Form Uc-2x - Pennsylvania Unemployment Compensation Correction Report - 2016
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1TRANSMITTAL #
of
PENNSYLVANIA UNEMPLOYMENT COMPENSATION CORRECTION REPORT
(To Amend Quarterly UC-2/2A Tax Reports)
(A separate form must be submitted for each quarter)
1.
ITJ-1 I I I I I I
EMPLOYER ACCOUNT NUMBER
D
3.
D
QUARTER/YEAR
I I I I I
R or M
CHECK DIGIT
1, 2,
3 or 4
4.
Reason For Adjustment
(Check all that apply):
D
D
Incorrect Gross Wages. *Please explain:
Exempt Wages Reported in Error.* Please explain:
2.
Employer Name and Address:
D
D
Incorrect Employee Withholding Rate Used
Calculation Error. Please explain: _____ _
List Rate Used ______ _
D
D
Incorrect Taxable Wages. Please explain:
Other Error. Please explain:
--------
D
*PROVIDE INDIVIDUAL EMPLOYEE CORRECTION
Incorrect Employer Contribution Rate Used
FORM (UC-2AX). IF NECESSARY.
List Rate Used
D
D
-------
PLEASE CHECK IF EMPLOYEE WAGE DETAIL WAS
Wages Reported to Wrong State *
CORRECTED ON ELECTRONIC MEDIA.
D
D
D
5.
Was the employee withholding correctly withheld?
Yes
No
Not applicable
(Please see instructions on reverse side.)
AMOUNT PREVIOUSLY
TAX RATE
CORRECT AMOUNT
DIFFERENCE (OVER) UNDER
REPORTED
6.
GROSS WAGES
7.
EMPLOYEE WITHHOLDING
8.
TAXABLE WAGES
9 .
EMPLOYER CONTRIBUTION
REFUNDS/CREDITS SHOULD
1 O.TOTAL (REFUND/CREDIT) OR TAX DUE (ADD LINES 7 AND 9) IN THE DIFFERENCE COLUMN
BE IN PARENTHESES I I
D
D
D
11.
Please check one:
Refund
Credit
Not Applicable
(Please see instructions on reverse side.)
12.
Employer Certification: I certify that the information on this form is true and correct to the best of my knowledge and belief. No part of the
amount of employer contributions reported on taxable wages was deducted or is to be deducted from the employees' wages.
SIGNATURE OF OWNER, OFFICER, PARTNER, RESPONSIBLE OFFICER OR AUTHORIZED AGENT
TITLE
DATE
PHONE NUMBER
DEPARTMENT USE ONLY
(DO NOT WRITE BELOW THIS LINE)-------------------------------------------------------------
--------------------------------------------------------
0
O
CORRECTION REPORT
JOURNAL VOUCHER
CONTRIBUTION
INTEREST
PENAL TY
A
BASIC
SY
MO
YR
QTR
YR
WAGES
(X)
RATE
DEBIT
CREDIT
DEBIT
CREDIT
DEBIT
CREDIT
_J
_J
_J
_J
_J
Totals
TOTAL REMITTANCE
COMMENTS:
Rate Verification
Certification: Date Contribution Received
Date Report Received __________ _
---------�
---------�
D
D
D
D
D
D
8.1. Audit Needed
Yes
No
N/A
Benefit Charges
Yes
No
N/A
FSD CERTIFICATION/DA TE _________ _
TAX AGENT
DATE
TAX TECHNICIAN
DATE
OTHER REQUIRED SIGNATURE
DATE
D
D
Year
No Change
Rate Revised From
to
Year ___
No Change
Rate Revised From
to
----
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UC-2X REV 06-16 (Page 1)
COMMONWEAL TH OF PENNSYLVANIA
DEPARTMENT OF LABOR & INDUSTRY
OFFICE OF UC TAX SERVICES
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