New Hire Reporting Form - 2003
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1NEW HAMPSHIRE EMPLOYMENT SECURITY
F
I
N
:
EDERAL
DENTIFICATION
O
NEW HIRE REPORTING FORM
NHES E
A
N
:
MPLOYER
CCOUNT
O
R
T
: NHES -NEW HIRE PROGRAM
E
N
:
ETURN
O
MPLOYER
AME
PO BOX 2092
CONCORD NH 03302-2092
E
A
:
MPLOYER
DDRESS
F
(603) 229-4324
AX
:
(
)
-
Note:
Employer Telephone No
For “Type of Hire” write “W” for
W-2 E
“I”
1099
MPLOYEE OR
FOR
Independent Contractor
S
S
N
E
N
A
C
/T
S
Z
D
W
T
OCIAL
ECURITY
O
MPLOYEE
AME
DDRESS
ITY
OWN
TATE
IP
ATE
ORK
YPE OF
S
H
OF
TATE
IRE
NO PO BOX
H
IRE
“W”
“I”
OR
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
-
NOTE: All new hires must be reported within 20 days of the date of hire. The date of hire is the first day the individual performs services for you.
DES 605 R-10/1/03
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