Form C1a-Me - Employer'S Amendments To Unemployment Insurance Contributions And/or Wage Detail Report

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MAINE DEPARTMENT OF LABOR
BUREAU OF UNEMPLOYMENT COMPENSATION (division.uctax@maine.gov)
AMENDED REPORT - FORM C1A-ME
EMPLOYER’S AMENDMENTS TO UNEMPLOYMENT INSURANCE
CONTRIBUTIONS AND/OR WAGE DETAIL REPORT
UC EMPLOYER ACCOUNT NO.: _________________________
EMPLOYER NAME: ___________________________________
Period Covered: ___ / ___ / __ - __ / ___ / ___
Contribution Rate
Unemployment Insurance Contributions
%
(Lines 1 - 6 must be completed for each column)
A. Amount Last Reported
B. Correct Amount
C. Difference
1. Total Wages for Quarter _______________________
________________________
________________________
2. Excess Wages
_______________________
________________________
________________________
3. Taxable Wages
_______________________
________________________
________________________
4. Contributions
_______________________
________________________
________________________
5. Overpayment - Refund Will be Issued ...............................
________________________
6. Underpayment - Please Remit Payment with Return ........
________________________
7. Explanation of Adjustments Required:
__________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
8. INDIVIDUAL EMPLOYEE WAGE CORRECTIONS
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Make Check Payable to Treasurer, State of Maine
I certify that the information contained on this return, report and attachment(s) is true and
Mail to:
MAINE DEPARTMENT OF LABOR
correct.
BUREAU OF UNEMPLOYMENT COMPENSATION
P.O. BOX 259
AUGUSTA, ME 04332-0259
Signature _______________________________________________
Title ___________________________________________________ Date ______________________ Telephone ___________________________________________
IF YOU HAVE ANY QUESTIONS REGARDING THIS FORM, CONTACT YOUR LOCAL FIELD ADVISOR AND EXAMINER OR CALL THE WAGE RECORD UNIT AT 207-
287-1231. TTY (HEARING IMPAIRED ONLY) 1-800-794-1110.

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