Form DWS-ARK-223 "Dws-Ark-209b Adjustment Voucher" - Arkansas

What Is Form DWS-ARK-223?

This is a legal form that was released by the Arkansas Department of Workforce Services - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on June 1, 2006;
  • The latest edition provided by the Arkansas Department of Workforce Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DWS-ARK-223 by clicking the link below or browse more documents and templates provided by the Arkansas Department of Workforce Services.

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Download Form DWS-ARK-223 "Dws-Ark-209b Adjustment Voucher" - Arkansas

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DWS-ARK-209B
P.O. Box 8007
Department of
ADJUSTMENT VOUCHER
Little Rock, AR 72203-8007
WORKFORCESERVICES
Telephone (501) 682-3798
Date ______________________
Page _________ of ________
DWS Account Number ______________________________
Employer ______________________________________
Town __________________________________
Amend totals in Part A of my original DWS-ARK-209B for quarter ending ______________________________ as follows:
REPORTED ON THE
SHOULD HAVE BEEN
ORIGINAL REPORT
REPORTED
Item 2 – Total of all Wages Paid
Item 3 – Wages in Excess of $
Item 4 – Taxable Wages
Contribution Due @
% rate
Contribution Paid
Balance due check attached $ ____________ . ______
Credit amount $ ____________ . ______
Reason for adjustment: _________________________________________________________________________
Amended individual wages reported on DWS-ARK-209B for year and quarter specified below as follows:
TOTAL WAGES PAID
SOC. SEC. NO.
YEAR/
NAME OF EMPLOYEE
OF EMPLOYEE
QTR.
REPORTED ON THE
SHOULD HAVE BEEN
ORIGINAL REPORT
REPORTED
(For continuation sheet, see reverse side)
Signature ______________________________ Title __________________________ Phone# ______________
DWS-ARK-223 (Rev. 6-06) (PAGE 1 OF 2)
DWS-ARK-209B
P.O. Box 8007
Department of
ADJUSTMENT VOUCHER
Little Rock, AR 72203-8007
WORKFORCESERVICES
Telephone (501) 682-3798
Date ______________________
Page _________ of ________
DWS Account Number ______________________________
Employer ______________________________________
Town __________________________________
Amend totals in Part A of my original DWS-ARK-209B for quarter ending ______________________________ as follows:
REPORTED ON THE
SHOULD HAVE BEEN
ORIGINAL REPORT
REPORTED
Item 2 – Total of all Wages Paid
Item 3 – Wages in Excess of $
Item 4 – Taxable Wages
Contribution Due @
% rate
Contribution Paid
Balance due check attached $ ____________ . ______
Credit amount $ ____________ . ______
Reason for adjustment: _________________________________________________________________________
Amended individual wages reported on DWS-ARK-209B for year and quarter specified below as follows:
TOTAL WAGES PAID
SOC. SEC. NO.
YEAR/
NAME OF EMPLOYEE
OF EMPLOYEE
QTR.
REPORTED ON THE
SHOULD HAVE BEEN
ORIGINAL REPORT
REPORTED
(For continuation sheet, see reverse side)
Signature ______________________________ Title __________________________ Phone# ______________
DWS-ARK-223 (Rev. 6-06) (PAGE 1 OF 2)
Date _____________________
Page _________ of ________
DEPARTMENT OF WORKFORCE SERVICES
P O BOX 8007 – LITTLE ROCK AR 72203-8007
(501) 682-3798
DWS-ARK-209B ADJUSTMENT VOUCHER – CONTIUATION SHEET
DWS Account Number ______________________________
Employer ______________________________________
Town __________________________________
TOTAL WAGES PAID
SOC. SEC. NO.
YEAR/
NAME OF EMPLOYEE
OF EMPLOYEE
QTR.
REPORTED ON THE
SHOULD HAVE BEEN
ORIGINAL REPORT
REPORTED
DWS-ARK-223(A) (Rev. 6-03) (PAGE 2 OF 2)
Page of 2