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Get Form 941 Worksheet 1 Fillable

Directed to the UI Tax Accounting/ Adjustments Unit at (225) 342-2961 1. STATE ID. NO. 2. FEDERAL I. D. # 3. YEAR / QUARTER 4. EXPERIENCE RATE % This form is used to correct errors made on previously filed quarterly reports. Please print and review the instructions for completing this form prior to entering any data. 5. EMPLOYER NAME, D.B.A. & ADDRESS 6. Wages as Originally Reported 7. Wages as Amended ORIGINAL TOTAL WAGES AMENDED TOTAL WAGES ORIGINAL EXCESS WAGES AMENDED EXCESS WAGE.

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