of 

                        CORRECTED PENNSYLVANIA GROSS WAGES PAID TO EMPLOYEES 
  1.      EMPLOYER ACCOUNT        NUMBER                                                                                             3.             QUARTER/YEAR   (A separate               form  must       be    submitted for     each   quarter)  

                         -                                                                            -
                                                                                               R or M  CHECK DIGIT                                  1, 2,
                                                                                                                                                    3 or 4 

  2.  Employer Business Name and Address:                                                                                          4.               Reason For        Correction        (Check      all that apply):  
                                                                                                                                                           Incorrect Employee          Social  Security      Number    
                                                                                                                                                           Correct  Employee Social      Security         Number      
                                                                                                                                                           Employee Name       
                                                                                                                                                           Incorrect Employee          Name    
                                                                                                                                                           Correct  Employee Name        
                                                                                                                                                           Employee Social   Security        Number       
                                                                                                                                                           Exempt Wages.    Reason: 
                                                                                                                                                           Employee Wage      Adjustment (attach              UC-2X, necessary)    if       
                                                                                                                                                           Reason:  
                                                                                                                                                           Incorrect Credit  Weeks      
                                                                                                                                                           Other (Please  explain):    
                                                                                                                                     
  5.  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,  PARTNER, RESPONSIBLE                   OFFICER                   OR AUTHORIZED      AGENT                                           TITLE                                  DATE                       PHONE NUMBER              PLANT   NUMBER  

          EMPLOYEE’S 
  6.                                                                                                             NAME OF EMPLOYEE                                                                                             GROSS WAGES                     CREDIT 
   SOCIAL  SECURITY NO.                                  FIRST NAME                                                           INITIAL                                          LAST  NAME                                     DOLLARS       CENTS             WEEKS 

COMMONWEALTH  OF PENNSYLVANIA                                                            DEPARTMENT OF LABOR                                           & INDUSTRY                                 OFFICE OF UNEMPLOYMENT COMPENSATION TAX SERVICES                                 
UC-2AX REV 09-23 (Page 1)  

                     INSTRUCTIONS FOR COMPLETION OF FORMS UC-2X AND UC-2AX 
Purpose of Forms                                                                                                      Statute of   Limitations       on  Refunds              
Use  Form  UC-2X to      make  changes to      Gross  and/or  Taxable                                                 The PA UC Tax Law specifies certain limitations on refunds.                                                
wages  (increase or   decrease)                         from      those  wages  reported  on                          In   general, your request for refund must be submitted                                                    
the  original  PA  Form  UC-2.                                                                                        within  four (4) years from the date the original tax report                                              
                                                                                                                      was due. 
Use  Form  UC-2AX to      correct  wage  records or      credit  weeks  
from   that reported on the original PA Form UC-2A. This                                                              Documentation Requirements                      
includes correcting               Social        Security         Numbers                  (SSN) or   credit           You may   be    contacted        for  documentation                       depending  on  the  
weeks  previously reported; adding SSN’s or credit weeks                                                              reason  for the adjustments. For this reason, we ask that                                                 
not previously          reported to            our         agency;           adding or          increasing            your  form  be  complete  and  accurate  and  that  you  include a      
wages  or credit weeks previously reported incorrectly; or                                                            phone number in the event we must contact you. 
deleting  or decreasing wages or credit weeks previously                                                           
reported incorrectly.                                                                                                 Questions  
                                                                                                                      Questions regarding the processing of your correction form(s)                                              
   If you are changing Gross and/or Taxable wages and                                                                 should be referred to Employer Tax Services. Weekdays                                                   
individual  employee wages or credit weeks, you will be                                                               7:30 a.m. to 4:00 p.m. Eastern Time at 866-403-6163. 
required to   submit            both         Forms         UC-2X           and       UC-2AX.        
                                                                                                                      Photocopying 
Where to   File                                                                                                       The Forms UC-2X and UC-2AX may be  photocopied. 
Send  completed forms to the PA Department of Labor                                                                
   & Industry, Office of Unemployment Compensation Tax                                                                Quarters 
Services, PO         Box  68568,             Harrisburg,               PA    17106-8568.                              Quarter One-January, February, March (due April 30)  
                                                                                                                      Quarter Two-April, May, June (due July 31) 
Overpayment Corrections                                                                                               Quarter Three-July, August, September (due October 31)  
Refund  requests may not always result in the refund of                                                               Quarter Four-October,  November,  December (due January 31)                                              
the exact      amount of        your            calculation.                Offsets of        the      refund      
request will        be  processed               and      the     net         check        will  be    sent to         Adjusting Wage Information Electronically 
you with     an     explanation              for   the       reduction or                 increase in   the           For   information on adjusting wage information online                                                     
refund amount           requested.                Examples where                          this offset      may        or  by file upload, call Employer Tax Services at                                                   
happen are:                                                                                                           866-403-6163.     

1.  Taxable  wage reductions along with reduction in                                                                               SPECIFIC INSTRUCTIONS FOR UC-2AX 
    the  contributions paid cause an increase in rates                                                                1.  Enter  your PA Unemployment Compensation account                                                     
    subsequent to   year of                    adjustment.                                                                number.  (Only complete the shaded box if you are                                                    
2.  Correction of      exempt  employment                                       previously  reported                      “R”- reimbursable or   “M”-                   municipality.) 
    where these              individuals  were  paid  UC  benefits  because                                           2.  Complete your          business         name             and address.             
    of  this        reported          employment.                                                                     3.  Complete  the quarter and year using four digits.                                                    
3.        A calculation error was made in the requested refund                                                               A separate form must be submitted for each quarter                                                
    amount.                                                                                                               being corrected.           
4.  You   owe contribution, interest, penalty and/or court                                                            4.  Check  the appropriate box to indicate the reason for                                                
    costs  on  your            account or      have  past  due  unfiled  quarterly                                        the adjustment         and   complete               any      additional           information        
    reports in      another  quarter.                                                                                     as requested.       
                                                                                                                      5.  Complete  the employer certification by signing, and                                                 
Underpayment Corrections                                                                                                  entering title, date, phone number and plant number                                                  
For  any corrections made by you that result in additional                                                                (if applicable).     
tax  due, our agency must have a check attached for the                                                               6.  Following the format of employees SS number, name                                                    
additional  contribution due (unless an overpayment was                                                                   of  employee, gross wages and credit weeks, enter                                                    
also made).         Do  not       include        any       penalty or            interest           that   may            the  information as it should have been reported for                                                 
be due.    We      will  bill     you      for   these           amounts             due, if     any.    Make             each employee           being     corrected.                 (Use    additional           sheets     
all checks     payable to       the             PA UC      Fund.                                                             if necessary -    photocopies of            this          form      are      acceptable.)         

                                              Auxiliary  aids  and  services  are  available  upon  request to      individuals  with  disabilities. 
                                                                                             Equal  Opportunity  Employer/Program 
 UC-2AX REV  09-23    (Page    2)