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Address for De9adj 1 Form 2013
(PLEASE PRINT) YEAR / QUARTER BUSINESS NAME EMPLOYER ACCOUNT NO. ADDRESS CITY, STATE, ZIP CODE REASON FOR ADJUSTMENT (1) SECTION II: ADJUSTMENT TO WAGES AND CONTRIBUTIONS (2) Previously reported Should have reported (3) DIFFERENCES Debit/(Credit) 0.00 0.00 B. UNEMPLOYMENT INSURANCE (UI) Taxable Wages ......... 0.00 0.00 C. STATE DISABILITY INSURANCE (SDI) Taxable Wages ..... 0.00 0.00 D. EMPLOYER’S UI CONTRIBUTIONS (UI Rate 0.00 % times B)... 0.00 0.00 E. EMPLOYMENT TRAINING...Show details
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