THIS IS A FILLABLE FORM INSTRUCTIONS - EMPLOYER’S QUARTERLY ADJUSTMENT REPORT 1. Enter Federal Identification Number. 2. Enter Oklahoma Account Number. 3. Enter business name and address. 4. Signature and title of individual authorized to complete this form. 5. Quarter and year being adjusted. 6. Automatically calculates when Item's 6-b & 6-c are entered. 6-a. Enter the Total Wages previously reported on the OES-3, Employers Quarterly Contribution Report. 6-b. If Item 6 is greater than Item 6-a, enter the Total Wages under reported here (Item 6 - Item 6-a). 6-c. If Item 6 is less than Item 6-a, enter the Total Wages over reported here (Item 6-a - Item 6). Enter as a negative. 7. Enter the correct amount of wages in excess of the taxable limitation (Item 6 - Item 8). 8. Automatically calculates when Item's 8-b & 8-c are entered. 8-a. Enter the Taxable Wages previously reported on the OES-3, Employers Quarterly Contribution Report. 8-b. If Item 8 is greater than Item 8-a, enter the Taxable Wages under reported here (Item 8 - Item 8-a). 8-c. It Item 8 is less then Item 8-a, enter the Taxable Wages over reported here (Item 8-a - Item 8). Enter as a negative. 9. Enter the contribution rate for the quarter being adjusted. Enter rate as a decimal. Ex: 0.3% = .003 10. Automatically calculates when rate is entered. (Item 8-b x Item 9). 11. Enter the amount of interest due (1% per month x Item 10). 12. Total amount due for the quarter being adjusted. 13. C redit due (Item 8-c x Item 9). 14. Enter Oklahoma Account Number. 15. Quarter and year being adjusted. 16. Enter the SSN(s) for ONLY the employee(s) being corrected. Enter the Name of the employee(s) being corrected. Enter the Total Wages previously reported for each employee listed as reported on the OES-3, Employers Quarterly Contribution Report. Enter the Taxable Wages previously reported for each employee listed as reported on the OES-3, Employers Quarterly Contribution Report. Enter the Correct Total Wages paid for each employee listed. Enter the Correct Taxable Wages paid for each employee listed. |
OES-3B (Rev. 09-19) AUXILIARY AIDS AND SERVICES ARE AVAILABLE UPON REQUEST TO INDIVIDUALS WITH DISABILITIES OKLAHOMA EMPLOYMENT SECURITY COMMISSION RESET EMPLOYER’S QUARTERLY ADJUSTMENT REPORT PO Box 52003 Oklahoma City, OK 73152-2003 1. Federal Identification Number 2. Oklahoma Account Number 6. Correct total wages paid this quarter $ _________________________0.00 6-a. Total wages previously reported $ _________________________ 3. 6-b. Total wages under reported $ _________________________ Name ________________________________________________ 6-c. Total wages over reported (Enter as Negative) $ _________________________ Address ________________________________________________ 7. Correct wages in excess of taxable limitation $ _________________________ Email ________________________________________________ 8. Correct taxable wages paid this quarter $ _________________________0.00 Phone _________________________________________________ 8-a. Taxable wages previously reported $ _________________________ 8-b. Taxable wages under reported $ _________________________ 4. I certify that the information contained in this report is true and correct. 8-c. Taxable wages over reported (Enter as Negative) $ _________________________ Signed _________________________________________________ 9. Contribution Rate (Enter rate as a decimal) _________________________0.0% Title ____________________________ Date ___________________ 10. Contribution Due (Item 8-b x Item 9) $ _________________________0.00 5. Quarter ______________________ 11. Interest due (1% per month from due date) $ _________________________ 0.00 List in the schedule below ONLY those 12. Total amount due with this report $ _________________________ PLEASE NOTICE: employees whose wages are being corrected. 13. Credit due (Item 8-c x Item 9) $ _________________________0.00 14. Oklahoma Account Number ____________________________ 15. Quarter ______________________ 16. Employee’s Social Employee’s Name Total Wages Taxable Wages *Correct Total *Correct Taxable Security Number (Type or Print) Previously Reported Previously Reported Wages Paid Wages Paid ENTER THE TOTALS. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 0.00 0.00 0.00 0.00 FOR COMMISSION USE ONLY-DO NOT WRITE IN THE SPACES BELOW Date Rec’d Batch # OES-3B Rev. 10-16-19 EQUAL OPPORTUNITY EMPLOYER/PROGRAM 003B |