_____ 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, if necessary)
                                                                                  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, OFFICER, PARTNER, RESPONSIBLE OFFICER OR AUTHORIZED AGENT                      TITLE             DATE          PHONE NUMBER          PLANT NUMBER

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

 UC-2AX REV 06-16 (Page 1)           COMMONWEALTH OF PENNSYLVANIA          DEPARTMENT OF LABOR & INDUSTRY          OFFICE OF UNEMPLOYMENT COMPENSATION TAX SERVICES

   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 the   In general, your request for refund must be submitted within 
original PA Form UC-2.                                          four (4) years from the date the original tax report was due.

Use Form UC-2AX to correct wage records or credit weeks         Documentation Requirements
from that reported on the original PA Form UC-2A. This          You may be contacted for documentation depending on the 
includes correcting Social Security Numbers (SSN) or credit     reason for the adjustments.  For this reason, we ask that your 
weeks previously reported; adding SSN’s or credit weeks not     form be complete and accurate and that you include a phone 
previously reported to our agency; adding or increasing wages   number in the event we must contact you.
or credit weeks previously reported incorrectly; or deleting 
or decreasing wages or credit weeks previously reported         Questions
incorrectly.                                                    Questions regarding the processing of your correction form(s) 
                                                                should be referred to the UC Employer Contact Center, 
If you are changing Gross and/or Taxable wages and individual   Monday through Friday 8:30 a.m. to 4:30 p.m. Eastern Time 
employee wages or credit weeks, you will be required to submit  at 866-403-6163.
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 Services,     Quarters
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 the          Quarter Four-October, November, December (due January 31)
exact amount of your calculation. Offsets of the refund request 
will be processed and the net check will be sent to you with an Adjusting Wage Information Electronically
explanation for the reduction or increase in the refund amount  For information on adjusting wage information online or by file 
requested. Examples where this offset may happen are:           upload, call the UC Employer Contact Center at 866-403-6163.

1.  Taxable wage reductions along with reduction in the         SPECIFIC INSTRUCTIONS FOR UC-2AX
   contributions paid cause an increase in rates subsequent 
   to year of adjustment.                                       1.  Enter your PA Unemployment Compensation account 
2.  Correction of exempt employment previously reported         number. (Only complete the shaded box if you are “R”- 
   where these individuals were paid UC benefits because        reimbursable or “M”- municipality.)
   of this reported employment.                                 2.  Complete your business name and address.
3.  A calculation error was made in the requested refund        3.  Complete the quarter and year using four digits. A 
   amount.                                                      separate form must be submitted for each quarter being 
4. You owe contribution, interest, penalty and/or court costs   corrected.
   on your account or have past due unfiled quarterly reports   4.  Check the appropriate box to indicate the reason for 
   in another quarter.                                          the adjustment and complete any additional information 
                                                                as requested.
Underpayment Corrections                                        5.  Complete the employer certification by signing, and entering 
For any corrections made by you that result in additional tax   title, date, phone number and plant number (if applicable).
due, our agency must have a check attached for the additional   6.  Following the format of employees SS number, name 
contribution due (unless an overpayment was also made). Do      of employee, gross wages and credit weeks, enter the 
not include any penalty or interest that may be due. We will    information as it should have been reported for each 
bill you for these amounts due, if any. Make all checks payable employee being corrected. (Use additional sheets if 
to the PA UC Fund.                                              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 06-16 (Page 2)