Blank Texas C 5 PDF Form Get Texas C 5 Here

Blank Texas C 5 PDF Form

The Texas C 5 form is an essential document used by employers to report corrections to previously submitted wage information on the Employer’s Quarterly Report, known as Form C-3. This adjustment report allows employers to rectify discrepancies in total and taxable wages for specific quarters, ensuring accurate tax contributions. Each submission requires careful attention to detail, as adjustments can impact both current and future tax liabilities.

Get Texas C 5 Here
Article Structure

The Texas C 5 form, officially titled the Adjustment Report, serves a crucial role for employers in maintaining accurate wage reporting to the Texas Workforce Commission (TWC). This form is specifically designed to correct previously reported amounts of total and/or taxable wages on the Employer’s Quarterly Report, known as Form C-3. Each adjustment necessitates a separate C 5 report for every calendar quarter that requires changes. Employers must provide essential details, including their TWC account number, name, and address, along with the quarter for which the adjustment is being made. The form also requires a breakdown of amounts originally reported and the corrected figures, ensuring transparency in wage reporting. Additionally, it addresses potential penalties for late submissions and outlines interest calculations for any additional tax due. Employers are reminded to indicate the reason for the adjustment and, if necessary, attach a Wages List Adjustment Schedule to account for changes affecting individual employees. Completing this form accurately is vital, as it certifies the truthfulness of the reported information and helps maintain compliance with state regulations.

Texas C 5 Preview

TEXAS WORKFORCE COMMISSION

33333

PO BOX 149037

 

AUSTIN, TX 78714-9037

 

ADJUSTMENT REPORT

1.TWC Account number:

-

 

 

 

 

 

 

-

 

 

 

 

 

 

 

 

2.Employer’s Name and Address:

3.Adjustment for the Quarter Ended:

 

 

 

 

 

 

2

0

 

 

 

 

 

 

 

 

 

 

 

 

Month

 

Day

Year

PURPOSE:

This report shall be used to correct amounts of total and/or taxable wages previously reported on Employer’s Quarterly Report, Form C-3.

A separate report is required for EACH calendar quarter adjusted.

Individuals may receive, review, and correct information that TWC collects about the individual by emailing to:

open.records@twc.state.tx.us

or writing to:

TWC Open Records

101 East 15th St Rm. 266

Austin, TX 78778-0001

For TWC Use Only:

Result of Audit?

 

 

 

 

 

Yes /

 

No

Column A Verified?

 

Yes /

 

No

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mo.

 

Day

Year

 

 

 

 

 

Postmark Date

 

 

Dollars

Cents

 

 

 

 

 

 

 

 

 

 

 

Amount Received

AE #

 

Inits.

Wages List Adjustment

Keyed by WRCE Keyed by B-27

Attached Not Attached Not Required

Please note: Lines 4 and 5 must be completed for columns A, B and C, even if no changes are made for one of the items.

(If no change for an item, please enter the same figure in columns A and B, and show $0.00 for column C.)

 

 

 

 

A

 

 

B

 

 

C

 

 

Amounts as Originally Reported on Form C-3 (or

 

 

 

 

 

Difference

 

ITEMS

previously adjusted on Form C-5) for this quarter:

 

 

Correct Amounts

 

Over Reported or Under

 

 

 

 

 

 

 

 

 

 

Reported

 

 

 

 

Dollars . Cents__

 

 

Dollars .

Cents__

[Column A - Column B]

4.

Total Wages Paid

 

 

 

 

 

 

 

$

 

5.

Net Taxable Wages

 

 

 

 

 

 

 

$

 

6.

Tax Contribution

at

%

$

at

%

$

 

at

% $

7.

Interest – If item 6C (Tax Contribution Difference) indicates additional tax due for this quarter, compute interest at 1.5%

$

 

 

of the additional tax due for each month after which the original payment became due.

 

 

 

8.

Penalty – If the original Employers Quarterly Report (Form C-3) was submitted more than 15 days late for this quarter,

 

 

 

and the taxable wages have changed (as shown in item 5C), calculate the difference in penalty amount due.

$

 

 

 

 

 

9.

Total for this

Underpayment: Attach remittance for the additional amount due.

$

Overpayment: Amount will be reflected on your next tax report and can be used to offset future

 

Quarter

 

 

 

liabilities.

 

 

 

 

 

IMPORTANT: This section must be completed for each form submitted

Indicate reason for adjustment:

If amounts reported on Form C-4 for any individual employee(s) are affected by the

 

Form C-7:

adjustment for this quarter, attach a Wages List Adjustment Schedule (Form C-7),

 

 

Submitted

 

Not Submitted

showing adjustment of the total wages reported for each affected employee.

 

 

 

 

 

 

 

I certify that all information in this Adjustment Report is true and correct:

Signature:___________________________________________________________________

Phone: ( )

Print Name:

Title:

Date:

 

(Owner, Officer, Partner, etc.)

 

Form C-5 (0507)

Document Specs

Fact Name Details
Purpose of the Form The Texas C-5 form is designed to correct previously reported total and/or taxable wages on the Employer’s Quarterly Report, known as Form C-3.
Quarterly Requirement A separate C-5 report must be submitted for each calendar quarter that requires adjustments.
Governing Law This form is governed by Texas Labor Code, Section 201.001 et seq., which outlines employer reporting requirements.
Contact Information Individuals can request to review or correct their information by emailing open.records@twc.state.tx.us or writing to TWC Open Records, Austin, TX.
Penalty for Late Submission If the original Form C-3 was submitted more than 15 days late, a penalty may be assessed based on the changes in taxable wages.
Please rate Blank Texas C 5 PDF Form Form
4.52
(Superb)
21 Votes

Other PDF Documents