Form CONN.UC-5A "Correction of Employee Quarterly Earnings Report" - Connecticut

What Is Form CONN.UC-5A?

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

Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the Connecticut Department of Labor;
  • 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 fillable version of Form CONN.UC-5A by clicking the link below or browse more documents and templates provided by the Connecticut Department of Labor.

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Download Form CONN.UC-5A "Correction of Employee Quarterly Earnings Report" - Connecticut

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CORRECTION OF EMPLOYEE QUARTERLY EARNINGS REPORT
FORM CONN UC-5A
(CORR) (Rev. 3/18)
PLEASE READ INSTRUCTIONS BELOW FOR FILING REQUIREMENTS AND EXPLANATION OF ITEMS
CONN.
CONNECTICUT DEPARTMENT OF LABOR
REG. NO.:
EMPLOYER TAX ACCOUNTING UNIT
200 FOLLY BROOK BOULEVARD
QUARTER
YEAR
WETHERSFIELD, CT 06109-1114
EMPLOYER
TOTAL PAGES ON THIS REPORT
TRADE NAME:
INCLUDING CONTINUATION SHEETS:
LIST ONLY THOSE EMPLOYEES WHOSE WAGES ARE BEING CORRECTED.
TYPE OR PRINT
1. EMPLOYEE
2. NAME OF EMPLOYEE
4. CORRECT AMT.
5. INCREASE
6. DECREASE
3. WAGES AS LISTED
SOCIAL SECURITY
FIRST INITIAL, LAST NAME
OF WAGES
ON ORIGINAL REPORT
NUMBER
7.
TOTAL FOR THIS PAGE
DO NOT WRITE IN THIS
SPACE
WAGE RECORD
CORRECTED_______________
8.
TOTAL FOR THIS REPORT
INSTRUCTIONS
This form is a Quarterly Combination Correction for to be used to correct an EMPLOYER CONTRIBUTION RETURN (Form Conn. UC-2)
and EMPLOYEE QUARTERLY EARNINGS REPORT (Form UC-5A), which you have previously filed with this department. Submit the
original and keep a copy for your files. A separate form must be submitted for each quarter in which there is a correction to be made.
DO NOT USE these forms to correct social security numbers or employee names. Please submit a detailed letter on your
company letterhead explaining the correction addressed to the DEPARTMENT OF LABOR, EMPLOYER TAX ACCOUNTING UNIT,
200 FOLLY BROOK BLVD., WETHERSFIELD, CT 06109-1114.
HOW TO PREPARE FORM CONN. UC-5A (CORR.)
Heading:
Enter your Connecticut Registration Number, Quarter/Year, and Employer Trade Name. Enter the total pages on this
report, including Continuation Sheets.
LIST ONLY EMPLOYEES WHOSE WAGE ARE BEING CORRECTED.
Enter employees’ Social Security Numbers
1.
2.
TYPE or PRINT the name of each employee
Enter the Employees’ Wages as listed on original Employee Quarterly Earnings Report.
3.
Enter the Employees’ Correct Wages.
4.
5.
If the difference in Item 3 and 4 is an increase, enter difference here.
6.
If the difference in Item 3 and 4 is a decrease, enter the difference here.
7.
Enter the Totals for this page in Column 5 and Column 6.
8.
Enter the totals for this sheet and all Continuation sheets attached.
If there is not enough space to list all employees on form Conn. UC-5A (Corr.) then a Continuation sheet may be used. The
Continuation Sheet should be on 8½”X11” paper showing employer’s name and tax registration number. Each page must show a page
number beginning with page 2, following the format of page 1.
IF YOU FILED YOUR ORIGINAL RETURN WITH ZERO GROSS WAGES PLEASE CHECK HERE.
PAGE 1 OF 2
CORRECTION OF EMPLOYEE QUARTERLY EARNINGS REPORT
FORM CONN UC-5A
(CORR) (Rev. 3/18)
PLEASE READ INSTRUCTIONS BELOW FOR FILING REQUIREMENTS AND EXPLANATION OF ITEMS
CONN.
CONNECTICUT DEPARTMENT OF LABOR
REG. NO.:
EMPLOYER TAX ACCOUNTING UNIT
200 FOLLY BROOK BOULEVARD
QUARTER
YEAR
WETHERSFIELD, CT 06109-1114
EMPLOYER
TOTAL PAGES ON THIS REPORT
TRADE NAME:
INCLUDING CONTINUATION SHEETS:
LIST ONLY THOSE EMPLOYEES WHOSE WAGES ARE BEING CORRECTED.
TYPE OR PRINT
1. EMPLOYEE
2. NAME OF EMPLOYEE
4. CORRECT AMT.
5. INCREASE
6. DECREASE
3. WAGES AS LISTED
SOCIAL SECURITY
FIRST INITIAL, LAST NAME
OF WAGES
ON ORIGINAL REPORT
NUMBER
7.
TOTAL FOR THIS PAGE
DO NOT WRITE IN THIS
SPACE
WAGE RECORD
CORRECTED_______________
8.
TOTAL FOR THIS REPORT
INSTRUCTIONS
This form is a Quarterly Combination Correction for to be used to correct an EMPLOYER CONTRIBUTION RETURN (Form Conn. UC-2)
and EMPLOYEE QUARTERLY EARNINGS REPORT (Form UC-5A), which you have previously filed with this department. Submit the
original and keep a copy for your files. A separate form must be submitted for each quarter in which there is a correction to be made.
DO NOT USE these forms to correct social security numbers or employee names. Please submit a detailed letter on your
company letterhead explaining the correction addressed to the DEPARTMENT OF LABOR, EMPLOYER TAX ACCOUNTING UNIT,
200 FOLLY BROOK BLVD., WETHERSFIELD, CT 06109-1114.
HOW TO PREPARE FORM CONN. UC-5A (CORR.)
Heading:
Enter your Connecticut Registration Number, Quarter/Year, and Employer Trade Name. Enter the total pages on this
report, including Continuation Sheets.
LIST ONLY EMPLOYEES WHOSE WAGE ARE BEING CORRECTED.
Enter employees’ Social Security Numbers
1.
2.
TYPE or PRINT the name of each employee
Enter the Employees’ Wages as listed on original Employee Quarterly Earnings Report.
3.
Enter the Employees’ Correct Wages.
4.
5.
If the difference in Item 3 and 4 is an increase, enter difference here.
6.
If the difference in Item 3 and 4 is a decrease, enter the difference here.
7.
Enter the Totals for this page in Column 5 and Column 6.
8.
Enter the totals for this sheet and all Continuation sheets attached.
If there is not enough space to list all employees on form Conn. UC-5A (Corr.) then a Continuation sheet may be used. The
Continuation Sheet should be on 8½”X11” paper showing employer’s name and tax registration number. Each page must show a page
number beginning with page 2, following the format of page 1.
IF YOU FILED YOUR ORIGINAL RETURN WITH ZERO GROSS WAGES PLEASE CHECK HERE.
PAGE 1 OF 2
Page of 2