Voluntary Plan for Disability Insurance 
                                                           Quarterly Adjustment Form 

The Voluntary Plan for Disability Insurance Quarterly Adjustment Form        (DE 938) is used to request corrections to information 
previously reported on a Quarterly Contribution Return (DE 3D) and/or Quarterly Contribution Return and Report of Wages        
(Continuation) (DE 9C). A claim for refund must be filed within 3 years of the last timely date of the quarter being adjusted,  
6 months after an assessment becomes final, or 60 days from the date of the overpayment, whichever date occurs later. 
You can also file adjustments to previously filed returns online through the Employment Development Department (EDD) 
e-Services  for Business (edd.ca.gov/e-Services_for_Business). Refer to the      Instructions for Completing the Voluntary Plan for
Disability Insurance Quarterly Adjustment Form      (DE 938-I) (PDF) (edd.ca.gov/pdf_pub_ctr/de938i.pdf) for additional information.
Check the box    ☐    If only adjusting the DE 3D,         ☐  If only adjusting the DE 9C,        ☐ If adjusting DE 3D and
that applies:         complete Sections I, II, III, and V.   complete Sections I, II, IV, and V.    DE 9C, complete all sections.
Section I: Employer Information. Complete all fields (Please print).                                                 Quarter 
Business Name:           _______________________________________________                                             YY/Q 
                         _______________________________________________                          Employer Account Number 
Street Address:          _______________________________________________ 
City, State, ZIP Code:   _______________________________________________ 
Section II: Reason for Adjustment. Enter a detailed reason for the adjustments requested. (Required) 
____________________________________________________________________________________________________ 
____________________________________________________________________________________________________ 
Section III: Request to Adjust the DE 3D.                            (1)                      (2)                       (3) 
Complete all fields. If requesting a credit (decrease)     Amounts Reported on           Amounts That            Difference 
to SDI or PIT previously reported, you must also           DE 3D or Most Recent       Should Have Been           Debit/(Credit) 
complete Line Q below.                                     Adjustment Form               Reported 
A. Total Subject Wages
B. Unemployment Insurance (UI) Taxable Wages
C. State Disability Insurance (SDI) Taxable Wages
D. Voluntary Plan DI (VPDI) Taxable Wages
E. Employer’s UI Contributions (UI rate ___ % times B)
F. Employment Training Tax (ETT rate ___ % times B)
G. SDI Withheld (SDI Rate ___ % times C)
   (Includes Paid Family Leave)
H. Voluntary Plan Assessment (VPDI Rate ________ % times D)
I. Personal Income Tax (PIT) Withheld
J. Subtotal (Add amounts on Lines E, F, G, H, and I)
K. Plus: Erroneous SDI Deductions Not Refunded (Refer to Note below)
L. Less: Contributions and Withholdings Paid for the Quarter
M. Total Taxes Due or Overpaid (J2 – K + L). (If balance due, complete N, O, and P)
N. Penalty (If balance is due, calculate 15% of the amount on Line M)
O. Interest (Refer to the DE 938-I for instructions)
P. Total Due (Lines M + N + O)
Q. SDI and PIT Overpayments. If requesting a credit (decrease) to SDI or PIT, you must           SDI Deductions  PIT Deductions 
   answer the following questions:
   1.Was the credit claimed above (column 3) withheld from the wages of employee(s)?              ☐ Yes   ☐ No       ☐ Yes   ☐No
   2.If yes, has this amount been refunded to the employee(s)?                                    ☐ Yes   ☐ No       ☐ Yes   ☐No
   3.Was the correct PIT reported on the Form W-2 issued to the employee(s)?                                         ☐ Yes   ☐No
Note: SDI and PIT deductions are employee contributions. The EDD cannot refund these amounts unless you first refund the 
erroneous deductions to the employee(s). If you have issued Form(s) W-2, do not refund PIT overwithholdings or 
change the amount reported on the employee(s) Form W-2. The employee will receive a credit for the PIT overwithheld 
when they file their California Income Tax Return    (Form 540) with the Franchise Tax Board. If you are requesting a PIT credit 
for a prior year because you paid the EDD more than the amount withheld from the employee(s), attach a copy of Form(s)  
W-2 filed for each affected employee. Refer to the DE 938-I for additional instructions.
     Sign on Page 2 and Mail To: Employment Development Department / PO Box 989073 / West Sacramento, CA  95798-9073 
DE 938 Rev. 47 (1-23) (INTERNET)                           Page 1 of ________                                                 CU

                                                                                       Quarter        Employer Account Number 
                        Business Name: ______________________________________          YYQ 

Section IV: Request to Adjust the DE 9C. Complete Item A for all DE 9C adjustments. Complete Item B only for wage plan 
code corrections to all employees. Complete Item C to request adjustments to individual employee information.  
A. DE 9C Grand Totals for the Quarter
   A1. Enter the correct grand totals for all    Total Subject Wages              Total PIT Wages        Total PIT Withheld 
       employees for the quarter. 
   A2. Enter the number of employees full-time and part-time who                  1st Month       2nd Month            3rd Month 
       worked during or received pay subject to UI for the pay period 
       which includes the 12 thof the month.   
                                                                                                                  Wage Item Count 
   A3. Enter the correct total number of wage lines for all employees for the quarter. 

B. Wage Plan Code Corrections for All Employees. Leave blank if not correcting all wage plan codes. Refer to the
   Information Sheet: Reporting Wage Plan Codes on Quarterly Wage Reports and Adjustments (DE 231WPC) (PDF)
   (edd.ca.gov/pdf_pub_ctr/de231wpc.pdf) for additional information.
   Enter Number of Employees: _________ Prior Plan Code: ____ Correct Plan Code: _____
   (Item C below is not required if only adjusting wage plan codes for all employees.)

C. Individual Wage Line Adjustments. Identify the adjustment type for each affected employee and complete the fields
   indicated. Include only the wage lines that need to be corrected. Make corrections to the quarter(s) in which the
   information was originally reported. Do not report negative amounts.
   Adjustment Type                                                                Fields to Complete for Each Affected Employee 
   Add employee(s) not previously reported.                                       C1 – C6. Leave C7 – C9 blank. 
   Remove employee(s) reported in error.                                          C1 – C6. Enter 0.00 in C3 – C5. 
   Adjust wages or PIT amounts previously reported.                               C1 – C6. Leave C7 – C9 blank. 
   Correct employee name(s).                                                      C1 – C6 and C7. Leave C8 – C9 blank. 
   Correct a Social Security number (SSN).                                        C1 – C6 and C8. Leave C7 and C9 blank. 
   Correct wage plan code for one or more employees but not all.                  C1 – C6 and C9. Leave C7 and C8 blank. 
   Multiple adjustments.                                                          C1 – C6 and C7 – C9 if they apply to adjustment. 
                                                                                  For name, SSN, or plan code corrections, enter 
   Enter the information that should have been reported in fields C1 – C6. 
If a correction reduces wages or withholdings amount to zero, enter 0.00 in the   the information previously reported in fields 
                                                                                  C7 – C9. Leave these fields blank for all other 
                                      field.                                                      adjustment types. 
C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last) C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages          C5. PIT Withheld                   C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last) C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages          C5. PIT Withheld                   C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last) C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages          C5. PIT Withheld                   C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

                        Please attach additional pages if reporting more than 3   wage line adjustments. 
Section V: Declaration. I declare that the information herein is true and correct to the best of my knowledge. (A signature is 
required on all adjustments.)  
Signature _____________________________  Title ___________________________   Date ___________________________ 
Print Name ____________________________   Phone _________________________   Email __________________________ 

         Sign and Mail To: Employment Development Department / PO Box 989073 / West Sacramento, CA  95798-9073 

                                                       Page 2 of ________
DE 938 Rev. 47 (1-23) (INTERNET)   

                                                                                         Quarter        Employer Account Number 
                        Business Name: ______________________________________            YYQ 

Enter the information that should have been reported in fields C1 – C6.                  For name, SSN, or plan code corrections, enter 
                                                                                         the information previously reported in fields 
If a correction reduces wages or withholdings amount to zero, enter 0.00 in the          C7 – C9. Leave these fields blank for all other 
                                      field. 
                                                                                                 adjustment types. 
C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

C1. Social Security Number (SSN)  C2. Employee Name (First, Middle Initial, Last)        C7. Previously Reported Name (First, Middle Initial, Last) 

C3. Total Subject Wages C4. PIT Wages        C5. PIT Withheld                     C6. Plan Code  C8. Previously Reported SSN  C9. Previously Reported Plan Code 

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DE 938 Rev. 47 (1-23) (INTERNET)