South Dakota New Hire Reporting Form
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1SOUTH DAKOTA NEW HIRE REPORTING FORM
FEDERAL ID NUMBER (FEIN):
EMPLOYER NAME:
MAILING ADDRESS:
CITY, STATE, ZIP:
CONTACT PERSON:
PHONE:
Employee Social Security Number:
Name (First, M, Last):
Mailing Address:
City, State, Zip:
Hire Date:
Birth Date:
State of Hire:
Optional Info
Employee Social Security Number:
Name (First, M, Last):
Mailing Address:
City, State, Zip:
Hire Date:
Birth Date:
State of Hire:
Optional Info
Employee Social Security Number:
Name (First, M, Last):
Mailing Address:
City, State, Zip:
Hire Date:
Birth Date:
State of Hire:
Optional Info
Employee Social Security Number:
Name (First, M, Last):
Mailing Address:
City, State, Zip:
Hire Date:
Birth Date:
State of Hire:
Optional Info
Employee Social Security Number:
Name (First, M, Last):
Mailing Address:
City, State, Zip:
Hire Date:
Birth Date:
State of Hire:
Optional Info
Mail: New Hire Reporting Center
Fax:
1-888-835-8659 (Toll Free)
South Dakota Department of Labor
1-605-626-2842 (Local)
P.O. Box 4700
Phone: 1-888-827-6078 (Toll Free)
Aberdeen, SD 57402-4700
1-605-626-2942 (Local)
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