Ohio New Hire Reporting Form
ADVERTISEMENT
1Ohio New Hire Reporting Form
Effective October 1, 1997 Ohio Revised Code Section 3121.89-3121.8911 requires all Ohio Employers, both public and private,
to report all newly hired, rehired, or returning to work employees to the State of Ohio within 20 days of hire or rehire date.
Information about new hire reporting and online reporting is available on our Web site:
To ensure the highest level of accuracy, please print neatly in
Send completed forms to:
capital letters and avoid contact with the edges of the boxes.
Ohio New Hire Reporting Center
The following will serve as an example:
PO Box 15309
Columbus, OH
43215-0309
A
B
C
1
2
3
Fax: (614) 221-7088 or toll-free fax 1 (888) 872-1611
EMPLOYER INFORMATION
Federal Employer ID Number (FEIN)
(Please use the same FEIN as the listed employee’s quarterly wages will be reported under):
Employer Name:
Employer Address (Please indicate the address where the Income Withholding Orders should be sent).
Employer City:
Employer State:
Zip Code (5 digit):
Employer Phone (optional):
Extension:
Employer Fax (optional):
Email:
EMPLOYEE INFORMATION
Employee Social Security Number (SSN)
Employee State of Hire:
Employee First Name:
Middle Initial:
Employee Last Name:
Employee Address:
Employee City:
Employee State:
Zip Code (5 digit):
Date of Hire:
Date of Birth:
Is this employee an Independent
Contractor?
Yes
No
REPORTS WILL NOT BE PROCESSED IF REQUIRED INFORMATION IS MISSING
Questions? Call us at (614) 221-5330 or toll-free 1 (888) 872-1490
Rev (02/03) JFS 07048
This form may be duplicated
Formerly DJFS 7048
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Business