Division of Unemployment Insurance                     
     Unemployment Insurance Employer Services 
     P.O. Box 8789, Denver, CO 80201-8789 
 
                   UNEMPLOYMENT  INSURANCE  QUARTERLY-REPORT  ADJUSTMENT 
 
                                                      INSTRUCTIONS  ON  REVERSE 
 Employer Account Number                                                                             Batch/Page 
  
 Owner, Partners, or Corporate Name 
  
 1. Correct total number of workers as of the 12 thof each month. 
            1 stQuarter                       2 ndQuarter                3 rdQuarter                 4 thQuarter 
    Jan.     Feb.           Mar.       Apr.        May      June    July   Aug.       Sept.    Oct.      Nov.                                               Dec. 
                                                                                                                                                             
                                              Revised Report             Prior Report                Difference 
  Qtr./Yr.  2. Total Wages                                                                                                                                   
            3. Excess Wages                                                                                                                                  
  Rate      4. Chargeable Wages                                                                                                                              
            5. Premiums Due                                                                                                                                  
            6. Interest                                                                                                                                      
                                                                                                                                                             
            7.Total Due 
  Qtr./Yr.  2. Total Wages                                                                                                                                   
            3. Excess Wages                                                                                                                                  
  Rate      4. Chargeable Wages                                                                                                                              
            5. Premiums Due                                                                                                                                  
            6. Interest                                                                                                                                      
                                                                                                                                                             
            7.Total Due 
  Qtr./Yr.  2. Total Wages                                                                                                                                   
            3. Excess Wages                                                                                                                                  
  Rate      4. Chargeable Wages                                                                                                                              
            5. Premiums Due                                                                                                                                  
            6. Interest                                                                                                                                      
                                                                                                                                                             
            7 .Total Due 
  Qtr./Yr.  2. Total Wages                                                                                                                                   
            3. Excess Wages                                                                                                                                  
  Rate      4. Chargeable Wages                                                                                                                              
            5. Premiums Due                                                                                                                                  
            6. Interest                                                                                                                                      
                                                                                                                                                             
            7 .Total Due 
 
 8.  Check the box that describes the correction you are making                       10. Total Paid 
      Form UITR-1a  (enclosed)          Form UITR-6a (enclosed)                        
      No wage report needed 
 9. Reason for Adjustment                                                             11. Signature 
                                                                                       
                                                                                      12. Date 
                                                                                       
UITR-3 (R 03/2021)                          303-318-9100 (Denver-metro area) 1-800-480-8299 (outside Denver-metro area) Fax 303-318-9013 www.coloradoui.gov 

INSTRUCTIONS  FOR  THE  UNEMPLOYMENT  INSURANCE  QUARTERLY-REPORT  ADJUSTMENT 
                                                               
1. Number of Workers–Complete this item if the number of workers reported on the original Form 
   UITR-1, Your Quarterly Report of Wages Paid and Premiums Owed, was incorrect.  Enter the correct 
   total number of workers for each month. 
 
2. Total  Wages–Enter  the  total  wages  paid  within  the  quarter(s)  being  adjusted  that  are  subject  to 
   unemployment insurance premiums (total gross wages minus allowable deductions).  
      
     NOTE:  Form UITR-6a, Multiple Quarter Adjustment of Worker’s Wages, must be completed and 
     attached to show any quarterly wage adjustments. 
 
3. Excess Wages–Enter wages paid during the quarter that were in excess of the chargeable wage limit 
   for the calendar year.  To track excess wages throughout the year, you can download the Premiums 
   Calculator from our website.  Go to www.coloradoui.gov and click on Employers                 .  Then scroll to the 
   bottom, click on Online Tools and select Premiums Calculator. 
    
                                                     Chargeable Wage Limits 
    2021                         2020             2019             2018             2017              2016 
    $13,600                      $13,600          $13,100          $12,600          $12,500           $12,200 
 
4. Chargeable Wages–This is the first $13,600 wages paid to a worker during calendar year 2021. 
 
     EXAMPLE  OF  COMPUTING  CHARGEABLE  WAGES FOR 2021 
 
                                           1 stQuarter   2 ndQuarter    3 rdQuarter       4 thQuarter 
         Gross Wages                           $6,000         $6,000            $6,000        $6,000 
         Excess of $13,600                           -0-           -0-          $4,400        $6,000 
         Chargeable Wages                      $6,000         $6,000            $1,600           $0 

5. Premiums Due–Calculate this amount by multiplying the employer’s rate times the chargeable wages.   
 
     Example:  0.0170 x $6,000=$102.00. 
 
6. Interest Due–Enter the amount of interest due.  Interest is charged at a rate of 1.5 percent (.015) per 
   month or any portion of a month for premiums paid after the due date. 
 
7. Total Due              –Enter the total amount of premiums plus interest due for the quarter. 
    
8. Check the appropriate box as described below: 
 
    Form UITR-1a, Your Report of Individual Employee’s Wages (enclosed)–Check this box if you 
     are reporting wages using a single quarter form. 
 
    Form UITR-6a, Multiple Quarter Adjustment of Worker’s Wages (enclosed)–Check this box if you 
     are correcting wages previously reported or if wages were incorrectly reported under the wrong 
     unemployment insurance account number and must be transferred to another account. 
 
    No Wage Report Needed–Check this box if completing this form does not affect worker wages 
     previously reported. 
 
9.  Reason for Adjustment–List the reasons the original report is being changed. 
 
If  you  have  any  questions,  please  call  Unemployment  Insurance  Employer  Services  at  303-318-9100 
(Denver-metro area) or 1-800-480-8299 (outside Denver-metro area) Fax 303-318-9013. 
 
UITR-3 Page 2 (R 03/2021)