Form C-61 Web - New Hire Reporting
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1Federal Identification No.:
NEW HIRE
Employer Name:
REPORTING FORM
Employer Address:
VERMONT
DEPARTMENT OF LABOR
Return to:
Vermont Department of Labor
ATTN: New Hire
P.O. Box 488
This information may also be submitted through the internet at
Montpelier, VT 05601-0488
the following address:
or FAX to: 802-828-4286
Date Employee
Address (Street, City/Town, State, Zip Code)
Actually Began
Employee Name
Social Security No.
Working
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.
C-61 WEB (8/05)
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Parent category: Business