Employer's Wage Adjustment Report 
68-0061 (7-16)

Section 1                                               Section 2
UI Account #:                                           Reason Codes For Adjustments 
                                                         1:  Correct Reported Wages 
FEIN:                                                    2:  Add Employee 
Legal Business Name :                                    3:  Correct Social Security Number
                                                         4:
Quarter/Year:            Reporting Unit :

Section 3: Adjustment to Reported Wage Detail
                                         Employee Name                            Total Wages                                        Taxable Wages
Reason Social Security Corrected Social                                           Amount                                     Amount 
Code   Number Reported  Security Number 
             As          Only                                                     Previously                       Corrected Previously   Corrected 
                                         Last, First, MI                          Reported                         Amount    Reported     Amount

Section 4: Adjustment to Wages & Contribution
                                                                                                                   Amount               Corrected 
Totals As Reported on Original Report & Corrected Totals
                                                                                                                   Reported               Amount
Total Wages
Taxable Wages
State Experience Rate @                 %
Contribution Overpaid/Underpaid
Interest Due [Additional due x .0003333 (Rounded to two decimals) then take Daily Rate x # days late              ]
Total Additional Due (Additional Penalty could apply if original report was late)
Total Amount Enclosed - Make Check Payable to Iowa Workforce Development

Section 5
                                                           Fax Completed Form to: 515-242-6301    OR 
Authorized Signature:                                      Mail Completed Form to: Iowa Workforce Development 
                                                                                             Unemployment Insurance Tax Bureau 
Print Preparer's Name:                                                                       1000 E Grand Ave 
Preparer's Title:                                                                            Des Moines, IA 50319-0209 
                                                             
Phone:                                                     Questions: 1-888-848-7442 
Date Submitted:

Equal Opportunity Employer/Program                                                                                                   Page of
Auxiliary aids and services are available upon request to individuals with disabilities. For deaf and hard of hearing, use Relay 711.

Employer's Wage Adjustment Report 
68-0061 (7-16)

Section 1 Instructions: 
· Enter 8 digit myIowaUI account number 
· Enter 9 digit Federal Employer Identification Number 
· Enter Legal Business Name as it appears in myIowaUI 
· Enter Quarter/Year of adjustment 
· Enter Reporting Unit number 
    
Section 2 Instructions: 
· Determine which code best describes the adjustment: 
    1. Correct Reported Wages: code used to correct wages originally submitted to myIowaUI incorrectly 
    2. Add Employee: code used to add  wages for employee not previously reported in Quarter/Year  
    3. Correct Social Security Number: code used to correct Social Security Number previously reported 
              incorrectly 
    4. Other: code used if reason not listed above, describe on line provided 
      
Section 3 Instructions: 
· Reason Code- enter numeric code from Section 2
· Social Security Number Reported As- enter social security number as reported on original report for Quarter/Year 
· Corrected Social Security Number (SSN Corrections Only)  - enter correct social security number if previously 
   reported incorrectly for the Quarter/Year 
· Employee Name  - enter name of employee in the following format:  Last Name, First Name, Middle Initial 
· Total Wages  - enter amount of total wages as reported on original Quarter/Year in the Amount Previously Reported 
   column, then enter corrected total wages in the Corrected Amount column  
· Taxable Wages- enter amount of taxable wages as reported on original Quarter/Year in the Amount Previously 
   Reported column, then enter corrected taxable wages in the Corrected Amount column  
  
Section 4 Instructions: 
· Total Wages  - enter amount of total wages as reported on original Quarter/Year in the Amount Previously Reported 
   column, then enter corrected total wages in the Corrected Amount column  (this should include the total wages for 
   all employees) 
· Taxable Wages - enter amount of taxable wages as reported on original Quarter/Year in the Amount Previously 
   Reported column, then enter corrected taxable wages in the Corrected Amount column (this should include the  
   taxable wages for all employees) 
· State Experience Rate @ - multiply the corrected taxable wages by the state experience rate assigned for Quarter/ 
   Year of adjustment 
· Contribution Overpaid/Underpaid  - enter amount of contribution overpaid/underpaid based on original report 
   submitted 
· Interest Due  - use calculation provided on form to determine additional interest that may be due 
· Total Additional Due  - enter amount of additional contribution and interest due if applicable 
· Total Amount Enclosed  - enter amount of payment enclosed if applicable 
    
Section 5 Instructions: 
· Authorized Signature  - signature of the individual authorized to make changes to employer's myIowaUI account 
· Preparer's Signature  - signature of the individual that is preparing wage adjustment 
· Preparer's Title  - enter title of individual that is preparing wage adjustment 
· Phone  - enter phone number of individual to be contacted if Iowa Workforce Development has questions 
· Date Submitted  - enter date wage adjustment was submitted to Iowa Workforce Development

Employer's Wage Adjustment Report 
Reporting of Out of State Wages 
68-0061 (7-16)

Section 1
UI Account #:
FEIN:
Legal Business Name :
Year:
Reporting Unit #:

Section 2: Adjustment to Reported Wage Detail Due to Out of State Wages

Quarter                            Employee Name     Out of State Taxable   State Wages                                                   Worked Here 
Wages    Social Security Number                      Wages Reported         Reported To                                              Before Iowa Y/N
Earned                             Last, First, MI

Section 3
                                                  Fax Completed Form to: 515-242-6301    OR 
Authorized Signature:                             Mail Completed Form to: Iowa Workforce Development 
                                                                Unemployment Insurance Tax Bureau 
Print Preparer's Name:                                          1000 E Grand Ave 
Preparer's Title:                                               Des Moines, IA 50319-0209 
                                                    
Phone:                                            Questions: 1-888-848-7442 
Date Submitted:

Equal Opportunity Employer/Program                                                                                                   Page of
Auxiliary aids and services are available upon request to individuals with disabilities. For deaf and hard of hearing, use Relay 711.

Employer's Wage Adjustment Report 
68-0061 (7-16)

Section 1 Instructions: 

• Enter 8 digit myIowaUI account number 
· Enter 9 digit Federal Employer Identification Number 
• Enter Legal Business Name as it appears in myIowaUI 
• Enter Year of adjustment 
• Enter Reporting Unit number 
  
Section 2 Instructions: 

• Quarter Wages Earned  - enter the quarter in which the wages were earned in another state 
• Social Security Number Reported As  - enter social security number as reported on original report for Quarter/Year 
• Employee Name  - enter name of employee in the following format:  Last Name, First Name, Middle Initial 
• Out of State Taxable Wages Reported  - enter the taxable wages reported to the state earned in, other than 
  Iowa.  Taxable wages must be reported by the quarter in which they were earned and not as an 
  accumulated amount.  Credit is determined by which state the employee first met the taxable wage base.  If 
  employees taxable wages combined with Iowa wages exceed the other states taxable wage base then the 
  credit will be reduced by the amount up to the wage base from which the state credit was requested.  
          o For example: Employee worked in Nebraska and earned $7000.00 taxable wages for 1 stquarter.  
                                                nd                                       rd                     
              Employee came to work in Iowa 2  quarter and earned $7000.00.  In 3  quarter the employee  
              worked in Nebraska first and earned $5000.00 then Iowa that same quarter and earned $5000.00.   
              Credit is given for the $7000.00 earned in Nebraska for the 1 stquarter but no additional credit given  
              since taxable wage base of $9000.00 in Nebraska had been met with Iowa's combined taxable  
              wages. 
          o The following link will direct you to a list of all State Unemployment Insurance Taxable Wage  
              Bases:  http://www.americanpayroll.org/members/stateui/state-ui-2/  
• State Wages Reported To  - enter the two letter state abbreviation in which taxable wages were earned and 
  reported, other than Iowa 
          o The following link will direct you to a list of all US State Abbreviations:  
              http://state.1keydata.com/state-abbreviations.php 
• Worked Here Before Iowa Y/N  - enter “Y”  for yes or “N” for no to show if the employee earned wages in the other 
  state before wages were earned in Iowa  
  
Section 3 Instructions :

· Authorized Signature  - signature of the individual authorized to make changes to employer's MyIowaUI account 
· Preparer's Signature  - signature of the individual that is preparing wage adjustment 
· Preparer's Title  - enter title of individual that is preparing wage adjustment 
· Phone  - enter phone number of individual to be contacted if Iowa Workforce Development has questions 
· Date Submitted  - enter date wage adjustment was submitted to Iowa Workforce Development