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                                              Quarterly Contribution and Wage 
                                                            Adjustment Form 

The   Quarterly Contribution and Wage Adjustment Form (DE 9ADJ) is used to request corrections to information previously 
reported on a Quarterly Contribution Return and Report of Wages      (DE 9) 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 Quarterly
Contribution and Wage Adjustment Form     (DE 9ADJ-I) (PDF)     (edd.ca.gov/pdf_pub_ctr/de9adji.pdf) for additional information.
Check the box       ☐ If only adjusting the DE 9,           ☐ If only adjusting the DE 9C,        ☐  If adjusting DE 9 and DE 9C,
that applies:         complete Sections I, II, III, and V.    complete Sections I, II, IV, and V.    complete all sections.

Section I: Employer Information. Complete all fields (Please print).                                                  Quarter 
Business Name:         _______________________________________________                                                  YYQ 
                       _______________________________________________                            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 9.                            (1)                    (2)                      (3) 
Complete all fields. If requesting a credit (decrease) to  Amounts Reported on      Amounts That                Difference 
SDI or PIT, you must also complete  Line   below. O         DE 9 or Most Recent    Should Have Been             Debit/(Credit) 
                                                              Adjustment Form           Reported 
A. Total Subject Wages
B. Unemployment Insurance (UI) Taxable Wages
C. State Disability Insurance (SDI) Taxable Wages
D. Employer’s UI Contributions (UI rate _____% times B)
E. Employment Training Tax (ETT rate _  ____% times B)
F. SDI Withheld (SDI rate _____% times C)
   (Includes Paid Family Leave)
G. Personal Income Tax (PIT) Withheld
H. Subtotal (Add amounts on Lines D, E, F, and G)
I. Plus: Erroneous SDI Deductions Not Refunded (Refer to Note below)
J. Less: Contributions and Withholdings Paid for the Quarter
K. Total Taxes Due or Overpaid (H2 + I – J). (If balance is due, complete L,
   M, and N)
L. Penalty (If balance is due, calculate 15% of the amount on Line K)
M. Interest (Refer to the DE 9ADJ-I for instructions)
N. Total Due (Lines K + L + M)

O. 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 9ADJ-I for additional instructions.
        Sign on Page 2 and Mail To: Employment Development Department / PO Box 989073 / West Sacramento, CA  95798-9073 

DE 9ADJ Rev. 4 (1-23) (INTERNET)                           Page 1 of ________                                                CU

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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
Total Subject Wages Total PIT Wages Total PIT Withheld
A1. Enter the correct grand totals for all
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. 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

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

DE 9ADJ Rev. 4 (1-23) (INTERNET) Page 2 of ________ CU

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Quarter Employer Account Number
Business Name: ______________________________________ YYQ

For name, SSN, or plan code corrections, enter
Enter the information that should have been reported in fields C1 – C6. 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)