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Division of Unemployment Insurance
Unemployment Insurance Employer Services
P.O. Box 8789, Denver, CO 80201-8789

UNEMPLOYMENT INSURANCE QUARTERLY-REPORT ADJUSTMENT

INSTRUCTIONS ON REVERSE
Employer Account Number Batch/Page

Owner, Partners, or Corporate Name

1. Correct total number of workers as of the 12 thof each month.
1 stQuarter 2 ndQuarter 3 rdQuarter 4 thQuarter
Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec.

Revised Report Prior Report Difference
Qtr./Yr. 2. Total Wages
3. Excess Wages
Rate 4. Chargeable Wages
5. Premiums Due
6. Interest

7.Total Due
Qtr./Yr. 2. Total Wages
3. Excess Wages
Rate 4. Chargeable Wages
5. Premiums Due
6. Interest

7 .Total Due
Qtr./Yr. 2. Total Wages
3. Excess Wages
Rate 4. Chargeable Wages
5. Premiums Due
6. Interest

7 .Total Due

8. Check the box that describes the correction you are making 10. Total Paid
Form UITR-1a (enclosed) Form UITR-6a (enclosed)
No wage report needed
9. Reason for Adjustment 11. Signature

12. Date

UITR-3 (R 03/2021) 303-318-9100 (Denver-metro area) 1-800-480-8299 (outside Denver-metro area) Fax 303-318-9013 www.coloradoui.gov

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INSTRUCTIONS FOR THE UNEMPLOYMENT INSURANCE QUARTERLY-REPORT ADJUSTMENT

1. Number of Workers–Complete this item if the number of workers reported on the original Form
UITR-1, Your Quarterly Report of Wages Paid and Premiums Owed, was incorrect. Enter the correct
total number of workers for each month.

2. Total Wages–Enter the total wages paid within the quarter(s) being adjusted that are subject to
unemployment insurance premiums (total gross wages minus allowable deductions).

NOTE: Form UITR-6a, Multiple Quarter Adjustment of Worker’s Wages, must be completed and
attached to show any quarterly wage adjustments.

3. Excess Wages–Enter wages paid during the quarter that were in excess of the chargeable wage limit
for the calendar year. To track excess wages throughout the year, you can download the Premiums
Calculator from our website. Go to www.coloradoui.gov and click on Employers . Then scroll to the
bottom, click on Online Tools and select Premiums Calculator.

Chargeable Wage Limits
2021 2020 2019 2018 2017 2016
$13,600 $13,600 $13,100 $12,600 $12,500 $12,200

4. Chargeable Wages–This is the first $13,600 wages paid to a worker during calendar year 2021.

EXAMPLE OF COMPUTING CHARGEABLE WAGES FOR 2021

1 stQuarter 2 ndQuarter 3 rdQuarter 4 thQuarter
Gross Wages $6,000 $6,000 $6,000 $6,000
Excess of $13,600 -0- -0- $4,400 $6,000
Chargeable Wages $6,000 $6,000 $1,600 $0

5. Premiums Due–Calculate this amount by multiplying the employer’s rate times the chargeable wages.

Example: 0.0170 x $6,000=$102.00.

6. Interest Due–Enter the amount of interest due. Interest is charged at a rate of 1.5 percent (.015) per
month or any portion of a month for premiums paid after the due date.

7. Total Due –Enter the total amount of premiums plus interest due for the quarter.

8. Check the appropriate box as described below:

 Form UITR-1a, Your Report of Individual Employee’s Wages (enclosed)–Check this box if you
are reporting wages using a single quarter form.

 Form UITR-6a, Multiple Quarter Adjustment of Worker’s Wages (enclosed)–Check this box if you
are correcting wages previously reported or if wages were incorrectly reported under the wrong
unemployment insurance account number and must be transferred to another account.

 No Wage Report Needed–Check this box if completing this form does not affect worker wages
previously reported.

9. Reason for Adjustment–List the reasons the original report is being changed.

If you have any questions, please call Unemployment Insurance Employer Services at 303-318-9100
(Denver-metro area) or 1-800-480-8299 (outside Denver-metro area) Fax 303-318-9013.

UITR-3 Page 2 (R 03/2021)

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