Georgia Dol 3C Form PDF Details

The Georgia Department of Labor (DOL) 3C Form plays a crucial role for employers in the state when it comes to amending or updating records related to employees' wages. This form is primarily used either to correct previously submitted wage information or to report new wages for employees that were mistakenly omitted from the original tax and wage reports. It's key to note that this form demands strict attention to detail, as it involves entering specific data regarding the employer, including their DOL account number, total tax rate, and the pertinent quarter and year, in addition to comprehensive information about the employees in question. This includes their social security numbers, names, and the corrected wage amounts. Employers are required to use black ink for this form, not staple any documents together, and ensure the form is free of copies when mailing it to the specific address provided by the Georgia Department of Labor. The aim is to facilitate the accurate calculation of taxes owed or credits due to corrections, which ultimately affects the financial responsibilities of the business and the rights of the workers involved. Therefore, understanding and completing the DOL-3C Form correctly is vital for maintaining compliance with Georgia's labor laws and ensuring the integrity of wage reporting.

QuestionAnswer
Form NameGeorgia Dol 3C Form
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesfill in dol 3c, ga dol 3c form, get the dol 3c form, dol 3c fillable form

Form Preview Example

Electronic Form Processing - DO NOT STAPLE OR SUBMIT COPIES - Use Black InkDOL - 3C (R-8/05)

 

 

 

 

 

GEORGIA

 

 

 

 

 

 

 

 

REPORT TO ADD NEW WAGES

 

 

*00301*

 

 

 

 

DEPARTMENT OF LABOR

 

 

AND/OR CORRECT REPORTED WAGES

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

00301

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mail Completed Form To:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ForDepartmentUseOnly

 

 

 

409

 

 

 

 

GDOL- EMPLOYERACCOUNTS, Room 768

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

148AndrewYoung International Blvd., N.E.,

 

 

 

 

 

 

 

Date Received

 

 

 

 

 

Supplemental

 

 

 

Atlanta, GA30303-1751

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

M

M

/

D

D

/

Y

Y

Y

Y

 

 

 

 

 

 

Phone: (404) 232-3245

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Correction

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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Employer Name, Address and E-mailAddress

 

 

 

 

 

DOLAccount Number

 

 

 

 

 

 

 

 

 

Total Tax Rate

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-

 

 

 

 

 

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Qtr / Yr

 

 

End Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Q /

Y

Y

Y

Y

 

 

 

 

M

M

/

D

D

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Y

 

Y

 

Y

Y

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Federal I.D. Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION B

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PLEASEINCLUDEYOURDOL

 

 

 

 

DOL-4, Item 2

 

 

 

 

 

 

DOL-4, Item 3

 

 

 

 

 

 

 

DOL-4, Item 4

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCOUNTNUMBERONALLCHECKS

 

 

 

 

 

Total wages

 

 

 

 

 

Non-Taxable Wages

 

 

 

 

 

 

 

Taxable Wages

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ANDCORRESPONDENCE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SECTION C

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Individual Quarterly Wages ReportedAnd Corrected

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Social Security No.

 

 

 

 

Employee Name

Pages

 

 

 

 

 

 

Total Wages

 

 

 

 

Taxable Wages

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Reported

 

Corrected

 

 

 

Reported

Corrected

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Totals

 

 

 

 

 

 

 

 

SECTION D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Increase

 

 

 

 

 

 

 

 

 

Decrease

 

 

 

 

1.

Total GROSS WAGE Corrections

 

 

 

,

 

 

 

,

 

 

 

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,

 

 

 

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2.

Non-Taxable Wage Corrections

 

 

 

,

 

 

 

,

 

 

 

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,

 

 

 

,

 

 

 

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3.

Taxable Wage Corrections

 

 

 

,

 

 

 

,

 

 

 

.

 

 

 

 

 

 

,

 

 

 

,

 

 

 

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4.Contribution Tax on Corrections

5.Admin Assessment on Corrections

6.Interest on Lines 4 & 5

7.Additional Tax or Credit Due

 

 

SECTION E

 

Corrected Summary of Total Wages

Corrected Summary of Taxable Wages

 

 

 

 

 

 

 

Explanation

 

Submitted By_______________________________

Title________________________

Date____________

(

)

Phone_______________________

Page of

INSTRUCTIONS FOR COMPLETING FORM DOL-3C

“REPORT TO ADD NEW WAGES AND/OR CORRECT REPORTED WAGES

The form is designed to: (1) correct previously reported wages and/or (2) report individuals that were omitted from the original Employer’s Quarterly Tax and Wage Report, Form DOL-4. Complete one or more of these forms separately for

each quarterly report that is to be corrected.

SECTION A

Enter the DOL Account Number. Enter the Total Tax Rate, (Contribution plus Administrative Assessment). Enter the quarter and 4 digit year. Enter the quarter ending date. Enter the Federal I.D. Number. Enter Employer Name, Address and E-mail.

SECTION B

Enter the amounts as originally reported on lines 2, 3 & 4 of the Employer’s Quarterly Tax and Wage Report, Form DOL-4 being corrected. Taxable wages in Georgia for 2012 and prior years is the first $8,500 paid per employee per year. Taxable wages beginning 2013 is $9,500.

SECTION C

Enter the Social Security Numbers and Names of the employees omitted or incorrectly reported on the original report. Enter the page number on which the employees were originally reported. In the spaces provided, enter the amount of total wages reported for the employee; the corrected amount of total wages; the taxable wages reported (amount included in Line 4 of the Quarterly Tax and Wage Report), and the corrected amount of taxable wages.

Total and taxable wages as reported and as corrected should be totaled, as the last item in Section C. Page totals should be entered on each page if more than one form is submitted for a quarter. The final total should be entered on the last page.

SECTION D

Line 1: Enter the difference between the Total Wages Reported and the Total Corrected Wages from Section C as either an increase or decrease, if applicable.

Line 2: Enter the difference in the Corrected Non-Taxable Wages and the previous reported Non-Taxable Wages from Section B either an increase or decrease.

Line 3: Enter the difference between the Total Taxable Wages Reported and the Total Corrected Taxable Wages amount from Section C as either an increase or decrease.

Line 4: Multiply the Taxable Wages, Line 3 by the contributory tax rate for that quarter.

Line 5: Multiply the Taxable Wages, Line 3 by the administrative assessment tax rate for that quarter.

Line 6: Interest is computed on the tax due (Line 4 + Line 5) from the due date until paid at the rate of one and one-half percent (1-1/2%) per month or fraction of a month. Interest is not applicable on a tax decrease.

Line 7: Enter total of Line 4 through 6. If the total reflects an increase in tax due, make check payable to Georgia Department of Labor. Please include your Georgia DOL Account Number on your check. A decrease may result in a credit to your account.

SECTION E

To adjust total wages, the amount of increase should be added to the amount entered in Item 2 in Section B or the amount of decrease should be subtracted from Item 2 in Section B. The result of the addition or subtraction should be entered as Corrected Summary of Total Wages.

To adjust taxable wages, the amount of increase should be added to the amount entered in Item 4 in Section B or the amount of decrease should be subtracted from Item 4 in Section B. The result of the addition or subtraction should be entered as Corrected Summary of Taxable Wages.

Enter your explanation of the adjustment in the space provided.

Enter your name on the “Submitted By” line, Title, Date, and Telephone Number and return as indicated on the front of the form.

DOL-3C Instr (R-12/12)

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NonTaxable Wage Corrections, Explanation, and Taxable Wage Corrections in dol 3c

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