Form DOL-3C "Report to Add New Wages and/or Correct Reported Wages" - Georgia (United States)

Form DOL-3C is a Georgia Department of Labor form also known as the "Report To Add New Wages And/or Correct Reported Wages". The latest edition of the form was released in September 1, 2014 and is available for digital filing.

Download a PDF version of the Form DOL-3C down below or find it on Georgia Department of Labor Forms website.

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Download Form DOL-3C "Report to Add New Wages and/or Correct Reported Wages" - Georgia (United States)

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Electronic Form Processing - DO NOT STAPLE OR SUBMIT COPIES - Use Black Ink
DOL - 3C
(R-9/14)
*00301*
REPORT TO ADD NEW WAGES
GEORGIA
DEPARTMENT OF LABOR
AND/OR CORRECT REPORTED WAGES
00301
Wage
Mail Completed Form To:
For Department Use Only
Investigation
GDOL - Employer Accounts, Room 752
Supplemental
148 Andrew Young International Blvd., N.E.
Date Received
Atlanta, Georgia 30303-1751
M M
D D
Y Y Y Y
/
/
Phone: (404) 232-3245
Correction
SECTION A
Employer Name, Address and E-mail Address
DOL Account Number
Total Tax Rate
.
-
Qtr / Yr
End Date
Q
Y Y Y Y
M M
D D
Y Y Y Y
/
/
/
Federal I.D. Number
SECTION B
PLEASE INCLUDE YOUR DOL
DOL-4N, Item 2
DOL-4N, Item 3
DOL-4N, Item 4
ACCOUNT NUMBER ON ALL CHECKS
Total Reportable Gross Wages
Non-Taxable Wages
Taxable Wages
AND CORRESPONDENCE
SECTION C
Individual Quarterly Wages Reported And Corrected
Total Reportable Gross Wages
Taxable Wages
Social Security No.
Employee’s Full Name
Reported
Corrected
Reported
Corrected
Totals
SECTION D
Increase
Decrease
.
.
,
,
,
,
1. Total Reportable Gross Wage
Corrections . . . . . . . . . . . . . . . . . . . .
.
.
,
,
,
,
2. Non-Taxable Wage Corrections . . . . .
.
.
,
,
,
,
3. Taxable Wage Corrections . . . . . . . . .
4. Contribution Tax on Corrections
5. Admin Assessment on Corrections
6. Interest on Lines 4 & 5
7. Additional Tax or Credit Due
SECTION E
Corrected Summary of Total Reportable Gross Wages
Corrected Summary of Taxable Wages
Explanation
(
)
Submitted By
Title
Date
Phone
Page
of
Electronic Form Processing - DO NOT STAPLE OR SUBMIT COPIES - Use Black Ink
DOL - 3C
(R-9/14)
*00301*
REPORT TO ADD NEW WAGES
GEORGIA
DEPARTMENT OF LABOR
AND/OR CORRECT REPORTED WAGES
00301
Wage
Mail Completed Form To:
For Department Use Only
Investigation
GDOL - Employer Accounts, Room 752
Supplemental
148 Andrew Young International Blvd., N.E.
Date Received
Atlanta, Georgia 30303-1751
M M
D D
Y Y Y Y
/
/
Phone: (404) 232-3245
Correction
SECTION A
Employer Name, Address and E-mail Address
DOL Account Number
Total Tax Rate
.
-
Qtr / Yr
End Date
Q
Y Y Y Y
M M
D D
Y Y Y Y
/
/
/
Federal I.D. Number
SECTION B
PLEASE INCLUDE YOUR DOL
DOL-4N, Item 2
DOL-4N, Item 3
DOL-4N, Item 4
ACCOUNT NUMBER ON ALL CHECKS
Total Reportable Gross Wages
Non-Taxable Wages
Taxable Wages
AND CORRESPONDENCE
SECTION C
Individual Quarterly Wages Reported And Corrected
Total Reportable Gross Wages
Taxable Wages
Social Security No.
Employee’s Full Name
Reported
Corrected
Reported
Corrected
Totals
SECTION D
Increase
Decrease
.
.
,
,
,
,
1. Total Reportable Gross Wage
Corrections . . . . . . . . . . . . . . . . . . . .
.
.
,
,
,
,
2. Non-Taxable Wage Corrections . . . . .
.
.
,
,
,
,
3. Taxable Wage Corrections . . . . . . . . .
4. Contribution Tax on Corrections
5. Admin Assessment on Corrections
6. Interest on Lines 4 & 5
7. Additional Tax or Credit Due
SECTION E
Corrected Summary of Total Reportable Gross Wages
Corrected Summary of Taxable Wages
Explanation
(
)
Submitted By
Title
Date
Phone
Page
of
DOL - 3C
(R-3/14)
INSTRUCTIONS FOR COMPLETING FORM DOL-3C
“REPORT TO ADD NEW WAGES AND/OR CORRECT REPORTED WAGES”
The form is designed to: (1) correct previously reported wages and/or (2) report wages of individuals who were omitted from the original
Employer’s Quarterly Tax and Wage Report, Form DOL-4N. Complete one or more of these forms separately for each quarterly
report that is to be corrected.
SECTION A
Enter the DOL Account Number, Total Tax Rate (Contribution plus Administrative Assessment), quarter and 4-digit year,
quarter ending date, Federal I.D. Number, Employer Name, Address and E-mail Address.
SECTION B
Enter the amounts as originally reported on lines 2, 3 & 4 of the Employer’s Quarterly Tax and Wage Report, Form DOL-4N being cor-
rected. Taxable wages in Georgia for 2012 and prior years is the first $8,500 paid per employee per year. Taxable wages beginning 2013
is $9,500.
SECTION C
Enter the following information:
• 9 digit Social Security Number(s)
• Full Last Name(s) and Full First Name(s) of any employee(s) omitted or incorrectly reported on the original report
• Total reportable gross wages reported for the employee(s) and the corrected amount of total reportable gross wages
• Taxable wages as originally reported and the corrected amount of taxable wages
Add
• All entries in the Total Reportable Gross Wages Reported column and enter total
• All entries in the Total Reportable Gross Wages Corrected column and enter total
• All entries in the Taxable Wages Reported column and enter total
• All entries in the Taxable Wages Corrected column and enter total
If more than one form is submitted for the same quarter, each form should include the totals for that form only.
SECTION D
Line 1: Enter the difference between the reported Total Reportable Gross Wages and the corrected Total Reportable Gross Wages from
Section C as either an increase or decrease, if applicable.
Line 2: Enter the difference in the Corrected Non-Taxable Wages and the previously reported Non-Taxable Wages from
Section B as either an increase or decrease, if applicable.
Line 3: Enter the difference between the Total Taxable Wages from Section B and the corrected Total Taxable Wages from
Section C as either an increase or decrease, if applicable.
Line 4: Multiply the Taxable Wage amounts in the increase and/or decrease column on Line 3 by the contributory tax rate for
the quarter.
Line 5: Multiply the Taxable Wage amounts in the increase and/or decrease column on Line 3 by the administrative assessment tax rate
for the quarter.
Line 6: Multiply the total tax due (Lines 4 +5 increase column only) by one and one-half percent (1 ½ %) per month or fraction of a
month calculated from the due date until paid. Interest is not applicable on the tax amount in the decrease column.
Line 7: Enter the total of the increase column for Lines 4 through 6, minus the total of the decrease columns for Lines 4 and 5. If the
total reflects an increase in tax due, submit payment to Georgia Department of Labor. If paying by check, please include your
Georgia DOL Account Number on your check. A decrease may result in a credit to your account.
SECTION E
To adjust total reportable gross wages, the amount of increase should be added to the amount entered in Item 2 in Section B or the
amount of decrease should be subtracted from Item 2 in Section B. The result of the addition or subtraction should be entered as Cor-
rected Summary of Total Reportable Gross Wages.
To adjust taxable wages, the amount of increase should be added to the amount entered in Item 4 in Section B or the amount of decrease
should be subtracted from Item 4 in Section B. The result of the addition or subtraction should be entered as Corrected Summary of Tax-
able Wages.
Enter your explanation of the adjustment in the space provided.
Enter your Name on the “Submitted By” line, Title, Date, and Telephone Number and return as indicated on the front of the form.
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