Purpose of form: The information in this adjustment form will be used to correct employee wage
information reported on or omitted from a previously filed Employer's Quarterly Report.
Requirements: This form MUST BE signed by an Owner, Officer, Partner, or Individual
with power of attorney for the business. A separate form must be filed for each quarter being corrected.
If you have any questions, contact the nearest Texas Workforce
Commission Tax Office for assistance.
Completed forms, inquiries, or corrections to the individual information contained in this form shall
be sent to the TWC Tax Department, PO Box 149037, Austin, TX 78714-9037,
(512) 463-2699. Individuals may receive and review information that TWC collects about the individual
by emailing to firstname.lastname@example.org or writing
to TWC Open Records, 101 E. 15th St., Rm. 266, Austin, TX 78778-0001.
Where do I mail Tax Forms?
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