittance payable to NYS Employment Contributions and Taxes.
NYS EMPLOYMENT CONTRIBUTIONS AND TAXES
•
Enter your telephone number below your signature.
PO BOX 4119
Need help or forms? See the instructions.
BINGHAMTON NY 13902-4119