Quarterly Contribution and Wage Adjustment Form (DE 9ADJ) : Date Requested: April 8, 2021
Quarterly Contribution and Wage Adjustment Form (DE 9ADJ) : Date Requested: April 8, 2021
: 0-272-732-832
Date Requested: April 8, 2021
Account Number: 136-7849-5
GENEVA M ADAMS
Page: 1
Quarterly Contribution and Wage Adjustment Form (DE 9ADJ)
Quarter Ended: September 30, 2020
H. Subtotal $0.20
STATE DISABILITY INSURANCE (SDI) AND CALIFORNIA PERSONAL INCOME TAX (PIT)
OVERPAYMENTS
SDI and PIT deductions are employee contributions. The EDD cannot refund these contributions to you unless
you first refund the erroneous deductions to the employee(s).
SDI deductions PIT deductions
1. Was the overpayment withheld from the wages of employee(s)? Yes No Yes No
If the overpayment has not been refunded because employee(s) are no longer employed and you are unable to
locate them, you will not be able to submit this request electronically. It must be filed on paper. Please file a
paper Tax and Wage Adjustment Form (DE 678) found at the link below and on a separate page list the
following: Social Security Number, employee(s) name, last known address, and amount of SDI not refunded.
If you have not issued W-2s, EDD will allow PIT wage and withholding credit adjustments.
Please change your online Wage Report to reflect these changes.
If you have issued W-2s, the employee will receive a credit for the PIT overwithholdings when filing
his/her California Income Tax Return (Form 540) with the Franchise Tax Board. Do not refund PIT
overwithholdings to the employee. Do not change the California PIT withholding amount shown on the
Form W-2. Do not file a claim for refund with EDD.