51919412
Amended Quarterly Combined Withholding,
Wage Reporting, and Unemployment Insurance Return
UI Employer registration number
Withholding identication number
This return should be completed to amend a
previously led return. A separate return must be
completed for each quarter to be amended. Mark only
one box to indicate the quarter and enter the year.
Employer legal name:
Part A - Unemployment insurance (UI) information
1. Total remuneration paid
this quarter ......................
2.
Remuneration paid this quarter
in excess of the UI wage base
since January 1
(see instr.)
.......
3. Wages subject to contribution
(subtract line 2 from line 1) .....
4. Enter your
total UI rate
(see instructions)
%
5. UI contributions due
(multiply line 3 x line 4) ........ 5a 5b
6. Overpayment to be applied to outstanding liabilities and/or refunded
(if line 5a is greater than 5b, enter the difference here) .............................................
7. Additional unemployment insurance amount due
(if line 5a is less than 5b, enter the difference here) .....................................................................................................................
Part B - Withholding tax (WT) information
8. New York State
tax withheld ........................
9. New York City
tax withheld ........................
10. Yonkers
tax withheld ........................
11. Total tax withheld
(add lines 8, 9, and 10) ...........
12. If you marked line 20b on your previous quarter’s Form NYS-45, enter the
amount from line 20 of that form ...................................................................
13. Form NYS-1 payments made for the quarter you are amending .................
14. WT payments made with previously led Forms NYS-45 (line 19) and/or
Form NYS-45-X (line 19) for the quarter you are amending .........................
15. Total payments (add amounts on lines 12, 13, and 14) ........................................
16. Overpayment, if any, shown on previously led Forms NYS-45 (line 20)
and/or Form NYS-45-X (line 18) ...................................................................
17. Subtract line 16 from line 15 .........................................................................
18. Overpayment to be applied to outstanding liabilities and/or refunded
(if line 17 is greater than line 11, enter the difference here) ............................................
19. Additional withholding tax amount due
(if line 17 is less than line 11, enter the difference here) .......................................................................................................................
20.
Additional payment due (add lines 7 and 19 ; make one remittance payable to NYS Employment Contributions and Taxes).
An overpayment of either UI contributions or withholding tax cannot be used to offset an amount due for the other ....................
NYS-45-X
(1/19)
Correct amounts (an amount equal to or
greater than zero must be entered on each line)Previously reported amounts
Jan 1 -
Mar 31
Apr 1 -
Jun 30
July 1 -
Sep 30
Oct 1 -
Dec 31 Year
1 2 3 4 Y Y
Sign your return: I certify that the information on this return is to the best of my knowledge and belief true, correct, and complete. If you are using a paid preparer or a payroll service, complete the section on the back.
Signature (see instructions) Signer’s name (please print) Title
Telephone number
( )
For ofce
use only
Postmark Received date AI SI
Previously reported amounts Correct amounts Difference
Date
UI
SK
Complete Parts C and D on
back of this form, if required.
WT
SK
If seasonal employer, mark an X in the box:
0 0 0 0 0 0
0 0
0 0
0 0
0 0
0 0
0 0
51919429
Part D - Form NYS-1 corrections/additions
Use Part D only for corrections/additions to the quarter being reported in Part B of this return. All corrections to withholding information originally reported
on Web- or paper-led Form(s) NYS-1 for the quarter must be reported here by completing columns a, b, c, and d. All additional withholding information not
previously reported on Form(s) NYS-1 must be reported here by completing only columns c and d. Lines 8 through 11, Correct amounts column, on the front
of this return, must reect these corrections/additions. See Form NYS-45-X-I, Instructions for Form NYS‑45‑X.
a
Original
last payroll date reported
on Form NYS-1, line A (mmdd)
b
Original
total withheld
reported on Form NYS-1, line 4
c
Correct
last payroll date
(mmdd)
d
Correct
total withheld
Amended quarterly employee/payee wage reporting and withholding information
(Do not use negative numbers. See instructions on ling amended wage and withholding information.)
Note: Complete Form DTF-95, Business Tax Account Update, to report changes in federal identication
number/withholding ID number, ownership, business name, business activity, telephone number,
owner/ofcer/partner/responsible person information, or changes that affect any other tax administered by
the Tax Department. For questions regarding additional changes to your unemployment insurance account,
call the UI Employer Hotline at 1-888-899-8810.
If you are using a paid preparer or a payroll service, the section below must be completed:
Withholding identication numberUI Employer registration number
Checklist for mailing:
File original return and keep a copy for your records.
Complete lines 7 and 19 to ensure proper credit of
your payment.
Enter your Withholding ID number on your remittance.
Make remittance payable to NYS Employment Contributions and Taxes.
Enter your telephone number below your signature.
Need help or forms? See the instructions.
Mail to:
NYS EMPLOYMENT CONTRIBUTIONS AND TAXES
PO BOX 4119
BINGHAMTON NY 13902-4119
Part C - Amended employee wage and withholding information
a Social Security number b Last name, rst name, middle initial
d
Gross federal wages or
distribution (see instructions)
e
Total NYS, NYC, and
Yonkers tax withheld
NYS-45-X (1/19) (back)
c
Total UI remuneration
paid this quarter
Payroll service’s name
Paid
preparers
use
NYTPRIN
excl code
Preparer’s signature Date Preparer’s NYTPRIN Preparer’s SSN or PTIN
Preparer’s rm name
(or yours, if self‑employed) Address Firm’s EIN Telephone number
( )
Payroll
service’s
EIN