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TEXAS WORKFORCE COMMISSION PO BOX …

33333 TEXAS WORKFORCE COMMISSION PO BOX 149037 AUSTIN, TX 78714-9037 Form C-5 (0507) ADJUSTMENT REPORT 1. TWC Account number: - - 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. For TWC Use Only: 2. Employer s Name and Address: Result of Audit? Yes / No Column A Verified?

33333 texas workforce commission po box 149037 austin, tx 78714-9037 form c-5 (0507) adjustment report. 1. twc account number: - -

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